Assignment 4: Final Portfolio Paper

Bennett, PhD; Hilary J. Liberty, Ph 2013 107). Prior research has evaluated the prevalence of MH concerns and opportunities for treatment at various points in the military/veteran career including post deployment, among those being treated at Veterans Affairs (VA) facilities, and in the general population) (Andrew Golub, PhD; Peter Vazan, PhD; Alexander S. Bennett, PhD; Hilary J. Liberty, Ph 2013 107). The National Survey on Drug Use and Health (NSDUH) data indicate that a substantial portion of young veterans in the general population have substance use disorder (18%) or Serious Psychological Distress (SPD) (14%) (Andrew Golub, PhD; Peter Vazan, PhD; Alexander S. Bennett, PhD; Hilary J. Liberty, Ph 2013 111). All in all, the NSDUH proved to be an extremely valuable resource for this study, and indeed, the results of this analysis for unmet treatment needs have identified important directions for further research into reasons for not getting treatment, especially for SPD (Andrew Golub, PhD; Peter Vazan, PhD; Alexander S. Bennett, PhD; Hilary J. Liberty, Ph 2013 113). The Veterans Administration and National Survey on Drug Use and Health (NSDUH) are taking steps in the right direction to help our veterans with their unmet needs with substance abuse and PTSD. Some examples of improvements are, better mental health evaluations before leaving active duty, more information about military service, and tracking trends among veterans in the general population, who are not necessarily in contact with the

The VA runs the largest substance use disorder treatment program in the world. Treatment of veterans with SUDs and co-occurring psychiatric disorders is one of the following three paradigms; parallel, sequential, and integrated. Most VA programs are parallel, where the patient receives treatment for SUD in one program and treatment for PTSD in another. Many SUD-PTSD veterans may be unable to navigate the separate systems or make sense of the disparate messages about PTSD treatment and recovery. One challenge to dissemination and implementation of EBTs is that of dual disorders, particularly SUD and PTSD. These patients use costly inpatient services, tend to have frequent relapses, and are less likely to adhere to or complete treatment.

These words left the pen of judge Stephen Reinhardt two years ago from the 9th circuit court of appeals on a case of veterans against the Department of Veterans Affairs (VA); The dispute for a veterans right to healthcare is still raging. The United States is facing a larger population of veterans every year, who suffer from a number of debilitating ailments, and finding itself with less means to take care of them. The VA is allowing health assessments go unnoticed for years due to lack of funding. Without this necessary treatment veterans who suffer from mental disorders like depression, anxiety or Post Traumatic Stress Disorder (PTSD) will build up tension and develop a risk for breakdowns which can cause not only mental, but physical damage to themselves and their community. These valiant men and women deserve proper treatment by means of formal evaluation, cognitive therapy, and monitored medication. Our service members have been promised treatment and it is our obligation as a country is to ensure it is

The research is limited in that there is enough on just the narrative of substance abuse and enough research on mental illnesses, but research is limited when it comes to dual diagnoses. There are inconsistencies within the research, where researchers fail to address advocacy at the state and federal levels; therefore not addressing the snowball effect of the poor

According to the American Foundation for Suicide Prevention, (2015) veterans comprise 22.2% of all suicides. The suicide data reports of 2012 estimated 22 veterans commit suicide everyday (Kemp & Bossate, 2012). Evidence-based studies show one of the major reasons behind the large number of veteran suicides may be related to undiagnosed mental disorders such as Post Traumatic Stress Disorder (PTSD). The Department of Veteran Affairs reports, “8 percent of the five million veterans using VA care have been diagnosed with PTSD” (U.S. Department of Veterans Affairs, 2014). This gap in mental health treatment among veterans negatively affects our nation as a whole. It is our duty to implement policies that provide a better quality and quantity of mental health services for the soldiers that

“The Veterans Health Administration (VHA) is home to the United States’ largest integrated health care system” (Mason e.t. al 2016). Because of technological and medical advancement, surviving injuries from war has lead to a greater need for post deployment and discharge care. I often hear the phrase “Freedom is not free”; the mental health of our active duty soldiers and veterans is one area that ends up costing America. Some lose time with their families, some are injured physically and mentally, and some lose their lives.

