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VA’s 80-bed mental health facility opened June 21, 2012, in Palo Alto, California, at a time when 2.4 million service members have deployed to war zones since 2001. The psychiatric injury rate among returning veterans is nearly 40 percent according to a 2009 VA study. The suicide rate among veterans of the same group is more than twice that of non-veterans. The average wait for transitioning veterans to receive VA benefits is more than 300 days.
This Veterans Administration's 80-bed mental health facility opened June 21, 2012, in Palo Alto, California. The rate of psychiatric injury among returning veterans is nearly 40 percent, according to a 2009 VA study. The suicide rate among veterans of the same group is more than twice that of non-veterans. The average wait for transitioning veterans to receive VA benefits is more than 300 days.
Before heading out for a speech at Fort Bliss, Texas, today, President Obama signed an executive order directing the Department of Veteran Affairs to expand its suicide prevention mental health services. In addition to adding new staff for this purpose, the department will bolster its own efforts by seeking partners among local mental health professionals.

Veterans with mental health issues—including post-traumatic stress syndrome and the effects of traumatic brain injuries that have been so common in the Iraq and Afghanistan wars—complain that getting appointments with Veterans Administration mental health staff can take months. Rather unhelpful when suicide is a possibility:

Much of what's outlined in the executive order are initiatives that were previously announced earlier this summer by the VA.

Obama is instructing the VA to ensure that any veteran with suicidal thoughts is seen by a mental health professional within 24 hours—a standard already set for the VA, but which the department often fails to meet.

Suicides among combat veterans as well as active-duty personnel have been on the rise for a long time and spiked in July to their peak for the Afghanistan-Iraq period. The number of veterans of all wars who commit suicide rose to 18 a day that month. Of the 1.5 million military men and women who have left the service since the decade-long conflicts in Afghanistan and Iraq began, 425,000 are seeking treatment for mental disorders. One recent VA report concluded that 245,658 have been examined for potential PTSD.

The VA announced earlier this summer that it is adding 1,900 mental health clinicians, including psychiatrists, psychologists and social workers, to its existing mental health staff. That's nearly a 10 percent staffing increase. The problem is that there is a nationwide shortage of such professionals and the VA has had difficulties in attracting them to work for it. Since 2009, the administration has increased the mental health budget for the VA by 39 percent.

The question in the minds of many veterans is whether this will be enough. When the VA opened its new 80-bed mental health facility in Palo Alto this summer, Shad Meshad, co-founder and president of the National Veterans Foundation, said:

I’m sorry, but this is all smoke and mirrors. There are 2.4 million people who have served in these wars. There’s a tsunami of mental health issues coming and will be with us for decades. It’s great that the people who use these 80 beds have a shot. But as a country we have yet to put our arms around this problem.
While many veterans may not be happy with how things have gone regarding mental health care under the Obama administration, vice presidential candidate Paul Ryan has made it clear that veterans are just another group whose services will be put in the budget-axing hopper. The House Budget Committee, which Ryan chairs, seeks to cut $6 billion a year from the VA budget by eliminating from the rolls 1.3 veterans whose health care is now covered.  

Originally posted to Meteor Blades on Fri Aug 31, 2012 at 08:48 AM PDT.

Also republished by DKos Military Veterans, Military Community Members of Daily Kos, Mental Health Awareness, and Daily Kos.

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Comment Preferences

  •  I hope that someday these soldiers (15+ / 0-)

    get taken care of, and that they figure out how they're being used, abused, and discarded by the GOP. Republicans put on such a good show of respect for the troops, why don't they care about them when the war's over? If anything, they see the soldiers' benefits as a resource to be exploited.

    "If God dropped acid, would he see people?" -- Steven Wright

    by tytalus on Fri Aug 31, 2012 at 09:04:11 AM PDT

  •  Good things can happen as Congress in recess. (15+ / 0-)

    The Constitution allows broad authority for the Executive to implement and maintain the laws enacted by Congress.

    My desire is that the President should be using the tool of the Executive Order to assist him to bringing about the Hope & Change he promised, realizing the useless  112th Congress has no desire to accomplish ANYTHING.

    *Austerity is the opposite of Prosperity*

    by josmndsn on Fri Aug 31, 2012 at 09:18:16 AM PDT

  •  they can barely handle the cases from prior wars (10+ / 0-)

    since they have decades of ignoring PTSD diagnoses.

