Tag Archives: VA Mental Health Care./ U.S 9th Circuit Court of Appeals Decicson on VA Health Care./ Veteran Suicides

Are Expectations For VA Mental Health Care Achievable?

Recently a federal appeals court scolded the Veterans Administration for failing to care for the returning veterans who are experiencing post-traumatic stress disorder at alarming rates that are not leveling, even with all the Outreach programs.

The U.S 9th Circuit Court of Appeals stated in a 2-1 ruling that the delays are so “egregious” that they “violate a veterans constitutional rights.”

I do not see it that way. There is little doubt that the approximately 6500 suicides a year must be addressed with urgency and budget allocations. Yet I do not see that it is the sole job of the VA to ameliorate a seeming intractable problem that is owned by the entire war making machine.

The data is showing that an average of 18 returning Armed Service members commit suicide each day.  Most folks cannot even allow this to seep into their own activities of daily living, let alone a national psyche.

The genesis of the problem is not the VA. While the Courts tried to no avail to get the VA to “work faster” in providing mental health care, I do not see how one provides “fast” mental health care.  And I do not quite grasp what the fraternal veterans organizations that filed suit two years ago are going to achieve with more pressure piled on a system that is already maxed with personnel shortages and adequately trained staff that can deal with PTSD.

PTSD is not like the flu. This syndrome begs for a degree of bonding between the therapist and client that does not suit itself to “fast” therapy.  If the ruling from Judge Steven Reinhardt and Judge Procter Hug is intended to speed up the disability claim process, I am on their side.  If the intent is to speed up mental health care, I am in opposition. Insensitive “check list” therapy can well be the cause of suicides. Many of the staff Psychiatrists and Psychologists in the nations VA Mental Health clinics have resigned prematurely and in quiet protest over the mandated 45 minutes allowed with each veteran. The VA monitors the time spent with each suffering soul. Time In, Time Out. I suggest that herein lies some of the problem with suicide prevention programs.

The slam bam thank you mam atmosphere that is created in a crisis of care and with political voyeurs looking on for their own gain of popularity is part of the zeitgeist that exacerbates the problem. This decision by the 9th Court is like sending a pregnant woman to Weight Wathchers.

The ruling goes on to state, “the VA’s unchecked incompetence has gone on long enough; no more veterans should be compelled to agonize or perish while the government fails to perfom its obligations.”    Might I simply transpose that sentence to state that the incompetence of corporate America to take up the mantle of responsibility, in the context of ungodly war profiteering, and provide the funding for private sector outreach clinics in every neighborhood and library in America.

Where is the chorus of Tea Party patriots on this, “support the troops,” issue?  Michele Bachman wants the Government out of our daily lives.  Does she have a non-federalist solution to this epidemic?

The dissenting Judge Kozinski stated, “much as the VA’s failure to meet the needs of returning veterans with PTSD  might shock and outrage us, we may not step in and boss it around.”   Why are we as a nation not shocked and outraged at the 4 and 5 tours these troops are serving? Never since the days of Continental Army have our combatants served 5 tours in defense of the country.  The Department of Defense in its back door draft, coupled with the intense ongoing need to provide bodies for the war on terror, have created a hybrid human being that is not amenable to “speeded up,” treatment regimens.

With all of the siren cries for more private sector involvement in the operation of our government, how about some tax breaks for the Halliburton Suicide Prevention Centers? Or the Blackwater Center For Transition Warriors.  They are making hundreds of millions of dollars on the backs of these suicides. This is not the VA’s problem. They are not the sole culpable party. War has many accomplices. Most as unseen as the interiority of  PTSD itself. Lets bring them into the light with some  fiscal responsibility for a ten year long war, that is not ending soon. Maybe even a few of the Swiss bank accounts for offshore corporations could be tapped when Johnnie comes marching home.

When Veterans For Common Sense and Veterans United For Truth filed suit four years ago alleging systematic failures in the processing of disability claims, they were on track. Like I said earlier, if the focus is the processing of claims, they have my undying support. I was a volunteer Veteran Service Officer, and know well the ramifications of the delays and the the unbearable burden of the soldier and their families.  The Mental Health Stategic Plan that was submitted in 2004,(seven more years of war have passed), mandated deadlines for treatment requests and benefit claims.  General Shinseki was not the head of the VA then. Those mandates have taken root.

I return to my thesis. The co-mingling of  mental health treatment and the claims process is not good problem solving.

Since the presidency of Abraham Lincoln we have afforded the legal guarantee to veterans that they will receive treatment for war wounds. Why does all that treatment have to be conducted on the grounds of  Veterans Administration? If we can farm out the work of private mercenaries, why not dole out some cotracts for mental health care?

There are 25 million veterans in the United States. 1.8 million have served in Iraq or Afghanistan in the last 11 years. And the show ain’t over. The Rand Institute study that was competed in 2008 estimated that 300,000 plus returning veterans suffer from PTSD. Think that is a big enough risk pool for a private contractor? Throw in the residual Vietnam Veterans and the lingering population of Korean War veterans who are still under Doctors orders and you have a business plan.

I travel alot. I have visited many VA Hospitals and Vet Centers. I do not see an open wound in the offering of mental health care in these facilities. Is it possible that this crisis of care is arranged so as to privatize?  Naomi Klein’s theory in her book, “The Shock Doctrine,” may apply.