Veterans do not only matter one day of the year. Beyond Veterans Day, it is not only important to reflect on the lives lost and the sacrifices made by those who served our country, but to ask: are we doing enough as a nation to give veterans the support and care that they need? Veterans deserve to be more than a political football. We discuss “supporting our troops” and “honoring our veterans,” while also cutting funding to Veterans Affairs programs like mental health services, education, and housing resources. In actuality, there is so much more that we could be doing to improve the quality of life for veterans in the United States.
Veterans are one of the most underserved, high-risk health populations in this country. As a physician who spent eight years working with unhoused veterans, I’ve seen firsthand how veteran health care does not receive the attention that it deserves. In fact, in the midterm elections, veteran health care was not discussed once by any candidate during their debates. Not once.
To what extent does this reflect how much our nation cares about the health and well-being of veterans?
Today, there are 40,456 vacancies in the Veterans Health Administration. To put that in perspective, there are 23.4 million veterans in the United States, and according to the Substance Abuse and Mental Health Services Administration, 18.5 percent of service members returning from Iraq or Afghanistan have post-traumatic stress disorder (PTSD) or depression. Making matters worse, only 50 percent of returning service members seek mental health treatment who need it, and barely half of those who receive treatment experience adequate care.
While all of those statistics are staggering, it’s also incredible how many veterans my colleagues at the VA are able to help given such limited resources. The VA has 9 million veterans actively enrolled in their health care program and they serviced 109 million outpatient visits last year alone. There is a clear need for the critical work that these physicians and mental health professionals are doing, and what we need is the support to make these services more widely available.
So what motivated me to begin work with the VA? After 9/11, I was inspired to take action and get involved working with veterans. I wanted to do something for those who were risking their lives and serving our country. I saw that there was a dire need for more physicians to be supportive of our service members. And, I realized that it was necessary for physicians to be specifically trained to recognize the many additional stresses and mental health challenges some veterans were facing when returning to everyday life.
What I remember most about my time at the VA was how committed my fellow physicians were, how hard they worked, and how dedicated they were to improving the lives of veterans. In fact, the VA has one of the lowest physician turnover rates in the country, and amongst the physicians who work there, I saw how much pride they took in the work that they do. However, the demand for their services is significant, and we must provide the VA with more resources to help all of the veterans in need.
This need cannot be over-exaggerated: 20 veteran suicides happen per day in the United States. Veterans have also experienced multiple, long-term deployments in Iraq and Afghanistan, which has aggravated existing trauma they have been experiencing and exacerbates their mental health issues, particularly with PTSD.
So what can be done to improve the health care and quality of care, especially around mental health issues for veterans?
First, we need to make it a priority to fill health care positions. The government needs to invest in hiring, especially in hiring more clinicians trained to work with veterans. Primary care physicians are a valuable resource responsible for over half of mental health diagnoses, and 90 percent of the time they provide a correct diagnosis, which enables veterans to get proper care.
Additionally, we need to focus on training our physicians to be compassionate, empathic, and resilient. For example, when meeting with a Veteran for the first time, harm reduction can drastically help decrease harmful thinking and ideation, and assist in doctors gaining the trust of their patients. When working with unhoused veterans in particular, I learned that by listening and building rapport with veterans, these servicemen would return to the VA regularly, and this gave physicians like myself more opportunities to treat and rehabilitate those experiencing mental health issues.
Another key element to helping veterans have more access to health care, and specifically to mental health services, is taking advantage of technology. One of the obstacles veterans face is their physical distance from a VA facility and millions of veterans live in remote areas known as “health care deserts.” Services like telemedicine can greatly alleviate this problem by allowing veterans to visit primary care physicians and mental health care professionals from their homes or place of work. Additionally, many veterans face stigma, particularly around receiving mental health care. Telemedicine enables Vets to get the care that they need in the privacy of their own home, and as telemedicine adoption and usage in the United States increases, it could be a very useful tool in helping combat the veteran mental health crisis.
Over the next few years, there are multiple steps that we can take to ensure that veterans are not left behind when it comes to receiving health care. In order to support our veterans, we need to hire more clinicians at the VA, train physicians to identify and diagnose mental health issues, and leverage technology to provide veterans with greater access to health care resources. By doing this, we not only honor our veterans and the time that they served our country, but we make it possible to improve their quality of life and their ability to build a better future.
Ian Tong is an internal medicine physician.
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