"Combating Issues Against Poor Military Mental Health Services"
"Studies indicate that 56% to 87% of service members experiencing psychological distress after deployment report that they did not receive psychological help" (American Public Health Association). Upon returning from war, soldiers suffer from physical injuries as well as mental injuries. Though, mental injuries are a lot less obvious than physical injuries, it is still imperative that mental illness is held in the same regard. Civilian society tends to overlook and misunderstand the magnitude of the mental warfare that resides within veterans. Universal society often sees mental illness as a weakness and ignores the fact that mental health requires professional treatment. This stigma is popular in military culture as well, as soldiers have high expectations to be mentally and physically tough. The common mental illnesses that plague the military community include PTSD (post-traumatic stress disorder), TBI (traumatic brain injury), major depression, anxiety, and suicidal thoughts. Soldiers mask these mental battles out of fear of being weak and unsuitable to serve. The mental illnesses that derive from traumatic experiences involve witnessing the death of a fellow comrade, sniper attacks, killing the enemy, bombings, as well as surprise attacks by the enemy.
Dismissing these experiences and ignoring such mental health issues, results in serious consequences for a soldier's mental state; it impedes a soldier's ability to function and rejoin civilian society. The ramifications of ignoring mental illnesses include homelessness, substance abuse, and suicide. "The average of 17.6 Veteran suicide deaths per day in 2018 was higher than the 17.5 average suicide deaths per day in 2017. In 2018, the average of 17.6 Veteran suicides per day comprised 6.5 Veterans with recent VHA use and 11.1 Veterans without recent VHA use" (U.S. Dept. 15). To prevent such tragedies among the veteran community, it is time to act and provide veterans with proper compensation for serving the United States and its citizens. Soldiers endure many hardships during combat, but keep fighting for the freedoms of the United States. Consequently, the Department of Veterans Affairs fails to provide adequate services to soldiers returning home. It is an injustice to not help returning troops, who fight to protect this country. Therefore, veterans are the most deserving of efficient mental health care as a thank you for serving in the military. The current Veterans Affairs mental health care system has many flaws. This research focuses on improving military mental health care by eliminating the wait time before receiving prompt treatment for the military, establishing a system to assist veterans transitioning back into civilian life, and increasing health care.
One of many obstacles veterans face is not receiving immediate mental health treatment due to long waiting times. These delays are attributable to the scarcity of mental health care providers, substandard appointment practices, and issues relating to the difficult transition from active military health care to veteran health care. The Department of Veterans Affairs is currently struggling to hire health care providers and retain staff. A severe shortage of health care providers is due to applicants lacking qualifications, a lack of competitive salaries, and high employee turnover. The shortage of VA staff in combination with the ever-growing patient population of veterans, also contributes to long waiting times. This is because the VA cannot meet demands for care; these gaps in vacancies cause a domino effect that leads to a lack of appointment slots. Many facilities make patients wait weeks or months to receive access to care. Another frustration in the appointment system is the complex policies and procedures. The cumbersome scheduling practices cause confusion amongst scheduling clerks and front-line supervisors. For instance, the VA policy in 2014, requires a first-time veteran to complete a comprehensive mental health examination within thirty days of submitting a request for services. However, this policy is contradictory to the Uniform Mental Health Services in VA Medical Centers and Clinics. The Uniform Mental Health Services in VA Medical Centers and Clinics require veterans to complete a comprehensive mental health examination within fourteen days of submitting a request for services. These conflicting policies are confusing to VA staff, who are uncertain when to schedule appointments for veterans. Although there are corrections to these policies since 2015, this is a prime example of how perplexing the VA mental health care system is for veterans. Military members share similar frustrations about the Veterans Affairs appointment process; the system is "burdensome" and "unsatisfying", according to one veteran, who has several negative experiences with the Veterans Affairs services (Christensen).