    Don't roof rack me bro', Now the brown's comin' down; Präsidentenelf-maßschach; "Nous sommes un groupuscule" (-9.50; -7.03) "Ensanguining the skies...Falls the remorseful day".政治委员, 政委‽ Warning - some snark above ‽

    by annieli on Fri Aug 31, 2012 at 09:26:46 AM PDT

    •  Last week I received determination for a PTSD (24+ / 0-)

      claim for my service in Vietnam (31 months in-country, Purple Heart and Bronze Star) which I submitted 19 months ago.

      During the wait time I was treated like a moocher and derelict by some of the local VA administrative staff. The psyc and medical people were wonderful but terribly undermanned and overworked. My congressman, Bob Goodlatte (R-VA6) was of no help whatsoever.

      The last few months I didn't have hope of ever making it through the process and was faced with living under a bridge. I lost my home to foreclosure 2 years ago and haven't been able to find more than odd jobs in the meantime.

      I have a college degree and 35 years of telecommunications construction experience. That entire industry has bottomed out like so many others.

      The VA needs to gear up for the coming onslaught. I've been saying this for 10 years and have witnessed the VA budget being sliced and diced all the while.

      Since WWII and Korea modern warfare has become much swifter and more lethal. Combatants are taken from one engagement to the next in record time unlike the slow progress of forces across Europe or the Pacific. There's no time to gather your thoughts or compose yourself for the coming onslaught. No time to care or mourn for your comrades.  

      Then the veteran finally makes it home and is told by the VA to just sit there and wait while we take our sweet time in determining if you were affected by your service to your country.

      It's a national disgrace the way veterans are treated.
       

      "Family, religion, friends.. these are the three demons you must slay if you wish to succeed in business." --Monty Burns

      by Gordon20024 on Fri Aug 31, 2012 at 10:07:34 AM PDT

      [ Parent ]

      •  VA funding is based on year-to-year ... (12+ / 0-)

        operating needs.  Every penny fought for with the help of the various service organizations as each year's budgets seek Congressional approval..

        This country has overwhelming historical evidence to project the additional VA needs the very moment troops are sent to war, but that funding is never provided.

        It is despicable that my fellow veterans, like yourself have to fight the battle over and over, again.

        *Austerity is the opposite of Prosperity*

        by josmndsn on Fri Aug 31, 2012 at 11:13:13 AM PDT

        [ Parent ]

        •  There was a two month period where I didn't (13+ / 0-)

          know whether I was going to kill myself or that asshole behind the counter at the VA office.

          "Family, religion, friends.. these are the three demons you must slay if you wish to succeed in business." --Monty Burns

          by Gordon20024 on Fri Aug 31, 2012 at 11:28:09 AM PDT

          [ Parent ]

          •  been there, doing that /nt (6+ / 0-)

            Don't roof rack me bro', Now the brown's comin' down; Präsidentenelf-maßschach; "Nous sommes un groupuscule" (-9.50; -7.03) "Ensanguining the skies...Falls the remorseful day".政治委员, 政委‽ Warning - some snark above ‽

            by annieli on Fri Aug 31, 2012 at 05:18:35 PM PDT

            [ Parent ]

          •  I know that feeling (9+ / 0-)

            I also was awarded 100% P&T last November.  My claim went in in 2002.  After it went to BVA I finally was able to get an attorney.  We're appealing the decision still as the VA played a little game of mixed ratings, i.e. I was 3 months in the clinic and was awarded 100% until the day of discharge then 30% until the next time in the clinic when it went up to 100% then down again to 30%, and on and on since I've been in the clinic six times now since then and they finally backdated the P&T to 07.  VA games.

            When MB wrote above about the increase in Mental Health staff I cynically thought to myself, "yea, sure, they're all going over to the VBA side to write up opinions that the vet's claims are a result of pre-service personality disorders."  But I am sure they're going to the medical side of the VA, I was just being cynical.

            I would never advise anyone to write their Congressmembers (and I had Goode VA05) because all the VA does is pull the file out of line, looks at it and writes a form letter to the Rep., then your file goes to the back of the line and the wait is even longer.  The Rep. gets a letter stating "we're working on it" which they forward to the vet and not only is nothing done, but the vet just screwed themselves.

            In any case, I too was homeless for a while, couldn't afford food at the end of the month, etc.  Some of the older Kossacks around here remember my dire straights as dKos was a couple of times, literally, my life line when I just about put a noose over my head.

