VA NY Harbor Healthcare System

Dr. Marion Eakin

The VA offers patients with mental health issues a huge range of services to meet a Veteran’s complex combination of medical and psychological issues. Dr. Marion Eakin, Director of Outpatient Mental Health Services and VA Liaison for the Adult Psychiatry Residency Program affiliated with NYU Langone Medical Center, has worked at VANYHHS for almost ten years. “One of the things that VA can do particularly well is to provide a full gamut of services to address mental health, physical, and psychosocial needs.

She explained that mental health problems often occur at the same time as many other issues such as homelessness, financial need (even to the extent that the lack of funds for carfare affects attendance at medical appointments) and unstable domestic situations. Treatments and experts to help Veterans address these problems are as varied as the issues.

In terms of psychiatry, basically the goal is to balance medicine and therapy, behavior modification and education. Patients may receive counseling in both group and individual sessions. “The overall goal is to achieve the best outcomes and allow Veterans to conduct life in a way that maximizes their potential,” said Dr. Eakin.

“In the clinic, we see a full range of psychological problems often compounded by PTSD, substance use or both,” said Dr. Eakin. “It’s a very big challenge.” Shedding some light on each of the care options, Dr. Eakin said medicine may be prescribed to manage mood symptoms, psychotic symptoms or anxiety. Behavioral therapy engages the Veterans in learning to manage anger, to control impulsivity and to improve their ability to manage stress. Education, explained Dr. Eakin, focuses on enlisting Veterans as partners in their own healthcare. “Helping them gain a full understanding of what their medications are for, why it is important to take them consistently. The patient needs to understand and accept his role as part of the healthcare team, “said Dr. Eakin.

Acknowledging that demand for long range individual therapy far exceeds the supply of mental health counselors, VA has placed significant emphasis nationwide on "evidence based therapies," some of which may be conducted in a group setting. These include Cognitive Behavioral Therapy (CBT), Prolonged Exposure Therapy (PE), and Dialectical Behavior Therapy (DBT).

Mental Health outpatients may also participate in one or more skills groups that address particular problems. The NY campus currently offers skills groups for distress tolerance, relaxation/meditation,, social skills, anger management, and dialectical behavioral skills (which includes modules on managing interpersonal relationships and regulating emotions). Support groups, facilitated by a psychologist or specialized social worker include sobriety maintenance groups and a Friday weekend planning group for those patients who find lack of structured activity depressing. There is a substance abuse treatment program based within the Mental Health Clinic, as well. SARP (Substance Abuse Recovery Program) is an intensive outpatient service.

There are also PTSD groups held separately for Veterans of every era providing an environment of support and understanding of inner personal functions among those who have powerful shared experiences. Connectivity or socialization with the outside world is also seen as having therapeutic value and is the reason that computer classes are available to mental health patients. Similarly, recreation has a role in mental health and the well attended Clubhouse provides an informal setting to talk, read, and participate in communal meals. Veterans enrolled in VA mental health services may also be referred to the VA's work-therapy programs which collaborate closely with mental health providers in advancing a veteran's capacity and skills for (re-) entering the work-force. There is a Manhattan Veterans Advocacy Council (with a Facebook page of that name) that provides an opportunity for veterans to work together with mental health leadership in giving veterans a voice in mental health care.

In addition to treating patients, VA psychiatrists like Dr. Eakin and Chief of Psychiatry Dr. Adam Wolkin, are participating in a nationwide multi-center clinical research trial involving many VA hospitals studying the use of a drug called Prasozin for the treatment of trauma-related nightmares and other symptoms of PTSD.

Emergency phone numbers may be called at any time:

Veterans Crisis Line: 1-800-273-8255 (1-800-273-TALK)

VA Nurse’s HELPLINE: 1-800-877-6976

Confidential online chat at VeteransCrisisLine.net

The VA Emergency Room is available 24 Hours a day.

VANYHHS maintains wide-ranging outpatient mental health services at both Manhattan and Brooklyn Campuses. Experts are also scheduled regularly at the Community Living Center in St. Albans.