7.2 Final Project-Healthcare Delivery Systems Research Paper (Mental Health Access for Veterans)
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Mental Health Access for Veterans
Karyna Valerio
1
7-2 Final Project: Healthcare Delivery Systems Research Paper
Mental Health Access for Veterans
Karyna Valerio
Southern New Hampshire
HCM-340: Healthcare Delivery Systems
Professor Catina L. Flagg
October 15, 2023
Mental Health Access for Veterans
Karyna Valerio
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The topic I chose to discuss for the assigned project is the lack of mental health access for
veterans.
Veterans are crucial to our society because they risked their lives to defend our country
and allow us to have the freedom to live day to day.
The Department of Veterans Affairs is one
of the largest and most complex agencies in the U.S. government, but unfortunately, when
veterans return home, they are not the same as when they left.
Some suffer from homelessness,
physical deformities, and mental health problems.
According to the Substance Abuse and Mental
Health Service Administration, “More than half of Veterans with a mental illness did not receive
treatment within the past year.
Additionally, more than 90 percent of those experiencing substance use disorder did not
receive treatment" (Owens, 2022).
As of 2023, the lack of mental health access for veterans in
the United States remains a pressing use, characterized by high demand, shortages of mental
health professionals, geographic disparities, stigma, and inadequate funding.
Addressing this
problem is vital to providing the care and support that veterans need and deserve.
One significant healthcare initiative addressing the lack of mental health access for
veterans in the United States is the Veterans Health Administration's "VA Mental Health
Services." The idea of providing care for veterans started during the war in 1863 due to the high
prevalence of mental health needs among veterans.
Then, by March 3, 1865, President Abraham
Lincoln signed a law establishing a national soldier and sailors’ asylum.
Many circumstances
have increased the importance of mental health for veterans, such as the mid-1960s and 1970s,
which addressed the Vietnam War and post-traumatic stress disorder.
Then, in the 1980s and
1990s, it saw an increase in the long-term and widespread impact of post-traumatic stress
disorder that affected veteran’s well-being and their reintegration into civilian life.
Throughout
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Karyna Valerio
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all these years, the VA health care system has grown from 54 hospitals in 1930 to 150 hospitals,
800 community-based outpatient clinics, 126 nursing home care units, and 35 domiciliaries.
The VA Mental Health Services initiative contains many programs and resources
designed to provide veterans with mental health care and support.
These initiatives started in
response to the recognition that many veterans, particularly those who have served in combat
zones, experience mental health challenges such as post-traumatic stress disorder, depression,
anxiety, and substance use disorders.
The key components and features of the VA Mental Health
Services include:
mental health care access
suicide prevention
evidence-based treatment
military sexual trauma support
peer support
community partnerships
research and innovation
These initiatives represent a comprehensive effort to address the mental health needs of
veterans and reduce barriers to accessing care.
It acknowledges veterans' unique challenges and
strives to provide them with the support and treatment necessary to improve their mental well-
being.
Mental Health Care Access
The VA Mental Health Services initiative ensures that veterans have timely access to
high-quality mental health care and support services, which addresses the lack of mental health
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access to veterans.
One primary goal is to expand access to mental health services by reducing
appointment wait times and offering same-day access to mental health care when needed.
They
enhance outreach, which aims to identify and reach out to veterans who may need mental health
services but have not sought help.
Outreach efforts target veterans in both urban and rural areas.
The VA facilities have implemented same-day access programs for mental health services at all
VA Medical Centers and Community Based Outpatient Clinics.
Same-day services could include
a face-to-face or virtual appointment, such as telehealth.
They also offer returned phone calls or
secure messages to answer health concerns.
They have also implemented the VA Same-Day
Scheduling Act, which improves veterans’ experiences with the VA by prioritizing customer
service.
This legislation guarantees that any veteran who makes a phone call requesting care is
guaranteed a scheduled appointment during that phone call.
Suicide Prevention
Another significant focus is preventing suicide among veterans.
This focus involves
providing immediate crisis intervention through the Veterans Crisis Line and offering ongoing
mental health care and support for veterans at risk of suicide.
This crisis line offers veterans the
chance to call, text, chat, or there is a military crisis line, and all platforms are available 24 hours,
seven days a week.