      •  I am working with a vet now on a claim (6+ / 0-)

        and OMG I feel I am on a countdown.  It is ridiculous how this vet has been treated and for over 40 years,
        I am pushing very hard on this case because it has now come to life or death situation...Daily.   I have recruited several to help me just establish a percentage that is nowhere near where this vet needs to be.  100 pllus and denied so many times before I got a peek at the records and it is beyond ridiculous.   Sent home more times than I can count on suicide ideation..no intervention.

        We the People have to make a difference and the Change.....Just do it ! Be part of helping us build a veteran community online. United Veterans of America

        by Vetwife on Fri Aug 31, 2012 at 05:28:34 PM PDT

        [ Parent ]

      •  It's going to take a huge change of mind (6+ / 0-)

        You guys are expensive. Vets from the last few wars come home and need way more care than WWII and even Korea. Way more in dollars, and way more in years. It's going to take a huge change of mind for most people to see that as a good thing.

        Before helicopter evacuation, and before advanced trauma care, lots of guys with serious injuries never would have made it back at all. More injured soldiers come back alive, and soldiers come back with more severe injuries. They come back with injuries (physical and mental) that our civilian hospitals don't have any experience with. If we can't prevent a war, we damn well better be ready to pay for it.

        And, every soldier we treat today helps us learn to not only treat the next week's casualties better with improved care techniques. It helps us learn to prevent next year's casualties with improved helmets and field procedures. It even helps treatment of traffic injuries, sports medicine and basic research.

        If someone tells me the VA's too expensive, because it was already a fine size for older wars, he's telling me that too many of you made it home. And he'll know better than to tell me that again.

        Why is there a Confederate Flag flying in Afghanistan?

        by chimpy on Fri Aug 31, 2012 at 05:31:15 PM PDT

        [ Parent ]

    •  I can't tell you how much this will (6+ / 0-)

      lighten some of we advocates load and LONG
      overdue.  Thank you Mr. President.

      We the People have to make a difference and the Change.....Just do it ! Be part of helping us build a veteran community online. United Veterans of America

      by Vetwife on Fri Aug 31, 2012 at 05:24:17 PM PDT

      [ Parent ]

      •  While I'm glad of this and can only hope it (0+ / 0-)

        works out as well as you project, Amanda, I'm still appalled new cases are being created EVERY DAY in A-stan and elsewhere (female soldiers, sailors, Marines and airmen {airwomen?} being raped is not limited to deployment) while your caseload goes back to Vietnam and even WW2.

        Unlike Obamacare, which I think is a good start and will be improved, this intolerable situation has been tolerated for way, way too long.

        "I believe more women should carry guns. I believe armed women will make the world a better place. Women need to come to think of themselves not as victims but as dangerous." Anna Pigeon

        by glorificus on Sat Sep 01, 2012 at 09:44:22 AM PDT

        [ Parent ]

    •  War bonds (1+ / 0-)
      Recommended by:
      Jeffersonian Democrat

      We need war bonds. Not the kind in the old posters, but maybe a visible funding stream would help, too. The kind of bond I mean is like the kind of bond you have to get as insurance for major project. Before the first kid clears his bunk and steps onto a plane, we'd have to secure a bond to pay for his long term care. Construction and hiring could start on time, and nobody would be allowed to pretend was was cheap.

      Why is there a Confederate Flag flying in Afghanistan?

      by chimpy on Fri Aug 31, 2012 at 05:40:45 PM PDT

      [ Parent ]

  •  Thank YOU for this report , Meteor Blades ... (12+ / 0-)

    it's badly needed. Whereby it would be crucially important that Veterans, who seek help in a suicidal moment could approach any therapist of their choice free of cost.

    Often the VA clinics have, as you said, not enough personel and sometimes also inexperienced personel, which are rejected by some Veterans. The "therapy" consists of a nice advice "to go upstairs and get your meds". They pump Veterans full with medication and there are many, who feel that this is NOT what they need. The meds often create emotional imbalances that seem to rather to increase the problems than to treat it. Veterans stay for years on those meds. They are a profit making entity for the pharmaceutical industry.

    The process for getting a PTSD claim through the system is so confusing and slow that many, many claims just "get lost in the system", because in the meanwhile Veterans can get homeless, have to move to other states and the address is not fixed. Mail gets lost, what have you, any stupid thing can happen.

    If a Veteran facing homelessness tries to find a job, the outlook that he is categorized as disabled with PTSD is another draw-down for the employer. Usually employers imagine that soldiers with PTSD have drug and alcohol addiction problems and anger management problems, if it is proven to be the case or not. They don't want to hire them.

