A Brain Injury Case Manager Reflects: A personal journey becomes career focus

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Mike Bruns (2) - TBI

Six months ago I joined the staff of Brookhaven Hospital in Tulsa, Oklahoma as a Case Manager to the Neurologic Rehabilitation Institute (NRI). Here, my experience in working with Traumatic Brain Injury, Dual Diagnosis mental health counseling and case managing disabled veterans is being utilized for assessment and outreach to patients referred to the hospital dealing with the behavioral and emotional side effects of traumatic brain injury (TBI).

Prior to joining NRI at Brookhaven Hospital, I was involved in counseling and advocating veteran’s services in the homeless shelters of inner city Kansas City and rural Missouri. My caseload has included clients dealing with a multitude of behavioral and mental health issues. Most situations involved substance abuse and one or more co-occurring mental health diagnoses. Post Traumatic Stress Disorder (PTSD) and traumatic brain injury are the most common, yet many are dealing with other disorders. My training through the VA PTSD Clinical program in Palo Alto, California has been very helpful to my work with this population. I utilized all of this training and experience when called to support the May 2011 Joplin Tornado relief efforts. My work has also included helping clients deal with physical barriers due to service related injuries. This includes working with Veterans Treatment Courts, Drug Courts, federal, state, local probation and parole, and prison re-entry community action agencies. It included outreach to judges, victim’s advocates, sheriff and police departments, prison re-entry programs. It also opened the door to working as a counselor with inmates dealing with dual diagnoses in a 650 bed substance abuse facility in the Department of Corrections.  My outreach in this community also included working with the Kansas City Indian Center, a community center for eleven different tribal nations.

The drive to this vocation came from a personal experience that I have shared with very few people. I am a post Vietnam Army National Guard Artillery and Active Duty Infantry veteran. My active duty time included experiencing Korea and the Demilitarized Zone (DMZ) My active duty service was cut short by a series of events after experiencing a non-reported concussion from a training incident.  After a couple days of Tylenol and sleep I was back on duty. The incident though triggered (what I failed to recognize until 20 years later) behavioral and physical invisible wounds.  About 5 years prior to connecting the physical and behavioral pieces together, came a realization that I was exhausted from ignoring the emotional fallouts of life after the concussion.  What started out as a journey to help myself put me in front of many great teachers who helped me develop coping strategies in addressing my perceptions of life. Through the help of other veterans and veterans advocates the doors opened for treatment and education on how to manage the hearing loss and tinnitus that is a daily reminder of my brain injury.  Their help inspired me to become an advocate for others, and opened the doors to Veteran’s Service Officer training.

Helping other veterans brought unique experiences of participation in VA clinical training programs, retreats on the moral and spiritual injuries of war; personal direction towards resources and training on Traumatic Brain Injury by VA Neuropsychologists;  exposure to first hand experiences and perspectives of psychologists on the ground in the initial deployments of US Soldiers to Afghanistan and Iraq; ; collaborating with federal, state and local prison re-entry partners as an Offender Workforce Development Specialist (OWDS); and the inspiring veterans and legal minds behind the launch of Judge Russell’s Veteran’s Court model nationwide.

I have had the personal experience as well as professional privilege of working with the Veterans Health Administration (VHA) and Veterans Benefits Administration (VBA) through one of their biggest transitions over the past thirty years.  In 2005, the US Department of Defense and VA were in the midst of many new challenges from the Post 9/11 war efforts. Innovations in combat protection were allowing soldiers to live through situations that would have killed veterans in previous wars. Traumatic Brain Injury and Post Traumatic Stress Disorder were emerging as the signature wounds. At the same time new discoveries in the effects of “Agent Orange” in Vietnam veterans identified roughly 30 more presumptive illnesses that needed to be addressed as well as emerging mental health issues from veterans aging with combat trauma from Vietnam and the Gulf War.  The VA continues to strive to meet these needs, and there are many obstacles in its path.

In my current position with the Neurologic Rehabilitation Institute at Brookhaven Hospital (NRI), I have been able to continue my work with the VA.  I have participated in the Veteran’s Administration Mental Health Summits, and will be sharing my experiences in an upcoming blog series.  I am hopeful that, with the VA opening doors with community partners, progress will be achieved.

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