Dr. Barbara Van Dahlen, Founder of Give an Hour

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Mark Masselli: This is C onversations on Health Care I’m Mark Masselli.

Margaret Flinter: And I’m Margaret Flinter.

Mark Masselli: Well Margaret , a busy week in Washington with hearings planed
on immigration, and the president’s proposal on gu n control.

Margaret Flinter: And a b ipartisan agreement to -- in the Senate mark that would
pave the way for legalizing the 11 million immigrants who live in the country
illegally, that would be positive on many levels, one of them being just a public
he alth perspective certainly making it easier for these population to access health
services.

Mark Masselli: That’s very important because immigrants suffer from so many
untreated illnesses due to the lack of access. So this could be a positive step if
th e legislation makes it all the way through congress.

Margaret Flinter : But I think we both agree it’s going to be harder to find
bipartisan consensus in the talks on gun control . Mark , hard to imagine that with
the nations real obsession with guns that this is going to be cure by legislation ,
and yet with so many guns injuries and deaths per year . I have to agree with
CDC and the American college of physicians we have got to talk about gun
control and the context of public health.

Mark Masselli: And a s part of that public health discussion , i t’ s also focusing on
behavioral health and in spite of the mental health parity bill passed in congress.
There’s still a big disconnect between those needing behavioral health services
and those receiving them. S o in a round about way it behave, health may finally
get the attention it deserves.

Margaret Flinter: Well I think we’re going to see a lot of talk on the state level as
well aimed to addressing the difficulties in accessing behavioral health services
an d probably in the light of recent events looking specifically at schools as one
place to deliver those services and what else can be done to fill that void.

Mark Masselli: Our guest today certainly understands the importance of these
issues Dr. Barbara V an Dahlen is the founder of Give A n Hour , an organization
dedicated to providing free mental health counseling for returning veterans and
their family members as well.

Margaret Flinter: About a fifth to a quarter of the soldiers returning from the wars
i n Iraq and Afghanistan suffer from a multitude of lingering effects. There is so
much need to help and grapple with post - traumatic stress disorder with traumatic
brain injury or just the difficulties of adjusting to civilian life after multiple chores of

duty. Dr. Van Dahlen’s organization is working with the White House and with
the veterans health administration to help address that need.

Mark Masselli: Dr. Van Dahlen’s work has earned her the distinction of ton of
magazines, hundred people who are ch anging the world so really looking forward
to our conversation with her today.

Margaret Flinter: And also looking forward to hearing from Lori Robertson the
Managing Editor of FactCheck. o rg who is always on the hunt for mistr uths that
have been spoken on the public domain.

Mark Masselli: But no matter what the topic you can hear all of our shows by
Googling CHC Radio and as always if you have comments e - mail us at
www.chcradio.com or find us on Facebook or T witter . W e’d love to hear it from
you.

Margaret Flinter: We’ll get to our conversation with Dr. Van Dahlen in just a
moment.

Mark Masselli: But first here is our producer , Marianne O’ Hare with this week’s
Headline News.

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Marianne O’Hare: I’m Mari anne O’Hare with this Health Care Headlines. A
number of states around the country are looking at allocating more dollars
towards overhauling mental health services, legislatures in Florida, Illinois and
Minnesota among states looking to increase budgets for behavioral health, and
are looking at ways to improve services . Advocates in Illinois warned the mental
health system and that state is simply broken and needs to be completely
revamped. Meanwhile the behavioral health discussion is being had with th e
backdrop of gun laws also on the block, in Massachusetts a 43 year old law
which prohibits metal health information to be shared with the FBI even for gun
background checks. Governor Deval Patrick has twice attempted to pass
legislation that would allev iate that restriction, but was unsuccessful the measure
comes up again.

And as the GOP leadership gathered recently for their annual meeting they agree
to continue to disagree, leadership recommending that the party faith will not give
the verbal commitme nt to seek ways to cut the federal budget using cuts to
medicate , Medicare and social security as well as other safety net programs.
Now, in the wake of the new pole out by Kaiser Health which shows a majority of
Americans near 70% say they do not want to see any cuts to services for the
elderly like Medicare and social security.