    People even within the VA and VA representatives at schools think these soldiers want to milk the system.

    Well you can imagine what that means ... you simply give up. Then if you have no job, you have no money for security deposits, rent and most probably no good credit report. Another blow. They can't find secure rental spaces to live in, get into trouble with other homeless people and there you go ...

    All that could easily be differenly organized.

    As this will be an emergency conditions to be reckoned with, if a miracle doesn't happen, there could be a statute that would demand from private therapists, psychologist to take on these cases without any cost to the Veteran or soldier.. Also social workers need to be better prepared to deal with combat veterans and all other potential problems they face.

    It is crucial that social workers get intensely involved to really find jobs for those Veterans.

    These Veterans lack ANY kind of security in their lives. I would go crazy or angry myself, if it happened to me.

    Basically there is no hope. These soldiers sacrifice twice, first to "defend" the country, then to "defend" their own survival chances.

    •  Therapists, social workers (4+ / 0-)

      I feel that anybody who becomes licensed as a psychiatrist, therapist psychologist, should be required, as part of their continuing licensing upkeep, to do pro-bono services for veterans.  If every one who has a license, or gets a license takes on at least 2 pro-bono veteran patients, it would make a good sized dent in the numbers of people being able to get help.  

      There are about 90,000 licensed psychologists in the US (as of 2009, according to APA) and about 40,000 MDs who specialize in psychiatry (AMA 2008).  Psychiatry is the 5th largest specialty for MDs.  

      Lawyers have to do some pro-bono work (or they are encouraged to) along with their CE credits.  Doctors do.  Some veterinarians do (and they all should - think of how many shelter animals or abused animals could be helped if every single vet in this country had to take on a pro-bono case once a month).  

      Then the VA could use it's funds for they physical care of more veterans, get more of them evaluated more quickly and find them a doctor to help without being dependent on only VA doctors.  Obviously, non-VA doctors would have to keep VA type records and files and deal with the VA red tape, but is that such a bad thing?  If they are helping our veterans - couldn't they live with a little extra paperwork and giving up an hour or two a week to treat a veteran?  

      "Focusing your life solely on making a buck shows a certain poverty of ambition. It asks too little of yourself. Because it's only when you hitch your wagon to something larger than yourself that you realize your true potential." - Barack Obama

      by Ricochet67 on Fri Aug 31, 2012 at 06:58:03 PM PDT

      [ Parent ]

      •  Can't speak for other states... (1+ / 0-)
        Recommended by:
        Jeffersonian Democrat

        but Ohio has  a program (OhioCares) designed to plug some of the gaps in VA care. It's run in collaboration with the VA and involves community mental health and substance abuse programs as well as private providers.

        The conventional view serves to protect us from the painful job of thinking. John Kenneth Galbraith

        by Psyche on Fri Aug 31, 2012 at 11:41:19 PM PDT

        [ Parent ]

        •  Hope every other state... (0+ / 0-)

          Either has something like that or sets one up.  Key is requiring every practitioner to contribute in some way.  

          Glad Ohio is doing something to help!

          "Focusing your life solely on making a buck shows a certain poverty of ambition. It asks too little of yourself. Because it's only when you hitch your wagon to something larger than yourself that you realize your true potential." - Barack Obama

          by Ricochet67 on Sat Sep 01, 2012 at 07:43:26 AM PDT

          [ Parent ]

  •  This order getting done is the kind of thing I (8+ / 0-)

    like to see. A lot of what O is doing is stuff where without legislation his powers are limited, that is, he has small bricks to work with, but the bricks stack up and up. Unlike the 'grandiose meteor flash arcing across the sky' sorts of Big Ideas that the Rs are talking about. Yes, this should in a perfect world have been done earlier, but it got done once the findings got made. This kinda thing happens when a large chunk of Congress decides as a matter of policy that it is important to send troops but not to care for the consequences of their doing so, or to pay for them, but somebody else doesn't forget and has O look into that smaller tool box for what is available, and gets him to do it.

  •  Very good news. Thanks, MB. n/t (5+ / 0-)

    "Southern nights have you ever felt a southern night?" Allen Toussaint ~~Remember the Gulf of Mexico~~

    by rubyr on Fri Aug 31, 2012 at 02:59:50 PM PDT

  •  Romney claim will be " Obama says vets are (3+ / 0-)

    Crazy."

