It wasn’t so long ago that the idea of post-traumatic stress wasn’t taken seriously. From a time when troops were slapped for being “shell-shocked” and some leaders within VA were dismissive, we’ve come far. And today, expanding access to mental health care services for Veterans returning from war is a key mission for Secretary Shinseki. Those concerns have driven a fundamental shift over the last few years in how VA approaches treatment for mental health conditions like PTSD and depression.


In 2011, VA leaders and clinicians are focused on providing Veterans with the most effective treatments available—and there are effective treatments—for mental health conditions like PTSD. The Department recognizes that, despite the best training, a positive mindset, and the strongest of character, no service member is immune from the mental effects of war. Whether the injury is sustained during a mountain firefight or behind the wire of a mortar-prone forward operating base, VA knows that a war without front lines is incredibly difficult for even the most highly-trained mind to accommodate.

Therefore, VA has changed how we do business. For the past several years, the Department has worked to provide greater access by integrating mental health care into VA’s primary care setting. We’ve increased the number of Veterans Readjustment Counseling Centers (Vet Centers). And we’ve increased mental health staffing levels, to include expanding the availability of tele-mental health services and off-hours clinic appointments. With thousands of new Veterans entering the system each year, we’re committed to providing superior care that will enable Veterans to be successful. To that end, we want you to know about some of the strides we’ve made in mental health treatment during the last three years.

• In FY2010, 408,167 Veterans received specialized mental health treatment for PTSD; this number has risen each year, for example from 254,930 in FY2006.
• A main reason for this increase is proactive screening to identify Veterans who may have PTSD or who have experienced military sexual trauma and who need further evaluation and treatment planning if a diagnosis is made.

• Mental health staff levels have increased, from 14,207 in FY2006 to more than 21,000 currently.

• Expanded access is available, with longer clinic hours, tele-mental heath capability to deliver services, and standards that mandate rapid access to mental health services.

• State-of-the-art treatment, both psychotherapies and biomedical treatments, are available for the full range of mental health problems, including PTSD.

• VA offers high quality care, based on a recovery-oriented model that offers rehabilitation as well as symptomatic treatment.

• Specialized care is available for Veterans who experienced military sexual trauma (MST). All MST-related care is provided free of charge and Veterans may be able to receive this care even if not eligible for other VA care.

• VA has programs for Veterans whose mental health problems result in interactions with the Justice system.

• Mental health staff is integrated into primary care clinics (becoming Patient-Aligned Care Team sites) throughout the VA system; they assist with patient education, medication management, follow-up for full mental health evaluations and many other important functions designed to provide comprehensive mental health care.

• State-of-the-art treatments are available for Veterans with PTSD:

o Over 3,500 VA mental health professional staff have been trained to provide the most effective known therapies, Prolonged Exposure and Cognitive Processing Therapy.
o Medication treatments also are offered and may be especially helpful for specific symptoms of PTSD.
o The National Center for PTSD guides a national PTSD Mentoring program, which works with every specialty PTSD program across the country to improve care at every site.

We’ve also further integrated our substance abuse, suicide prevention, and homelessness prevention efforts more seamlessly with our overall mental health care efforts.

Now, this is not to say we don’t have a long way to go. We’re aware that some facilities still struggle with wait times. We also know that not every civilian therapist will immediately make a connection with a combat Veteran who’s never received treatment before—even though Veterans often expect it. But these are facets of the issue we’re taking seriously. Veterans are entitled to the best possible care, and we aim to provide it. We believe that if you’re not already satisfied with the care you’re receiving, you should let us know. It’s feedback from Veterans like you that helps us continually improve the services that VA provides.

Brandon Friedman is VA’s Director of Online Communications. He served as an infantry platoon leader and executive officer in Iraq and Afghanistan.

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13 Comments

  1. Paulina March 12, 2012 at 13:30

    Whether or not treatments offered are actually helpful is debatable. Is the VA doing any outreach to spouses and families, who are now also hurting? My marriage is basically over, due to my husband’s PTSD. I’m trying my little heart out, but he no longer has the ability to care or engage. The VA’s answer? An Rx for Viagra. Yeah, thanks. How do you compensate a wife whose husband can no longer feel love for her? How do you compensate the kids when Daddy can’t stand to be around them, anymore? They can’t, so they don’t even try. And we’re left with two options… a lifetime of unrelieved pain or divorce. Sigh.

  2. Andrew P Carpenter January 14, 2012 at 13:48

    I have reported my MST, TBI, and PTSD to the local VA clinic. They are no better then the meat market in San Francisco. I see my Psychologist once every 3-4 months, because of the extensive load of Vets they carry. So He told me that we cannot talk about my issues because they require more appointments and they don’t have enough personnel. So we talk about my meds and that’s it. The past and present Mental health care, sucks from my viewpoint and I hope to do better in the civilian theater…

  3. Todd Bowles November 29, 2011 at 12:15

    You MUST be joking with this PR based propaganda! If the VA is so committed to ‘quality mental health care” then why am I having to write Congressmen to ask for help just to receive the individual therapy that has been recommended for me by a VA treatment team? Why was I told, just yesterday (by the Patient Advocate at the VAMC St. Louis- JB) that I am NOT going to be provided the care that I need because….and I quote….”That’s just the way it is.”???? As a 100% S/C Veteran (70% PTSD) I get a ton of pills and the “opportunity” to sit in a cramped little room once a week to “learn” a remedial version of the exact same material that I’ve already been given! HOW, exactly, is that considered “top quality mental health care” in YOUR book???????