An additional barrier to accessing care is the transition from active military health care to veteran health care. The Department of Defense does not integrate medical records to the Department of Veterans Affairs after a soldier leaves active duty. Veterans Affairs also needs the approval of the Department of Defense to transfer medical records to the Veterans Health Administration. Accessing veteran health care is a tedious process for new veterans:
Transitioning to the VA system requires successfully completing several critical steps or "handoffs" from the Department of Defense (DoD) based providers and facilities to VA providers and facilities: enrollment in the VA system, identification of and enrollment in programs, and the successful transfer of medical records. (Evaluation of the Department of Veterans Affairs Mental Health Services)
There is a program by the name of FCRP (The Federal Recovery Coordination Program) that works with the VA and the DoD, to coordinate care for active military members and veterans. However, the failure to share medical information between the two military health care systems does not allow for the FCRP to successfully help troops. This communication barrier makes it difficult to coordinate services for military members. It increases the enrollment of similar services, and can cause patient confusion. Moreover, transitioning from active-duty health care disrupts a patient's continuity in receiving treatments, as it takes time for health care providers to become familiar with a veteran's medical history. This overwhelming transition causes veterans to withdraw from seeking care. There must be a change in improving the crossover of treatment for veterans because failure to do so leads to inadequate mental health care.
The VA and the government can implement several solutions to prevent long waiting times for care. To avoid vacancies, the VA can develop a new employee replacement planning program, improve hiring practices, and reduce employee turnover. Many psychiatrists are reaching retirement and there are fewer medical students that are specializing in psychiatry. This poor correlation is not conducive to establishing effective health care. An employee replacement plan is essential in this predicament; the VA providing financial assistance to medical students attending the Uniformed Services University can create a new line of recruitment. This satisfies not only the shortage of mental health providers but also the worries of hiring unqualifying applicants. Repairing the archaic hiring process within the VA system is critical to acquiring new staff members. The amount of time it takes for mental health professionals to formally begin work takes four to eight months in the VA. Shortening the time to hire health care professionals improves employee satisfaction and patient's access to treatment. Lastly, to reduce employee turnover the VA must offer competitive salaries, and better employee compensation. It helps retain staff and reduces burnout. Proactively implementing these strategies can eliminate the shortfall of mental health professionals in the VA.
Similarly, there are action steps the VA can implement to improve appointment practices and the transition to veteran care. Since there is extreme difficulty to acquire an appointment for veterans' services, the VA must revise its health care policies and procedures. This revision can allow for a clearer understanding of practices for VA staff and veterans. The VA also needs to develop an easier application process for veterans' mental health care. Veterans should not have to struggle and maneuver a complex system of care. It's a stressful transition from active military care; the goal of veterans' health care is to better a veteran's mental wellness, not place more stress on veterans. A strategy to combat the lengthy process of transitioning to veteran health care, is for the Department of Defense to integrate medical information with the Department of Veterans Affairs. These action steps are practical solutions to eliminating the wait time it takes for veterans to receive prompt care.
Many veterans are experiencing difficult transitions to civilian life after serving in violent war zones like Iraq and Afghanistan. According to Hooper, a Navy veteran that possesses a master's degree in social work, finds that twenty-seven percent of veterans say re-entering the civilian world is difficult and that "number increases to 44% among veterans who served in the ten years since September 11th." Veterans struggle with family reconnection, rejoining the labor force, adjusting to providing necessities, and developing structure in daily life. Veterans serve in the military for long periods of time and during these periods, veterans acclimate to the military culture. In the same regard, families of soldiers adjust to the absence of the soldier over time, so reintegrating a veteran into the family can be an issue. Veterans need to develop new skills like interviewing when returning to civilian life, since there is no previous exposure to a different career; soldiers also need to adapt to the social climate of the new position. The military is the main provider of necessities for soldiers. Such services and needs the military provides include food, housing, clothes, and medical care. It is now up to veterans to provide these necessities and services. Furthermore, military culture is known for its values of order and strong routines. It is hard for veterans to recreate the military experience in civilian society, especially in a world that does not abide by the same values as military culture. Veterans must adjust to the uncertain surroundings and create a personal routine. Additional circumstances that interfere with veteran crossover is the soldier's mental health.
