Montana-Virginia launched a new mobile medical unit in March to expand access to mental health treatment for rural veterans in parts of Montana and northern Wyoming.
The unit offers transcranial magnetic stimulation (TMS) therapy, a procedure that uses magnetic pulses to stimulate parts of the brain in patients with treatment-resistant depression.
“I think the opportunity to offer this to more patients, more veterans of all ages, will change some lives for the better,” said Peter Richardson, a veteran who received TMS therapy. said. “It has allowed me to become the person I want to be and the father I want to be. I am no longer held back by the weight of depression and suicide.”
Provide insurance to rural veterans
Dr. Elizabeth Walter, Montana-Virginia TMS Program Director, said the goal of the mobile TMS unit is to find a better way for veterans to access more treatment options. “We want to provide maximum coverage and maximum access to veterans in rural and remote areas,” Walter said.
According to the VA Department of Local Health, Montana and Wyoming are geographically among the most rural states in the country, with the majority of their land classified as rural or very rural. Additionally, both states have consistently had the highest suicide rates in the nation over the past 20 years.
Mobile medical units are vans or trucks that travel within the Veterans Affairs Medical System to provide services to eligible veterans who may not have access to a local VA medical center. While other departments connect veterans to a full range of services including mental health, social workers, women’s health, audiology, labs and telehealth, this will be the first department to offer TMS therapy.
TMS therapy is relatively new to the VA. It was first approved for use by the FDA in 2008, but it was not widely used in veteran’s facilities until 2017. Currently, approximately 60 VA facilities offer this treatment. Virginia-Montana introduced his first TMS machine in 2021 and currently has three fixed units installed at his Kalispell, Helena, and Billings facilities.
“Given the number of people suffering from treatment-resistant depression, it became really important to think about what else we could do for these veterans,” Walter said.
In addition to location, another barrier to receiving TMS treatment is the high number of sessions required for treatment. Usually, a full course requires 30-36 sessions in 6-9 weeks.
“For many veterans, coming to Virginia every day for 30 or more consecutive days can be very daunting, especially if they have to travel to another city for treatment.” said Dr. Michelle Madore, a neuropsychologist and clinical director at the Veterans Administration. TMS program.
rapid treatment protocol
However, during the COVID-19 pandemic, VA healthcare workers in Tampa developed an advanced rapid TMS treatment protocol that provides five sessions per day for five days.
“It turned out to be so effective that we decided to adapt it for use in situations like mobile medical units, which can be very logistically challenging for healthcare providers and patients. We are now able to offer this treatment to patients who may otherwise not have access to it due to their relationships, and we are now able to provide this treatment closer to the patient’s home base and social supports,” Madore added. .
VISN 19 Clinical Resource Hub Adult Psychiatrist Dr. Emily McMillan is one of the clinicians who offers TMS therapy to her patients. She estimates she has treated 40 to 50 patients so far, and she said the results were unlike anything she had seen before. She said: “I’ve seen some incredible transformations and incredible recovery stories. It’s been really rewarding.”
McMillan acknowledged that mental health treatments don’t work for everyone, and not everyone who receives TMS therapy sees improvement.
“But as a psychiatrist, I know that I can send someone to another treatment based on a procedure they’ve never tried before and give them additional hope when many medications have already failed.” It’s great to have,” McMillan said.
If you or someone you know is considering suicide, contact the Veterans Crisis Line for free, confidential support and crisis intervention 24 hours a day, 7 days a week. Dial 988 and press 1 or text 838255.