And it may pain folks living chronic pain to hear this but FDA is seriously
considering restrictions on narcotic based pain relievers like Vicodin, that class of
pain killers inc luding Oxycontin now caus ing more drug death than cocaine and
heroin combined. Doctors would be barred from writing more than a 30 day
prescription and patients would be barred from renewing their medications
without first coming in for another consult wi th the provider. I’m Marianne O’Hare
with this Health Care Headlines.

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Mark Masselli: We’re speaking today with Dr. Barbara Van Dahlen Clinical
Psychologist Founder and Director of Give A n Hour , a n organization that links
soldiers returning from duty and their families to mental health clinicians
volunteering their time . Dr. Van Dahlen is a consultant to the White House, the
Pentagon and veterans administration and also the founder of You Serve LLC
which links government agencies and non - profits serving the military community.

Dr. Van Dahlen was named by women’s day magazine as one of the 50 women
who are changing the world and was on T ime magazine list of world’s 100 most
influential people in 2012 for her work. Dr. Van Dahlen, welcome to
C onv ersations on Health Care.

Dr. Barbara Van Dahlen: Thank you very much.

Mark Masselli: Barbara , last year we just past pretty sobering mile stone more
American GIs died in 2012 by suicides than died in combat and that’s just one
aspect of the massive men tal health problem being faced by our veterans and
their families. When you founded Give A n Hour in 2005 there’s simply wasn’t
enough attention being paid to those unique mental health issues. So tell us
from a clinicians ’ perspective about the depth and breadth of the mental health
problems being faced by our military community.

Dr. Barbara Van Dahlen: First it’s really important to understand that what folks
come home with in terms of post - traumatic stress, traumatic brain injury , the
invisible injuri es of war if you will , w e would expect this, it make sense this is a
human reaction to war, to the atrocities that service members see the traumatic
brain injuries to the kinds of blast that they’re exposed to. And i n fact most of our
service members who come home do not developed sever e forms of PTSD and
are reintegrating back into our society. I t doesn’t mean that there aren’t
difficulties with just regular reintegration after being away, but it is a range of
issues and it’s important to think about it as a continuum. So you have everyone
from the service member who’s been away for, you know, multiple tours over the
last ten years, he’s coming home now , he’s actually doing okay he or she. But a
transition back to life with your family after spending so much time away,
transition to a different kind of job, a different kind of life, that’s challenging and
comes with all sorts of mental health at a patients required. All the way to

service members who have experience very severe and brutal combat are
com ing home with p ost - t raumatic stress, and sometimes a traumatic brain injury,
and then in their effort to deal with that sometime you see substance issues in
their attempt to self medicate. Most service members they come home in their
assets in our communi ties the goal is for us to make sure we provide what they
need so that they become that.

Margaret Flinter: Barbara , as a clinical psychologist , do you and your colleagues
are trained to confront these many issues, when you founded Give A n Hour you
had a vision in mind and I’m sure you had to quickly move from the vision to the
strategy of how are you going to make this work and meet this huge unmet
needs or perhaps share with us how exactly does Give A n Hour work.

Dr. Barbara Van Dahlen: Sure, well the idea is very simple and I think that’s why
it works . T he concept was really to ask mental health professionals to G ive A n
H our a week of their time to build it into their clinical practice, to do it at the time
that work for them , s o we wanted to make it easy for folks t o give. A nd on the
other side make it very easy for those in need to receive. So service members,
veterans , and military family members come to our website, they put in their zip
code, and they get a list of providers in their areas. We h ave now over 6 , 500
providers throughout the country . I f they can’t find someone right in their
community then that flags us and our staff steps in and starts working with our
broad network to locate a provider, and they start doing the work that leads the m
to heal and get what they need to move on with their lives.

Mark Masselli: Barbara that’s a great innovation and -- it’s like you work with the
founder of Craigslist to develop this clearing in - house of mental health clinician s
across the country. Tel l us about that collaboration and how do you determine
which providers would be most helpful and what other hurdles do you face and
how do you overcome them?

