Senator Hagan steps up on veterans' mental health

I received this earlier today via e-mail from a Governor's Focus member:

U.S. Senator Kay R. Hagan (D-NC) yesterday cosponsored a bipartisan bill to help service members access mental health care services...

“Our service men and women put their lives on the line for our country, and they now face an unnecessary, administrative hurdle to accessing mental health care,” Hagan said. “As a U.S. Senator from North Carolina and member of the Senate Armed Services Committee, I am focused on ensuring our veterans, active duty military and their families can access the services they need. Mental health care for our returning troops is so critical, and I will work with my colleagues to ensure this important bill is signed into law.”

Here's the core of the problem Kay is trying to fix:

Currently, TRICARE, the health care system for service members, requires them to obtain a physician referral in order to see a licensed mental health counselor. However, this same obstacle is not applied to licensed social workers or certified marriage and family therapists.

I'm going to attempt to give you some background on this issue, but if any MH professionals notice any fallacies or points that need clarification, please let us know. Getting it right is critical.

TRICARE is not a facility or a group of practicing clinicians, it's a funding vehicle. And for those who have left active duty service, it soon becomes a health care insurance plan that requires a monthly premium payment, if they want to remain enrolled. It doesn't provide care, it pays for care, and the dollars are appropriated for and administered by the Department of Defense. And it's not some sort of entitlement program dreamed up by soft-hearted politicians, it's an integral part of our nation's defense framework.

I wanted to make that clear upfront, because the bill in question, if passed, will facilitate the needed treatment of thousands of current and former service members. And that's going to cost money. A lot of money. As such, there will be opposition to this increase in spending, both from Congress and the DoD itself. Opposition which should (and probably will) be ashamed to show its face in public.

Now to the "why" this is needed. Within the mental health field in general, and the substance abuse field in particular, the vast majority of counselors and clinicians are not (medical) doctors. This is not to disparage the value of doctors in the system, but to provide demographics. The number of MD's is so limited, the few in the system are often responsible for serving several clinics, making an appearance at each maybe once a week. Meaning, if an individual must see a physician before he/she can even begin the evaluation/treatment process, that appointment could be weeks in coming. And for some, those few weeks could be a lifetime.

Speaking of, now is as good a time as any to talk about suicide rates in the ranks:

June was not only the worst month ever for American combat deaths in Afghanistan. It was the worst month ever for suicides in the Army, CBS National Security Correspondent David Martin reports.

A total of 32 soldiers, both active duty and reserve, took their own lives in those 30 days. So far this year, 145 soldiers have committed suicide compared with 130 during the first six months of last year, which at the time was the worst on record.

We've lost more troops to suicide in the last nine years than have died in combat in Afghanistan. To say we have a mental health crisis is such an understatement that I can find no analogy with which to make a suitable comparison. And the scary part is, even if we withdrew all forces from the theater today, the legacy of that mental health damage will continue to take lives for years.

Back to the people who can ease that suffering and save those precious lives and families. Those non-MD's; the PA's, nurses, psychologists, licensed counselors, etc., are the eyes, ears, mouths (and yes) hearts of our mental health system. They have the brains and ability to both assess problems and open doors where solutions can be found. Whether it's in- or out-patient treatment relying on government, private, or faith-based resources, these folks are armed with answers. Our troops are in desperate need of those answers, and the extra funding that would require.