ScarceMental Health Resources for Veterans
Veteransand active military servicemen and women returning from combatantzones suffer many and serious mental health issues. They oftenexperience anger, anxiety, grief, substance abuse, post-traumaticsubstance abuse, and depression. According to the United StatesGovernment Accountability Office (2011), 2.1 million veterans andactive military service members received treatment for mental illnessfrom the Veterans Affairs between 2006 and 2010. Substance Abuse andMental Health Services Administration (SAMHSA) shows that“approximately 50% of returning service members who need treatmentfor mental health conditions seek it, but only slightly more thanhalf who receive treatment receive adequate care” (2014” Para3).GAO (2011) estimates that of the 1.8 million veterans and activemilitary personnel who were deployed in the Middle East, 300, 000suffer from psychological problems like major depression. In additionto that, VA (2009) estimates that around 13,000 of Afghanistan andIraq veterans experience alcohol dependence syndrome. Women veteransare especially likely to experience mental health challenges. The VAindicates that 1 in 5 female veterans suffer from PTSD associatedwith military sexual trauma (Williamson, & Mulhall, 2009).
VAMental Health Services
Mentaland physical health problems embody a real challenge to militarymembers and veterans. Veterans and returning military service men andwomen are at risk for being rendered joblessness, family instabilityand homelessness in addition to mental health issues. The activemilitary service members returning home from combatant zones to acountry that is ill-prepared with resources, training and policies tohelp them come of serious mental health crisis (Hicks, 2011).Americans are aware of the increased mental health needs of veteransand returning soldiers. The military has not treated mental healthissues with similar seriousness it accords to physical issues.Unfortunately, service members returning home do not get acomprehensive care they need.
Bothveterans and active service members face obstacles to access mentalhealthcare. The challenges active military personnel and veteransface in obtaining mental health services include limited providers,time constraints/work schedule, long wait times, and lack oftransportation options (Committee on the Assessment, 2013). Lack ofthe mental health resources in VA can lead to unmet needs with longterm negative consequences. The long term implications of unmetmental health needs are evident, including violence, high suiciderates. Besides economic and social distance, mental health problemsare the barriers to finding secure housing. They contribute to thehomeless problems, inability to get family support, acquire skillsand limited opportunities for social relationships and economicadvancement.
Stigmarelated to mental health issues in veterans and other militarycommunities serves as barrier to seek help. Service members oftenmention the fear of being viewed as weak, shame over the need to seekhelp, disappointing comrades, dishonorable discharge and loss ofopportunity for career advancement as the reasons they do notdisclose mental health symptoms from colleagues, friends and family(Wright et al., 2009).
Mostservice members and veterans do not live near VA mental healthfacilities and are forced to travel distances in search of theseservices. Although they account for nearly 41 percent of thoseregistered in the veteran Affair systems, veterans living in ruralareas have additional challenge as far as VA is concerned: theirgeographical proximity from the VA offices limits their ability toaccess services (GAO 2011). They face logistical challenges andlimited transportation alternatives due to distance issues and traveltime. Studies have demonstrated the VA clients in rural places havemore disorders and poor health-related outcomes compared to theircounterparts in urban areas. Yet they have limited access to VA careservices and resources to cope with mental health issues (West &Weeks, 2006). Because they have limited access to mental healthcareservices, they rarely seek help for their problems. In fact, many optfor civilian mental care or private mental care to address theirmental health needs. Thus long distance travel predicts poor service,and poor treatment for alcohol abuse.
TheVA mental health department does not have adequate staff to addressthe increased capacity or workload. This means that the staff is notable to see clients within the desired dates. Furthermore, not all VAmental health staff professionals are trained to meet the veterans’care needs. The VA staff does not follow appropriate schedulingprocedures causing confusion in the collection of data. Schedulingclerks make unrealistic schedules while the health providers schedulereturn appointment for established clients based on their knownavailability as opposed to the clinical needs of the patient(Committee on the Assessment, 2013). Therefore, Shortage of mentalhealth practitioners can hinder access to receiving care services byservice members.
