Officials Break Ground for Brain Injury Center of Excellence

By Fred W. Baker III
American Forces Press Service

June 5, 2008 - Just inside the gates of the National Naval Medical Center, Bethesda, Md., officials today ceremoniously turned the dirt at the site of what will become the military's premier institute for the study and care of psychological health and traumatic brain injuries. Defense Department Secretary Robert M. Gates, alongside two other department secretaries, top military leaders, recovering wounded warriors and the namesakes of the Fisher House Foundation joined to break the ground for what will become the National Intrepid Center of Excellence for psychological health and traumatic brain injury.

Construction of the $70 million, 75,000-square-foot facility is being funded by the Intrepid Fallen Heroes Fund, a not-for-profit agency that raises funds to support military servicemembers and families. The project mirrors the organization's funding and construction of a physical rehabilitation facility – The Center for the Intrepid -- built at Brooke Army Medical Center in San Antonio last year.

This facility will serve as the clinical research and educational arm of the DoD Center of Excellence for psychological health and TBI -- a collaborative network of military, private and public health care and educational organizations linked to discover and promote best practices in the care of treatment of psychological health and TBI.

Gates said the need for such a facility has "never been more pressing or more important."

He said that the conflicts in Iraq and Afghanistan have presented DoD with a unique mix of injuries, stress and strains on its military force.

"As in every conflict in America's history, many of our troops have returned bearing the scars of war – scars both seen and unseen," Gates said. "These invisible wounds are in many ways more pernicious, more grievous, because they are not readily apparent and have not always received the attention they should."

Gates said advancements in armor protection and battlefield medicine have led to more troops surviving what would have been otherwise fatal injuries. As result, though, there has been an increase in cases of TBI. The secretary conceded that although much about the condition still is not understood, $150 million has been dedicated to the injury's prevention, diagnosis, treatment and recovery.

Also, the military has implemented better reporting mechanisms for those potentially affected, and DoD has launched departmentwide efforts aimed at reducing the stigma attached with receiving mental health services in the military.

"That change in our culture represents our biggest challenge, and we know it will not happen overnight," Gates said.

Last month, DoD changed a longstanding question on its security questionnaire that asks if servicemembers have received mental health counseling. Now, the question excludes counseling for combat-related stress and post-traumatic stress disorder.

"We hope that with this change, more will be willing to come forward and seek help," Gates said. "The main point is to do everything we can to ensure that the inevitable anxiety and stress from combat does not turn into something tragically worse."

Gates said that the new center symbolizes that the United States is keeping its contract with servicemembers and their families to provide care should they be injured on the battlefield.

"After the wars themselves, I have no higher priority. And this superb new center will be a living reminder that America honors that contract and keeps faith with those who have sacrificed so much for all of us," Gates said.

The honorary chairman of the Intrepid Fallen Heroes Fund, Arnold Fisher, said that the contributions provided for the center were not charity, but a duty by Americans to care for its troops.

"This is not charity work. This is our duty to give back to this country, especially to the military," Fisher said. "We are no longer embarrassed to talk about mental health of our brave warriors. They deserve the best care, and this center will be the core of that effort."

The Fisher family's Fisher House Foundation raises money to build homes on military installations and at Veterans Affairs medical centers across the United States. Families of those recovering at the hospitals are allowed to live in the homes for free. So far, the foundation has built 38 such homes. It plans to build more at the Bethesda campus, officials announced.

Once complete, the building will be turned over to the Defense Department for resourcing and management. The building is planned to be finished by November 2009.

The center is another example of the ever-expanding partnership between VA and DoD and other governmental agencies. So far, the two agencies have collaborated on revising policies and procedures that have been sticking points for servicemembers transferring their care between the agencies. They've also joined to hire federal recovery coordinators who will oversee the management of the cases of the most severely injured. VA, DoD and the National Institutes of Health will collocate at the new center. The deputy director of the DoD Center of Excellence for psychological health and TBI is a VA employee.

"This Intrepid Center of Excellence will play an absolutely essential role in a unwavering commitment to continue that forward movement in getting it right in caring for those who have borne the battle," VA Secretary Dr. James B. Peake, a retired lieutenant general who served as Army surgeon general, said.

Marine Gen. James E. Cartwright, vice chairman of the Joint Chiefs of Staff, said the collaboration of the political administration, the military and the private sector shows long-term commitment toward servicemember care.

"We all are committed to making sure this is not just a short-term flash in the pan," Cartwright said. "We are committed to making this work, to addressing every problem that we can find and we can go after. This is absolutely essential. This is our duty."

The director of the DoD Center of Excellence for psychological health and TBI said the center will put in one place the partnerships that her office has been working to cultivate and will serve as a hub of global efforts to provide evaluation, diagnosis, and treat those suffering from PTSD, TBI and other psychological issues.

"We've always worked together to some extent, but this center will provide that galvanizing focus that will bring the VA, the National Institutes of Health, and bring the Department of Defense and the private and public sectors together, all united in one great effort," said Army Brig. Gen. Loree Sutton, who also serves as the special assistant to the assistant secretary of defense for health affairs.

Sutton added that the center will benefit not only military medicine, but also civilian medicine in terms of its findings in research and diagnosis.

"Whatever we can find in terms of best practices around the world, we're bringing it here. Whatever we learn here, we'll push it out," Sutton said.

The groundbreaking is the first of many changes to the landscape of the historical naval hospital campus, as it prepares to merge with the Walter Reed Army Medical Center by 2011 to become the Walter Reed National Military Medical Center.