    I can’t decide who’s cuter – the dead guy with the arrows in his chest, or the guy in the ditch with the seeping wound. -- Game of Thrones (Heard on Set)

    by prodigal on Fri Aug 31, 2012 at 05:01:53 PM PDT

  •  300 day-long waiting period is a travesty (4+ / 0-)

    but not all that surprising.

    My bro-in-law is an Iraq vet and another close friend is an Afghanistan vet, and they both say that, as a cost-containing measure, the DOD set up the VA in such a way to make it so difficult and annoying for vets to actually receive their benefits, that many just give up rather than deal with the headache.

  •  Good n/t (2+ / 0-)
    Recommended by:
    chimpy, Jeffersonian Democrat

    "Do what you can with what you have where you are." - Teddy Roosevelt

    by Andrew C White on Fri Aug 31, 2012 at 05:08:25 PM PDT

  •  I have a suggestion though (9+ / 0-)

    let's stop putting our young men and women in war zones to begin with.

    "Do what you can with what you have where you are." - Teddy Roosevelt

    by Andrew C White on Fri Aug 31, 2012 at 05:09:20 PM PDT

  •  Nice touch for the Veterans Day weekend (3+ / 0-)

    This darn calendar of mine is way too retro.  It keeps popping up these foreign commie holidays that have nothing to do with war.

  •  This can only save lives. (2+ / 0-)
    Recommended by:
    KayCeSF, Jeffersonian Democrat

    ( All of us 2008 majority so voted for right guy ... I say let's do that again! )

    "Four more years!" (Obama Unencumbered - The Sequel)

    by jwinIL14 on Fri Aug 31, 2012 at 05:19:16 PM PDT

  •  PLEASE distinguish VBA from VHA!!!!!!! (8+ / 0-)

    Let's just say I can speak with some 'inside' knowledge about the VA. Consider the last sentence in the caption to the picture above:

    ...The rate of psychiatric injury among returning veterans is nearly 40 percent, according to a 2009 VA study. The suicide rate among veterans of the same group is more than twice that of non-veterans. The average wait for transitioning veterans to receive VA benefits is more than 300 days.
    Yes, it's lousy that service-connected benefits (i.e., monthly disability payments) are taking so long. But the Veterans Benefits Administration - VBA - is NOT THE SAME THING as the Veterans Health Administration. The VHA is where you find the actual MH providers who offer treatment. For returning Veterans, they receive 5 years of free MH (mental health, and other) services following discharge from active duty. According to policy (and, generally speaking, practice at the 154 main medical centers and many more community outpt centers and Vet Centers), TREATMENT SERVICES can be accessed within 14 days of referral from PC or many other points of entry in the VA (e.g., OEF/OIF/OND clinics).

    Veterans more than 5 years post-honorable-discharge meeting minimum service time requirements and income levels are eligible for healthcare at the VA even if they have no service-connected disability rating. The copays for appts range from $10 to $50 for Veterans who are above the income limits; if they have insurance, the VA will try to get third party payment, yes. There are more details and nuance we could get into, but let me say this again:

    VETERANS, ESPECIALLY OEF/OIF/OND VETERANS WITHIN 5 YEARS OF DISCHARGE, DO NOT NEED TO WAIT FOR DISABILITY "BENEFITS" IN ORDER TO GET MH HELP.  Please spread the word and help clarify this all-too-often overlooked distinction.

    And, while I'm on this rant, let's be clear that combat Veterans OF ALL ERAS and Veterans dealing with military sexual trauma (MST) can get readjustment counseling services FREE at Vet Centers. This includes individual, group, couple, and family counseling.

    Go here for VA/Vet Center facility locations:
    locations nationwide

    •  And if you want to improve VBA (2+ / 0-)
      Recommended by:
      Jeffersonian Democrat, Susipsych

      You have to staff with boring old clerks and administrative management.  Not sexy.  We wouldn't want any of that bureaucratic management stuff going on and we sure wouldn't want to give anyone a raise or training or anything that might encourage retention.  These agencies just run themselves.

    •  I thought the 300 day wait (2+ / 0-)
      Recommended by:
      Susipsych, Joy of Fishes

      was VHA for an appointment.  My VBA wait was 9 years of back and forth decisions and appeals.  In any case, I've no choice but to use FMP anyway since I'm overseas (which is very difficult because the VA issues no "chip card" or anything official of any kind except the award letter and a downloadable translation of the eligibility requirements - it is extremely difficult to find a doctor who will trust it enough to treat you)

      •  sorry -- way too long (3+ / 0-)

        Yeah, the 300 days is probably a median rather than a mean statistic, and likely the time to first decision letter.  I've encountered several folks who've waited years, as you have (maybe not nine years!), to get a final decision. I can't in good conscience say that a Veteran will always get that first mental health appt within 15 calendar days, but I know that it the explicit policy and I know there is A LOT of diligent effort from front-line staff up to top mgmt to meet that expectation. The recent hiring of 1600 additional mental health staff (already largely in place, well before the stated July, 2013 deadline) is already making a difference on the ground, particularly with something called "primary care/mental health integration," where a multidisciplinary MH team directly supports a Patient Aligned Care Team (formerly known as 'primary care').