Dr. Barbara Van Dahlen: It was Craigslist that was the inspiration, I was at the
time a single m om in Washington D . C . raising my two daughters, you know, I
already had too busy practices. And I was fascinated with here we could find, I
could find child care provider who is moving from across the country, moving to
Washington and we could trade infor mation and end up matching so that, that
person came to work and live in my family and I thought this is great, if we can
use this model to match those in need with those who are offering services , s o
that was really what led me to start to talk to folks w ho are far smarter than me
on the technology side. We built our first version of Give A n Hour with O pen
Source software and later then down the road I met Craig and we talked about
this notion of again keeping it very simple so that those who are looking for a
service in this case free mental hea lth care can easily go to a site use their zip
code and there they have a whole list of folks who are available to them and it
makes it very easy for our providers because they are in charge of what -- of the
hours that they offer , what services and that gets to your question about who is

the most appropriate and the most effective we believe that all mental health
professionals are needed for this current generation of folks coming home
because it's not just those who are severely injured, it's folks who are
transitioning and dealing with family issues or it's the parent of a service member
or the sibling of, so everyone who has mental health expertise can really serve a
very critical role right now.

Margaret Flint er: I will back to , Barbara, look a little more deeply into these
innovations that you are spearheading as part of this mission , you know there’s
so many hundreds of thousands I would imagine veterans needing help, it may
need more than just our clinical volunteers but something that you’ve called this
community blueprint. Tell us about the community blueprint. What's in it and
how does that relate to this model of care that you’re hoping to see provided.

Dr. Barbara Van Dahlen: Yes . A s I began buildi ng Give An Hour seven years
ago and traveling around the country what was clear that all over our country
folks were stepping up and trying to help , yet there was not very much
collaboration or coordination and I ’ m talking across services mental health,
he althcare, employment, education for the service members and their families
and so a number of my colleagues and I got together and started to talk about
what if we created some tools for communities that led to the development of
what is now the initiative known as the community blueprint , and the idea like
Give An Hour is very simple , it’s very action oriented. Let's get the stakeholders
in a community together and then we offer them a whole slate of very concrete
next steps, if you want to create a job f air here’s what it looks like, if you want to
train your civilian metal health professionals here’s how it's been done in other
communities that effects employment, education, family life , the homeless
population unfortunately has many veterans who are dea ling with , that is an
issue . S o the community blueprint is a way literally to organize communities at
the community level and bring folks together and then help them move forward
with action oriented plans.

Mark Masselli: We are speaking today with Dr B arbara Van Dahlen, clinical
psychologist, founder and director of Give An Hour and organization that links
soldiers returning from duty and their families to mental health clinicians
volunteering their time. Barbara , tell us a little about the Obama A dmin istrations
initiatives they launched last year in partnership with a 100 teaching hospitals
across the country now, how is this initiative helping you and your colleagues
prepare the next generation of clinicians to address this great behavioral health
nee d.

Dr. Barbara Van Dahlen: Very soon after the President came into office in 2008,
the F irst L ady and Dr. Biden got together to create the joining forces initiative and
that led to identifying all variety of opportunities to literally encourage individua ls,
organizations, colleges, universities to step up and join forces and it's been
delightful to work with many wonderful folks at the White House connect that with

the community blueprint with Give An Hour , the W hite H ouse provides a
wonderful platform, i t encourages colleges and universities to look at their
programs and really make sure that those up and coming professionals are
properly trained because without that knowledge and expertise then we miss
opportunities to provide what these men and women an d their families deserve. I
feel very hopeful because all of the key players in our country at all the different
levels, the state, local, federal were stepping up working together, it's a huge
issue to tackle but I feel very optimistic about where we are heading.

Margaret Flinter: Barbara , in the work that your volunteers are doing I think a s I
understand that it's primarily a traditional in person counseling sessions and
certainly a very valuable and effective model but as we look at the distribution
g aps between rural and urban areas and the distribution of providers and the role
that technology might play in helping bring treatment to people who have
difficulty getting to that sort of traditional in person session, what are you looking
at with other t echnologies using Skype , teleconferencing , texting as part of the
treatment paradigm and there’s something that you look to incorporate into your
work?