On top of the external issues' veterans have, veterans must also deal with internal struggles. The mental trauma soldiers experience during active-duty results in emotional distress and makes it less likely for soldiers to successfully re-enter civilian society. Moreover, soldiers who have PTSD and acute stress experience flashbacks or haunting memories. A coping mechanism soldiers turn to is substance abuse, which affects a veteran's ability to get a job or to successfully return to education. Such stressful situations also lead to transition stress. Veterans may experience a loss of identity and purpose, strain on relationships with family and friends, little to no employment opportunities, as well as, facing challenges to rebuild a good civilian life. Transition stress can also cause homelessness and suicide; a veteran's mental wellness affects all facets of life, so it is imperative to establish a system that aids soldiers in this overwhelming transition.
There are recommendations the DoD and the VA need to consider for assisting soldiers with a seamless transition into veteran status. It is best for veterans to start planning a transition to civilian status two years prior to leaving the military. The Department of Defense does offer transition assistance programs (TAP) that assist with two-year transitions, but it is not enough; veterans are still not receiving treatment. The Department of Defense needs to strengthen these TAP programs by addressing the feedback of TAP users. Another beneficial strategy is to bring more awareness to these programs so soldiers can have an easier integration to veteran status. The veteran community needs employment services, assistance with figuring out VA programs, establishing basic life necessities, as well as counseling services. Others include family assistance services, educational services, and housing services as well. Military health care systems need to collaborate and combine these services into one program, as well as, implement feedback from veterans. This creates an adequate transition program that successfully launches veterans back into the civilian world. Although a significant part is that this program has funding to continue to successfully serve veterans.
Increasing health care funding in the Department of Veterans Affairs programs can improve veterans ' access to mental health services and the overall quality of life for veterans. Without sufficient support from the veterans' affairs mental health care system, returning soldiers battling mental illness will not seek treatment and may suffer from homelessness or alcoholism. In 2005, the U.S. federal government did not prepare for the growing number of returning soldiers with mental health conditions as they did not have sufficient funds and staff (Issues and Controversies). The government must provide veterans with high caliber services that meet the needs of the returning soldier; the government can be ahead of the curve by giving the Department of Veterans Affairs a fair fiscal year budget. The Department of Veterans Affairs budget for the 2021 fiscal year is $243 billion, which is a 10.2% increase from the 2020 fiscal year (VA Strengthens Care and Benefits for Veterans with $243 Billion Budget Request for Fiscal Year 2021). This significant increase to the Department of Veterans Affairs is extremely useful to providing veterans with quality health care services and benefits. Although the VA receives funding, it is essential that the department follows through and puts that funding to effective use by focusing on improving the veterans' mental health care system.
It is of the utmost importance that citizens advocate for and the government implements the extensive appointment wait times, so veterans can receive effective mental health care. To prevent veterans from succumbing to homelessness or suicide, it is essential that the government sets up a successful system for returning soldiers to effortlessly transition into civilian society. As the government increases the budget for the Department of Veterans Affairs, veterans can have a better quality of life by using these higher quality programs. If these efforts are put into action and the Department of Veterans Affairs adheres to these improvement strategies, the overall military mental health care system can have significant changes that enhance veterans' lives. It is only ethical that the United States government and its citizens help veterans, who take on huge sacrifices, and endure so much trauma for the sake of the nation's freedom. In President Obama's words, "Just as we have a solemn responsibility to train and equip our troops before we send them into harm's way, we have a solemn responsibility to provide our veterans and wounded warriors with the care and benefits they've earned when they come home" (Issues and Controversies).
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