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Kevlar for the Mind: Rise in returning troops puts strain on mental health care

Jun. 1, 2012 - 02:39PM   |   Last Updated: Jun. 1, 2012 - 02:39PM  |  
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About the author

Bret A. Moore is a clinical psychologist who served in Iraq and is the author of "Wheels Down: Adjusting to Life after Deployment." Click here to send him an email. Names and identifying details will be kept confidential. This column is for informational purposes only. Readers should see a mental health professional or physician for mental health problems.

The mental health system that serves our troops and veterans is under tremendous strain.

With the rising numbers of troops returning from combat to struggle with post-traumatic stress disorder, depression, substance abuse and traumatic brain injury, this already stressed system will continue to buckle under the weight.

Nowhere is this strain more evident than in the Veterans Affairs Department. An internal VA investigation recently found that veterans are waiting much longer for mental health care than previously reported by VA itself. One stark finding: Nearly 100,000 veterans waited about six weeks before starting treatment.

A related finding was a substantial shortage of psychiatrists, who generally handle medication management.

There are various reasons why so many veterans must wait for treatment. One of the biggest: VA sees an increase of 10,000 new patients suffering from PTSD every three months. This is less important, however, than what is required to solve the problem.

In an April 23 letter to Congress, the American Psychiatric Association offered suggestions on how best to recruit and retain psychiatrists:

• Reconfigure the professional roles psychiatrists play in VA to make the positions more professionally satisfying.

• Address the pay inequity between VA and civilian psychiatrists by increasing VA psychiatrists' salaries to about $225,000-$250,000 a year.

Two days later, a subsection of the APA issued suggestions of its own. The main one: Psychologists trained in dispensing psychiatric medications should be allowed to fill positions not filled by psychiatrists. This is not a new concept; some psychologists currently prescribe psychiatric medications in New Mexico, Louisiana and various federal health care facilities, including those run by the Army, Air Force and Navy.

Unfortunately, until the military and VA mental health care systems can do more than tread water, many troops and veterans may have to pursue other options.

For active-duty troops, Military OneSource is a great resource that can put you in touch with civilian mental health care providers in your community, at no cost to you.

For veterans, another option is to rely on private insurance if you're fortunate enough to be employed and covered by an employer health plan.

Regardless of which option you pursue, be persistent and patient. Always remember: You can get better with treatment.

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