Need For And Use Of The Department Of Veterans Affairs Mental Health Care Services
Department Of Veterans Affairs Mental Health Services: Need Usage And Access And Barriers To Care
Since Operation Enduring Freedom , Operation Iraqi Freedom , and Operation New Dawn began in 2001, 2003, and 2010, respectively, an increasing number of veterans from this era have been receiving health care services through the Department of Veterans Affairs . These services have included care to address mental health conditions that developed following their military service . The purpose of this chapter is to detail the characteristics of the OIF, OEF, and OND veteran population, describe the mental health needs that exist within this population, and explore how these veterans are using mental health services, including treatment provided by the VA and other non-VA sources of care. To address a key task in the committee’s charge, this chapter relies on its own survey to examine in depth the mental health service needs and treatment patterns for OIF, OEF, and OND veterans who are not currently enrolled to receive mental health services at a VA facility. The committee examines survey and site visit findings on the experience of veterans with VA mental health services, barriers to accessing these services, current attitudes toward VA mental health services, and the factors influencing veterans’ future use of these services. The chapter concludes with a summary and the committee’s conclusions regarding the use of VA mental health services.
The specific questions addressed in the major sections of this chapter are
Distribution Of Mental Health Service Need And Use
Estimates derived from the committee’s survey results provide insight into whether the VA is addressing the mental health care needs of OEF/OIF/OND veterans. Survey respondents, which included both users and non-users of VA services, were categorized in terms of their possible need for mental health services and their actual use of mental health services. Veterans were classified as users if they had received mental health care in the past 24 months from either the VA or from a non-VA provider. Veterans who did not receive mental health care in the past 24 months were considered non-users.
shows the results of the analyses of the need for and use of mental health services. According to above, 6 in 10 of OEF/OIF/OND veterans did not have a need for mental health services. shows that among the remaining 41 percent who did have a mental health need, over half did not seek care, while 28 percent used VA services, and an additional 16 percent sought non-VA care only. Among those who did not have a mental health need, there was negligible use of services, either VA or non-VAâthat is, there were few false positives.
Among All OEF/OIF/OND Veterans, Adjusted Odds Ratios of Having a Perceived Mental Health Care Need .
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Quick Facts About The Us Veteran Population
Veterans represent around 7 percent of the US population. Sixty-eight percent of US veterans are age 55 and older, and 23 percent are over 75 years old. As of 2016, the number of Gulf War-era veterans exceeded the number of Vietnam-era veterans. The most recent data released by the US Census Bureau estimated that there were more than 7.3 million Gulf War-era veterans, nearly 6.5 million Vietnam-era veterans, over 1.4 million Korean War veterans, and over 600,000 World War II veterans. California has the largest population of veterans in the country, followed by Florida and Texas.
Not All Veterans Served in Combat
However, it is also important to recognize that research has found that veterans who have never been deployed to war zones may have also been diagnosed with military-connected mental health conditions and physical injuries. Military training and service expose individuals to unique and heightened risk of trauma.
Watch Shannon, Navy Veteran, describe the changing nature of war and medical interventions.
Race and Ethnicity Demographics
Gender Demographics
A guide for professionals to identify women veterans within their organization, better understand the issues they face, and form strategies for more effective care.
LGBTQ+ Veteran Demographics
Estimates Based On Census Data Suggest That Long Covid Is Keeping The Equivalent Of As Many As 4 Million Working
Forget the work-from-home revolution or quiet quitting: The COVID-19 pandemics biggest impact on the U.S. labor market will be as a mass disability event. Its a shock that the economy is not well prepared to handle.
An estimated 1 in 4 COVID patients experience symptoms lasting months. In principle, not all of them should have to leave the labor force. First, they should be able to call in sick. If work-impairing symptoms persist beyond a week or two, they should have the option of requesting reduced hours or claiming short-term disability benefits. Only in severe cases, lasting several months or more, should they have to transition to long-term disability insurance.
Unfortunately, thats not how things operate in practice. Almost a quarter of US private-sector workers cant take any paid sick days. More than half have no access to short-term disability insurance, and those that do must fight to get long-COVID claims approved. Affected workers have a right to request workplace accommodations such as part-time schedules, but employers have ample leeway to deny such requests as unreasonable.
Kathryn Anne Edwards is an economist at the Rand Corp. and a professor at the Pardee Rand Graduate School.
©2022 Bloomberg L.P. Distributed by Tribune Content Agency, LLC.
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Read The Detailed Findings
AARP has a long history of supporting veterans, the U.S. military, and their families.
According to U.S. Census Bureau data, there are about 19 million veterans age 18 and older in the United States, with about 13 million age 50 and older. About six million are AARP members.
