San Francisco VA Medical Center

If you continue to be upset for more than three months, seek help. You can feel better!

June is Post Traumatic Stress Disorder (PTSD) month. Did you know the San Francisco VA Medical Center (SFVAMC) was one of the first VA Medical Centers to offer a PTSD program?

“We were one of the first ones to get established when VA started to create specialized PTSD programs in the 1980’s,” said Tom Neylan, MD, PhD, Director, SFVAMC PTSD Program. “We’ve been here a long time and have a lot of experience. We have really excellent staff who have extensive experience working with Veterans across a very large age range—from the still-surviving Word War II Veterans to the young 19-year olds who are coming home. We have adapted and changed our program quite rapidly in the last few months to reach out to more people and provide more variety of types of resources to Veterans, recognizing that they have very complicated lives.”

Addressing those goals, our PTSD program offers individual and group therapy during weekday and evening hours. “We are interested in having people come in, learn something about PTSD, get definitive treatment, and then move on with their lives,” said Neylan. “We do offer ongoing maintenance help as well to people who feel like they want booster sessions or stay connected to people whom they’ve met here.”

“We have also expanded our program with the addition of a Wellness Program, in partnership with the local YMCA, which I’d say is the fasted growing program in the past five years,” said Neylan. “We have people who meet with our Recreation Therapist, Chris Geronimo, and go out and learn better ways of taking care of themselves by exercise, breathing, nutrition health, healthy living, and acquiring healthy habits.”

Another outreach initiative has been the addition of a VA mental health clinic next to the Veterans lounge at City College of San Francisco. “It was in recognition of the fact that there are 1,200 Veterans enrolled at City College alone, taking advantage of the GI Bill,” said Neylan. While not a full-scale medical clinic, it’s a way to get enrolled and scheduled for medical treatment, and it provides onsite mental health treatment.

SFVAMC’s PTSD Program has received some funding from pop singer John Mayer to develop new treatments, which resulted in a new therapy being offered at the City College clinic involving mindful exercise and breathing. “The idea is this would be an alternative way of treating stress symptoms, and we’re hoping this will be attractive to a larger group of Veterans,” said Neylan.

The most common and effective treatment for PTSD is prolonged exposure therapy, per the National Center for PTSD. It’s a cognitive behavioral therapy in which you talk about your trauma repeatedly until your memories are no longer upsetting. You also go into situations that are safe but which you may have been avoiding because they are related to the trauma. “We have national experts here who provide this therapy,” said Neylan. “And these are good treatments that work. We’re also trying to figure out a way to reach a larger group of people. Not everybody wants to come in and get exposure therapy.”

SFVAMC is a leader in PTSD research, with 20 principal investigators funded to do various types of PTSD-related work. “A number of them are in mental health, but a number of them are also in internal medicine, radiology, laboratory medicine, and neurology. So these investigators are broadly interested in effects of PTSD on the brain, and the effects of PTSD in the body—such as, how PTSD has an effect on cardiovascular health and how it has in impact on risk for obesity and diabetes,” said Neylan. “We have health services researchers who are trying to understand how we can structure clinics here better so we can reach more Veterans. And through that was created the integrated care clinic, co-founded by Rina Shah, MD, and Karen Seal, MD, MPH.” Additionally, about three years ago, a mental health program was integrated into the Women’s Comprehensive Health Center so women Veterans who are coming in for health care can come see their primary care provider and can also see someone in mental health in the same setting, in an area mostly designed for women, explained Neylan.

What might the future hold for PTSD programs at SFVAMC? “The long-term goal of the Medical Center is to integrate primary care and mental health, to try to make mental health more closer to mainstream medicine, but also to reduce the stigma and barriers to care,” said Neylan. “This Medical Center is the top-funded research center in the country in the VA, and we have studies that look at parts of the brain affected by PTSD. We have a strong connection to a world-class university, and we have the ability to test novel treatments. Ultimately, we’re always interested in coming up with new, better, and more effective treatments.”

If a Veteran believes he or she may have PTSD, or a family member feels their Veteran might have PTSD, call SFVAMC’s Mental Health Central Access for more information at (415) 750-6674 or visit here.

Veterans, are you in crisis? You have options:
• Call 911
• Go to the nearest Emergency Department
• Call the Suicide Prevention Lifeline: 800-273-8255
• 24/7 Veterans Crisis Line: 800-273-8255 and press "1"
• Veterans Confidential Live Chat with a counselor, or text 838255

What is PTSD? Do I have it?

Post traumatic stress disorder, or PTSD, can occur after you experience, see, or learn about a traumatic event such as combat exposure, childhood sexual or physical abuse, terrorist attack, sexual/physical assault, a serious accident, or natural disaster, according to the National Center for PTSD, U.S. Department of Veterans Affairs

In your life, have you ever had any experience that was so frightening, horrible, or upsetting that, in the past month, you:

• Had nightmares about the experience or thought about it when you did not want to?
• Tried hard not to think about the experience or avoided situations that reminded you of it?
• Were constantly on guard, watchful, or easily startled?
• Felt numb or detached from others, activities, or your surroundings?

Most people have some stress-related symptoms after a trauma. If those symptoms don’t fade after a month though, it might be PTSD. Only a mental health or medical professional can tell you if you have PTSD. If you went through a trauma and answer “yes” to at least three of the questions above, you should have a PTSD evaluation. Call SFVAMC’s Mental Health Central Access for more information: (415) 750-6674.