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Veterans Day 2004: Take Action

Veterans Day is a lasting memorial to the spirit and the humanity of the brave men and women who have sacrificed their lives for their country and to celebrate the service of all of our nation’s veterans and to the soldiers fighting in Iraq and Afghanistan and stationed around the world.

For many of our veterans, the battle scars, disabling injuries and prolonged illnesses help to keep the memory of their wars and battles fresh in their minds. Veterans deserve the assurances from a grateful nation that what they accomplished, at such high personal cost to them, enables all of us to enjoy our freedoms and a future free from fear.

How can NAMI pay tribute to our veterans on this important day? By paying special attention to the needs of those who have served and do everything possible to ensure they receive the benefits and entitlements they have earned. By doing that, we will be granting them the dignity and respect they deserve.

NAMI places the highest priority on meeting the treatment and community support needs of individuals with severe mental illness that have protected our freedom through military service. The Department of Veterans’ Affairs (VA) is the largest single provider of psychiatric services in the U.S., and according to the Veterans’ Health Administration (VHA):

  • Nearly 460,000 veterans are service connected for a mental illness;
  • Over 130,000 veterans are service connected for a psychosis - a chronic, severely debilitating disorder that often emerges or is aggravated during time in the service;
  • Nearly 180,000 veterans are service connected for post-traumatic stress disorder (PTSD), a disorder most often directly related to combat duty; and
  • In 2002, more than 750,000 veterans received mental health services from the VA.

NAMI believes that veterans should receive at least the same full range of integrated services within the hospital and upon discharge to the community that are received by people with mental illnesses served by other public systems such as: the availability and accessibility of physicians services, state of the art medications, family education and involvement, inpatient and outpatient care, residential treatment, supported housing, assertive community treatment (ACT), psychosocial rehabilitation, peer support, vocational and employment services, and integrated treatment for co-occurring mental illness and substance abuse.

Recent congressional action includes authorization for expansion of rehabilitative services for veterans with mental illness in the area of supported employment. Specifically these programs include work skills training and development services, employment support services, and job development and placement services. These new services will help veterans with mental illness achieve greater independence and community integration through employment. NAMI has urged Congress to hold the VA accountable in meeting the goals of this expanded authority for employment services.

NAMI recommends continued vigilance on the part of Congress to ensure that the VA continues efforts to expand access to the most effective evidence-based models for mental illness treatment and community support programs including:

  • Open access to the newest and most effective medications – The VHA should be prevented from using restrictive prescription drugs formularies to limit access to the newest and most effective psychiatric medications including typical psychotropics and selective serotonin reuptake inhibitors (SSRIs).
  • Expanding ACT – The VA should ensure compliance of the VHA directive for Mental Health Intensive Care Management (MHICM), which was issued in October 2000. A recent survey by the Serious Mental Illness committee (SMI) revealed that just over 8,000 veterans currently received some form of mental health team case management from the VHA, and of those, only 2,000 met ACT criteria for intensive case management.
  • Screening for Homeless Veterans – The VA needs to continue expanding its capacity to conduct outreach and screening efforts to homeless veterans with severe mental illnesses, particularly in settings such as local jails and prisons, homeless shelters and the streets. Studies have shown that nearly one-third (approximately 250,000) of homeless individuals have served in our country’s armed services. Moreover, approximately 43% of homeless veterans have a diagnosis of severe and persistent mental illness, and 69% have a substance abuse disorder.
  • Community Based Outpatient Clinics (CBOCs) – Many of the VA’s CBOCs serve as primary care clinics and were instituted in areas in which the VA health services were not easily accessible, allowing many more veterans access to needed health care. However, the SMI committee reports that out of the 350 CBOCs operated, only 40% of the facilities offer treatment services for veterans with severe mental illness.

Action You Can Take NOW

The Senate VA-HUD bill provides total funding of $28.354 billion for the Veterans Health Administration for fiscal year (FY) 2005. This includes $19.498 billion for VA medical services; $4.7 billion for medical administration; $3.745 billion for VA medical facilities and $405.593 million for VA medical research. This is $1.2 billion more than President Bush requested and more than $1.9 billion above current year funding. The Senate bill rejects several controversial Bush Administration proposals for fees and collections from certain non-service connected veterans using the VA health system.

Most importantly, the Senate bill – unlike the President’s budget and the separate House proposal – contains an emergency designation for as much $1.2 billion of the proposed increase. This emergency designation is related to the expected stress on the VA medical care system that will be occurring as active duty, reserve and national guard service personnel return from Iraq and Afghanistan during FY 2005 and begin turning to the VA system for treatment. This emergency designation allows for extra funds to be added to the bill without being counted against the VA-HUD bill’s strict overall allocation.

Finally, the report accompanying the Senate bill makes a special note of support for the VA’s efforts to focus on ending chronic homelessness among veterans with severe mental illnesses. According to the report, the VA will spend as much as $1.47 billion in FY 2005 ($100 million more than in FY 2004) in medical care funding to homeless veterans and another $188 million in specialized homeless programs ($12.3 million over FY 2004). The report goes on to request a detailed plan from the VA by next spring on a plan to end homelessness among veterans.

We are requesting that you contact your Senators and your congressional representative to ask them to contact Senators Kit Bond (R-MO) and Barbara Mikulski (D-MD) and Rep. James Walsh (R-NY) and Rep. Alan Mollohan (D-WV) respectively – in order to push them to fight aggressively for:

  1. The increase in the Senate bill above the President's request, and
  2. The emergency designation that makes this increase possible.

Contact your representatives now using NAMI's online advocacy tool. Enter your zip code in the box below. If you do not see the box for entering your zip code, click here.

For more information please contact:

Joel Miller, Acting Director, NAMI Policy Research Institute at 703-600-1109 or joel@nami.org

More resources from NAMI:

Veterans Issue Spotlight

 


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