Veterans Mental Health Services

Veterans experience a variety of mental health problems, including posttraumatic stress disorder (PTSD), depression, anxiety, aggression, bipolar disorder, and schizophrenia (Wooten, 2015). More specifically, statistics indicate that up to 50% of veterans experience PTSD (Institute of Medicine [IOM], 2013). These problems often stem from exposure to combat. Mental health problems among veteran are further compounded by other problems such as financial difficulties, joblessness, marriage problems, social isolation, and homelessness (Smith et al., 2017). These problems are major risk factors for suicide and substance abuse.

Indeed, approximately 22 veterans commit suicide every day (American Public Health Association [APHA], 2014). This paper focuses on this social justice problem, specifically highlighting the oppression faced by veterans with regards to access to mental healthcare, the ethical dilemmas associated with the problem, and policies enacted to address the problem. For Veterans, access to mental healthcare remains a major challenge, with veterans in rural areas as well as those facing financial difficulties being the most affected.

For instance, reports indicate that 56-87% of military service members undergoing psychological distress following deployment do not get psychological help (APHA, 2014). These are startling figures without a doubt, underscoring the need for improved access to mental healthcare by veterans. Shortage of mental health providers is one of the main factors that hinder access to mental healthcare by veterans (APHA, 2014). With shortage of mental health practitioners, veterans often grapple with delay or even cancellation of appointments. In most cases, veterans have to wait for months before seeing a doctor.

By the time one receives help, it is often too late. In fact, the problem of delayed appointments is so serious that the Department of Veteran Affairs (VA) has in the last few years been undergoing extensive changes within its health system in an effort to ensure timely access to quality care. Access to mental healthcare by veterans is also hindered by the requirements associated with VA benefits. To receive VA health benefits, veterans must have either an honorable or general discharge (APHA, 2014).

In other words, only veterans honorably discharged from duty or those who have served actively for not less than two continuous years are eligible for VA benefits. This means that veterans released from duty prior to the end of their call-up period or due to reasons of hardship or disability sustained in the line of duty cannot receive VA health benefits. Therefore, for veterans experiencing financial difficulties, seeking healthcare becomes an overwhelming burden.

Other factors that may hinder access to mental healthcare among veterans include stigmatization, insufficient training on evidence-based practice on the part of VA healthcare personnel, as well as demographic factors such as gender and racial background (IOM, 2013). On the whole, constrained access to mental health care by veterans continues placing the already vulnerable population at a greater risk. For social workers, working with veterans presents significant ethical dilemmas.

According to the National Association of Social Workers' (NASW) Code of Ethics, one of the core values underpinning the work of social workers is social justice (NASW, 2017). In essence, social workers have a responsibility to help vulnerable and oppressed populations. This means that social workers must be sensitive to the needs of vulnerable and oppressed groups, and that they must ensure access to the required services, resources, and information.

For social workers in the military context, however, the fulfillment of this role may be hampered by conflicts between professional and military ethics. For instance, social workers working with veterans may have to consider exceptions in relation to informed consent and confidentiality (Prosek & Holm, 2012). In other words, social workers may be required to report beyond the normal ethical protocols or to exercise greater flexibility as far as informed consent is concerned.

On its part, the federal government has enacted a number of policies aimed at expanding access to healthcare by Veterans. One of the major legislations is the Clay Hunt Suicide Prevention for American Veterans Act passed in 2015. The legislation was passed with the aim of expanding access to mental healthcare by veterans, including veterans in the other-than-honorable (OTH) discharge category.

The legislation provides for independent evaluation of suicide prevention programs instituted by VA, creation of peer support programs, and increased recruitment of mental health practitioners into the VA health system (VA, 2015). Further, the legislation calls for increased access to mental health information by veterans as well as collaboration between VA and non-profit mental health organizations in suicide prevention efforts. Other legislations include the Jacob Sexton Military Suicide Prevention Act and the Veterans Access, Choice and Accountability Act of 2014 (Chang & Brannen, 2015).

The passage of the Clay Hunt Suicide Prevention for American Veterans Act has considerably improved access to mental health care among veterans as it covers not only actively serving members and honorably discharge veterans, but also OTH veterans. However, even with the passage of the legislation, VA is yet to fully meet the mental health needs of veterans. Factors such as budget constraints, administrative bureaucracy, and inefficiencies within the VA health system have hampered the effectiveness of mental health policies (Smith et al., 2017). Addressing these challenges requires greater legislative support.

The Executive and Congress must push for policies that.