APA Urges Congress to Extend Types, Length of Care for All Vets

Adding three more years of eligibility for veterans' health care treatment to the existing two years of postcombat care new veterans may receive was among the measures APA urged members of Congress to support during recent testimony.

James H. Scully Jr., M.D., APA's medical director, told members of the House Veterans Affairs Committee in May that extending the coverage period would allow the symptoms of posttraumatic stress disorder (PTSD) and other combat-related mental illness to become clear in returning troops. This would make it more likely that they would receive the specialized care for which the Department of Veterans Affairs (VA) is often lauded.

Extended VA health care access “is especially important when it comes to monitoring PTSD and traumatic brain injury (TBI) as their effects can take time to become apparent,” Scully stated.

He was on Capitol Hill to express APA's support for a bill, Returning Servicemember VA Healthcare Insurance Act of 2007 (HR 612), that would extend eligibility for VA health care following service in current and future military conflicts. The measure is sponsored by the chair of the committee, Rep. Bob Filner (D-Calif.).

Greater congressional funding is needed to expand knowledge related to the detection and treatment of TBI, Scully said. This relatively new area of mental health will have an impact on many Iraq and Afghan war veterans because of the extensive use of improvised explosive devices, which cause extensive head injuries.

Saul Rosenberg, Ph.D., a clinical and forensic psychologist at the University of California, San Francisco, and the San Francisco VA Medical Center, told members of the congressional committee that TBI is very treatable, though not much of the benefit from care is derived in the first six months after the injury is sustained. The increasing use of waiting lists for care within the VA “squander[s] the opportunity for the most effective care,” he said.

Among those who urged expanded support and coverage for PTSD care was Beth Hudnall Stamm, Ph.D., director of Telehealth at the Institute of Rural Health at Idaho State University. She testified that the many homeless Vietnam-era veterans need a package of treatment and other types of support to prevent them from having to use much more expensive institutional care because their mental illness has gone untreated.

“We can move people from a position where they are a drain on society to where they are contributing,” she said.

Among the immediate steps Congress could take to improve veterans' access to care overnight, Scully told committee members, is increasing reimbursements as a way to attract physicians and other health care professionals who do not participate in the system.

He also urged Congress to allow members of the National Guard and Reserves access to the VA system, which is experienced in providing mental health care. The lengthy combat exposure of these units in Iraq and Afghanistan and their dependence on private, postdeployment health care with weak mental health coverage will leave many untreated, Scully noted.

“Members of the National Guard now get their care from private employer-sponsored health insurance renowned for not covering quality mental health care,” Scully said.

Members of Congress noted that part of the challenge of mental health care efforts is that the private-sector health care system does not provide the mental health detection and care that the military and VA systems are now urged to cover. But that difference does not excuse their obligation to the members of the military and veterans, Scully said.

“We could use our position to make changes that could become models for other parts of the community,” Filner said.

Rep. Vic Snyder (D-Ark.) called for better mental health screening of military applicants to avoid recruitment of people at high risk of mental illness or addiction, “who are not going to do well in a military or combat environment.”

The text of the Returning Servicemember VA Healthcare Insurance Act of 2007 can be accessed at<http://thomas.loc.gov> by searching on the bill number, HR 612. ▪