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Online Mental Healthcare Tool Clicks with Philadelphia Veterans
By Catherine Spader, RN
Monday November 17, 2008
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Veterans with mental illnesses often get caught in a revolving door of treatment in which they find themselves in and out of care with little chance for recovery. A new online tool is helping caregivers direct these veterans toward achievable goals.

"We have a population of seriously mentally ill veterans who are underserved. The treatment that we have been delivering to them for years doesn't work, and they keep cycling back into the system," says Felicia A. Zimmer, RN, MSN, BS, PMHCNS-BC, CCM, a clinical nurse specialist at the Veterans Empowerment Center, Department of Veterans Affairs, Philadelphia.

Zimmer provides psychosocial rehabilitation services for veterans with serious mental illnesses, including schizophrenia, schizoaffective disorder, major depression with psychosis, and bipolar disorder. Her mission is to help these veterans empower themselves to achieve goals in treatment and improve overall health and well-being.

"Goals can include anything, from going fishing, to attending college, to getting a job, to improving relationships, to getting a date," she says.

One tool Zimmer uses is the Web-based My HealtheVet program, located within the VA Web site (www.myhealth.va.gov.) My HealtheVet is the gateway to VA benefits and resources that help veterans understand and manage all aspects of their health, including mental health. It provides reliable information, many links to health information to build the quality of a veteran's life, and other tools, such as online medication refill requests and links to healthcare providers and treatment facilities.

The program includes computerized learning models, which Zimmer combines with other services — such as individual recovery planning, social skills training, and illness self-management ­— to maximize success in social, occupational, and educational roles.

Building Blocks of Confidence

The first step in reaping the benefits of the My HealtheVet program is to know how to use a computer. Zimmer often must teach basic computer operation, such as using a mouse and accessing the Internet. For veterans with serious mental illnesses, mastering basic computer skills is a pivotal and life-changing accomplishment in itself.

"It's all about skill building. I shape learning to build confidence," says Zimmer.

Once veterans are comfortable around a computer, they can progress to interactive online MyHealtheVet courses, such as Manage Your Triggers, Succeed at Work, and Manage Your Stress.

One of her clients became so confident in using the Web site after taking her computer training and Internet class that he enrolled in more computer classes offered in his community.

"I feel like a college man," he told Zimmer.

"Learning to use My HealtheVet opens up a whole other world for veterans," says Zimmer. "It builds self-esteem because they can do what everyone does, working on a computer. It's just a few short steps from there to getting job training, going to college, or applying for a job. It snowballs; once people achieve a small success, they build on it."

Many Potential Uses

Zimmer believes that the My HealtheVet program has the potential to transform not only the mental health system but also the care of many types of patients, both within and outside the VA's umbrella.

"Nurses are key, because there is a strong link between this program and the nursing philosophies of advocacy, teaching, holistic care, and psychosocial rehabilitation," she says.

My HealtheVet can be accessed by anyone, including people who are not veterans, and many aspects can be applied to patients with diagnoses other than mental illness. For example, the site includes teaching information about a multitude of health topics, from abdominal aortic aneurysm to medication management to smoking to vasectomy.

My HealtheVet also gives users the ability to enter, track, and graph key health indicators, such as lab work, weight, and vital signs. There are links to screening tools for mental illnesses as well as countless other health-related components.

Zimmer says the program can be used to improve patient education, self-care, and health promotion in clinical, acute care, rehabilitation, home care, and long-term care settings.

"I see great potential for application in any [healthcare] area that is using notebooks or laptops for patient education," she says.

In the near future, Zimmer plans to use My HealtheVet to help veterans address metabolic syndrome, which has a high occurrence rate in the veteran population. She says the program also could be employed in cardiac rehabilitation and diabetes education.

Although veterans are not generally known to advertise their achievements, they do express sincere appreciation for the program, and Zimmer hears plenty of thank-yous.

"They often express their new success as gratitude," she says.

Catherine Spader, RN, is a contributing writer.

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