As the wars continue in Iraq and Afghanistan, the Department of Veterans Affairs can be sure of something: more people will leave the military in need of long-term medical care – and long-term mental health care.
Robert A. Petzel, undersecretary for health at the VA, was in Baltimore for a meeting of mental health professionals trying to get up to speed on the latest treatments and services, and I was able to quiz him on the latest efforts to care for former service members. Joining in the discussion was Sonja V. Batten, Assistant Deputy Chief Patient Care Services Officer for Mental Health.
They told me that the agency has been working to bolster its staff of mental health professionals – adding 6,000 staffers from the field in the last four years, bringing the total to 20,673.
The VA has also added a suicide prevention hotline, which has taken 293,000 calls in the last two years, referred 35,000 callers to a suicide prevention coordinator and rescued 9,700 of those in immediate crisis.
But the number of those on active duty taking their own lives is, not surprisingly, rising. And many more are coming home from combat distressed.
For post traumatic stress disorders, almost 366,000 vets were treated in fiscal 2009. That number is also rising. There were almost 255,000 treated in fiscal 2006. Of course, during conflicts, there will be more PTSD – as estimated 30 percent of those who served in Vietnam, for example, experienced PTSD and 10 percent of those in the Gulf War did. (About 6.8 percent of Americans will experience PTSD at some time in their lives.)
Officials say a main reason the numbers are going up now is because screening has gotten better. But certainly more vets need care.
In fiscal 2009, more than 1.4 million vets received care from the VA for a mental health problem, up from close to 1.2 million in fiscal 2006.
Petzel and Batten say that the VA is screening vets when they come in to a center during their reintegration period for PTSD, alcoholism and other mental health issues. Officials are also screening vets who come in for any health issue.
They also try to reach family members who can help steer vets into care and they have been heading out into the field to find vets who may need help. That includes going to military outings, National Guard stations, reunions and even rodeos to find vets where they live.
Batten said the VA has put together a handbook that clarifies all the services offered at clinics.
Still, Petzel said, "Assessing how effective the programs are is incredibly difficult." In other words, he doesn't know who the VA is missing – and surely it's missing many. Once members of the military leave active duty, and coverage by the Defense Department, it's up to the VA to find them and treat them.
He doesn't even have accurate data on how many vets commit suicide because states don't list military status when they report the deaths.
And reaching vets once they leave urban areas with easy access to clinics is another problem. Petzel said there is an increased use of private providers and telemedicine.
"We're still not getting everyone we need to and want to," Petzel said. "There are a lot of young people who want to get back to their jobs and lives and think they are immortal and don't avail themselves to services."
But, if they do find the VA – or the VA finds them – officials say they are ready.
"The sooner you can begin to treat a person, the more likely they are to avoid social consequences, such as a disrupted marriage, loss of a job, drug use disorders," said Batten.
Think the VA is doing enough to help those who served their country? Know anyone who needs help?
The suicide prevention hotline is 1-800-273-TALK. The number to call to enroll for VA health care services in Maryland is 800-463-6295 ext 7324 or go to www.maryland.va.gov. Enrolled vets who need advice can contact the care line in Maryland 24-hours a day at 800-865-2441.
Associated Press photo of a U.S. Marine taking cover behind a Humvee in Iraq