The Veterans and active-duty service members can call the toll-free number
1-800-273-8255 and press 1 to reach the Veterans Crisis Line, and all staff are trained crisis
counselors.
They can text a message to 838255 and contact someone, and veterans can utilize
the online chat, which is available to them and family through the Veterans Crisis Line website.
All responses are by professionals in real-time.
Along with the available options, the Veterans
Crisis Line also ensures the following:
Mental Health Access for Veterans
Karyna Valerio
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Conversations are confidential and anonymous, ensuring privacy for those seeking
help.
Counselors certified to talk to veterans at risk of self-harm or suicide and provide the
support they need.
Emotional support is available for a range of issues, not just suicide.
Referrals and resources are available to local VA facilities or other appropriate
resources.
Chat services are available for veterans who are deaf and hard of hearing.
Spanish-speaking language support is available.
Outreach and education to raise awareness about mental health issues and suicide
prevention within the veteran community are shared.
International access is available to international callers who may be experiencing a
crisis and are seeking support.
Evidence-Based Treatment
The VA also emphasizes the use of evidence-based treatments for mental health
conditions.
These treatments include cognitive behavioral therapy, prolonged exposure therapy,
and medication management when appropriate.
According to the U.S. Department of Veterans
Affairs, "Veterans face barriers to MH treatment, including stigma, shame, and lack of
understanding, as well as logistical barriers such as long wait times and travel distances, and
provider assumptions based on demographics" (May 2022).
These initiatives also put particular
emphasis on addressing post-traumatic stress disorders and other trauma-related conditions that
are prevalent among veterans.
This commitment to evidence-based care is rooted in providing
Mental Health Access for Veterans
Karyna Valerio
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the most effective and proven treatments to improve mental health outcomes.
Some critical
aspects of how the VA emphasizes evidence-based treatments for mental health are:
The VA promotes peer support programs, where veterans who successfully manage their
mental health conditions provide support and mentorship to fellow veterans.
The VA has developed and regularly updates clinical practice guidelines for treating
various mental health conditions based on the latest research and evidence.
Mental health providers are trained and certified in evidence-based practices.
Ongoing research and evaluations assess the effectiveness of various mental health
interventions continuously.
The National Center for PTSD, a division of the VA, is a leading center focused on post–
traumatic stress disorder.
The VA integrates mental health services with primary care, ensuring veterans receive
holistic care that addresses their physical and mental health needs.
Military Sexual Trauma Support
The VA has recognized the importance of supporting veterans who have experienced military
sexual trauma (MST).
Military sexual trauma refers to any sexual harassment or assault that
occurs during military service.
The VA has implemented a range of services and programs to
address the unique needs of these veterans, such as:
Counseling and mental health services are provided by professionals trained to address
the specific trauma-related needs of survivors.
The VA established Women Veterans Health Centers, designed to provide specialized care
for female veterans, including those who have experienced MST.
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Each VA facility has an MST coordinator who serves as a point of contact for each
veteran seeking information and support.
Specialized treatment programs such as Cognitive Processing Therapy and Prolonged
Exposure Therapy are available.
Veterans who have experienced long-term consequences from MST may be eligible for
VA disability benefits and compensation.
It is important to note that the VA's approach to supporting veterans who have experienced
sexual trauma is rooted in trauma-informed care, which recognizes the potential impact of
trauma on an individual's physical and mental health.
This approach ensures that care is
sensitive to the survivor's experiences and needs.
Peer Support
Peer support is an integral part of the VA mental health care system and provides veterans
with assistance, encouragement, and understanding from individuals who have had similar
experiences.
The following are some peer support works within the VA:
Peer Support Specialists:
The VA employs Peer Support Specialists who are veterans
and have successfully coped with their mental health challenges.
Recovery–Oriented Approach:
Peer support emphasizes hope, resilience, and the
potential for veterans to lead fulfilling lives despite their challenges.
Veteran-to-Veteran Connection:
Shared military experiences that facilitate a deeper
understanding and trust between peers.
Mental Health Access for Veterans
Karyna Valerio
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Services and Activities:
Specialists engage in various activities and services that cover
various topics, such as coping strategies, emotional regulation, and navigating the VA
healthcare system.
