So says a three-judge panel of the 9th U.S. Circuit Court of Appeals in San Francisco, after reviewing the evidence about the ability of the U.S. Department of Veterans Affairs (VA) to offer an appropriately level of mental health care and treatment to returning soldiers.
In this way, the costs of the ongoing wars in Iraq and Afghanistan have been grossly underestimated, because they don’t take into account the increased needs and costs of the vets’ ongoing and increasing mental health care. The longer we’re at war, the worse it’s going to get.
According to the article on TIME.com about the recent ruling, not only do some vets have to wait weeks to get in to see a mental health professional at many VA medical centers, but there’s often no significant triaging done. Actively suicidal vets may not get the care they need, before it’s too late.
The result? Nearly one-third of the vets who end up committing suicide do so while under VA care. But two-thirds aren’t even being seen by the VA for a mental health concern.
The evidence is more than a little eye-opening:
About five of every 18 veterans who kill themselves each day are under the VA’s care, the court said.
“Although the VA is obligated to provide veterans mental health services, many veterans with severe depression or post-traumatic stress disorder (`PTSD’) are forced to wait weeks for mental health referrals and are given no opportunity to request or demonstrate their need for expedited care,” the decision said.
“The delays have worsened in recent years, as the influx of injured troops returning from deployment in Iraq and Afghanistan has placed an unprecedented strain on the VA, and has overwhelmed the system that it employs to provide medical care to veterans and to process their disability benefits claims.”
So the three judge panel concluded that the lack of timely access to mental health care through the VA system violates veterans’ Constitutional rights:
The United States Constitution confers upon veterans and their surviving relatives a right to the effective provision of mental health care and to the just and timely adjudication of their claims for health care and service-connected death and disability benefits… their entitlements to the provision of health care and to veterans’ benefits are property interests protected by the Due Process Clause of the Fifth Amendment.
The deprivation of those property interests by delaying their provision, without justification and without any procedure to expedite, violates veterans’ constitutional rights.
The solution will be an expensive fix, but a needed one. The VA will have to hire more mental health professionals — primarily psychologists, because they are the most diverse professional available and are already well-entrenched within the VA system.
It seems odd — and short-sighted — to me that our government sends soldiers off to fight in wars, but doesn’t realize that the costs of taking care of those same brave men and women when they return home is going to increase. And increase at a rate consistent and in direct correlation with (a) the length of time you’re engaged in combat operations and (b) the amount of soldiers you send into a combat zone.
Perhaps such decisions as this federal court’s one will make the government think twice before entering yet another conflict. A nation — and its budget — can only take so much fighting.
Read the full article: California federal appellate court rules poor VA mental-health care for vets is unconstitutional
24 comments
I agree with the content of your article however I am quite ashamed for the auther that after 10yrs of continuous conflict on two major fronts, he still uses the word “Soldier” to refer to all of the Armed Services. Soldier is specific to ARMY, The Marine Corps produces “Marines”, The Navy produces “Seamen and Women”, The Air Force produces “Airmen and Women”. There is great pride in the services. Please stop rolling them all into one.
Please don’t forget those who serve in the United States Coast Guard.
Gwen, you have a ‘myopia’ problem. Once you sell your body and soul to the DoD they can put you in any branch at any time without your prior approval. You are just another cog in the machinery that is called a war making machine. All of us who went thru 20 years of pure torture, just to salvage something called a ‘career’, I see 1,000s of guys at the VA meander about like burnt out zombies. Consider yourself lucky you are still in one piece, with a functioning mind. The guys I encounter regret, to the man, of wasting their life to get such a paltry return.
I am a 100% Disabled and Decorated Combat Marine-Two tours in Vietnam during the main TET offensive and the other two “mini” TET’s. I am 70% Service Connected with TBI, from getting bombed with two 500 lb Canisters of Napalm, August 4, 1968. I also have been diagnosed, by VA Neurologist-Movement Disorders. My life has been pure hell, since I was 19 years old, now 69. Do you think I give a …. about what you seem to think is so important, to put down this author. It offended me greatly, to read your comment.