Treatment for co-ocurring disorders fall under the outpatient spectrum for addiction rehabilitation, however, it is an essential and successful form of treatment specifically for veterans. For many civilians who have not been to combat it is difficult to comprehend the toxic combination of pride, anger, duty, anguish and anxiety many veterans feel after their time in the service. Consequently, adjusting back to civilian life is a difficult task to accomplish; while some veterans sustain only minor physical and psychological wounds from combat, others aren’t as lucky. As mentioned above, for veterans, PTSD is considered a mental health condition caused by the traumatic events experienced in wartime. Thus often causing veterans to drugs or alcohol to self-medicate. If left unaddressed, PTSD and substance abuse in veterans can be

Veterans are everywhere throughout the United States, but just because they are everywhere, doesn’t meant they are getting the proper care. According to the Iraq and Afghanistan veterans of America, “One in three veterans return home and suffer from some sort of mental health issue.” Their mental health issues vary from post traumatic stress disorder to anxiety and depression. The switch from fighting everyday to being home is tough for the veterans and they need to receive the proper treatment so they can possibly live a life as normal as possible. The state Department of Mental Health and Addiction Services, started a $810,000 program to support these veterans with their issues returning home. The transition is hard, not

There has been controversy about whether the U.S. Department of Veteran Affairs is taking care of their veterans or are resisting in recognizing Post-Traumatic Stress Disorder. The Union of Concerned Scientist found that the Department of Defense stated that, “The U.S. Army allegedly pressured psychologists not to diagnose Post-Traumatic Stress Disorder (PTSD) to free the Army from providing long-term, expensive care for soldiers. The Department of Veteran Affairs (VA) has also been implicated in pressuring staff to misdiagnose veterans with the aim of cutting costs” (UCS). In result of not properly diagnosing the veterans, they are left unsure why treatment

Therefore, Spelman, Hunt, Seal, & Burgo-Black (2012) recommend that the best practices for care should consist of an interdisciplinary approach involving integrated teams of primary care, mental health, and social work providers which can normalize and de-stigmatize mental health treatment. Recognizing that co-located, interdisciplinary care may not be feasible for many providers, they suggest utilizing local resources and facilitating interagency collaboration with local Veteran Centers or with the VA (Spelman et al., 2012).

The mission statement of the VA Social Workers is to eliminate significant barriers to clients in need and offer interventions for veterans and families. It is accomplished by developing and maintaining integrated, in-depth programs in patient care, research, and education (Hoffer, Elizabeth. F., Dekle, Judith. Ward., & Sheets, Carol., 2014). Its proposed 11 percent to 20 percent of Iraq, Afghanistan veterans as well as 30 percent of Vietnam vets encounter (PTSD) posttraumatic stress disorder traumatic incidents like combat can lead to PTSD, military sexual trauma of military service member, and veterans may possibly deal with depression, anxiety in addition to other mental health concerns. Vets distress from these mental health and cognitive

As awareness grows relating to the mental health problems of those who served in Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), much of the focus has been on providing adequate and effective care to the newest population of combat veterans. Although efforts have significantly increased with the employment of Evidence Based Practices (EBP) and while the Department of Defense (DOD) and the Veterans Healthcare Administration (VHA), have updated their clinical practice guidelines, barriers remain and reaching the majority of this particular population remains a challenge.

Both PTSD and substance abuse in Veterans not only affects themselves, but it also affects their families and communities (Substance Abuse and Mental Health Services Administration, 2017). The Substance Abuse and Mental Health Services Administration (2017) states that there are 3.1 million immediate family members to the veterans in the United States (Substance Abuse and Mental Health Services Administration, 2017). These family members can potentially suffer from second-hand trauma symptoms (Substance Abuse and Mental Health Services Administration, 2017). The U.S. Department of Defense and the U.S Department of Veteran’s Affairs both offer care that veterans and their families are eligible for, but a substantial number of veterans and their

These various stakeholders are all concerned about the same thing: the health and well-being of the active duty service members, reservists, and veterans. This is especially true when U.S. soldiers and veterans are unable to care for their own health due to mental illness. The existing landscape is a flawed Veterans Affairs system that many are calling for a complete overhaul. There are programs in place through the DoD that cause a “healthy soldier effect” in currently serving active duty and reservists, but this is not enough to cause a “healthy soldier effect” once they become veterans. The advantage to forming policy for veterans is to play off the current infrastructure, but the disadvantage is that the infrastructure is in dire need of assistance.

“I detached from everyone socially and emotionally. I took comfort in solitude and realized my drinking wasn 't to numb myself, it was to forget. The anathema of my actions has haunted me every day since my return. I envision the empty stare of the man I killed and the face of the mother who lost her son. It was only a few months after my return home when my family noticed the change in me and pleaded with me to visit Veterans Affairs; they saw the vacant look in my eyes. I was opposed to the idea that I needed help or that I was even ill. My first visit to the VA clinic in October 2004 involved a general practitioner asking me if I felt like hurting myself or others. His dismissive attitude made me want to change my answer. Being obstinate and adamant about not returning to the VA forced an ultimatum from my wife between her leaving, or for me to get help. Facing life alone, and in the pain I was in, I made the choice I should have made a long time ago, and that was to engage my new enemy: myself. I put my wife through years of hell that no one should do to someone they love. I returned to the VA in August of 2005. The interviews with therapists and psychologists all asking me to repeat the trauma I experienced were difficult. Being a combat veteran, it was not easy hearing that I was suffering from post-traumatic stress disorder. I thought it somehow made me less of a soldier and more of a victim. Talking to other combat veterans, it was clear that we all thought of