The Fight to Provide Veterans with the Best Mental Health Care Possible

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It wasn’t so long ago that the idea of post-traumatic stress wasn’t taken seriously. From a time when troops were slapped for being “shell-shocked” and some leaders within VA were dismissive, we’ve come far. And today, expanding access to mental health care services for Veterans returning from war is a key mission for Secretary Shinseki. Those concerns have driven a fundamental shift over the last few years in how VA approaches treatment for mental health conditions like PTSD and depression.

In 2011, VA leaders and clinicians are focused on providing Veterans with the most effective treatments available—and there are effective treatments—for mental health conditions like PTSD. The Department recognizes that, despite the best training, a positive mindset, and the strongest of character, no service member is immune from the mental effects of war. Whether the injury is sustained during a mountain firefight or behind the wire of a mortar-prone forward operating base, VA knows that a war without front lines is incredibly difficult for even the most highly-trained mind to accommodate.

Therefore, VA has changed how we do business. For the past several years, the Department has worked to provide greater access by integrating mental health care into VA’s primary care setting. We’ve increased the number of Veterans Readjustment Counseling Centers (Vet Centers). And we’ve increased mental health staffing levels, to include expanding the availability of tele-mental health services and off-hours clinic appointments. With thousands of new Veterans entering the system each year, we’re committed to providing superior care that will enable Veterans to be successful. To that end, we want you to know about some of the strides we’ve made in mental health treatment during the last three years.

• In FY2010, 408,167 Veterans received specialized mental health treatment for PTSD; this number has risen each year, for example from 254,930 in FY2006.

• A main reason for this increase is proactive screening to identify Veterans who may have PTSD or who have experienced military sexual trauma and who need further evaluation and treatment planning if a diagnosis is made.

• Mental health staff levels have increased, from 14,207 in FY2006 to more than 21,000 currently.

• Expanded access is available, with longer clinic hours, tele-mental heath capability to deliver services, and standards that mandate rapid access to mental health services.

• State-of-the-art treatment, both psychotherapies and biomedical treatments, are available for the full range of mental health problems, including PTSD.

• VA offers high quality care, based on a recovery-oriented model that offers rehabilitation as well as symptomatic treatment.

• Specialized care is available for Veterans who experienced military sexual trauma (MST). All MST-related care is provided free of charge and Veterans may be able to receive this care even if not eligible for other VA care.

• VA has programs for Veterans whose mental health problems result in interactions with the Justice system.

• Mental health staff is integrated into primary care clinics (becoming Patient-Aligned Care Team sites) throughout the VA system; they assist with patient education, medication management, follow-up for full mental health evaluations and many other important functions designed to provide comprehensive mental health care.

• State-of-the-art treatments are available for Veterans with PTSD:

o Over 3,500 VA mental health professional staff have been trained to provide the most effective known therapies, Prolonged Exposure and Cognitive Processing Therapy.

o Medication treatments also are offered and may be especially helpful for specific symptoms of PTSD.

o The National Center for PTSD guides a national PTSD Mentoring program, which works with every specialty PTSD program across the country to improve care at every site.

We’ve also further integrated our substance abuse, suicide prevention, and homelessness prevention efforts more seamlessly with our overall mental health care efforts.

Now, this is not to say we don’t have a long way to go. We’re aware that some facilities still struggle with wait times. We also know that not every civilian therapist will immediately make a connection with a combat Veteran who’s never received treatment before—even though Veterans often expect it. But these are facets of the issue we’re taking seriously. Veterans are entitled to the best possible care, and we aim to provide it. We believe that if you’re not already satisfied with the care you’re receiving, you should let us know. It’s feedback from Veterans like you that helps us continually improve the services that VA provides.

Brandon Friedman is VA’s Director of Online Communications. He served as an infantry platoon leader and executive officer in Iraq and Afghanistan.

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