Peer support within the VA is vital in improving veterans' mental health outcomes.
It fosters
a sense of camaraderie, hope, and resilience, making it a valuable complement to traditional
mental health treatment and care.
Community and Partnerships
Community and partnerships are crucial to the VA to provide comprehensive care and
support for veterans.
Collaborations with various organizations and community groups help
extend the reach of the VA’s services and address the diverse needs of veterans.
Some of the
organizations that establish community partnerships and provide comprehensive support include:
Veteran Service Organizations (VSOs):
VSOs include the American Legion, Veterans
of Foreign Wars (VFW), and Disabled American Veterans (DAV).
Non-Profit Organizations:
Non-Profit Organizations include the Wounded Warrior
Project, Iraq and Afghanistan Veterans of America (IAVA), and the Elizabeth Dole
Foundation.
Veterans Affairs Supportive Housing (VASH) Program:
The VASH program is a
partnership between the VA and The U.S. Department of Housing and Urban
Development.
It provides rental assistance and case management services for homeless
veterans.
Local Veterans Service Officers:
Assist veterans accessing housing resources, including
VA benefits and housing assistance programs.
Mental Health Access for Veterans
Karyna Valerio
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These collaborations create a network of support that extends the reach of the VA’s services
and addresses the diverse needs of veterans in various communities.
Community partnerships
play a crucial role in veteran-centered care and resources.
Research and Innovations
The VA is actively involved in research and innovation to improve the healthcare and well-being
of veterans.
These efforts encompass various areas, from medical treatments to healthcare
delivery to mental health and rehabilitation.
Some notable research programs within the VA are:
VA Research and Development:
This is the central research program within the VA.
It
focuses on research to enhance the healthcare and benefits provided to veterans.
VA Cooperative Studies Program (CSP):
The CSP is a significant initiative that
conducts large, multisite clinical trials and epidemiological studies.
It is instrumental in
improving clinical practice and patient outcomes.
Rehabilitation Research and Development (RR&D):
Focuses on research related to
rehabilitation, prosthetics, and assistive technologies.
It aims to enhance the quality of
life for veterans with disabilities and develop innovative rehabilitation therapies.
Health Services Research and Development (HSR&D):
Focuses on improving
healthcare delivery within the VA.
Research areas include access to care, quality of care,
patient safety, and healthcare management.
Clinical Science Research and Development (CSR&D):
Supports research in clinical
medicine and patient-oriented research.
The program advances medical treatments,
therapies, and interventions for veterans.
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VA Million Veteran Program (MVP):
This is one of the world's largest genomic
databases, collecting genetic and health information from veterans to research genetics
and health outcomes.
These research programs play a pivotal role in advancing healthcare for veterans and
contributing to the broader medical and scientific community by generating knowledge,
evidence, and innovations.
Although mental health services for veterans are a crucial topic of discussion, giving
veterans the necessary resources often faces budget constraints and provides limited resources,
leading to insufficient care.
VA Mental Health Services funding comes from various sources,
including federal appropriations, user fees, and grants.
These resources support various mental
health programs and services within the Department of Veterans Affairs.
The primary source of
funding is federal appropriations provided by the U.S. Congress.
These funds go through the
annual federal budget process.
They are used to support the salaries of mental health
professionals, the operation of the VA medical facilities, the development and implantation of
mental health programs, and the acquisition of necessary equipment technology.
The VA also
collects user fees for certain healthcare services from veterans who are not eligible for free or
subsidized care.
These fees help offset the cost of providing mental health services to veterans.
However, many veterans are exempt from these feeds due to their income and service-connected
disability status.
In addition, the VA collaborates with various government and non-government
organizations to secure additional funding through grants and partnerships.
These grants may
support mental health initiatives, research projects, outreach efforts, and programs to address
veterans' mental health needs.
The funding required for VA Mental Health Services can vary
Mental Health Access for Veterans
Karyna Valerio
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yearly based on factors such as the number of veterans seeking care, the severity of the mental
health condition, and changes in healthcare delivery.
However, the VA ensures that resources are
efficiently and effectively used to meet the mental health needs of the veteran population.
While the VA has made significant strides in addressing the mental health needs of
veterans, several challenges and areas of improvement continue.
