Where We Stand
Veterans Disabled by Mental Illness
NAMI’s Position (taken from the NAMI Policy Platform)
NAMI believes that veterans should receive the same full range of integrated services within the hospital and upon discharge to the community that are received by other people with serious mental illnesses. NAMI calls for veterans hospitals and veterans outpatient treatment programs to be held to the same standards of performance as all other hospitals and outpatient treatment programs.
In 2002/2003, an estimated 1.2 million male veterans were identified as suffering from serious mental illnesses. Approximately 340,000 of these individuals had co-occurring substance abuse disorders. Approximately 209,000 female veterans (13.1 percent) reported serious mental illness, and 25,000 (1.6 percent) reported co-occurring substance use disorder and SMI.[i]
These individuals require access to a comprehensive continuum of services, including inpatient treatment, physician services, appropriate medications, family education and support, residential treatment, supported housing, assertive community treatment (ACT) services, integrated mental health and substance abuse treatment, intensive case management, peer counseling, and vocational and employment assistance.
The Veterans Health Administration (VHA) Mental Health Strategic Healthcare Group provides general inpatient psychiatric services at 132 medical centers as well as mental health outpatient services in 689 medical centers and community-based outpatient clinics. In addition, readjustment counseling services are available for veterans and their families at 209 Vet Centers across the nation.[ii] Mental Health services are provided for a range of conditions, including Post Traumatic Stress Disorder (PTSD), depression and substance abuse treatment.
As the nation’s largest healthcare system, the Department of Veterans Affairs (DVA) has long struggled to address the treatment and supportive service needs of veterans with serious mental illness. These problems have been compounded by large numbers of veterans returning from Iraq and Afghanistan with serious mental health issues, including PTSD and other serious mental illnesses. A recent study revealed that 25% of veterans of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) were diagnosed with significant mental health problems.[iii]
Although inadequate resources are part of the problem, there is evidence that the DVA has not utilized resources targeted for mental health treatment wisely and efficiently. A recent report issued by the Government Accounting Office (GAO) revealed that a significant amount of resources targeted for mental health strategic plan initiatives in FY 2005 and 2006 were not allocated to DVA health care networks and medical centers and that the DVA was unable to account for how those monies that were allocated were spent.[iv]
Finally, many veterans with serious mental illness are falling through the cracks of the veterans system and are increasingly the responsibility of primary care physicians or local community mental health centers (CMHCS). This is particularly true in rural and sparsely populated regions of the country.[v] Moreover, national guard personnel, including those who have served as active duty military, are not eligible for veterans medical benefits and thus must rely on community mental health providers for their treatment and supports.
NAMI’s Policy Goals for Veterans Mental Health Services in 2007 and 2008:
- Increase funding for mental health and medical treatment for veterans with serious mental illness. Although funding for mental health treatment has increased in recent years, significant numbers of veterans with serious mental illness are still falling through the cracks because they are not getting the services they need. Ensure that monies designated for mental health and substance abuse treatment for veterans are allocated to Veterans Medical Centers, Community-Based Outpatient Clinics (CBOCs) and other programs serving veterans with mental illness and utilized for the treatment of these individuals.
- Implement evidence based practices with proven effectiveness in addressing the needs of individuals with serious mental illness such as assertive community treatment (ACT) programs, integrated mental health and substance abuse treatment, and supported employment throughout all 21 Veteran’s Integrated Service Networks (VISNs).
- Conduct and report outcomes studies on services received by veterans with mental illnesses to ensure that resources are being spent wisely and efficiently and are delivered in culturally competent manner.
- Protect access to psychiatric medications for veterans in accordance with clinical judgment and individualized needs.
- Adopt educational programs about mental illnesses for active duty military and veterans and their families to reduce stigma and encourage those with mental illnesses or mental health needs to seek help.
Encourage the DVA to contract with community mental health centers to provide services for veterans with mental illnesses and national guard personnel who have served as active duty military who do not have access to needed services through the VA system.
[iii] K.H. Seal, et al, “Bringing the War Back Home: Mental Health Disorders Among 103,788 US Veterans Returning From Iraq and Afghanistan Seen at Department of Veterans Affairs Facilities”, Archives of Internal Medicine, Vol. 167, No. 5, March 12, 2007: 476-482.
[iv] Government Accounting Office, “Preliminary Information on Resources Allocated for Mental Health Strategic Plan Initiatives”, Testimony Before the Subcommittee on Health, Committee on Veterans’ Affairs, House of Representatives, September 28, 2006,
[v] Medical News Today, “Veterans’ Mental Health Issues: Where is Help Coming From?”, June 26, 2007, www.medicalnewstoday.com