        •  Also (1+ / 0-)
          Recommended by:
          Jeffersonian Democrat

          Vets who have established care within a MH clinic can also call in every day for a "same day" appt. Vets can also come to the mh clinic and ask to see a Registered Nurse to discuss their concerns.

          As I wrote elsewhere Vets bear some responsibility for access problems when they "no show" their appts. A significant portion of my week is spent doing outreach work for missed appts. We (as providers) want vets to receive appropriate care for their MH concerns.

    •  Excellent Post/Response (2+ / 0-)
      Recommended by:
      Jeffersonian Democrat, Susipsych

      You do know you're talking about! At least today's vets are getting help for the invisible wounds of war which went (mostly) untreated in earlier generations.
      Caught early, PTSD therapy can really help. Unfortunately, I went 40 years before being diagnosed.

      Since then, I've received excellent care from the VA.

      You're a mammal, listen to your body.

      by post rational on Fri Aug 31, 2012 at 08:10:41 PM PDT

      [ Parent ]

    •  THANKS (0+ / 0-)

      You said the things that I should have said.....

  •  This just in: (4+ / 0-)
    Military hopes antidepressant nasal spray will prevent suicides

    The military is seeing unprecedented mental illness and suicide in its ranks, and is funding research to treat depression and prevent the most tragic of outcomes.

    In July, a report released by the military found that mental health disorders in active-duty troops increased 65 percent since 2000. Of the more than 900,000 diagnoses, about 85 percent included cases of adjustment disorders, depression, alcohol abuse and anxiety. This month, the Army reported 38 suspected suicides among active-duty and reserve soldiers in July, the highest monthly number of suicides since record-keeping began a few years ago.

    Col. Carl Castro, director of the Military Operational Medicine Research Program, told NBC News that the military is "leaving no stone unturned" in its hunt to find evidence-based treatments for depression and suicide. Included in its multimillion dollar research portfolio is a grant to evaluate whether a nasal spray using a fast-acting hormone could alleviate symptoms of both depression and suicidal behavior.

    http://usnews.nbcnews.com/...

    Or, we could always call off our international murder sprees. That right there is an example of evidence-based medicine.


    A child of five would understand this. Send someone to fetch a child of five. -- Groucho Marx

    by Pluto on Fri Aug 31, 2012 at 05:28:32 PM PDT

  •  Memorize this. Use it. (3+ / 0-)

    The House Budget Committee, which Ryan chairs, seeks to cut $6 billion a year from the VA budget by eliminating from the rolls 1.3 veterans whose health care is now covered.  

    If you can't support the veterans you have, don't make any new ones.

    by slackjawedlackey on Fri Aug 31, 2012 at 05:50:17 PM PDT

  •  I'm glad to hear they are upping their MH staff, (5+ / 0-)

    ... but speaking as a recent graduate of a clinical psychology doctorate program, the statement that ". . . there is a nationwide shortage of such professionals and the VA has had difficulties in attracting them to work for it" is misleading, in both my own experience and that of many of my colleagues and peers in clinical psychology (although I can't speak for social workers or psychiatrists).

    The VA would have no problem at all staffing its facilities and programs with any number of skilled, committed psychologists, if not for its longstanding and inexplicable policy of only hiring psychologists whose graduate training included an APA residency or internship.  I'm here to tell you that these APA training opportunities are few and far between, highly competitive, and usually require the grad student to move out-of-state for the duration of the internship.  There are not nearly enough such internships for any but a lucky few, and admission to such an internship is at least as much a matter of whether a given student's personal circumstances would allow uprooting one's life for a year or more as any question of merit or other measures of competitiveness.

    The rest of us, no matter our talents or accomplishments, must instead rely on internship opportunities accredited by state- or regionally-based bodies (such as CAPIC in California, which accredits the vast majority of doctoral psychology internships in the state).  The VA has long since decided that psychologists from such programs do not meet their exacting standards.  (Note: this is a separate issue completely from the question of whether a given grad school's doctoral program in psychology, as a whole, is APA-accredited - I'm referring to the field training component only).