Dr Barbara Van Dahlen: The relationship is so critical as people heal from
mental health issues and so yes we do maintain the opportunity for folks to meet
with clinicians individually then from the beginning we also offered a very low
tech solution for folks who live in rural communities or just couldn’t get into an
office and that's one support because e ven if you can't make it into an office to
have an opportunity to speak with a clinician to get support critically valuable so
we offer that from the beginning, we also started very early on sending our
clinicians out into the community to assist in a lot of different ways so they now
give talks at community centers or they’ll brief families at reintegration events .
S o from the beginning we saw that we had harnessed this wonderful resource
and the goal was to figure out how many different ways could we app ly it and
now we are very much looking at tele - help as an opportunity that we will be
offering in, we have expanded so quickly . T he goal for us is to keep up with what
we are being asked to do , we will in fact have the funding to put into place , the -
tele help capability so that our providers wherever they are in the state can in fact
provide face to face contact with service members and their families . S o there is
tremendous opportunity through technology to provide support, education and
care and we plan to explore and expand in as many directions as we can , in fact
with a million service members separating over the next several years , we’re
going to see a very long tail on these issues.

Mark Masselli: Barbara , we really loved the model you’ve developed at Give An
Hour and really what you are taking it and I loved the sort of high tech , high touch
aspects of it as you think about moving forward . B ut the recipients are also being
asked to give back in a meaningful way where they can and talk to us for a
moment about this cultural volunteerism in giving back as it relates to the

success of the healing process and can you give us some examples of the sort of
impact that’s having on those you are trying to help.

Dr. Barbara Van Dahlen: Absolutely . A nd it' s probably one of my favorite
features of the organization and it really comes from my dad. My dad was a
veteran of World War II and he was in combat in the Pacific and he never talked
about it and so I know very little about that, he passed away in 1986 , yet growing
up his service to our community was such a strong message in my life . A nd I
knew when I was building Give An Hour given the people that we were going to
serve that it was critical that we offer them the opportunity to give back ---

Margaret Flinter: What's the story of institutional partnership with the VA system
as an example or with State Mental Health Authority so that the volunteer
therapist is not feeling out there on their own and the veteran can get the help
they needed, I ’ m sure you are engaged in sort of policy discussions around
there. Can you share that with us a little bit?

Dr. Barbara Van Dahlen: Well it's been a wonderful evolution of thought and
policy an d it's true Give An Hour is outp atient mental health care, we don’t
pro vide inpatient services that's not how we are equipped , it is a clearing house if
you will it is mental health professionals stepping up , offering their significant
expertise but staying within their lane and so it's very important that we at Give
An Hour have back ups . T he good news is that we have not had to rely on that
type of back up very often . O ur providers are so skilled , when folks come to us
we’re pretty good at figuring out what they need if they can't be seen in an out
patient setting we do ha ve great relationships with the VA and with DOD and
because we’re in every state and we’re connected to every major mental health
association and we have friends on the hill and at the White House . W e are able
to then access whether it's state, local and so far we have been successful . W e
have never had to turn someone away; we have always been able to find either a
provider or a greater level of care through a VA contact . S o the system is
working well and what's important is this collaboration, it is wh ere we need to had
which is how do we look to leverage , what the different skills capacities are ,
connect the dot s then we can take care of our citizens and take care of our own
so to speak and there's a new movement that I ’ m very proud to be part of and I
guess a spokesperson for and that is harnessing skill based volunteers whether
it's , you know , the good work of D octors Without Borders , folks at Give An Hour
or other groups, how do we harness leverage those specific volunteers who had
the skills needed and how do we make sure that as you said they are supported.

Mark Masselli: We have been speaking today with Dr. Barbara Van Dahlen
founder and director of Give An Hour which links veterans and their families with
a network of volunteer mental health cou nselors to treat the effects of PTSD and
other war related brain injuries. She has been recognized as one of Time
magazines 100 most influential people in the world for her work, you can find out

more by going to g ive a n h our.org. Barbara , thank you so muc h for the work you
do and for joining us today on C onversations on H ealth C are.

Dr. Barbara Van Dahlen: Thank you. It's a pleasure and thank you again for
covering this important topic.

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Mark Masselli: At Conversation on Health C are, we want o ur audience to be
truly in the know when it comes to the facts about health care reform and policy .
Lori Robertson is an award - winning journalist and m anaging e ditor of
FactCheck.org, a nonpartisan, nonprofit consumer advocate for voters that aim to
reduc e the level of deception in US politics. Lori , what have you got for us this
week?

