As a U.S. Air Force veteran, past spokesperson for the U.S. Veterans Administration and Veteran Foundation’s Veteran of the Year Award recipient, I will always have unwavering regard for those who serve in the military. I also pledge to try to stay up to date on how they are being treated and compensated for their service and sacrifice.
Back in September 2022, I reported about a report published on Drugwatch, a news site that provides information about medications, medical devices and general health, disclosing that “military service members face a greater risk for hearing loss than civilians.” As reported at the time, Ed Timperlake, former assistant secretary for Public and Intergovernmental Affairs for the VA, while stating that they are still in catch-up mode, believes the VA is now doing a good job of addressing this health problem. “The Pentagon is now testing several different styles of hearing protection for troops in the field,” he says. “Confidence is high that the next generation of combat hearing protection will represent a substantial improvement.”
Then, in May 2022, I reported that, following a year of intense negotiations, members of the Senate Committee on Veterans’ Affairs came to an agreement on the PACT Act of 2022. Formally known as The Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics Act, and signed into law in August, it will now deliver health care and benefits to more than 3 million military veterans exposed to toxins while in service to their country. These are just two recent examples that highlight some of the distinct health needs of military members and their families.
Reported by The Washington Post, a recent study published in JAMA Network Open shows that up to 35% of military Tricare recipients — the health care program for uniformed service members, retirees and their families — don’t have access to adequate psychiatric care despite their coverage for such services. It is pointed out that fewer than 500 military treatment facilities provide psychiatric care, and many civilian psychiatrists don’t accept Tricare insurance.
“According to a 2021 evaluation of the program, just 37 percent of civilian behavioral health providers surveyed reported that they accepted military insurance,” writes the Post. “When the researchers applied that acceptance rate to their data, the number of beneficiaries experiencing shortages rose to 60 percent … Retirees were nearly twice as likely to experience shortages and nearly four times as likely to have no access.”
“Although more research into these disparities is needed, the researchers write, the military could respond with strategies such as satellite clinics and telemedicine. It could also raise its reimbursement rates or invest in nurse practitioners in underserved communities.”
While the response to this issue remains to be seen, NBC News reported that, thanks to a new policy and unlike for most other medical benefits, veterans now do not have to be enrolled in the VA system to be eligible for the free emergency mental health care. It is estimated that more than 18 million veterans in the U.S. could be eligible.
“Veterans who find themselves in suicidal crisis will be eligible for free emergency medical care at any Department of Veterans Affairs facility or any private facility,” reports NBC. The new VA policy includes “up to 30 days of inpatient or crisis residential care and up to 90 days of follow-(up) outpatient care … The VA will also reimburse veterans for ambulance rides to hospitals.”
Says VA Secretary Denis McDonough in announcing the new policy: “Veterans in suicidal crisis can now receive the free, world-class emergency health care they deserve — no matter where they need it, when they need it, or whether they’re enrolled in VA care. This expansion of care will save Veterans’ lives, and there’s nothing more important than that.”
According to NBC: “The VA reported that 6,146 veterans died by suicide in 2020, or an average of 16.8 per day. While that number was 343 fewer than in 2019, suicide and veterans in crisis remain the VA’s top clinical priority … Roughly 5,000 veterans are hospitalized in acute psychiatric units every month, generally at imminent risk for harm, said Cliff Smith, the director of analytics, innovation and collaboration within VA’s Office of Mental Health and Suicide Prevention … We are addressing the anxiety associated with a bill or cost. That’s off the table.” Smith is hopeful that the new policy will be “life-changing for many veterans.”
Laura Weiss Roberts is editor-in-chief for the journal Academic Medicine and author of “Military and Veteran Mental Health: A Comprehensive Guide,” recognized as an “authoritative and comprehensive dissertation” designed to “enhance best clinical practices for all healthcare providers who care for military service personnel and veterans.” In the guide’s 2022 edition, she looks at the impact “two decades of continuous war” continue to have on military personnel and veterans, while admitting that statistics fail “to capture the even greater number of family members affected by military service.”
“The most publicized mental health challenges facing veterans service members are PTSD and depression,” says Roberts, as well as other issues “like suicide, traumatic brain injury (TBI), substance abuse, and interpersonal violence can be equally harmful in this population.” Roberts describes PTSD as “a complex and evolving biological, psychological, and social entity, making it challenging to study and diagnose.”
“PTSD is often researched in war and disaster survivors but can affect anybody, including children,” she adds. “It is also possible to experience PTSD from secondhand exposure, such as learning that a close friend or family member experienced a violent threat or accident … In roughly 10 to 20% of cases, symptoms become persistent and debilitating.
Though it doesn’t get the same attention as PTSD, acute stress disorder, a form of depression, remains “one of the leading mental health conditions in the military. In fact, studies show that up to 9% of all appointments in the ambulatory military health network are related to depression … It is paramount to correctly screen for, identity, and follow through with appropriate treatments, especially in the active duty and veteran military population.”