Mental Health Intensive Case Management Program

With the end of the conflicts in Iraq and Afghanistan, many veterans are returning home suffering from Post-Traumatic Stress and Traumatic Brain Injuries (TBI). For various reasons, instead of seeking help, many self-medicate through drugs and alcohol, and lash out at loved ones. When this happens, a large percentage find themselves caught up in the already flooded legal system, further perpetuating their issues and overwhelming the system. Veteran's Treatment courts offer an alternative to traditional court procedures, closely resembling the already proven model of the Drug Courts, taking the individuals out of the legal system, and getting them the help they need to treat their problems and reintegrating back into the civilian world, instead of just pushing them through the system time and again.

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.

The first step in the process: making an appointment with your primary care physician, second, get a referral from your primary care physician to see a case worker, third, talk to your case worker about your mental health issues, fourth, getting an appointment with a mental health care doctor, fifth, attending your mental health care appointment, after you have taken all of these steps 2-7 months may have gone by. In the EBSCO article,” VA Health System and Mental Health Treatment Retention” it states,” Throughout the entire of process of trying to attain mental health care the patient (you) maybe deteriorating mentally more and more each day. It is stated in the EBSCO article “Access to VA Services for Returning Veterans with PTSD” “This is unacceptable”. We as veterans have voluntarily served our country proudly, because of this service we at times come back with one or many mental illnesses. We deserve proper mental health care that is administered in a timely and safe manner.

Both articles identify the issue of providing mental health services for veterans with an extra emphasis on those that served in Afghanistan and Iraq (OEF/OIF veterans). It is no surprise that returning veterans suffer from both visible/invisible (physical and mental) wounds. Most veterans have this “high” expectation that they are going to receive quality care from both the DoD and VA. Unfortunately reality steps in where veterans are slapped in the face because they are receiving a lack of poor quality care all while jumping through Beuracractic hoops. The challenges faced to access these services include resistance, stigma, lack of professionalism, and geographic and/or regional disparities in the distribution of services resources and/or benefits, and the system simply refusing to change.

This pilot program is required to be implemented in not less than five Veterans Integrated Service Networks (VISNs). The program includes community oriented veteran peer support networks that will provide peer-support training guidelines and the development of a network of veteran peer-support counselors that are trained and readily available to veterans. Also creation of community outreach team for each medical facility that will assist veterans transitioning into communities, establishment of an veteran transition advisory group to facilitate outreach activities, collaboration with community and government organization to help provide thorough services to veterans, and coordination with the VISNs to carry out an annual mental health summit to assess the veteran mental health programs an care and to develop new means to providing services (Clay Hunt Suicide Prevention Act, 2015). Evaluation of the community outreach pilot program is required 18 months after its initial inception and the final report is required 90 days before the dissolution. The pilot program is for a term of 3 years (Clay Hunt Suicide Prevention Act, 2015).

“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.

Outpatient rehab programs offer both drug and alcohol treatment sessions during weekdays and/or weekends. They usually take place in a doctor’s and/or psycholgists office, a community clinic, and Alcoholics Anonymous and/or Narcotic Anonymous equipped clinic. Many individuals with families prefer this type of treatment due to its scheduele flexibility and the option of continuing with their regular responsabilities at home. However, restrictions still apply as members are required to check into treatment at their allotted times for counseling and medication. Outpatient programs vary in formats and differ from levels of intensity with a vast amount of services primarily focusing on counseling and providing a network of support. For many veterans, outpatient treatments are extremely beneficial due to the fact that through counseling services they tackled post traumatic stress disorder (PTSD) which remains the primary psychological struggle for approximately 70 percent of veterans who are undergoing mental health care (U.S. Department of Veteran Affairs,

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

Being that I want to work with Veterans in the future, the approached that seemed to have a more significant over the others in this field, would be narrative therapy. Narrative therapy is a strength-based social constructive model that stresses empowerment and the inter subjectivity of the client(Day, 2009, pg. 86). This would be a great approach to use on veterans suffering from this disorder but it also depends on the gravity of their disorder. If a veteran is having severe issues, a more conventional approach might be taken like, cognitive-behavioral therapy or a collaboration of two. In narrative therapy we look for unique outcomes in people life 's that tell us about, life events and narratives that are not consistent with the person 's life story tend to be abandoned(Palgi & Ben-zra, 2010, pg. 8). These events are then used to form a new narrative

These traditional programs lacked several keys features, e.g. lack of understanding of the military culture, values, unique stressors, etc. As a result, these transitional programs were found not to be effective for service members and lacked a sense of trust and open communication between veterans and social workers. In order to improve the trust and communication between the service member and those involved with providing assistance, traditional transitional programs should be adjusted to appeal to the military population and

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 core mission of the VA’s mental health department is to focus on recovery, this means helping the veteran take charge of their treatment in order to help them live a meaningful

240.) The HUD-VA is one of the main programs that have expanded over the years that have supportive housing to end homeless population among the veterans (Tsai, Rosenheck, & Kane, 2014). This program subsidized the rent and gives vouches for the veterans with the help of a case management staff member from the VA. Also, this programs helps with clinical outcomes with substance abuse. When they are accepted in this program they receive a caseworker to help them to set up goals to figure out certain programs to come up with a treatment plan or a plan of action to get them back on their own again (Tsai, Rosenheck, & Kane, 2014). The Grant and Per Diem program uses communities by funding them by offering transitional housing for two years. Over the two years the veteran will no longer be homeless but also will learn how to attain stability in their jobs, have a steady income, advance skills, receive treatments for mental and addictive disorders, and to be have to integrate from being in the service to civilian life (Tsai, 2013). The third program that helps homeless veterans is The Healthcare for Re-Entry it helps incarcerated

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

In addition, one will conduct literature review to pinpoint evidence-base interventions from the Chronic Care and Transitional Care models. Furthermore, one will evaluate these interventions by executing a comparative analysis of Chronic Care and Transition care models improve post-hospitalization care for Veterans who are admitted into Non-VA