    I and a number of my immediate peers would be delighted to work for the VA.  Concern over suicidality, substance abuse, domestic violence, and PTSD among veterans looms large among early-career psychologists of my cohort.  However, the VA will not give most of us the time of day.  No APA internship on your transcript or CV?  Don't even bother applying, no matter what school or program you attended or what references or experiences you bring to the table.  The VA won't give you the time of day.

    I had one peer in my graduating class who modified her entire doctorate program, including her dissertation requirements, specifically to try to get a post-doc position with the VA.  Instead of a Psy.D. "doctoral project," she instead ran an (IIRC) empirical study on outcomes for preventative mental health care in a veteran population.  Upon the end of her final year she flew around the country, at her own considerable expense, to interview for post-doctoral fellowship positions at five or six different VA facilities.  She did literally everything possible to try to work for the VA, even for next to nothing, because of her deep passion and commitment to helping veterans with the specific problems they face.  Her references and letters of recommendation were stellar, and her efforts were nothing short of remarkable.  Nonetheless, she got no offers.  A heartbreaking travesty.  We were all inspired by her example and pulling for her, and she couldn't get anywhere with the VA.

    When VA changes this inane policy and recognizes the wealth of passion and talent available to them in the professional psychology community, I will be more prepared to applaud their efforts to get our vets the mental health services they need.

    "I seek the truth, which never yet hurt anybody. It is only persistence in self-delusion and ignorance which does harm." --Marcus Aurelius

    by electric meatball on Fri Aug 31, 2012 at 06:16:37 PM PDT

    •  Its not the VA (1+ / 0-)
      Recommended by:
      Joy of Fishes

      Congress needs to change the law. See:

      BASIC REQUIREMENTS:  The basic requirements for employment as a VHA psychologist are prescribed by:  Public Law 96-151 codified in Title 38, U.S.C. 7402.  To qualify for appointment, all applicants for the position of psychologist in VHA must meet the following:  

      Citizenship:  Citizen of the United States

      Education: (1)  Have a doctoral degree in psychology from a graduate program in psychology accredited by the American Psychological Association (APA).  the specialty area of the degree must be consistent with the assignment for which the applicant is to be employed.

         AND

      (2) Have successfully completed a professional psychology internship training program that has been accredited by APA.        Exceptions: (1) new VHA psychology internship programs that are in the process of applying for APA accreditation are acceptable in fulfillment of the internship requirement, provided that such programs were sanctioned by the VHA Central Office program Director for Psychology and the VHA Central Office of Academic Affiliations at the time that the individual was an intern a

      I think the lesson for the psychology graduate students is to compete for the internship training programs at the various VA's

      Otherwise pick up an ADN or LICSW certification and enter the system that way.

  •  It's called LEADERSHIP and COMPASSION (1+ / 0-)
    Recommended by:
    Jeffersonian Democrat

    Everyone is crying out for peace; no one's crying out for justice...

    by mojave mike on Fri Aug 31, 2012 at 06:31:14 PM PDT

  •  Anyone else catch PBO at Fort Bliss? (1+ / 0-)
    Recommended by:
    Jeffersonian Democrat

    He gave a simply amazing and powerful speech to the troops there. As I was watching and reflecting upon Rmoney and the Boy Wonder's performances at the RNCC I couldn't stop thinking, "Those two clowns don't measure up to this President's shoelaces."

  •  Thanks POTUS Barack Obama - for doing the (1+ / 0-)
    Recommended by:
    Jeffersonian Democrat

    right things.

    (and you too MB - for keeping U.S. informed)


    Mitt Romney was CEO of Bain until Aug 2001. Proof of Bain & Romney Fraud

    by laserhaas on Fri Aug 31, 2012 at 07:45:50 PM PDT

  •  I bet he thinks this is being progressive. (0+ / 0-)

    A real Democrat would be demanding that no veteran would be sleeping on the streets.  Apparently Obama is fine with that, as long as their suffering does not make them suicidal.  How about we offer our vets a guarantee of three hots and a cot, other than prison.  Yes, yes, I know.  We should be so thankful when President Obama throws us a few breadcrumbs, instead of throwing us under the bus.

    Fortunately, I live in Washington State, one of the few states that have no effect on the selection of our dictator in chief.  I can safely write-in Howard Dean or Bernie Sanders, and never worry that voting my conscience will let Bishop Willard get his hands on the wheel of state.