I commend this Author for his research, and his caring heart, for those Veterans, like myself, who the majority of our society who have no clue, as to what we lost, fighting for them. Nor do they want to take any amount of time, to get educated about combat PTSD and TBI and “Fight” for us!!!
Ken-USMC
Fox 2/5
Golf Co, 27th Marines
I don’t care if he calls me a soldier even though I didn’t serve in the Army. In the civilian world, soldier is an all encompassing term. I have bigger things to worry about than a title of who I once was.
I am a veteran….Women’s Army Corps….of the Vietnam Era.
It seems to me that even though there are a lot of women in the armed forces, they are kind of overlooked. I receive The American Legion Magazine; there is RARELY anything about women veterans.
It seems easier to forget about the true cost of war. Our Armed Forces not only put their physical life on the line they put their mental and emotional stability on the line as well. The trauma of war is expensive and the human cost could never really be reimbursed.
The LEAST we can do is give access to appropriate Mental Health and Substance Use Disorder treatment to alleviate some of the emotional pain.
It is nothing more than a token of our understanding for what they have been through.
When my husband and I planned for an early retirement we were both in our 50’s. Not only were we retiring, but we were moving to Nashville, TN. Since we resigned from our jobs, we knew we would have to buy health insurance and dental insurance in Tennessee. We purchased a PPO family plan, for just my husband and me, through “Penny Health Insurance” . We paid for the family plan ourselves, initially, the cost was a little less than $400 a month for both of us. Our co-pay was very reasonable at $25 each per office visit.
I have been horrified at my veteran husband’s treatment at the VA, absolutely horrified. He suffers from EXTREME PTSD and TBI from multiple Iraq deployments, in addition to over a dozen other deployment-related health conditions. It is even worse than people know. Waiting weeks? TRY MONTHS. (YEARS, in many cases.) And then you see a doctor for ten minutes and leave with eight or so prescriptions for antipsychotics and anti-anxiety pills, with basically no real treatment at all. (And that’s if your lucky.) And treatment for family members living with this? Non-existent. “Treatment” there is truly abysmal.
My husband suffers from severe PTSD, anxiety, and an array of other service connected issues, and has NEVER received the proper care he should have from the VA Healthcare System. Every visit to his Dr. (Psychiatrist) lasts approximately 10 minutes, and he too walks out with a handful of prescriptions, which either make him worse OR dysfunctional. He’s even more anti-social, angry and withdrawn than when he began going to the VA. I’ve plead with him to change his Doctor and go thru our local healthcare system, instead of the VA, but he won’t budge. He truly believes the VA is there to help the soldier, and provide the best level of care he could receive. I’ve personally witnessed the lack of care or concern, especially as it pertains to the amount of medication they prescribe my husband. He suffered an injury during his first mobilization to Iraq, and after numerous surgeries, he suffers paralyzation – the VA Dr., who is a Psychiatrist, prescribes him 240 vicodin, and 90 oxycodone a MONTH, not to mention a monthly supply of triazapram, diazepam, xanax, gabapentin and ambien. Is it JUST ME, or does this seem to be a lethal combination of medications! I fully believe he’s become an addict, and the once sweet, kind, thoughtful man I married is gone….wrapped up into the VA Healthcare System, with Dr.’s who don’t care about him OR his health whatsoever. This system needs to be reformed!!
You said your husband was better before these drugs? here’s why…
And if it were me here’s what I would do (so it’s not medical advice but anyway….)
The benzodiazepines (triazapram, diazepam, xanax) will fry him in short order and are extremely addictive so taper off slowly.
An occasional 5 mg valium for muscle relaxation /sleep say 2 – 3 x a week could be useful and likely non addictive. Those psyche drugs (gabapentin and ambien) will change his brain and zombify him so I’d avoid them like the plague (see all the horror stories online and on youtube on these drugs).
The cleanest, least dangerous on your list (in low doses) but nevertheless still unavoidably addictive are the opiates for pain. The nice thing about the opiates is the welcome “side effect” of mild euphoria which is anti-depressive too.