Sometimes,veterans turn to civilian mental health programs to receive services.Unfortunately, civilian mental health professionals do not understandmilitary culture to be able to offer appropriate mental healthcareneeds. They lack cultural competence skills to understand themilitary more, background, language and delivery apt care for mentalillness exceptional to the military.
TheVA mental health department is disjointed in addressing mental healthissues facing veterans. Veterans seeking mental health services atthe VA have to endure long wait times. It takes as longer as threemonths after making request for appointments. Inadequate number ofmental health practitioners in the VA is responsible for the longwait times. Another cause of long wait times is the poor schedulingpractices. Military members who screen positive for mental illnessfind it difficult to get time off work. Because of the timeconstraints, it becomes difficult to arrange for an appointment withthe providers. The problem is worsened by inadequate leave time andlong wait times.
Longwait times for scheduling are often cited by both veteran and activemilitary members as the reason they do not seek VA mental healthcare.Accompanying long wait times is the problem of locating healthproviders who are specialists. Poor distribution of specialistspresents a considerable obstacle to veterans to access care services(Brittet al.2011). Specialists tend to be located in urban areas,leaving rural areas largely underserved.
Manyveterans with mental illness do not reach out for help. This isbecause they do not know where to seek help or are unaware of theirmental illness. Only a small percentage of veterans and activemilitary personnel who screen positive for mental illness seekmedical attention from mental health practitioners. Some discontinuetreatment immediately after their initial treatment. In fact, thosewith PTSD, this implies that civilian mental health facilities havebecome their main resource (Committee on the Assessment, 2013).Reason given by frustrated veterans for not seeking the medicalsystem are lack of personalized interest, long waiting times, unwelcome cues of military culture, absence of meaningfulinterventions and the geographical remoteness of some VA medicalfacilities.
Themilitary health system falls short of trained personnel and fiscalresources needed to achieve its mission to support veterans withmental illnesses in peacetime. A lack of mental health practitioners,inability to reach geographically remote areas, stigmatizationrelated to military psychological problems, and lengthy wait timesare the main issues preventing veterans and active military memberswith mental illness from accessing care services they need.
Britt,T.W., Bennett, E.A., Crabtree, M., (2011). The theory of plannedbehavior and reserve component veteran treatment seeking. MilitaryPsychology, 23(1):82–96.
Committeeon the Assessment of the Readjustment Needs of Military Personnel,Veterans, and Their Families. (2013, March 12). ReturningHome from Iraq and Afghanistan: Assessment of Readjustment Needs ofVeterans, Service Members, and Their Families.Washington (DC): National Academies Press (US).
GAO(Government Accountability Office). (2011). VAMental-health: Number of Veterans Receiving Care, Barriers Faced, andEfforts to Increase Access.Washington, DC: GAO.
Hicks,M. (2011). Mental health screening and coordination of care forsoldiers deployed to Iraq and Afghanistan. The American Journal ofPsychiatry, 168: 341-343.
SAMHSA.(2014). Veteransand Military families. Retrieved on July 6, 2016 fromhttp://www.samhsa.gov/veterans-military-families
VAand VHA (Veterans Health Administration). (2009). VHAHandbook 1160.01: Uniform Mental-health Services in VA MedicalCenters and Clinics.Washington, DC: Department of Veterans Affairs.
West,A., & Weeks, W. B. (2006). Physical and mental-health and accessto care among nonmetropolitan Veterans Health Administration patientsyounger than 65 years. Journalof Rural Health, 22(1):9–16.
Williamson,V., & Mulhall, E. (2009). InvisibleWounds, Psychological and Neuroligical Injuries Confront a NewGeneration of Veterans.Iraq and Afghanistan Veterans of America.
Wright,K.M., Cabrera, O. A., Bliese P. D. et al. (2009). Stigma andbarriers to care in soldiers post-combat. PsychologicalServices, 6(1):108–116.