January 20, 2014

Veterans’ Affairs’ (VA) Mental Health Efforts Fall Short of Need

The VA will spend more than $7 billion on mental health care this fiscal year. But it will still not be enough to meet the needs of veterans who need mental health care, according to a new policy brief from the Center for American Security, which cites the numbers of suicides within this group as the most severe manifestation of the mental health need of veterans.

“Historically veterans’ mental health care needs have risen sharply over time, with peak expenditures occurring 10 to 20 years after the end of war,” the report states. “This was true for the Vietnam War cohort and will likely be true for the post-9/11 combat cohort as well. Now is the time for the VA to act decisively to meet these generations’ needs—while it has ample resources to do so, before the demand among post-9/11 spikes.”

The study recommends several approaches that the VA could use to expand access to mental health care, including better health record sharing, pairing with outside resources and contractors to deliver health services, and investing in emerging technology (e.g., telemedicine) and virtual reality technology. Telemedicine, according to the study author, holds particular promise for expanding VA care in underserved communities (such as rural areas), and for serving the “digital natives of the millennial generation, for whom communication via Skype is as natural as participa¬tion in a Vet Center rap group was for the Vietnam War generation.”

Also, according to the report, the latest advances in avatar technology and artificial intelligence provide computer-generated simulations that can replicate the clinical environment. “These simulations can be used to generate mental health care capacity, through training of new clinicians and developing cultural competency among existing providers. In the future, such technologies could also mature to the point where they can be used for clinical treatment as well. With additional investment and development, virtual reality counseling sessions could be used to moni¬tor veterans and provide other rote forms of clinical support. It is even possible to imagine counseling provided through virtual reality simulations that would go beyond this, such as counseling groups that would bring together veterans in a virtual environment to interact via avatars.”