Jun 07, 2017
Statement of
Kayda Keleher, Associate Director
National Legislative Service
Veterans of Foreign Wars of the United States
For the Record
Committee on Veterans' Affairs
United States House of Representatives
With Respect to
“Overcoming PTSD: Assessing VA’s Efforts to Promote Wellness and Healing”
WASHINGTON, D.C.
Chairman Roe, Ranking Member Walz and members of the Committee, on behalf of the men and women of the Veterans of Foreign Wars of the United States (VFW) and its Auxiliary, I want to thank you for the opportunity to present the VFW’s views on the Department of Veterans Affairs (VA) efforts in treating veterans struggling with Post-Traumatic Stress Disorder (PTSD).
Public Private Partnership
Since the enactment of Public Law 114-2, Clay Hunt SAV Act, VA has entered into new relationships with many private sector organizations to address PTSD within the veteran population as well as to combat veteran suicide. Some of these organizations include Bristol-Myers Squibb Foundation. This foundation has awarded over $15 million in grants to veteran service organizations and academic teaching hospital partners working to develop and improve innovative models of community-based care and support to improve the mental health and community reintegration of veterans. The VFW is also among the many organizations who have signed on to partner with VA.
This past year, the VFW launched a Mental Wellness Campaign to change the narrative in which America discusses mental health. We teamed with Give an Hour providers, One Mind researchers, the peer-to-peer group Patients-Like-Me, the family caregiver-focused Elizabeth Dole Foundation, the nation’s largest pharmacy Walgreens, and the Department of Veterans Affairs to promote mental health awareness, to dispel misconceptions about seeking help, and to connect more veterans with lifesaving resources. The goal of the VFW campaign is to de-stigmatize mental health, teach our local communities how to identify mental distress and what local resources are available to those struggling to cope with mental health conditions. To do this, VFW posts and VA employees from Richmond, Va. to Lakeside, Calif. and everywhere in-between, have held mental wellness workshops to spread awareness of VA’s mental health care services, as well as how to properly identify a fellow veteran in distress. The VFW and VA talked with local veterans about the Campaign to Change Direction and their five signs of mental distress –– personality change, agitated, withdrawal, poor self-care and hopelessness.
We know this campaign has saved lives, our members have told us so. Veterans have told us of how they were suicidal – gun in hand – but they put the gun down when they saw the pamphlet from the Campaign to Change Direction. Those veterans are still alive after they called the Veterans Crisis Line and received help. That is the power of the public private partnerships VA is continuing to develop.
With 14 of the 20 veterans who die by suicide every day not seeking care at VA, the VFW believes VA must continue expanding these partnerships with the mindset of providing better outreach to those who are not using VA services. By continuing to perform increased outreach to this vulnerable population, we will hopefully begin seeing a decrease in the veteran suicides.
Peer Support
The VFW has long advocated for the expansion of VA’s peer support specialists program. VA peer support specialists are individuals with mental health or co-occurring conditions who are trained and certified by VA standards to help other veterans with similar conditions and/or life situations. They are actively engaged in their own recovery and provide support services to others in similar treatment at VA. Veterans who obtain assistance from peer support specialist value the assistance they receive.
The VFW urges Congress to make sure VA has the resources required to continue expanding on this effective, low-cost form of assistance to veterans in need. To ensure VA is offering a holistic approach in effectively addressing PTSD within the veteran population, VA must have the ability to provide peer specialists outside of traditional behavioral health clinics. Veterans overcoming homelessness, veterans seeking employment, veterans in mental health crisis going to the emergency room or urgent care center could all benefit from peer support services.
Aside from veterans receiving support from fellow veterans who have recovered from similar health conditions and experiencing the bond and trust veterans share, peer support specialists also greatly assist in destigmatizing mental health conditions such as PTSD. For a veteran to become a peer support specialist they must have actively gone through treatment, and are living a relatively healthy lifestyle. This allows veterans who may be struggling to see that their condition is treatable, manageable and not something that has to negatively impact or control their lives.
Women Veterans
Women veterans seeking treatment for PTSD often times face unique barriers or challenges. While people of all genders struggle with PTSD for the same reasons, PTSD linked to sexual violence effects women at a much higher ratio than others in the veteran population. As the population of women veterans continues to rise, it is of the upmost importance VA continues prioritizing their often overlooked health care needs.
The VFW urges Congress and VA to continue expanding telemental health programs. These programs are often invaluable to women veterans wanting to use group therapy for PTSD linked to sexual violence. In VA’s where there may not be enough women to get a group therapy session started, telemental health provides this opportunity. The VFW also urges VA to do two things. First, begin more seriously taking sex into consideration before prescribing psycho-pharmaceutical treatments. Medications have different effects between people of different sexes. The VFW asks VA to begin being on the fighting end as a good example in beginning to prioritize this. Second, VA must continue training mental health providers and employees on treatments and proper handling of patients with PTSD due to sexual trauma.
The VFW also urges the Committee to swiftly consider and pass H.R. 2123, the VETS Act of 2017, which would expand VA’s authority to provide telemedicine. This important bill would improve the tele-mental health services VA provides women veterans.
Veterans Seeking Treatment
Veterans who seek treatment for PTSD at VA report that their treatment was effective. But this is not disregarding access to care issues VA has struggled with in the past. Veterans who choose to use VA for their health care must have access to treatment, particularly veterans struggling with mental health conditions such as PTSD.
The VA is the largest integrated mental health systems in the United States with specialized treatment for PTSD. The number of veterans seeking treatment at VA for PTSD has continued increasing as more veterans from Iraq and Afghanistan leave the military and transition to civilian life. This is part of the cost of war. Congress and VA must ensure those seeking these treatments are provided timely access to VA care.
Mental health staff members within VA have increasingly continued to receive training in areas such as prolonged exposure and cognitive processing therapy – which are the most effectively and empirically proven forms of known therapies for PTSD. Medication treatments are also offered, and thanks to Congress and the Clay Hunt SAV Act medications are being more closely monitored. Through VA’s Opioid Safety Initiative, opioids are being prescribed on a less frequent basis for mental health conditions and are being monitored for addiction and other negative consequences.
With the number of opioid prescriptions decreasing and the number of providers receiving training on effective psychotherapies specific to PTSD patients increasing, the VFW believes VA is successful in their efforts to treat veterans within this population. This is not to say more work does not need to be done.
Throughout the years PTSD research has allowed doctors and researchers to understand and diagnose PTSD in ways never before possible. The VFW urges VA to continue this research to better understand biological implications for diagnosis to avoid misdiagnosing and treatment. The VFW also urges Congress to provide VA with the necessities required to continue hiring more mental health care providers. The VFW also urges VA and Congress to work together in providing new technologies and researching new and/or alternative forms of treatment.
Information Required by Rule XI2(g)(4) of the House of Representatives
Pursuant to Rule XI2(g)(4) of the House of Representatives, the VFW has not received any federal grants in Fiscal Year 2017, nor has it received any federal grants in the two previous Fiscal Years.
The VFW has not received payments or contracts from any foreign governments in the current year or preceding two calendar years.