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Montana VA launching mobile van to help veterans with depression

  • Montana's VA will be using a mobile clinic to help veterans with depression
  • The mobile clinic will help bridge the access gap for vets in remote areas
  • TMS therapy is relatively new and research is ongoing 

The mobile health clinic the Montana VA will soon be using to deliver TMS therapy. Photo courtesy of the Montana VA Health System.

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(NewsNation) —  Montana’s VA Health Care System will soon roll out a first-of-its-kind tool to help veterans across the state who are struggling with mental health care.

Over the next month, the state will deploy a mobile van that offers what’s called transcranial magnetic stimulation (TMS) therapy — a special therapy that uses magnetic fields on the brain to help ameliorate the symptoms of depression, that specifically helps those who haven’t got results from medication.

Depression is one of the most common mental health conditions present among America’s veterans, with one estimate suggesting that 10 to 15% of veterans experienced depression after being deployed overseas.

The VA currently operates around 60 clinics across the country that use TMS to treat major depressive disorder among veterans. This treatment can be intensive, often taking six to eight weeks of sessions to complete.

Dr. Elizabeth A. Walter, a psychiatrist who works with the Montana VA, proposed the idea of a mobile clinic as a more efficient way to deliver this form of therapy. The clinic will provide what is called “accelerated TMS” where patients receive multiple TMS treatments per day for five days. Each treatment is about ten minutes long.

“That really made being able to take a mobile unit on the road with a TMS device in it doable,” she said.

By finding a way to make the treatment work in a mobile setting, VA hopes to treat these veterans across a state that is known for its dispersed population, much of which lives in rural and remote locations.

A view inside the mobile clinic. Photo courtesy of Montana VA Health System.

Montana is the fourth-largest state in the country, and accessing health care can be challenging for people living in rural communities far away from the state’s major population centers.

For example, someone living in the town of Scobey — which has a population of around 1,000 people — would need to drive over 350 miles if you want to get to Billings, where the Montana VA has provided accelerated TMS treatment to nine patients since the spring.

The mobile clinic can help the VA bridge those distances, and others are paying attention.

Dr. Michelle Madore, the VA’s National TMS Program Director, said that the truck is the first in the country to be able to provide mobile TMS service.

“Montana is a great first place to have this truck just given the widespread nature of the state,” she said.

The truck includes everything a typical TMS clinic would, like a sink and bathroom. It also has access to the VA’s telehealth service which would allow the VA to provide remote consultation to the clinic if needed.

TMS is a relatively new treatment for depression, as it was just approved in 2008 by the FDA. People typically receive TMS treatment after other approaches have failed to address their depression.

“So this becomes that next line of care,” Madore said.

TMS’s effectiveness varies from person to person. One estimate from Harvard Medical School is that over half of people with depression who’ve tried medications but didn’t see results got some form of meaningful response after receiving TMS; around a third of them have a full remission of their depression.

However, because of the nature of depression, there is no guarantee that patients who receive TMS and see remission will not have future depressive episodes.

Madore noted there is still a lot to learn about how to use this form of therapy to help people long term.

“I wish I had a short answer that oh we just have to have them come back in this amount of time. But we don’t know so we’re working very hard to understand what does this look like and how do we continue to help people stay level,” she said.

But Williams argued that the mobile clinic could offer relatively accessible relief to those suffering from depression.

“I think five days is a very palatable treatment option for people. To say hey, five days and I have the opportunity of my depression to either be significantly better or maybe remitted,” she said.

As the project rolls out, the VA will monitor its success and may in the future deploy similar solutions elsewhere in the country.

“There are several regions across the United States where I think something similar would be very beneficial to veterans who can’t get to larger metropolitan areas where the latest and greatest technology and treatments tend to be available,” Madore said. “What’s so awesome about this truck is we’re able to take this advanced very clinically effective treatment to the veterans in their community, helping to minimize the disruption in their lives.”

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