Skip main navigation

Military Health System

Clear Your Browser Cache

This website has recently undergone changes. Users finding unexpected concerns may care to clear their browser's cache to ensure a seamless experience.

Defense Intrepid Network Supports Service Members Across the Continuum

Image of U.S. Marine Staff Sgt. Anthony Mannino plays guitar as he receives music therapy as part of his traumatic brain injury treatment and recovery. Kalli Jermyn, a music therapy intern, observes, instructs, and works with Mannino. The therapy is conducted at the National Intrepid Center of Excellence, at the Walter Reed National Military Medical Center in Bethesda, Maryland. (Department of Defense photo by Marvin Lynchard). U.S. Marine Staff Sgt. Anthony Mannino plays guitar as he receives music therapy as part of his traumatic brain injury treatment and recovery. Kalli Jermyn, a music therapy intern, observes, instructs, and works with Mannino. The therapy is conducted at the National Intrepid Center of Excellence, at the Walter Reed National Military Medical Center in Bethesda, Maryland. (Department of Defense photo by Marvin Lynchard)

The Defense Intrepid Network for TBI and Brain Health’s Continuum of Caring, Healing, and Thriving initiative, headquartered at the National Intrepid Center of Excellence in Bethesda, Maryland, is a comprehensive interdisciplinary approach to address the full continuum of traumatic brain injury, behavior health, and brain health.

Over the past 22 years, more than 468,000 service members have sustained a TBI. The majority of TBI events occur in training: Breaching, anti-tank weapon use, combatives, parachute jumping, and blast exposure, according to the Traumatic Brain Injury Center of Excellence.

This high rate of TBI affects the readiness of the U.S. armed forces. To ensure a medical ready force, we must engage service members prior to an initial TBI event. This is the beginning of the continuum of care.

“We know the service members at highest risk for TBI and associated conditions and recognize the importance of preparing them for the careers they go into,” said U.S. Navy Capt. Carlos Williams, director of the NICoE. “In fact, to gain a better understanding of how widespread brain injuries are and the impact these injuries can have on our service members, we should also begin to more closely engage our aviation and undersea communities.”

“During this pre-TBI phase, we must use foundational tools such as education, integrative health services, and other best practices to build resilience and, when possible, prevent the event or complications altogether,” he said.

A goal of the continuum of care is to partner with the operational community and others in the TBI clinical, research, and academic spaces to educate service members and their families about TBI, its effect on brain function, and activities to help restore the brain immediately after an injury or after having persistent symptoms for many years.

In addition, service members can be taught elements of the integrative health services that are a part of the Defense Intrepid Network’s patient-centric interdisciplinary care model. These may include yoga, meditation, breath work, and art therapy to help process fragmented trauma memories and be used life-long to address future trauma and build resiliency, said Dr. Thomas DeGraba, chief innovations officer for the NICoE.

The continuum aligns with the Warfighter Brain Health Initiative that supports prevention and establishes resilience in the pre-TBI state.

The five lines of effort of the Warfighter Brain Health Initiative are:

  • Optimize cognitive and physical performance
  • Identify, monitor, and mitigate brain exposures
  • Prevent, recognize, and minimize the effect of TBI
  • Reduce or eliminate long-term/late effects
  • Advance warfighter brain health science

The next step in the continuum of care is treating those with TBI. For service members who visit the NICoE, one of the 11 Intrepid Spirit Centers or two clinics in the Defense Intrepid Network, the interdisciplinary care model enhances their trajectory of recovery with skills-based training and education. Patients can go at their own pace and process things in a safe environment at one of the ISCs or clinics.

After treatment, the continuum facilitates continued healing, recovery, and the transition to full duty or civilian life through a network of partnerships across the Department of Defense, Department of Veterans Affairs, non-governmental military and veterans support organizations, academia, industry, and the TBI community.

These partners provide top quality follow-up care, case management, peer support groups, and other services to assist in healing and thriving.

“Any organization that offers resources to our beneficiaries, we hope to identify them and help our members take advantage of those resources. Simply put, the continuum ensures that we prepare for, treat when needed, and continue to support lifelong recovery so that no one is left behind,” said Williams.

It also means continually evaluating how service members respond to care in the Defense Intrepid Network, which leads to constant updating of best practices throughout the continuum.

“I am excited for the future of the Defense Intrepid Network,” said Williams. “It is built on inclusiveness and allows participation from providers and experts across the Military Heath System and beyond to contribute to improving care and quality of life of our service members.”

You also may be interested in...