The 2022 Veterans in America Infographics provide a profile of veterans in each state, the District of Columbia, and Puerto Rico. Data for the Virgin Islands is not available in the American Community Survey . The infographics contain demographic data, and data on veterans health and well-being, including use of the U.S. Department of Veterans Affairs for healthcare services.
Methodology
The data are from the U.S. Census Bureau, 20162020 American Community Survey, five-year estimates. The data represent veterans 18 and older in the United States, including the 50 states and the District of Columbia. Data for Puerto Rico are included in a separate tabulation. Data for the Virgin Islands are not available in the American Community Survey .
The Changing Face Of Americas Veteran Population
There are around 19 million U.S. veterans as of this year, according to data from the Department of Veterans Affairs, representing less than 10% of the total U.S. adult population. Here are key facts from the VA, the U.S. Census Bureau and other sources about those who have served in the military and how this population is changing.
As U.S. demographics continue to shift, so does the makeup of the American veteran population. Pew Research Center has analyzed some of these changes using data from the Department of Veterans Affairs, the U.S. Census Bureau, the Department of Defense, Center surveys and other news reports. The 2021 and 2046 estimates of the veteran population come from projections published by the VA in 2018.
Gulf War-era veterans now account for the largest share of all U.S. veterans, having surpassed Vietnam-era veterans in 2016, according to the VAs 2018 population model estimates. VA estimates for 2021 indicate there are 5.9 million American veterans who served during the Vietnam era and 7.8 million who served in the Gulf War era, which spans from August 1990 through the present. There are also around 240,000 World War II veterans and about 933,000 who served during the Korean conflict, the VA estimates. Some veterans served through multiple eras but are counted only in their earliest era. Roughly three-quarters of veterans in 2021 served during wartime, and 22% served during peacetime.
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Million: Total Veteran Population
That’s according to the U.S. Census’ American Community Survey . The population has markedly decreased in recent years , with the decline in living World War II and Korean War vets. Veterans today make up nearly 8 percent of the nation’s adult population.
In 2016, only three states had a million or more veterans: California , Texas and Florida .
Measures Taken To Reduce The Percentage Of Homeless Veterans
38. Rapid re-housing by the SSVF
One of the recent measures on homelessness, rapid re-housing, was created by the Supportive Services for Veteran Families. Implemented by the VA, the program has already taken shape and is providing outstanding results thus far. It aims to provide housing to vets who are currently homeless, with tens of thousands of vets already seeing the benefits.
NAEH
39. How many homeless veterans have stable housing? A few, thanks to various charities
The HUD has a long-standing commitment to helping vets in need. The agency has three main programs that support this goal HUD-VASH , HPRP , and CoC .
HUD-VASH is a collaboration between the HUD and VA which combines HUDs housing vouchers with VAs supportive services to help all homeless veterans and their families.
USDVA
40. Charities provide help to different groups veterans and the homeless
Charities such as DAV help vets live a life with dignity by ensuring that they can access a full range of benefits at their disposal. Other charities that aim to help include Volunteers of America, US Vets, and IAVA.
41. VAs HCHV program is operating at over 100 sites
The VAs Health Care program for vets experiencing homelessness operates at 133 sites and includes health care services, treatments, referrals, and case management. It assesses over 40,000 homeless veterans per year and helps prevent mental disorders and a slew of other health problems among vets such as depression.
Military Wallet
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The Leading Causes Of Veteran Homelessness
6.Social isolation and lack of support are major risk factors among US vets
Research has shown that these two factors greatly increase the risk of vets going homeless. In general, veterans have low marriage and high divorce rates 1 out of 5 live alone. Without proper social support after discharge, the risk of going homeless is extremely high among vets.
NCBI
7.Veterans at greater risk of homelessness than non-veterans
A joint study between Yale University and the VA Connecticut Health Care System in 2015 found that veterans have a higher risk of going homeless than non-veterans. This disparity has declined a bit over time.
8.Veteran statistics point to substance abuse as a major factor for homelessness
Many studies have pointed the blame to substance abuse as one of the leading causes of vets being homeless. Not only that but its also a strong predictor of future homelessness, so to speak substance abuse includes both alcohol and drug abuse.
Psychology Today
9. Mental illness is yet another leading cause of despair among homeless vets
A large-scale VA study on the mental health of vets from 2012 revealed that mental disorders are common among homeless veterans. The VAs IG noted that mental illness is also a strong predictor of a vet going homeless after discharge from active duty. PTSD has been identified as the leading mental disorder among US vets. Anxiety closely follows suit.
Brainline
10. Lack of affordable housing is another major problem
City Lab
Veteran Homelessness Per State
30. California has the highest estimated number of veterans experiencing homelessness
Sunny California is sitting at the top of the list with nearly 11,000 veterans currently living without any shelter. The exact number in 2019 was 10,980, which is nearly 5 times more than the second state on the list. California also has the highest number of homeless people in the US per state.
Statista
31. Florida ranks second
The number of homeless veterans in Florida is significantly smaller than in California. In 2019, a total of 2,543 vets were counted by the authorities experiencing homelessness. Thats out of a total homeless population of just over 31,000 in Florida.
USICH
32. Texas, Washington, and Oregon follow suit
The number of vets experiencing homelessness is highest in California and Florida, with Texas coming right below them on the list. In 2019, a total of 1,806 veterans were homeless in Texas, with Washington and Oregon close behind .
Statista
33. New York and Colorado the last remaining states with over 1,000 US vets experiencing homelessness
Surprisingly, New York and Colorado are the only other states with a count of over 1,000 homeless people who have served in the Army.
Statista
34. North Dakota and Wyoming on the bottom of the list
Statista
35. North Dakota and Wyoming had the greatest decrease in homelessness among US veterans in 2018
The drop experienced in North Dakota was a massive 87.8%, far ahead of Wyoming , Kentucky , Delaware , and Washington .
Forbes
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Top 12 Veteran Reported Reasons Why They Do Not Have The Va Disability Benefits Deserved By Law
We asked 1,012 Disabled Veterans with a VA disability rating of 0% or higher about the primary reasons why they are stuck, frustrated, and underrated by the VA.
Of the Top 5 reported reasons, Mindset was the #1 overall reason, meaning Veterans mistakenly believe they dont deserve VA benefits, or that if they get benefits it will negatively impact other Veterans who need them more.
The other Top 4 reported reasons have to do with Lack of Education about the VA claim process, meaning, Veterans dont know what they dont know.
- I didnt think I deserved VA disability benefits because other Veterans are worse off than me .
- I didnt know I could file for a VA disability increase or add secondary claims, so I didnt even try .
- I wish I knew back then that I should have went to the clinic and documented my injuries. A lot easier to prove your case.
- I tried before and got denied so I quit.
- I didnt know VA disability compensation benefits existed until I left the military.
- I filed for an increase and added new disabilities with my VA representative, and they didnt know how to properly file the paperwork.
- C& P examiners were dismissive, condescending, and discouraging.
- I knew I could file for an increase but didnt know HOW to do it, so I never finished the process.
- VA doctors are not helpful. Wouldnt help with Medical Nexus Letters or DBQs.
- I was scared to tamper with my original rating for fear of a decrease in my VA benefits.
Demographics And Service Branch
This section summarizes the committee’s survey results related to the demographics of the OEF/OIF/OND cohort. presents the demographics of the OEF/OIF/OND veterans from the committee’s survey. Most OEF/OIF/OND veterans are under 50 the most common age category is 30â39 years of age, representing 35 percent of the total population. Twenty-one percent of OEF/OIF/OND veterans are female. Among the chosen race/ethnicity categories, 66 percent of the veterans in the study are non-Hispanic white 13 percent are non-Hispanic black, 12 percent are Hispanic, and the remaining 9 percent are various other races. Almost half of OEF/OIF/OND veterans have a 4-year college degree or more. Almost two-thirds are married or in a civil commitment or union , and the rest of the cohort is split relatively evenly between never married and formerly married. About three-quarters of these veterans are employed. The income of these veterans varies widely, with a similar percentage making less than $25,000 per year as there are making more than $150,000 per year. Allowing for missing responses to the survey question, 10 to 11 percent of the OEF/OIF/OND veterans surveyed do not have health insurance.
Percentage of OEF/OIF/OND Veterans Who Have a Mental Health Need by Screener and/or Received a Mental Health Diagnosis.
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Existing Data From The Department Of Veterans Affairs And The Broader Literature
As of 2015, VA data collection systems did not assess health care use patterns, which further complicates the already difficult task of predicting factors that may increase or decrease future use of VA health services . The committee notes, however, that delay-onset PTSD is one possible factor to consider when projecting the need of VA mental health services for OEF/OIF veterans in the future. The VA has seen many cases of veterans from previous eras presenting with PTSD and other mental health symptoms later in life , and the new cohort of Iraq and Afghanistan veterans may be no different. found that it often takes more than 2 years from the last deployment to seek mental health care. Furthermore, they found that there was a median lag time of 7.5 years between an initial first visit for mental health care and beginning âminimally adequateâ mental health treatment.
It is well established that young adults, especially males, tend to use heath care less in general , and therefore, because many OEF/OIF/OND veterans are males and still quite young, it is conceivable that they may now have a predisposition toward not accessing any health care services at all, including mental health care. A study by similarly found that âmen waited nearly 2 years longer than womenâ to seek mental health care, and also that younger age and racial/ethnic minority status were factors in delaying an initial mental health visit.