Battleland

A Better Way Forward

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Ebby Talebi / VA

Miller touring the James A. Haley VA Medical Center in Tampa, Florida.

The recent headline on the Drudge Report screamed, MORE AMERICANS NOW COMMIT SUICIDE THAN DIE IN CAR CRASHES. In a Wall Street Journal opinion article last week, we read about the life of Peter Wielunski, a veteran who, while receiving care from the Department of Veterans Affairs (VA) for Post-Traumatic Stress (PTS), took his own life. Another life cut short quite possibly by invisible wounds of war.

These stories are unfortunately, becoming all too frequent as we as a nation continue to struggle to adequately address the causes and effects of mental health issues like PTS on servicemembers, veterans, and civilians alike. Sadly, while these stories result in a lot of talk, a lot of articles, and a lot of analysis, they don’t often result in a lot action.

September was Suicide Prevention Month. More than 105 Americans commit suicide a day. Included in that statistic, it is estimated by VA and the Department of Defense that 18 veterans, and one active-duty servicemember, take their own lives every day. Those numbers are too high, despite the fact that more often than not, the treatment for PTS is readily available. Just not always through VA when it is needed most. And therein lies the problem.

In April, the VA Inspector General released a report that found that more than half of the veterans who seek mental health care through VA wait an average of 50 days to receive a full evaluation when they reach out for help. As Robert M. Morgenthau rightly pointed out, despite significant increases in VA’s mental health care budget over the past four years, VA is “still unable to provide timely care to every veteran seeking treatment or to reach out to many of those who are most at risk.”

Further, research suggests that those who do seek treatment at VA do not complete the recommended, evidence-based treatment regimen. While no one can argue that more resources for treatment has been money well spent to care for the men and women who have served, if it is not being used to connect those struggling with the services they need when and where they need them, and on a sustainable basis to actually improve health, it is of little use.

Eleven years into a multi-front war, we need to ask the tough question: is there better way forward?

I believe there is, and it is one that doesn’t require a new agency or bureaucracy. It doesn’t require trying to make myriad government programs work together. What it does require is an open mind. VA does not have the mental health care capacity to handle the number of veterans in need of treatment. In fact, VA has a mental health care provider shortage. Moreover, with approximately 40 percent of veterans residing in rural or highly rural areas, a VA facility is not always easily accessible.

If VA were allowed, however, to utilize a network of providers that is already in place and already works with our military and their families, such as TRICARE, then we might start making a difference in saving lives. By tapping into the TRICARE network, we would more than double VA’s mental health care capacity overnight.

Double.

That means more doctors, more locations, and more treatment options. Care would still be paid for and managed by VA, but treatment would be provided in a veteran’s own community. Governor Romney proposed this idea last month, and after talking with VSO representatives, I believe it is worth exploring in greater detail.

There are other options as well. We are blessed to live in a country in which our communities serve as a bridge to government and private services. It is to those communities where our veterans return home and often where they first turn for help.

So, if a veteran chooses, for his or her own personal reasons not to use VA, such as was the case for Daniel Hanson, a Marine, who testified last year before the Committee that he didn’t feel comfortable at VA, we need to ask: what is more important, getting a veteran care, or potentially risking a deadly outcome because he or she is not allowed to go outside the system in place? The responsibility of caring for veterans should, and always will, lie with VA, but we should not discount the power of faith-based and community groups to support government efforts.

We also must address the national stigma surrounding mental illness. I believe a mental injury is no different than a physical injury or illness in its impact on a person’s well-being.

Still, the public is bombarded with news and entertainment that perpetuates this stigma. After public shootings, news anchors question whether the shooters were veterans. On TV, we witness the disastrous effects on the career of a young CIA agent struggling with bipolar disorder in the popular television Homeland, a show that just won best television drama at last Sunday’s Emmy Awards.

Millions of Americans struggle with mental injuries, not just veterans, and not every veteran is going to have PTS. And few, of those millions, fit the clinical definition of “insane.” All deserve our respect and support, especially veterans struggling to adapt to the civilian world, many of whom have witnessed more carnage than our minds can conjure.

So, we have a choice.

We can continue to keep trying the same old ideas over and over again, getting the same result and keeping the status quo. Or we can take action and try a new approach, an approach that expands access to care and brings community partnerships into the equation to combat suicide, and hopefully decrease the stigma of mental injuries.

It is incumbent, therefore, on everyone working to help improve mental health care and to break through the stigma, to consider the following when debating this issue: does one answer fit all needs, or can we help veterans get better before it is too late?

For me, it is the latter. There are lives at stake, and every day that passes is another day that has taken the lives of 18 men and women who once wore our country’s cloth with pride.

Rep. Jeff Miller is chairman of the House Committee on Veterans’ Affairs.

3 comments
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Sue Frasier
Sue Frasier

The system has never made the important connection here that many of the PTSD cases who are getting through the system, are actually fraud cases or misdiagnosis cases and are not at all PTSD cases. Both the news media and the system get it wrong to assume that every PTSD claim has to do with war and deployment. In fact, it can be said that a significant amount of PTSD claims have nothing at all to do with war and deployment. On the internet, we as Activists get to see the other side of the story as the fraud cases are looking for validation and support from the rest of us. The system really does need a wake-up call on the fact that we now have alternative populations to compare to on PTSD which includes survivors of the World Trade Center and Oklahoma City. Something does NOT add up when making these important population comparisons. Miller is a civilian and not a military veteran so how would HE know anything at all???? - Sue Frasier, Army 1970, national veterans activist.

DevilDoc1
DevilDoc1

I caution your comment that "we now have alternative populations to compare to on PTSD"... I would summit that the type of PTSD that we are seeing  from these two wars is  not comparable to anything that we have seen before. The media and society are so desensitized with how our service men and women have been affected by these two wars. The fact is that the continuous stress our warriors are incurring, coupled with multiple deployments, and TBI to boot - results in a type of PTSD that has never been seen before. Perhaps it should not be called PTSD since the mechanism type is different when you get in to all the details. Albeit being traumatic - the trauma of what our warriors experienced and continue to experience in Iraq and Afghanistan is not like 9/11 or Oklahoma - althought these are very traumatic events. The length of time that the warrior experiences this trauma and the intensity is very different and has never been seen.

Bravo  Chairman Miller for your courage standing up for these issues and holding society accountable for doing everything needed to take care of our Veterans - and to never leave a Veteran behind. God Bless!

luria1
luria1

Rep Miller's comments highlight another problem: lack of coordination between DoD and VA. Congress and others have been complaining about the dearth of studies that evaluate and recommend the best programs. The Coming Home Project was actually  recently featured as among the top 8 reintegration programs in the country in an comprehensive study by the DCoE, a joint DoD and VA research body. And Coming Home Project was the only one of these 8 with significant data that also met all the DCoE criteria for best reintegration practices. 

Yet next to no one in VA, DoD or the Congress knows about this study, or is utilizing it to scale up the best programs nationwide. It is not just about a nationwide network of therapists.It is a nationwide network featuring best reintegration practices. Why is no on listening?


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