Veterans and Mental Health

Veteran heroes should be honored with access to quality medical, pharmaceutical, and psychiatric care to treat physical and mental disorders stemming from their service to our nation. Recent reforms at the Department of Veterans’ Affairs are inadequate and need to be greatly expanded.

Regardless of our political affiliation, race, income level, or age, Americans generally agree that a debt is owed to those brave men and women who have served our country in the armed services. Veterans are our heroes. Yet, too often our veteran heroes cannot avail themselves of life saving treatment. The problem is worsened by the social stigma related to mental disorders and substance abuse.

Each day, 20 veterans die from suicide most of whom have never received care from the VHA. In fact, the prevalence of suicide is twice as high among veterans as the civilian population. Opioid usage among the military is partly to blame and is progressively getting worse. The VHA’s recent attempts at reform are inadequate to address barriers to care other veterans have experienced. This must change.

To me, this issue is deeply personal. I would like to first share Sam’s story then statistical data from recent studies on veteran’s mental health which illustrate the problem.

SAM’S STORY
First is the case of “Sam.” Sam is a pseudonym for a real veteran of Operation Desert Storm of 1991 in Iraq as well as Operation Enduring Freedom of 2001 in Afghanistan. Sam approached me at a public forum in 2016 hosted by a small town in middle Georgia to share his story.

Sam said he was diagnosed with depression and Post-Traumatic Stress Disorder (PTSD) resulting first from his combat experiences in the US Army. Sam told me that he had “troubles” when returning home – nightmares about combat, difficultly keeping a job, and failed personal relationships. I learned from Sam that the effects of PTSD linger many years after their cause. Sam told me he often thought about suicide.

Sam’s depression was held in check by treatment from the VHA, but he had to physically travel a great distance from the rural area where he lived to a medical center.  He often was not able to make the trip. To make matters worse, Sam had been ostracized by his family and friends. Mental disorders and the social stigma associated with them have a hidden impact on the lives loved ones and relationships within families and communities.

Sam then told me that the system was broken and need to be fixed.  He asked me to do what I can to help other veterans in his situation.

I began to study suicide and depression among veterans. Some answers came when the Department of Veterans’ Affairs issued a report entitled Suicide Among Veterans and Other Americans 2001–2014 dated August 3, 2016. What I learned is summarized below.

Mental health disorders are proven to be associated with increased risk of suicide. Each day, 20 veterans die from suicide most of whom have never received care from the VHA. Prevalence of suicide is twice as high among veterans as the civilian population. The effect military service on suicide extends long into the future and affects women much more than men. Veterans who abuse opioids have an increased risk of suicide. And, substance abuse is progressively getting worse.

Yet, these are the steps which the VHA on their website says they are taking which I believe to be inadequate:

  • Adding a Veterans Crisis Line (Department of Veterans Affairs, US federal government, 2017);
  • Ensuring same-day access for veterans with urgent mental health needs (Department of Veterans Affairs, US federal government, 2017);
  • Using predictive modeling to determine at-risk veterans (Department of Veterans Affairs, US federal government, 2017);
  • Expanding tele mental health care (Department of Veterans Affairs, US federal government, 2017);
  • Hiring over 60 new crisis intervention responders for the Veterans Crisis Line (Department of Veterans Affairs, US federal government, 2017);
  • Building new collaborations in the community (Department of Veterans Affairs, US federal government, 2017); and,
  • Creating stronger inter-agency and new public-private partnerships focused on preventing suicide among Veterans (Department of Veterans Affairs, US federal government, 2017).

These measures undertaken by the VHA seem fine. But, they are inadequate to address barriers to care Sam and other veterans have experienced.

None of these measures help veterans physically travel to a VHA medical center. Nor do they support and educate family members of veterans who are suffering from mental health issues. Nor do they address substance abuse among veterans. Nor do they address opioid abuse among veterans. Nor do they close the gap between peacekeeping and combat operations for diagnosing PTSD and qualify veterans for VHA benefits.

But worse still, none of the measures address the root cause which is US involvement in ceaseless foreign wars which place our heroes in harm’s way. To honor our veterans, the US needs to end its bellicose global military strategy which inevitably leads to constant military operations in the interiors of other nations.

I propose the following solutions. First, raise public awareness of PTSD and substance abuse among our veteran heroes and will call for expanded services to educate family members of veterans. Next, seek measures that will assist veterans travel to VHA medical centers to receive care. Changed administrative procedures at the VHA to make it easier for veterans to qualify for veteran benefits. Close the gap between peacekeeping and combat operations for qualifying for benefits.

Ultimately, influence US defense policy to greatly reduce involvement in foreign wars in the interiors of other nations.

Our veteran heroes deserve it.

References
Department of Veterans’ Affairs. (2016). Office of Suicide Prevention. Washington, DC: US Federal Government.
Department of Veterans Affairs, US federal government. (2017, June 19). Office of Public and Intergovernmental Affairs.Retrieved from US Department of Veterans Affairs: https://www.va.gov/opa/pressrel/pressrelease.cfm?id=2807
Harris, E. &. (1997). Suicide as an outcome for mental health disorders. Br J Psychiatry.
[1] Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others. These drugs are chemically related and interact with opioid receptors on nerve cells in the body and brain. Opioid pain relievers are generally safe when taken for a short time and as prescribed by a doctor, but because they produce euphoria in addition to pain relief, they can be misused (taken in a different way or in a larger quantity than prescribed, or taken without a doctor’s prescription). Regular use—even as prescribed by a doctor—can lead to dependence and, when misused, opioid pain relievers can lead to overdose incidents and deaths. (National Institute for Drug Abuse, 2017)

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