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Building a 21 st Century VA: Challenges to Meeting the Mental Health Needs of the

Building a 21 st Century VA: Challenges to Meeting the Mental Health Needs of the Newest Generation of Veterans Jackie Maffucci , PhD Research Director Iraq and Afghanistan Veterans of America (IAVA) Institute of Medicine Public Meeting June 5, 2014. About IAVA.

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Building a 21 st Century VA: Challenges to Meeting the Mental Health Needs of the

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  1. Building a 21st Century VA: Challenges to Meeting the Mental Health Needs of the Newest Generation of Veterans Jackie Maffucci, PhD Research Director Iraq and Afghanistan Veterans of America (IAVA) Institute of Medicine Public Meeting June 5, 2014

  2. About IAVA Mission: Improve the lives of Iraq and Afghanistan veterans and their families. Nation’s first and largest nonpartisan, nonprofit representing Iraq and Afghanistan veterans Over 270,000 member veterans and civilian supporters Provides assistance to veterans, raises awareness about veteran issues and advocates for supportive policies IAVA Research Department analyzes key issues for this generation of veterans

  3. IAVA Annual Member Policy Survey Focus: Health, VA utilization and benefits, education and employment 2014 Survey Demographics: 26-35 years (42%) Male (90%) Caucasian (74%) FT employed (45%) Married (65%) Combat veterans (100%) Army (62%) Enlisted (77%)

  4. Mental Health Injuries Reasons Not Seeking Care 1. Don’t want to be perceived differently by friends, family or peers (46%) 2. Concern that it might affect their career (33%) 3. Difficulty getting time off work (23%) 4. Never returned after an initial visit (22%) 5. Prefer talking to friends/family (20%) 60% Physically wounded in service 53% have a MH injury • 74% seeking care

  5. Mental Health Support: Provider Choice and Satisfaction N=637 N=126

  6. Access to VA care continues to be a challenge “ Care, when I can get it, is great. However, they have an immense workload. Too many patients and not enough doctors.” “Once I got into a program and with a provider that fit, I’ve had nothing but positive things come out of my treatment.”

  7. Access to VA care continues to be a challenge “Their hours conflict with most employment hours. Severe wait for appointments. Poor access to high frequency care without having to be an inpatient.” “At times I have been extremely satisfied. But the VA has a habit of changing policy as to what medication they will support. I have been in the situation where the VA stops supporting the mental health medication that was found to work.”

  8. Mental Health Resources 39% know an Iraq or Afghanistan veteran that has a mental health injury and has not sought care 70% have suggested to a friend not getting care that they seek help Top 5 Recommended MH Resources Mental Health Professional (68%) Vet Center Counselor (55%) Veteran Crisis Line (51%) Peer Support Group (43%) VA Staff Member (38%) “The Vet Centers are great… If it weren't for the walk-in policies of the Vet Center I could have really done myself some damage.”

  9. Experiences with Suicide 31% have thought about taking their own life since joining the military 47% know at least one Iraq or Afghanistan veteran who has attempted suicide 40% know at least one Iraq or Afghanistan veteran who has died by suicide

  10. Summary from IAVA Member Survey IAVA member survey respondents have a variety of health challenges, including mental health. Majority of respondents with mental health injuries are seeking help. ~60% with MH injuries are seeking help at the VA. • Those seeking help at the VA indicate challenges with access to care, but generally are satisfied once in care. Loved ones play an important role in help seeking behavior.

  11. IAVA’s Principles to Combating Suicide (AC5) Access to high quality care • Ensure combat veterans have access to mental health care when they need it • Ensure our most vulnerable have access to care Capacity to support the need of servicemembers and veterans • Define the mental health provider need and hire to meet the need • Ensure the VA provides incentives that compete with the private sector and other Federal agencies

  12. IAVA’s Principles to Combating Suicide (AC5) Care that is based in evidence and of the highest quality. • Standardizing definitions of effective • Identifying effective programs with rigorous program evaluations • Shared best practices Crisis recognition to proactively identify those at risk and provide immediate intervention. • Train all VA personnel to identify warning signs and have an SOP for immediate care

  13. IAVA’s Principles to Combating Suicide (AC5) Continuity that ensures no servicemember or veteran is lost in the system on the road to recovery. • Interoperable electronic medical records • Advance notice for changes in care • Standard DoD/VA drug formulary Community support to ensure that troops and veterans have a network of care and a nation behind them throughout their lives. • Private/Public partnerships • Improve focus on integrating family/loved ones

  14. Contact Information Thank You! Jackie Maffucci, PhD Research Director, IAVA Phone: 202.544.7692 Email: jackie@iava.org www.iava.org

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