Dothan doctor develops technology for mental assessments

Before there is treatment, there must be an accurate diagnosis.

When dealing with the potential problems of soldiers returning from active duty, a quicker diagnosis of post-traumatic stress disorder, traumatic brain injury or potential suicide risk, can possibly save lives and avert disaster.

CliniCom, a computer-based technology developed six years ago by a Dothan psychiatrist, is currently being used by mental health professionals in 15 states and is extremely applicable to the military.

CliniCom was developed by Dr. Nelson M. Handal, founder and medical director of Harmonex and Dothan Behavioral Medicine. CliniCom is a comprehensive, self-assessment that screens for 56 possible mental illnesses.
It was released to the public in 2007 after four years of research and development.

“The technology can be equipped to run in most clinical environments using tablets, desktops or kiosks,” Dr. Handal said. “CliniCom evokes the appropriate question sets based on the user type and the patient’s age.”

Handal made his comments during a May 13 hearing before the U.S. House of Representatives’ Committee on Veterans’ Affairs. The hearing was on Innovative Technology and Treatments Helping Veterans.

The information is timely as a potential solution to a growing problem. The hearing was held just two days after an American Army soldier shot and killed five fellow soldiers at a counseling center in Iraq.

Mental condition after combat is a problem the military still struggles to acknowledge, and mental illness itself has such a stigma attached that officials are reluctant to pursue an issue that could open a Pandora’s box of claims.

Nationwide, incidents of alcoholism, domestic violence, suicide and other violent crimes being committed by returning soldiers, are up. According to a 1998 RAND study, about 1 in 5 new veterans are experiencing symptoms of Post Traumatic Stress Disorder or major depression.

If the mental health assessment process moved from being “available” to returning soldiers, as it is today, to being mandatory, it could make a difference.

A bill is currently being introduced that would mandate assessments, but there seems to be no hurry.

William Handal, chief operating officer of Harmonex, with offices in Dothan and Atlanta, said soldiers are looking for a vehicle through which stigma and access to care can effectively be addressed. A mandate would allow The Department of Defense and the Veterans’ Affairs to improve care by offering soldiers “an interactive and intuitive platform that can expedite care in a private fashion.”

Dr. Handal told legislators getting the Veterans’ Affairs' attention has been frustrating. “I think everyone gets very, very interested and excited about it,” Handal said, but doors have not opened. “A part of it is the bureaucracy.”
Committee Chairman Bob Filner, D-Calif., did not disagree, saying government agencies often do not react quickly to new ideas and technology.

“You’d think the VA would jump on this stuff,” Filner told various specialists and entrepreneurs who testified. “And yet, for some reason that I guess is a law of bureaucracy, it’s easier to say no.”

The one-hour CliniCom assessment could become as routine as a sight and hearing test, and could be administered at a lower cost than standard diagnosis. Doctors using CliniCom report that it might take a number of visits to collect the same information CliniCom can gather typically in one visit, William Handal said.

“The information CliniCom gathers is usually done in a face-to-face interview. It relies on a variety of factors to reach a diagnosis. It is quantifiable. Numbers aren’t just lost on a chart or in a shuffle of papers. It is part of a bigger picture presented in an organized way.”

While the technology recommends a diagnosis, it allows for individual clinical input. The doctor validates the answers, allowing for professional judgment that can help attest to the accuracy of the answers.

“The doctor can accept or reject the diagnosis,” William Handal said.

The cost is extremely cost effective and Handal believes returning veterans need the assessment.

“Soon many more of our soldiers will return and it is critical they have access to the highest quality of care for not only the visible wounds of war, but also for the ones that cannot be seen,” William Handal said. “We can do better.”

For more information, go to www.harmonex.us or call (866) 497-0111.

By the Numbers:
7,400 - Number of Iraq and Afghanistan veterans treated for drug addiction at VA hospitals
16,200 - Number of Iraq and Afghanistan veterans diagnosed with Alcohol Dependence Syndrome
196 - Number of Iraq and Afghanistan veterans who committed suicide as of December 2008

Source: VA Office of Public Health and Defense Manpower Data Center Statistical Information Division

To hear Dr. Handal’s testimony, at 1:22 into the video, go to:
http://veteransaffairs.edgeboss.net/wmedia/veteransaffairs/2009/090513.wvx