It is no secret our military veterans are at risk for mental health and related conditions when they come home. This is especially the case with regard to suicide.
As my career as a suicide researcher and prevention trainer has evolved, I have become uniquely interested in helping with this problem. From 2014 to 2015 I was honored to serve as a contracted partnering researcher with the Veterans Affairs Medical Center in Dayton, Ohio, on projects concerning training VA staff on suicide prevention and in-home violence prevention practices. Among the many meaningful community-engaged experiences I have had the good fortune to participate in, this was among the most important.
In this role, I of course did not have to deal with VA care as a patient. However, my one run-in with the administration was far from efficient. This past year, the IRS was kind enough to tell me I was responsible for thousands of dollars in back taxes – an honest mistake on their end based on another honest mistake by someone on the fiscal side of the VA who completed an incorrect 2015 1099. No problem. Track down the fiscal office, provide some paper work, and get a corrected 1099. Easily fixable?
Not so! In a six-week period, I was bounced back and forth like a ping pong ball between the fiscal office in Dayton and the main VA fiscal center in Austin, Texas. Despite repeatedly providing the required documentation to both centers by email, I received repeated denials of assistance with varying excuses. Yes, they eventually got it right – at the attention of a person in the central office who eventually responded, only after my efforts to contact my “local representative” to get involved on my behalf.
Once the situation was resolved, I wondered: If this was my experience as a sub-contracted researcher, what must the bureaucratic experience be like for our actual veterans, the ones the VA system – be it fiscal, health, or other domains – are supposed to serve? Is my experience representative of how we are treating our veterans? So, I turned to the available data.
In health services research, we usually begin with patient satisfaction. In recent years, the VA has begun releasing Hospital Report Card Data, which arguably examines veteran patients’ satisfaction with service provision (broadly defined). Examine the website for yourself, and you will find a fancy web of data tables and excerpts. However, as outlined in detail in a 2016 Arizona Republic piece, the VA cannot provide clear evidence of patient satisfaction as reflected by efficiently delivered services.
What about the objective data such as wait times or turn around on calls (like mine)? Not much better, unfortunately. For example, this 2016 NPR report shows that, despite an incredible amount of federal spending, wait times to see doctors continue to grow.
Peer-reviewed journal articles, the guidepost for best scientific data, mimic the patterns reported in the media. For example, among findings reported in a recent PLoS One article comparing cancer service delivery and outcomes, VA hospitals showed some delayed service response times compared to community provider comparisons. Concerning the prominent topic at hand – mental health services (e.g. PTSD, suicide) – a recent 2017 Psychological Services article shows promise of electronically based improvements to enhance mental health service provision, although other issues such as number of available providers are also crucial to improving mental health service access and care for our veterans.
Rest assured, these examples are just a few of many that paint mixed picture at best concerning the day-to-day experience of our veterans in terms of support from the VA. Rarely do I find myself in accord with Newt Gingrich, but as reported in a December 2016 Washington Post article, he has avidly called on the new presidential administration to solve the problem of VA (and other) needless bureaucracy. After my minimally inconvenient personal experience, I cannot support this idea with any greater fervor!
So, Mr. President, I think we may have finally (hopefully) found an issue that everyone can get behind: Improve the experience and access to services – be they medical, mental health, fiscal, or any other – for our veterans. Use your ever strong presence and military-heavy cabinet to make a difference for the very men and women who ensure that America has been, is, and will continue to be “great.” Get the DOD, VA and other leadership in a room and get down to the business of streamlined, enhanced support for our veterans. You want a presidential legacy? Provide our veterans with first-rate, efficient and cutting-edge healthcare.
Reduce the bureaucratic nightmare of redundancy – never let one of our veterans feel like the ping pong ball I did for the better part of six weeks. Increase federal funding for military healthcare research and service provision. As someone who has just begun to enter the world of veterans’ mental health research, I cannot imagine a stronger domestic and military difference a president can make.