If I was consistently swallowing 8 Vicodin per day then the acetaminophen alone would cause me progressive sickness and eventually possibly even a liver transplant and that’s without even knowing the hydrocodone dose (an opiate) that is added to it.
2 to 4 Vicodin a day m-i-g-h-t be survivable so long as NAC (N -Acetyl Cystiene 600mg) is taken daily to detox the liver.
3 Oxycodone a day (the cleanest, albeit still addictive) is the best thing you’ve got. I’m guessing they’re 10 or 30 mg per pill. If it were me (and I take them for pain too) I’d get by on the least dose possible because tolerance can build quickly and the need to increase the dose so perhaps take them alternatively with the Vicoden, one first then the other for a total of 3 or 4 max per day.
The take-away is use these these drugs sparingly, as needed, or the cocktail will destroy the brain and body and cause w-a-y more problems than they solve. Get online and do your research and may God be with you and yours.
The Dr who sent your hubby home with that witches brew after a 10 minute consult needs a long holiday and time to think about a new profession. Fool.
I am one of those. I am given pills and no therepy. The va tells me to go get a job and get over my thoughts. tells me to commit myself when I cant stand being around people. Since I am sensitive to most medications (Ive tried them all) I forsee no help. Every day I think of myself being hanged to just get this shitty life over. I have two boys and am a single parent. I try not ot let my symptons show but now they are getting older they seem to realize something is wrong. The va seems to think if you can take care things at the house you are “A OK”. I really dont get along with people and kida hate society and prettymuch everything. I usually have to pretend that life is dandy and it isnt in fear of losing my kids. I wish I could take a magic pill and everything would be fine but I know that wil never happen. Dose the goverment and people really care?
The VA electrocuted my marine, injected him with chemo, then put him into respiratory arrest, with Seroquel IV, during a course of time, and in the name of treatment, at several VA hospitals.
He is now dead.
I strongly recommend if you are pro-life, and sincerely want to help your veteran, please seek treatment elsewhere, and turn in the incompetent doctors, to you state boards.
Report the VA hospital to your state,federal senator, they are responsible for over-sight.
Stop the carnage, stop the targeting of veterans healthcare freedom is the freedom to choose.
I am soo sorry to hear about your pain the sad part is that even though mental health outside of the VA is a little better it is still at its worst. ALL the doctors are working for one entity “THE DRUG COMPANIES” as long as thy are prescribing medication..no one cares about on going therapy. The whole mental health system needs an over haul to included holistic therapy as well,such as treatments with vitamins and supplements..yoga..spirtual healing and more funding for in home personal aids and respite when families need a break….Doctors,Social workers and mental health workers are not doing their jobs in listening to the families members in what we need to help our love ones.
For my PSTD, the V.A.in El Paso gave me a bottle of medication and sent me on my way. If I didn’t help myself, I would have committed suicide years ago. The government doesn’t care about its veterans-medicate and sent them on their way. If they take their own lives, we save money!!!! I HATE AMERICA.J
i’ve read some misinformation in this blog. After the VA finally knew they had to treat PTSD they have been. When I hear incongruous stories like some in here I have to recall my experience with fellow patients who seemed unable to work with the docs etc. It seems that PTSD is a cash cow for some and they get angry when Bessie will not give milk.
Went to appt. 40 min. early. No parking available, wasted 20 min. parked in unsafe area. Went to check in waited 20 min. sent to Dr office got there right on time. Waited in their waiting room 30 min. when nurse called me in, said you are late. What a joke that was. Reminded them I waited in their waiting room and parking they were aware but still can’t understand. 4 elevators only one worked. Elevator at front broken had go all the way to end of hospital and return back. Doctor even though a professinal did not agrre with my family physician my family Dr has been doing this for 30 years he looked like he got his doctrine by mail order. one sided doctors see so many patients don’t care. most of them are just milking govrnment out of paycheck couldn’t make in the private sector
I disagree with this article. The VA does NOT need to hire more mental health professionals. Instead, the VA needs to bring in private and non-profit for treatment. Spend less money on hiring and more money on collaborating with outside entities. keeping all the wasted money and resources in house will just be same old same old. Consult the private and non-profit entities and get the job done.
Plus unions don’t help.