Lori Robertson: Well Mark and Margaret, we notice the statistic flooding around
on Face book about children and gun deaths in the U.S. The statistic is that 85%
of childr en that are killed with guns are killed children of United States . A nd it
was used on ABC N ews by Mark Kelly, former astronaut and husband of former
C ongresswoman G abrielle G iffords . Now that shocking statistic is attracting
attention on social media, bu t it's not true. Kelly left out an important qualifier.
The study decided to looked at the 23 highest income countries in the world in
2003, and found that 87% of children under age 15, who were killed by guns in
those countries lived in the U.S. So it' s not 85 or actually 87% of all child gun
dies in the world, but rather 87% of the death s in the 23 highest income
countries. That of course does show that child gun deaths in the U.S . far
outnumbered those in similar countries including Australia, Canada , France,
Germany, Japan, Finland, New Zealand, Norway, The United Kingdom and
others. But without that important qualifier, many may get the impressions that
the statistic includes violen ce played countries in Central and South America or
Africa , more gu n homicide rates far out case studies of the United States, and
that’s my FactCheck for this week. I am Lori Robertson, Managing Editor of
FactCheck.org.

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Margaret Flinter: FactCheck.org is committed to factual accuracy from the
country’s major political players and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania. If you have a fact, that you would like
checked, email us at www.chcradio.com . We will have FactCheck.org’ s Lori
Robertson check it out for you here on Conversations on Health Care.

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Margaret Flinter: Each week , C onversations highlight a bright idea about how to
make wellness a part of our communities and everyday lives. Vaccinations are

th
considered one of the great public health achievements of the 20 century,
r educing fatalities for most common and fail ed diseases by up to 99%. But in the
st
21 century, some of those numbers just aren’t stacking up. As recently as
2009, only 45% of the nation’s p re - school age children had received all of their
recommended vaccination and boosters. And researchers at the Children's
Outcomes Research Program at C hildren's H ospital in Colorado decided to take
an in - depth looked at the problem.

Dr. Allison Kempe : P rimary care practice nurse are so overstretch. There are so
many competing demands that it's rather in practical.

Margaret Flinter: Dr. Allison Kempe heads up the children's outcome research
program and she conducted the study on what would help to gene rate better
compliance with the require vaccinations, which is the goal of the governments
healthy people 2020 initiative. And she found that when parents receive timely
reminders from their state and local health departments, parents were much
more likel y to get the vaccinations and boosters for their children that they
needed.

Dr. Allison Kempe : What our study did was to centralize those efforts. So it
didn’t take away from the primary care providers but it helped them to do the
reminder recall for th eir practices essentially using a state registry. So this was
much more efficient and much more cost efficient.

Margaret Flinter: Dr. Kempe says her research shows that when we remind,
their message can be generated for an entire population across commu nities. It
takes the honest and the burden off of the primary care in pediatric practices.
Her study, publish in the December issue of the American Journal of Public
Health, show that those affects were pretty significant.

Dr. Allison Kempe : In a fairl y short six month period in the counties where, if this
was done centrally about 19% of children who are not up - to - date became up - to -
date verses about 13% in the practice space recalls state, which on a population
level within six month s, it’s really very powerful.

Margaret Flinter: And the study also suggests that it’s a cost savings for the
centralize state or county run database remind er system , both in terms of the
vaccines themselves and in reduce medical cost as fewer children fall ill.

Dr. Allison Kempe : You know, you have one case of I nfluenza e H aemophilus
M eningitis can cause tens of thousands of dollars. The costs are of not
preventing these illnesses are very high.

Margaret Flinter: A s tate h ealth d epartment driven vaccination program that
assist private practices in vaccine compliance for their patient population

improving vaccination rates of young and vulnerable children. Now, that’s a
bright idea.
(Music)
Margaret Flinter: This is Conversation on Health Care. I am Margaret Flinter.
Mark Masselli: And I am Mark Masselli, peace and health.
Conversations on Health Care, broadcast from the campus of WESU at
Wesleyan University, streaming live at www.wesufm.org and brought to you by
the Community Health Center .