In October 2020, the Commander John Scott Hannon Veterans Mental Health Improvement Act of 2019 (SHA) was enacted. SHA Section 305 mandated the Department of Veterans Affairs (VA) to develop and implement an initiative to identify and validate brain and mental health biomarkers in veterans. On April 17, 2022, the Office of Research and Development (ORD) and the Office of Mental Health and Suicide Prevention (OMHSP) launched the Scott Hannon Initiative for Precision Mental Health (SHIPMH). As outlined in SHA Section 305, SHIPMH is focused on promoting and coordinating biomarker research focused on mental illness, promoting data sharing by expanding publicly available anonymized research data, and, perhaps most importantly, translating research into clinical care convict veterans.
Precision medicine is an approach that aims to tailor disease prevention and treatment by accounting for differences in an individual’s clinical, lifestyle, genetic and biomarker information. In psychiatric care, precision medicine is still in its infancy. In October 2021, ORD and OMHSP convened an expert working group composed of renowned experts in the fields of mental health, structural, functional, molecular and physiological brain and mental health biomarkers from the VA Mental Illness Research, Education and Clinical Care Centers (MIRECCs) and VA Clinical Science Research and Development/Rehabilitation Research and Development (CSR&D/RR&D) research community.
The expert working group outlined a roadmap for success that focuses on research and data collection, data sharing, and translation of research into veteran care. To maximize data collection, VA leverages several ongoing research projects including the Consortium on Long-Term Effects of Military Brain Injury – Chronic Effects of Neurotrauma (LIMBIC-CENC), Translational Research Center for TBI and Stress Disorders (TRACTS), Million Veteran Program (MVP) /MVP-Measures Investigating Neuropsychiatric Disorders (MVP-MIND), Precision Medicine in Mental Health Care (PRIME Care) and an ongoing EEG clinical study. The goal is to integrate the assessments from LIMBIC-CENC, TRACTS and sites that have specific mental health/biomarker expertise by developing machine learning algorithms to enable a full 360° diagnosis of brain health.
Public data sharing is available through the Federal Interagency Traumatic Brain Injury Research (FITBIR) Informatics System and VA Data Commons. In addition, the sharing of anonymized MVP genomic and clinical data with VA and non-VA researchers is currently being explored in the VA Data Commons.
The final critical part of SHIPMH is the focus on translating current research into clinical care. The first use case of SHIPMH focuses on the use of psychogenetic testing to better manage drug prescribing in opioid use disorders. The cytochrome P450 2D6 gene has been shown to metabolize commonly prescribed opioids. The identification of this gene may influence medical decisions regarding the choice of alternative drugs, dosages or monitoring approaches for side effects. Currently, the SHIPMH team is aligning additional operational offices such as pharmacies and building the critical infrastructure to support seamless medical decision-making by VA clinicians.
If you are a veteran or know someone who is having suicidal thoughts, contact the Veterans Crisis Line 24 hours a day, 365 days a year. Call 1-800-273-8255 and press 1, text 838255, or chat online at http://veteranscrisisline.net/Chat.
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