A Gap in Equity Related to Mental Health Access for Veterans

A GAP IN EQUITY RELATED TO MENTAL HEALTH ACCESS FOR VETERANS

JAMES HALSTEAD

HCM 340 MILESTONE ONE

SNHU

PROFESSOR DAVIS

Abstract

As an active duty service member, with 24 years of continuous service, topics involving veterans become very personal. I joined the Navy in August of 1994 during the heart of Operation Uphold Democracy. This choice was made willingly due to the depth in which my family has served the U.S. military for over 200 years. Every generation of my family has provided at least one if not more members to serve in the military since the Revolutionary War. Regrettably, I will most likely be the last to do so due to how this country treats our military. My family has collectively come to this decision due to the toile it's taken on us. I’m a combat veteran, a patriot and a Special Operations member.  I suffer from Post-Traumatic Stress Disorder.

EQUITYAND MENTAL HEALTH ACCESS FOR VETERANS

"You cannot qualify war in harsher terms than I will. War is cruelty, and you cannot refine it, and those who brought war into our country deserve all the curses and maledictions a people can pour out. I know I had no hand in making this war, and I know I will make more sacrifices to-day than any of you to secure peace." ― William T. Sherman, Memoirs of General W.T. Sherman

THOSE WHO SERVE

For you grasp the information within this paper, you must first have some facts to base your own opinion. According to the Defense Manpower Data Center (DMDC) a body of the Department of Defense, As of Jan. 31 there were close to 1.4 million active duty service members. That means that 0.4 percent of the American population is active military personnel. According to the Department of Veterans Affairs (VA), As of 2014, there were 22 million military veterans in the U.S. population. If you add their figures on veterans to the active personnel numbers mentioned above, 7.3 percent of all living Americans have served in the military at some point in their lives. Only 2 million veterans and about 200,000 current personnel are women. Overall 1.4 percent of all female Americans have ever served in the armed services, compared to 13.4 percent of all male Americans. The U.S. Census reports that the current population of the United States is 327,079,855 million. That number fluxgates due to birth happen every eight seconds, a death occurs every ten seconds, and one international immigrant is gained every twenty-nine seconds. That means there is a net gain in population every eighteen seconds.  

THE PROBLEM

The equity gap starts with insufficient mental health care for veterans who served in Iraq or Afghanistan with significant depression or post-traumatic stress disorder. One in four exhibits symptoms of substance abuse disorder. PTSD, which usually begins to take effect after a veteran has been home for three to four months, is firmly connected to traumatic brain injuries, another significant mental health concern among veterans. Despite this known prevalence of mental illness among veterans, half of the veterans who require mental health treatment will not receive it due to many factors reported by the United States Government Accountability Office, including:

• Personal embarrassment about service-related mental disabilities
• Long wait times to receive mental health treatment
• Shame over needing to seek mental health treatment
• Fear of being seen as weak
• Stigma associated with mental health issues
• A lack of understanding, lack of awareness about mental health problems and treatment options
• Logistic problems, such as long travel distances to receive this type of care
• Concerns over the veteran psychological health treatment offered by Veteran's Affairs
• Demographic barriers and false perceptions based on these demographics such as age or gender

Post-traumatic stress disorder (PTSD) can occur after you have experienced trauma. Trauma is defined as a shocking and dangerous event seen or experienced. Going through trauma is not rare in fact in today's society it's prevalent. About 6 of every ten men (or 60%) and 5 of every ten women (or 50%) experience at least one trauma in their lives. Women are more likely to experience sexual assault and child sexual abuse. Men are more likely to suffer accidents, physical assault, combat, disaster, or to witness death or injury.

Among Veterans who use VA health care, about 23 out of 100 women (or 23%) reported sexual assault when in the military. 55 out of 100 women (or 55%) and 38 out of 100 men (or 38%) have experienced sexual harassment when in the military. That's only the number of reported incidents. The number of veterans with PTSD varies by service era Operations Iraqi Freedom (OIF) and enduring freedom (OEF): about 11-20 out of every 100 veterans (or between 11-20%) who served in OIF or OEF have PTSD in a given year. Gulf war (Desert Storm): about 12 out of every 100 gulf war veterans (or 12%) have PTSD in a given year. As we break this down, 11-20% of all veterans are reported are diagnosed with PTSD out of the 0.4% who serve. This is why there is a gap in equity. The number is so small that it is less than the number of deaths caused by heart disease in the U.S. each year which is 1 in 4 adults. While both are preventable and treatable, mental illness goes unnoticed unless there is a shooting or act of terror.

Most veterans use the VA for healthcare because it is relatively cheap, the clinicians understand the military jargon which makes translating the cause of injury more natural, and because we the veterans earned the right to be cared for by the government after giving so much. The location of VA facilities may not be convenient for the care needed, however. For veterans living in rural communities, access to medical care particularly mental health care can be a challenge. The Veterans Health Administration (VHA) Office of Rural Health reports some "important barriers" that rural veterans face, including long distances to Department of Veterans Affairs (VA) facilities, lack of specialty and urgent care within rural VA facilities, and shortages of healthcare providers. Such barriers can adversely affect the health of rural veterans, who typically report lower health-related quality of life than veterans living in urban areas.

The quality of care that is provided the VA is only as good as the organization providing it. As seen in the news lately, the VA has under the gone massive structure and policy changes due to the nature of care provided to our heroes. I don't know of many hospitals that had a six-month wait for care. The unfortunate deaths of veterans who were waiting for care did an excellent service by shedding light on this issue as well as others. "Hundreds of thousands of veterans listed in the Department of Veterans Affairs enrollment system died before their applications for care were processed, according to a report issued Wednesday. The VA's inspector general found that out of about 800,000 records stalled in the agency's system for managing healthcare enrollment, there were more than 307,000 records that belonged to veterans who had died months or years in the past. The inspector general said due to limitations in the system's data, the number of records did not necessarily represent veterans actively seeking enrollment in VA health care. In response to a request by the House Committee on Veterans Affairs' to investigate a whistleblower's allegations of mismanagement at the VA's Health Eligibility Center, the inspector general also found VA staffers incorrectly marked unprocessed applications and may have deleted 10,000 or more records in the last five years (CNN)".

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