    Workers of the world, unite! You have nothing to lose but your shackles. It is by the picket line and direct action that true freedom will be won, not by electing people who promise to screw us less than the other guy.

    by rhonan on Fri Aug 31, 2012 at 09:24:21 PM PDT

    •  There is a program (0+ / 0-)

      Called Health Care for Homeless Veterans. Their mission is to helpveterans access services to get off the street.To enter the program al they have to do is contact their local VA and ask for MH to schedule an intake appt.

      I can speak from personal experience that as a group VHA professionals work every day to remediate homelessness.

  •  and what the President could do in addition ... (1+ / 0-)
    Recommended by:
    Joy of Fishes

    all those formerly enlisted Veterans, who went into the military with no college education, and often have no family support or lost the support due to their anger management problems they have, not only do they need the psychological support from social workers and therapists, but logistical help to manage the combination of going to school on their post 9/1 GI bills and needing work to make enough money to pay for housing, food and gas and computer with internet connection. (all a must-have to go to school, if you don't live with your parents).

    The housing problem can be overwhelming for a Veteran, because they don't have enough skills to find a job, and in order to gain skills through school, they need according to the rules of the post 9/11 GI bill take a full-time class load.
    That prevents them to work any full-time job, which they don't even find. The living allowance is not enough and not paid out on a full amount monthly basis to secure the rent.

    Two month of each semester the living allowance is pro-rated according to how many days in the months the school classes take place. In the summer you would have to take four classes as well to be eligible for the living allowance. That is a course load few academically weak Veterans can manage, because they have only highschool education and then lots of hard work in the military and with years and years away from any "book education".

    Instead of paying the living allowance directly to the Veterans and leave it up to them to find housing, there could be a regulation that would force the schools to provide the (very few) post 9/11 GI bill Veterans (only 10-15 percent use it) on-campus housing for the Veterans and get paid by the VA directly for room and board. I do believe that would even be cheaper for the VA and it would be a secure "income" to the schools and it would take the pressure of the Veterans to "deal with all the logistics of surviving" without a job and without professional credentials. At least I could imagine it would be a solution to encourage more Veterans to actually use their GI bills.

    To an outsider like me, who watches in amazement the spaghetti mess of rules the VA came up to manage their support for Veterans, it seems that somehow for whatever reason they never seem to use a simple, straight forward solution to a problem, if they can make it complicated, non-transparent and for each state and school different. You really ask yourself sometimes why that is. To me it's incomprehensible.

  •  Have to call a foul... (1+ / 0-)
    Recommended by:
    Joy of Fishes

    If a veteran calls the crisis line it generates an automatic consult for mental health services.  (800 273 8255)

    If a vet presents at an ED for a VAMC and reports suicidal or homicidal ideation they will be seen and evaluated by a psychiatrist in the ED. As a psychiatric nurse (and a vet) a large portion of my job is triaging and creating access to care for vets.

    Sometimes veterans are their own worst enemy. If they schedule an appt and "no show" or "cancel" that is lost access to services for other vets.

    Ryans cat 7/8 cuts are not going to pass.

    Frankly one strategy to reduce medicare costs is to allow reservists and guardsman to enter the system at medicare age AND allow VA to bill medicare.With 26 million vets that would yield real medicare savings. VA services are delivered at about 2/3 the cost of FFS medicare.

  •  gotta say, though (0+ / 0-)

    it sure costs a lot to take care of those 1.3 veterans...

    when I see a republican on tv, I always think of Monty Python: "Shut your festering gob you tit! Your type makes me puke!"

    by bunsk on Sat Sep 01, 2012 at 09:19:31 AM PDT

  •  I was a patient in an Army hospital for nearly (0+ / 0-)

    a year back in '68. It was built as a "temporary structure" at the start of WWII, supposed to last for no more than 10 years. I believe some of it is still being used.

    When I was able to start PT, I often passed mental health patients in the miles of hallways, strings of blue pyjama clad kids holding onto one another in an irregular line with an Army medic to guide them. I was tole they had trouble walking because they were shot full of thorazine...their irregular gait was called the Thorazine Shuffle.

    ANYTHING that our President can do to improve treatment of military and/or veterans with mental problems is long overdue and more than welcome.

    My guess is that the GOP would hate this and would probably end it if they came  to power again.

    mark

    Retired AFSCME Steward and licensed gun carrying progressive veteran.

    by old mark on Tue Sep 04, 2012 at 12:02:50 PM PDT

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