I am a 100% disabled Marine. I suffer from severe Ptsd. I went into the VA hospital at age 22. I thought I was losing my mind, I thought I was going crazy do to recurring nightmares. As a 19 year old Marine I was stabbed in my heart and lung and clinically died as I suffocated to death in my own blood. At age 22 I was told I was fine and my symptoms were due to a bad marriage. I finally snapped about twenty years after my injuries and ended up in a VA hospital where I was diagnosed with severe PTSD. I am red flagged now and a written order pops up to disconnect my phone calls to the VA hospital if I am not rational. HOW do you hang up on a disabled veteran calling the VA for help. I had a PTSD therapist who was a volunteer because the VA is broke or just does not care about us.
I have family members that work at the VA, both professionals. They worked their lives in the civilian sector and both say that the VA is not one of the best places to work. They both say management is lacking and don’t do what needs to be done because of the unions. I say that is an excuse. They also say that at least half of the staff they work with are lazy. They also say the VA will allow people to do things out of their scope of practice. I am a retired (20 years) active duty combat vet. I have attended 18 sessions for PTSD and my counselor told me I was a hard case to diagnose. I stopped going to the VA for PTSD. I have not used the VA for medical care except for a few military related issues after I retired and was shocked at the way I was treated. I do not use the VA for medical care. I find it sad that veterans who are willing to give their lives for this country are given the VA for their care not to mention the co-pay a veteran has to pay. We can and should do better for our veterans.
I have been dealing with the VA for years. they had me on so many ‘anti’ drugs for ptsd (anti psychotics, anti anxiety, and anti depressants), that my friends were scared for me, as I was so doped up I was out of this world. as for my medical care, after trying to tell my pcp why a certain referral would not work, she wrote up in my records that I non stop complained about all aspects of my health care, was a difficult patient. just how the hell can I face the VA again after a note like that for all to see in my records? and I haven’t even mentioned all the things they have in my records that is just plain wrong. what are we suppose to do?
Shameful.
The VA has a difficult time hiring and maintaining psychiatrist and others in that sort of profession.
They force everyone to go through CBT at a 15:1 ratio for an hour each week for 11 weeks with little to any control over the Veterans in the room and expect you to sign up again if you’re not “cured†of whatever. The sessions I went to, we focused on 2 people… the IT guy was calling the suicide hotline 2-3 times a week and the former pharmacist who was a drug addict and his 8th time through (no lie). No one else got to talk. All they want to do is stick you on anti-depressants when in a lot of cases, the VA is part of why someone is having issues and if they would just fix it, some issues would be resolved.
/endrant
9 year vet. 7 years into psych with the va have taught me to NEVER trust again. 3 time suicide failure. A clinic with 5 therapists with a combined 20 years of exp. Anti anxiety/depression meds to many to count. Pain meds given out like candy. 3 months in a regional va domicile. 4 years dealing with comp/pen to finally get my 100%. priceless and worthless same. Veterans’ no-choice and veterans’ ADMIN no-accountability has driven my ptsd beyond hope. My last psych therapist was allowed 2 months after giving his notice he was quitting, to notify his 40 or so vets of this. He used his time productivity by diverting his va workload into his private practice. HIPPA violations of veterans all around. HIS last days with the va he trolled my records to keep track of my complaints. The last day of his employment I spent talking to the va clinics suicide prevention specialist on a welfare check.. Ironic nope totally allowed per the privacy and security. Patient avocation on the clinic to the regional level works like this : it is intended to keep a veterans complaint in house. OIG complaints are a even bigger joke OIG is a va branch designed to tie you up with no answers for a min. of 6 weeks or more or like for me no answer after 4 months. . NEVER assume anyone in the va system will put ANYTHING in writing for you. The therapist is gone, the vets in his care like me were left with no mental health care months. Sad part is the vets he harvested into his private practice were pulled out of his care thru community outreach. In my situation a simple call to the White house va hotline seems to have finally got some attention. Oh ya this is still in progress. I guess this is the only thing keeping: my hatred of the va mental health system, and hopefully helping other vets avoid their suicide. nothing follows
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