  4. Alan Lubke November 26, 2011 at 12:02

    Shame, shame on you for separating “Women Veterans” from other veterans in a separate paragraph in the Eligibility Handbook and for stating in that paragraph: “Women veterans are eligible for the same VA benefits as male veterans”. Please re-title the “Women Veterans” paragraph appropriately and delete the above mentioned sentence in that re-titled paragraph. Please do this with an addendum to the 2011 edition and please do so immediately!

  5. Alan Lubke November 26, 2011 at 11:45

    Shame, shame on you for separating “Women Veterans” from other veterans in the Eligibility Handbook and for stating in that paragraph: “Women veterans are eligible for the same VA benefits as male veterans”. Re-title the “Women Veterans” paragraph and delete the above mentioned sentence in that re-titled paragraph with addendum to the 2011 edition and please do so immediately!

  6. David Grooms November 20, 2011 at 17:07

    I visited the Dorn VAMC Psychiatric Facility in Columbia, SC about Noon on Friday, November 18, 2011.

    I didn’t have a watch, but I guess the receptionist probably took less than 2 minutes to put down the magazine that was being read.

    I asked the receptionist if I could see a mental health provider.

    To me the receptionist’s attitude was not appropriate, but it may have been only my opinion, because of the way I was feeling.

    The receptionist snapped that it was lunch time, and that no one would be back until after 2 o’clock. The receptionist summarily dismissed me by returning to reading the magazine that was being read when I arrived a couple of minutes earlier.

    One would have thought the receptionist would have signed me in to the clinic or place my name on a waiting list.

    I left Dorn VAMC feeling worst than when I arrived at the Dorn VAMC seeking
    help.

    I didn’t feel like waiting around for an hour and forty five minutes for VAMC Dorn lunch period to end, and to be dismissed for some other VAMC Dorn reason.

    I did not feel like returning to work, and I took vacation time to work out my problem as I have always done.

    This is not a complaint with the overall operation of the VA, but is being used by me to vent my frustrations with the hope that the experience I encountered was an isolated Incident with Dorn VAMC, otherwise this type of service to a young veteran could possibly result in an unfortunate but preventable
    incident.

  7. Richard Gill November 19, 2011 at 01:49

    Mental health problems are no where near as common as the number of claims would indicate. At least not those caused by anything to do with the crowd control exercises carried out by the military in the middle east (no they are not wars). Claiming these sorts of problems is just a scam popular among those mercenaries who were sent there (no they are not patriots, but joined the armed forces because they have the best paying jobs around). This makes most of these claims criminal acts especially since it means the VA won’t have the money to treat the veterans who were forced to serve and have legitimate health problems. If our government does ever get cleaned up this wouldn’t be a bad place for the disinfection to start.

  8. Charles T. Cauthen November 18, 2011 at 00:19

    Combat veterans, conceded to exposure of AO with PTSD should see a neurologists. Either the VA primary or phyciatrist should order it. PTSD mixed with Neuropathy is a bad situation. Harmful for the vet and anyone around him. A vet should not have to go outside the VA for treatment. Neuropathy can be treated. I wish the VA would consider looking into this. I know from experiance, I’m diagnosed with both.

  9. Blake November 17, 2011 at 18:03

    As a correction, no one can ever know what kind of capacity they have for stress or trauma as it occurs on a military or combat level, I understand this personally, and everyone’s case is different, before you have been in a firefight, or attacked, captured, etc, you can not imagine what kind of stress you can possibly handle or formulate it therafter.

  10. Blake November 17, 2011 at 17:57

    I agree that you have a very good point Amy, however I also believe that soldiers must have a high capacity for these things(trauma,stress)before being accepted into the military. I also think offering two year service contracts may help a bit with mental problems, because you would only have to deploy for a year during the two, not already dread your second deployment when your half way through your first, which isnt a happy thought when your over there doing the countrys most honorable dirty work. 11b1p 2/504 pir 82d ABN div, 06-08

  11. Humbert A Gressani November 16, 2011 at 17:18

    I have not received my last disability check

  12. Amy Megginson November 11, 2011 at 01:27

    I also would like to know what is to be done with soldiers that are incapable of following their orders due to PTSD. They are still being held accountable for their actions when they are not able to make rational decisions. I know of cases where their superiors refuse to allow them to seek medical attention and if they do go out and do so without permission, the military still holds them accountable and lists them as AWOL, even if they are Baker acted for their own safety. The regulations need to be amended so that if a medical facility deems them unfit, then can no longer be held accountable to the command in charge but rather released to the medical facility until they are deemed ready to return to their command. The command needs to have less say so over anyone that has PTSD and stop bullying helpless people with medical conditions. This is way too common and needs to be addressed immediately.

  13. Kristen Parrinello November 10, 2011 at 12:10

    This is great progress, Brandon. I also applaud the VA for seriously considering and adopting alternative therapies to heal our fellow vets. One of the issues I think we are still battling is the military’s culture on its view of illness or mental health issues as a weakness that will not be tolerated for fear of ridicule or worse. What steps is the VA taking to make a positive impact early on transitioning servicemembers?

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