Dayton Daily News

Half of post-9/11 vets lack mental health care

New report recommends changes at VA.

- By John Tozzi

About half of U.S. veterans who served during the wars in Afghanista­n and Iraq don’t get the mental health care they need, according to a new report that recommends changes to improve the care delivered by the Veterans Affairs health system.

While many veterans receive good mental health care through the VA, it’s inconsiste­nt across the system, according to the report from the National Academies of Sciences, Engineerin­g, and Medicine-nonprofit institutio­ns that inform public policy. The detailed, 439page assessment of the VA’s mental health services was ordered by Congress in 2013 and completed by a committee of 18 academics.

Veterans who seek help for post-traumatic stress disorder, substance abuse, depression or other mental health conditions can be stymied by the VA’s bureaucrac­y or short-staffed clinics and hospitals. Other factors such as lack of social support, distance and fear of revealing a mental health issue may discourage veterans from seeking care at all.

The VA has had persistent problems trying to care for the more than 4 million service members who have left duty since the start of the U.S.’s 16-year war in Afghanista­n. Those who served in Iraq and Afghanista­n-in an all-volunteer military-often did multiple tours, with longer deployment­s and less time at home, compared with earlier conflicts, the report notes.

The stresses of that service have been evident for years. In 2014, the suicide rate among veterans was about 22 percent higher than among adults who had not served in the military, the VA reported in September.

While some of the VA’s larger difficulti­es with providing care have been widely reported, the new report reveals some lesser-known hurdles. Researcher­s found that one seemingly mundane issue-parking-was a problem at almost all of the medical centers they visited. Veterans seeking mental health care were often late for appointmen­ts and stressed from looking for a spot. “You spend the first 15 minutes diffusing [sic] them from the frustratio­n with the parking situation,” one unidentifi­ed VA clinician in San Diego told the researcher­s. “You haven’t even started the therapy. The parking is a nightmare.”

Qualified staff in rural areas is hard to find. “There’s a lot of burnout.”

There’s no quick fix to the problems faced by the VA in providing sufficient mental health services. Breaking down barriers to care will require reaching out to veterans and streamlini­ng applicatio­n processes, as well as investment­s in the VA workforce, facilities and technology, according to the report.

If the VA can better connect patients in need with high-quality mental health care, it could serve as an example for the rest of the country, the authors write. The VA “is positioned to inform and influence how mental health care services are provided more broadly in the U.S.,” the report states.

The committee recommende­d the VA develop a plan to deliver reliable, high-quality mental health care throughout its system in three years to five years. That time frame is “an optimistic goal,” said Emily Blair, manager of military and veterans policy at the National Alliance on Mental Illness, a nonprofit advocacy group.

Veterans are often confused as to how to get benefits, unsure whether they’re eligible or frustrated by red tape, she said.

Veterans Affairs Secretary David Shulkin, the former health-care executive whom President Trump picked to lead the agency, has pledged to seek “major reform and a transforma­tion” of the VA.

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 ?? VICTOR J. BLUE / BLOOMBERG ?? David Shulkin, secretary of U.S. Veteran Affairs, has pledged to seek “major reform and a transforma­tion” of the VA.
VICTOR J. BLUE / BLOOMBERG David Shulkin, secretary of U.S. Veteran Affairs, has pledged to seek “major reform and a transforma­tion” of the VA.
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