Despite efforts to reduce wait
times and expand access to mental health services, some veterans still face barriers to accessing
timely care.
The VA has faced shortages of mental health professionals, including psychiatrists,
psychologists, and social workers; the stigma surrounding mental health issues can discourage
some veterans from seeking help.
Despite suicide prevention efforts, suicide rates among
veterans remain a significant concern.
Veterans often present themselves with complex mental
health needs, including concurring disorders and a history of trauma.
Transitioning from military
service to civilian life can be a vulnerable period, and some struggle with mental health issues.
Also, while collaborations with community organizations are valuable, there is still room for
improvement.
Ensuring sustainable funding to support mental health services is also an ongoing
challenge.
It is important to note that the VA acknowledges and has been working to address these
challenges.
The VA continues to evolve and improve, guided by veteran feedback, research
findings, and ongoing assessments.
Nevertheless, if the lack of access to mental health for
veterans is not corrected, the effects will affect veterans, families, communities, and society.
A
few of the possible impacts could be worsening mental health outcomes.
Veterans who do not
receive timely and appropriate healthcare may experience a deterioration in their mental health
condition, resulting in increased symptoms, higher rates of suicide, and overall suffering.
Due to
Mental Health Access for Veterans
Karyna Valerio
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the effect of these circumstances, this will cause an increase in healthcare costs, which leads to
other untreated mental health issues, which often lead to other health problems, such as
substance abuse and chronic physical conditions.
Sadly, this is a domino effect.
Addressing the
lack of access to mental healthcare for veterans is morally imperative and essential for the well-
being of veterans and the community.
Our veterans have given their lives for this country, and even though they do not ask for
much in return, their mental health and safety should always be a priority.
Improving access to
mental healthcare services is crucial and ensuring they receive the support they need to have
fulfilling lives.
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References
1.
Hananel, S., Molof, D., Shahi, M., Jordan, A., & Ross, K. (2017, May 17).
The
challenges facing the Department of Veterans Affairs in 2021
.
Center for American
Progress.
https://www.americanprogress.org/article/challenges-facing-department-
veterans-affairs-2021/
2.
Veterans Affairs
.
Go to VA.gov. (2020, August 4).
https://www.va.gov/healthpartnerships/updates/vcp/08042020.asp
3.
Va.gov: Veterans Affairs
.
Evidence-Based Treatment.
(2021, August
https://www.mentalhealth.va.gov/get-help/treatment/ebt.asp
4.
Office of Mental Health and Suicide Prevention.
(2021, September).
FAQ 2021 National
Veteran Suicide Prevention Annual Report
.
2021 National Veteran Suicide Prevention
Annual Report.
https://www.mentalhealth.va.gov/docs/data-sheets/2021/FAQ-2021-
National-Veteran-Suicide-Prevention-Annual-Report.pdf
5.
Owens, S. (2022, November 8).
Supporting the behavioral health needs of our nation's
veterans
.
SAMHSA.
https://www.samhsa.gov/blog/supporting-behavioral-health-needs-
our-nations-veterans#:~:text=More%20telling%20are%20the%20numbers,disorder
%20did%20not%20receive%20treatment
.
6.
(2022, May).
Health Services Research & Development: Spotlight on Mental Health.
U.S. Department of Veterans Affairs
.
https://www.hsrd.research.va.gov/news/feature/mental-health.cfm#:~:text=Veterans
Mental Health Access for Veterans
Karyna Valerio
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%20face%20barriers%20to%20MH,provider%20assumptions%20based%20on
%20demographics
.
7.
Office of Research & Development.
(2023, September 19).
https://www.research.va.gov/#:~:text=VA%20Office%20of%20Research%20and
%20Development%20%28ORD%29%20supports,such%20as%20AIDS%2C
%20alcoholism%2C%20schizophrenia%2C%20and%20rehabilitation%20efforts
.
8.
(2023, October).
Veterans Crisis Line.
https://www.veteranscrisisline.net/?
msclkid=6b66067fe3171c2fc0af63534a12c508&utm_source=bing&utm_medium=cpc&
utm_campaign=VCL988_Search+10.01.23-
2.24.24&utm_term=veteran+hotline&utm_content=Crisis+Hotline
Mental Health Access for Veterans
Karyna Valerio
15
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