VA Mental Health System Prof

VA Mental Health System

Prof name

The Veterans Health Administration, a department under the direction of the executive branch of the United States federal government, bills itself on its website that it is the largest integrated healthcare system in the country, home to some 152 medical centers and almost 1,400 community-based outpatient clinics. According to the department's own statistics, there are more than 53,000 independent licensed healthcare providers who successfully provide all-inclusive and competent care to the nation's more than 8.3 million veterans each and every year. But do they? Statistics independent of the government tell a startlingly different story.

Financed almost entirely out of taxation from the general public, the Veteran's Health Administration (VHA) can be viewed as a sort of comprehensive health care system focused solely on veterans at the expense of the general American public. Of particular concern are the nation's veterans with mental health issues, a not uncommon occurrence as a condition subsequent to the nature of their jobs.

Adam Oliver avers that by the early 1990s, the VHA had developed a dubious reputation for delivering not only limited, but poor-quality healthcare to the nation's veterans (5). The collective national disgust and accompanying public outcry with which our nation's veterans were being treated led to expansive healthcare reforms.

By 2005, the VHA had ostensibly improved in its delivery of healthcare, as evidenced by the fact that its overall performance exceeded that of the rest of the national healthcare system (Oliver 5).

The U.S. VHA is divided into 21 Veterans Integrated Service Networks, known as VISNs, which operate as local healthcare systems under the theory that the community-based models can better meet local health care needs and provide greater access to individualized care, particularly with respect to those veterans suffering from mental health issues (Greenberg et al. 1013).

By way of comparison, the studies performed by Oliver's research shows dismal figures when compared to other governmental-run medical programs and especially incongruent figures when compared to private healthcare programs. For those veterans treated for mental health issues, within thirty days after such treatment, 70% needed follow-up inpatient treatment for their condition (12). Surprisingly, in the commercial sector, the figure rose to 76%, though one could convincingly suggest this higher figure is more likely the result of private hospitals wanting to charge for such care. As for those patients with mental health issues covered under Medicare and Medicaid, the figures were 61 and 55% respectively. (It should be noted that this study concluded all commercial insurance patients had much higher rates of follow-up care, most likely due to the aforementioned ability to pay for such care via the patient's private insurance carriers.)

Greenberg et al. sought to investigate whether the community-based model coupled with the implementation of service-line delivery of mental healthcare to local veterans would improve upon its previous numbers. Mental health services at 139 Department of Veterans Affairs Medical Centers (VAMCs) were studied over a 6-year period. Four areas of concern were measured: 1) the continuity of care veterans received for their mental health issues; 2) recidivism after discharge; 3) the community-based model as compared with the traditional inpatient hospital care model; and 4) the maintenance of proportionate funding being that the program is almost exclusively taxpayer-supported (Greenberg 1013). In other words, could a publicly-funded entity adequately take care of its patients' mental health issues just as well or even better than private, commercialized healthcare facilities?

Chapko et al.'s study found that the community-based models fared better at responding to geographically-specific areas and its veterans, producing more personalized care and thus facilitating the ability to respond to individualized cases. These community-based models could be run by the VA using local staff or even contracted with outside local healthcare providers, thereby producing the desired outcome of individualized, patient-specific care, shorter wait times, and a bona fide doctor/patient relationship (556).