Article Around MHS
Apr 26, 2024

Researchers and Guard Physicians Set Their Sights on Mitigating the Impact of Blast Exposures

Military personnel and civilian researchers at a training at Fort McCoy

Red Arrow soldiers from the 1-120th Field Artillery Battalion and 1-105th Cavalry Squadron were visited by a team of civilian researchers and Wisconsin National Guard surgeons on April 9, 2024, during their training at Fort McCoy, Wisconsin, to discuss a study to measure blast exposure and evaluate associated effects among soldiers during routine ...

Article Around MHS
Mar 4, 2024

Walter Reed Salutes Capt. Carlos Williams’ Leadership During Black History Month

Carlos William graduated with honors from Albany State University with a bachelor’s degree in biology and a minor in chemistry before earning his medical degree from the Morehouse School of Medicine. He later earned graduate degrees in public health and business administration from Johns Hopkins University.

When you meet U.S. Navy Capt. Carlos Williams, director of the National Intrepid Center of Excellence at Walter Reed National Military Medical Center, you’ll likely notice that he embodies the Navy’s core values of initiative, accountability, integrity and toughness.

Article Around MHS
Dec 5, 2023

When Your Spouse Has a Traumatic Brain Injury

Lorie Falaminiano, an MRI technologist assigned to Naval Medical Center San Diego (NMCSD), conducts an MRI scan of a patient's brain at the NMCSD hospital.

As a spouse of a service member who has suffered a traumatic brain injury, you may be experiencing a range of emotions. It is important to allow yourself to feel every emotion that surfaces and attend to your own needs. Here are some strategies to consider as you prepare to take on your new role as a caregiver to your spouse.

Article Around MHS
Dec 1, 2023

Walter Reed's National Intrepid Center of Excellence Scientists to Present New TBI Battlefield Biomarkers Research During 2023 MHSRS

Dr. Ping-Hong Yeh all smiles at Walter Reed in preparation for presenting new biomarkers TBI research at 2023 MHSRS. (Photo Credit: Ricardo Reyesguevarra)

Walter Reed National Military Medical Center is pleased to announce that researchers from the National Intrepid Center of Excellence (NICoE) will present a groundbreaking study on diagnosing traumatic brain injuries (TBIs) during the 2023 Military Health System Research Symposium (MHSRS) taking place Aug. 14-17, 2023 at the Gaylord Palms Resort and ...

Article Around MHS
Dec 1, 2023

Be a 'Brain Warrior' and Protect Yours

The National Intrepid Center of Excellence (NICoE) at Walter Reed National Military Medical Center (WRNMMC), along with the entire Military Health System (MHS), places emphasize on protecting the brain, as well as seeking treatment for brain injuries, every day.  (courtesy photo)

March is annually observed as Brain Injury Awareness Month (BIAM), and the National Intrepid Center of Excellence at Walter Reed National Military Medical Center, along with the entire Military Health System (MHS), places emphasize on protecting the brain, as well as seeking treatment for brain injuries, every day.

Article Around MHS
Dec 1, 2023

Neuropsychiatry/TBI Unit at Walter Reed Unique in DOD

Dr. David Williamson, medical director for the Neuropsychiatry/Traumatic Brain Injury unit at Walter Reed National Military Medical Center and his staff are breaking new ground in identifying and treating TBI and behavioral health challenges.  (courtesy photo)

Walter Reed National Military Medical Center (WRNMMC) has the Department of Defense’s only Neuropsychiatry/Traumatic Brain Injury (TBI) Unit. It serves as a referral program for Military Health System (MHS) beneficiaries throughout the defense department, as well as for congressional members needing care for the impacts of head injuries and other ...

Article Around MHS
Dec 1, 2023

U.S. Army Medical Materiel Development Activity Pharmacist Excels as Warfighter Brain Health Product Manager, Mom, and Leader

U.S. Army Maj. Dana Bal tests a brain hemorrhage detection device during familiarization training at the headquarters of the U.S. Army Medical Materiel Development Activity, Fort Detrick, Md., Dec. 28, 2022. Bal serves as part of the Program Management-Acquisition Internship Program and as assistant product manager with USAMMDA’s Warfighter Brain Health Project Management Office. (U.S. Army Photo by T. T. Parish)

Aiming to join the Army Medical Service Corps as a pharmacist, Dana Bal graduated and earned her commission in 2008 before being awarded a Health Professions Scholarship Program (HPSP) educational delay to complete pharmacy school. Find out why Bal credits the Army for her success as a Warfighter Brain Health Product Manager, a mom, and a leader.

Skip subpage navigation
Refine your search
Last Updated: December 01, 2023
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery