AND OUR OWN JAY CHEF SKI GETS
FRIENDLY WITH A RATHER R RATHER
LARGE IN SITTING.
LIVING VETERAN STRUGGLES WITH
ANOTHER ENEMY, THE CORONAVIRUS
PANDEMIC.
JOINING US TO TALK ABOUT HOW
VETERANS FAIRED THE PAST YEAR,
ARE DR. JEFFERY OKEN ACTING
CHIEF OF STAFF AT EDWARD HYNES
JUNIOR VA HOSPITAL IN MAY WOOD
AND DR. SARA UNTERMANE DOCTOR IN
CHICAGO.
THANK YOU FOR JOINING US.
DR. OKEN LET'S START BY TALKING
ABOUT MENTAL HEALTH BECAUSE SO
MANY CIVILIANS AND NONVETERANS
HAVE SUFFERED THROUGH THE
PANDEMIC, REPORTS OF LONELINESS,
DEPRESSION AND SO FORTH AND NEW
STUDY ON MILITARY VETERANS,
PSYCHIATRIC SYMPTOMS AND
SUICIDAL IDEATIONS ARE PREVALENT
IN VETERANS WHO SURVIVED COVID
19.
DURING THE PANDEMIC DID YOU SEE
MORE PATIENTS STRUGGLING WITH
MENTAL HEALTH.
>> WE DID.
SO THEY'RE GREAT THING ABOUT THE
PANDEMIC AND ABOUT MENTAL HEALTH
SERVICES ARE WE CAN PROVIDE
THESE VIRTUALLY.
SO ALL OF OUR VETERANS WERE ABLE
TO GET THE CARE AND ACCESS TO
THE CARE THEY NEEDED.
SO IF THEY WERE HAVING PROBLEMS,
THEY REACHED OUT.
WE COULD REACH OUT TO THEM,
EITHER BY VA VIDEO CONNECT OR
TELEPHONE.
WE CONTINUE TO DO THAT, SOME ARE
COMING BACK HAVING FACE-TO-FACE
VISITS BUT THERE'S OPTIONS FOR
THE VETERANS TO GET THE CARE
WHEN NEEDED AND AMOUNT THEY NEED
IT.
>> AS I UNDERSTAND IT MOST OF
YOUR, MOST OF YOUR CONNECTING
WITH VETERANS HAD TO DO ZOOM AND
TELEPHONE IS THAT JUST AS
EFFECTIVE AS MEETING WITH
VETERANS PERSONALLY?
>> YOU KNOW, IT IS.
ONE OF THE THING WE DO ENCOURAGE
IS THE VIDEO VISIT WHERE WE CAN
ACTUALLY SEE THE VETERAN.
MANY VISITS ARE SHORT VISITS,
JUST DONE BY TELEPHONE BUT IF
THEY NEED A MORE EXTENSIVE VISIT
WE ENCOURAGE THEM TO BE SEEN AND
TO HAVE THAT CONNECTION EYE TO
EYE.
>> DR. UNTERMAN YOU'RE IN THE
EMERGENCY ROOM, WHAT ARE YOU
SEEING IN TERMS OF PEOPLE
PRESENTING WITH MENTAL HEALTH
CONCERNS?
>> SO WE'RE SEEING, WE WERE
VERY CONCERNED ACTUALLY ABOUT AN
INCREASED RISK OF MENTAL IT'S
AND SUBSTANCE USE AMONG PATIENTS
ESPECIALLY THOSE WHO WEREN'T
ENGAGING IN CARE, BUT OUR
VIRTUAL MODALITIES LIKE DR. OKEN
WAS DISCUSSING, HAVE REALLY
HELPED WITH CONNECTING OUR
PATIENTS IN WAYS THAT WE HADN'T
BEEN FOCUSING ON NEARLY AS MUCH
PRIOR TO THE PANDEMIC.
SO WE HAVE BEEN ABLE TO REACH
OUR PATIENTS IN THE PLACES THEY
NEED AND AT THE TIMES WHEN THEY
NEED.
WHICH IS REALLY HELPED
CONSIDERABLY.
WE DID HAVE A PATIENT WHO CAME
IN JUST A FEW WEEKS AGO WHO WAS
AN OPIOID USER, AND HE CAME WITH
SIGNIFICANT SIGNS OF WITHDRAWAL,
AND ONE OF THE THINGS WE HAD
FOCUSED ON DURING THE PANDEMIC
WAS INCREASING THE AVAILABILITY
OF SUB OONE AVAILABILITY.
AND WE WERE WILL THE START THIS
PATIENT IMMEDIATELY SET HIM UP
WITH PRIMARY CARE, HAVE HIM COME
BACK THE NEXT DAY FOR CHANGING
HIS DOSE BASED ON HIS SYMPTOMS,
AND WE WERE REALLY ABLE TO HOOK
HIM UP INTO THE APPROPRIATE
MODALITIES HE NEEDED TO HELP
HIM.
WE LEARNED A LOT.
>> WHAT EXACTLY IS SUBOEX- ONE.
>> ONE OF THE MEDICATIONS THAT
CAN BE USED TO HELP PEOPLE WHO
DO USE NARCOTICS, SPECIFICALLY
OPIOIDS, TO STOP NEEDING
NONPRESCRIPTION OPIOIDS AND TO
PREVENT THEM FROM HAVING SEVERE
WITHDRAWAL SYMPTOMS.
>> DOCTOR OKEN, NOW THAT THE CDC
HAS ISSUED ITS SUGGESTION, ITS
RECOMMENDATION ABOUT MASKS AND
THERE'S A QUOTE RETURN TO
NORMALCY TO A CERTAIN EXTENT ANY
ISSUE USERS SEEING WHAT APPEARS
TO BE A NEW PHASE.
>> ONE OF THE THINGS AT VA AND
ALL MEDICAL CENTERS WE CONTINUE
TO HAVE MANDATORY MASKING ON
CAMPUS, WE DO HAVE CONCERN
OBVIOUSLY AS THE MASK USAGE GOES
DOWN, WE ARE OPTIMISTIC THAT
MEANS VACCINATION IS UP.
HOWEVER, WE'RE STILL CONCERNED
AND WE'RE STILL PREPARED IF WE
DO SEE A SURGE IN COVID CASES
BECAUSE OF THE CHANGE IN
RECOMMENDATIONS BY CDC.
>> DR., EXCUSE ME FOR
INTERRUPTING.
DR. UNTERMAN, ARE YOU SEEING
VACCINE HESITANCY ON THE PART OF
VETERANS.
>> WE'RE SEEING SOME VACCINE
HESITANCY, WHAT WE FOUND IS MOST
EFFECTIVE IS TO JUST KEEP
TALKING ABOUT IT WITH THE
VETERANS OVER AND OVER.
THIS ISN'T A ONE-TIME DISCUSSION
THAT THEN YOU LEAVE.
THIS IS A MULTIPLE DISCUSSION,
WHERE YOU AT EVERY SINGLE VISIT
AND EVERY CONTACT WITH THE
PATIENT DISCUSS WITH THEM THE
POSITIVE REASONS TO RECEIVE A
VACCINE, DISCUSS ANY CONCERNS
THEY MAY HAVE, AND WE'VE SEEN
MANY CASES OF VETERANS WHO
INITIALLY WERE SKEPTICAL BUT
OVER TIME COME TO THE CONCLUSION
IT'S RIGHT THING FOR THEM AND
FAMILIES
>> DR. OKEN DURING THE HEIGHT OF
PANDEMIC, SOME PEOPLE MAY HAVE
DELAYED MEDICAL CARE ON OTHER
ISSUES, NOT JUST MENTAL HEALTH,
BUT ARE YOU SEEING ANY SORT OF
PENT UP DEMAND FOR HEALTHCARE ON
THE PART OF VETERANS?
>> HUGE PENT-UP DEMAND, IT'S
REALLY AMAZING, THERE ARE
PROCEDURES THAT WERE PUT OFF,
OTHER CARE NEEDS PUT OFF, OUR
CLINICS ARE FULL.
