July 2008

Learning from History: Ensuring Access to Care for a New Generation of Veterans

They say that those who do not learn from history are doomed to repeat it. Decades ago, amid a polarized political situation in which veterans were alternately heralded and despised depending on one’s view of the war in Vietnam, society failed to address veterans’ crippling psychological wounds. NYSHealth recently unveiled an initiative to ensure that we do learn from mistakes in treating the psychological wounds of Vietnam veterans, and that we avoid failing a new generation of returning soldiers.

Many of the 30–50,000 Iraq and Afghanistan veterans who have returned to New York State face challenges seeking care for psychological wounds incurred during their duty overseas. Early national data show that one in three Iraq veterans will suffer from psychological injuries, including depression, anxiety or Post Traumatic Stress Disorder (PTSD). The incidence and severity of psychological wounds is heightened by multiple deployments—one study showed that soldiers deployed more than once to Iraq were 50% more likely to be diagnosed with mental health injuries than those on their first deployment. We also know that when veterans’ psychological wounds are not addressed promptly, they are at increased risk of chronic mental illness, substance use, domestic violence, homelessness, joblessness and even suicide.

NYSHealth has identified three challenges affecting veterans’ health that must be addressed in a timely manner:

1. The families of veterans returning from Iraq and Afghanistan are in need of readjustment mental health services, but are ineligible for care through the U.S. Department of Veterans Affairs (VA) health care system.
2. Veterans do not consistently have timely access to primary care and mental health and substance use services through the VA or other systems of care because of bureaucratic barriers and real or perceived stigmas.
3. A unified, knowledgeable, and credible voice in New York State needs to emerge to communicate the needs of returning veterans and their families and recommend policy solutions for addressing these needs.

NYSHealth has awarded two grants to help returning veterans and their families immediately address psychological wounds and reintegration issues:

The Rochester Veterans Outreach Center

The Jewish Board of Family and Children’s Services

Additional grantees under this initiative will be selected and announced over the next several months.

Addressing veterans’ health issues requires a coordinated effort among numerous agencies and stakeholders (both public and private) to ensure that veterans and their families have the support they need to reintegrate into society. Our veterans have made so many sacrifices for our nation; we owe it to them to create a health system that ensures their needs are met as they return to civilian life.

James R. Knickman