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Hey, Mr. President: Here’s How to Really Help Hurting Vets

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white house photo / lawrence jackson

President Obama announced expanded access to military mental-health care last Friday at Fort Bliss, Texas.

I was initially excited by President’s Obama executive order entitled Improving Access to Mental Health Services for Veterans, Service Members, and Military Families. But then I was disappointed as I read the details.

The order calls for the Department of Veterans Affairs to add mental-health professionals and expand crisis-line capacity to ensure that any veteran who says he or she is in crisis connects with a mental-health professional within 24 hours.

No offense, Sir, but big deal. There is so much more that should be done.

The VA is already trying to hire 1,600 more mental-health professionals. They’re having a tough time helping vets in crisis. Mental-health professionals are in short supply – I get job offers daily, as do my psychiatry colleagues.

What more could an executive order do? Here are some suggestions from military mental-health professionals, including me. While there are no simple solutions to the triple threat posed by post-traumatic stress disorder, traumatic brain injury and suicide, these big problems require thinking big:

– We need a national effort which includes the nation, not just the VA.

– We need to expand work force development, which includes paying for education for people to enter psychiatry, psychology, social work and related fields in mental health.

– We need to educate civilian mental-health workers on dealing with veterans. There are a number of grassroot efforts in this arena, but a Presidential push would really help.

– We need to educate police officers, correctional officials and others in working with veterans. Again, there are a number of grassroot efforts in this arena, but a Presidential push would really help.

– We need to train more college counselors in working with veterans. Not to be repetitive, there are a number of grassroot efforts in this arena, but a Presidential push would really help.

– We need to re-look at gun laws, and ensure that gun safety is emphasized.  This is the “third-rail” of suicide prevention, and I fear that no Presidential candidate will discuss this.

– We need to re-look at the requirement to reveal counseling on a security clearance, and decide whether that question (Question 21) is helpful in reducing security threats.  The question is clearly a barrier to seeking treatment.

– We need to promote help-seeking methods that the veteran finds attractive such as animal-assisted therapy, virtual reality, and complementary and alternative therapy. We also need robust research to evaluate these methods of treatment.

– We need to get more medications that mitigate PTSD and suicidal thoughts into the pipeline. This may involve pharmaceutical companies, the National Institute for Mental Health, or others.

– We need to fully endorse the Substance Abuse and Mental Health Services Administration (SAMHSA) strategy of going state by state, and fixing the gaps in economic security (jobs and benefits). health care, educational support, ending homelessness, and criminal justice for veterans.

– We need a federal task force to develop a national strategy.

Mr. President: you are the commander-in-chief. Be bold. Go beyond “more shrinks” and “more hotlines” to a sustained national effort. Veterans will support you on this larger national mission.

Thanks to the many who proposed and discussed these added initiatives with me, including Dr. Larry Ronan of Massachusetts General Hospital, and the folks working with the SAMHSA policy academy.

5 comments
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Rick Rogers
Rick Rogers

It is well past incredible that Cameron Ritchie is leading the charge to help vets after she and her ilk pushed mental health drugs that even years ago everyone knew didn't work and many believed were actually destructive. DOD has tacitly acknowledged this in recent years and is  pulling away from the pharmacological model -- the old med 'em and send 'em credo that Ritchie followed with careerist precision.  

When she was in uniform she made a bad situation worse and now in a perverse way she capitalizes on it. Brilliant, just brilliant.

rexreed
rexreed

Many of these suggestions especially use of outside resources were made years ago when you were in command.  DoD/VA said, "all was under control and we are fully funded. 

So where did you, Ira Katz et al. screw up. Too busy spinning nonsense to the press.

Again, please come clean.  It would be good for your conscience.

You could have a group - Katz, Chandler, Oemoto, Hoge, Schoomaker, Cifu and yourself.  Add almost anybody else at the top of DoD/HA and VA from 2001 to present since you all dropped the ball.

It seems no one in authority at the time of these disastrous decisions is willing to man up and accept their failure in public.

Jim S.
Jim S.

Hey, Elspeth Cameron Ritchie  and U.S.  citizens served: Here's How to Really Help Hurting Vets

No Revenues {nor private capital economic investments, free market capitalism} = No Sacrifice = No Support = DeJa-Vu all over again!. Now a decade and counting, told to go shopping, added to the previous decades of under funding the VA, while the peoples reps Still try and lay blame on the Agency, after rubber stamping, deficits started rising as surplus was depleted Before 9/11, wars and costs, off the books till the present exec. admin. and borrowed, of and those represented cheered on these wars!

While the wealthy and other investors garner their booty, still, from both and many have the chutz·pa to call themselves more patriotic{?} then others wrapped in those false flags, using false slogans and various cheap symbols of and then seek one day events or parades to wave all that patriotism, call it "Supporting the Troops", then go home and either ignore or forget about those that actually sacrificed for the country!USN All Shore '67-'71 GMG3 Vietnam In Country '70-'71

ULURU
ULURU

Veterans need jobs and job-training; they don't need more clap-trap psychobabble.

O_No
O_No

Ma'am-Completely agree about all of these things, but especially WRT Question 21. I am an officer who suffers from depression, but I won't get treatment because 1) I know it will mess with my clearance; 2) even if it doesn't mess with my clearance, it will expose certain things of a private nature to my chain of command; 3) even if it doesn't expose those private things, it will still put my chain of command on notice that I am in therapy, thereby giving them reason to doubt my leadership ability. No matter what the party line is, you are still treated differently if you are in therapy.

Also, all of the DoD's messages about "Hey, it's better to get help than to have some sort of incident" disregard our ability to suffer. For me, it is better to suffer and have a job. I have been taught from day 1 how to suffer.

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