WE ARE GETTING OUR VETERANS IN
YOU KNOW, BOTH FACE-TO-FACE AS
WELL AS VIRTUALLY, GETTING THE
PROCEDURES THEY NEED DONE, YES,
THERE'S A HUGE PENT UP DEMAND
OUT THERE.
AND YOU KNOW, WE WE ARE VERY
FORTUNATE TO HERE AT HYNES WE
WERE BEEN ABLE TO MEET THE
DEMAND OUT AND OUR COMMUNITY
CLINICS AND MAIN CAMPUS.
>> DR. UNTERMAN, WE BOTH ALLUDED
TO THE USE OF TELEMEDICINE, DOES
THE EXPERIENCE IN THE PAST YEAR
OR SO CAUSE YOU TO THINK THAT
SOME OF THESE CHANGES MIGHT BE
PERMANENT, GREATERER RYE
ALLIANCE ON TELEMEDICINE.
>> DEFINITELY.
WHEN WE TALK ABOUT CLINICS BEING
FULL, WHICH THEY ARE, WE'RE
FULLY BACK OPEN AND READY FOR
ALL BUSINESS IN EVERY SPECIALTY,
WE ARE NOT GOING BACK TO THE OLD
MODEL OF FACE-TO-FACE
APPOINTMENTS, WE'RE GOING TO
MAIN A SIGNIFICANT PORTION OF
OUR APPOINTMENTS AS VIDEO
APPOINTMENTS SO THAT THERE'S A
GREATER FLEXIBILITY FOR OUR
PATIENTS, AND IT REALLY HELPS
BREAK DOWN BARRIERS, ESPECIALLY
FOR THOSE THAT HAVE TROUBLE
COMMUTING TO FACILITIES, THEY
MAY LIVE FAR, THEY MAY NOT HAVE
GOOD TRANSPORTATION, THIS ALLOWS
US TO MEET PATIENTS WHERE THEY
ARE LITERALLY AND FIGURATIVELY.
SO THAT THEY CAN CONTINUE THEIR
CARE.
>> DR. OKEN, ACCORDING TO
MILITARY TIMES VETERANS AFFAIRS
OFFICIALS REPORTED NO NEW COVID
19 DEATHS LAST WEEK BECAUSE
ACROSS THE COUNTRY, ARE YOU
SEEING FEWER COVID 19
HOSPITALIZATIONS?
>> YES.
I MEAN, THE NUMBERS HAVE
CONTINUED TO GO DOWN, OUR
VETERANS CONTINUE TO GET MORE
VACCINATIONS, WHICH IS HELPING
THAT AND I THINK THEY'RE VERY
COMPLIANT AND THEY'VE BEEN
THROUGHOUT THE PANDEMIC WEARING
MASKS AND FOLLOWING SOCIAL
DISTANCING.
SO WE'RE SEEING A DEFINITE DROP,
IT'S NOT 0.
>> DR., WE'RE BEEN FOCUSING ON
COVID AND IMPACT ON VETERANS,
LOOKING AT THE BIG PICTURE, WHAT
WOULD YOU SAY RIGHT NOW IS MOST
PRESSING HEALTH NEEDS VETERANS
FACE?
>> WELL, IT'S HARD TO PUT YOUR
FINGER ON JUST ONE.
I THINK ONE BIG ONE IS ACCESS TO
CARE, TO INSURE THAT THEY'RE
RECEIVING THE SPECIFIC TYPE OF
CARE THEY REQUIRE IN THE TIME
FRAME THEY REQUIRE IT AND WE'VE
MADE HUGE STRIDES IN PROVIDING
THAT CARE.
ANOTHER IS MENTAL HEALTH AND
SUICIDE PREVENTION, WHICH WE'RE
DEEPLY IMBEDDED IN, AND THAT'S
ONE OF OUR BIGGEST FOCUSES AND
WE HAVE SOME OF THE MOST
TALENTED MENTAL HEALTH
PROFESSIONALS WORKING FOR US.