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
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
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
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. ▪