Psychology

Mental health problems such as major depression, post traumatic stress disorder, and traumatic brain injury affect thoughts, moods and behavior affect the majority of United States solders returning from war. Unlike physical injuries, these conditions are difficult to detect. The symptoms of these conditions may delay only to show months after one has been exposed to stress. These conditions pose serious threats if inadequately treated. This paper argues that U.S. veterans returning home do not receive quality health care due to factors that will be discussed in the paper.

Quality of mental Health Care for U.S. Veterans
The United States has been involved in war for almost a decade. This began with the 2001 Operation Enduring Freedom in Afghanistan and the 2002 Operation Iraqi Freedom. The number of troops that has been deployed to serve in these wars totals more than 1.5 million. Veterans that return home from these wars often endure a unique set of stressors associated with long duties and intense urban warfare that results in personalization of violence. In some instances, troops involved in these operations serve multiple tours in theatre with very short breaks which leave them and members of their family to endure the difficulties and worries that characterize separation. When all these factors are combined, the stressful conditions that comes along with more than half a decade of engagement in Afghanistan and Iraq has resulted in the emergence of the need for mental health services which has proven difficult to satisfy.

The United States veterans returning home from combat do not often receive quality health care and this is despite the fact that the majority of veterans suffer from various mental conditions. Statistics suggest that more and more veterans suffer from mental health conditions. Of the troops who have served in Afghanistan and Iraq, approximately 18 percent have symptoms of a major depression or post traumatic stress disorder (Mann, 2009). This population is also likely to have other psychiatric diagnoses and may be at an increased risk of committing suicide and engaging in reckless behavior. By March 2008, the Department of Veteran Affairs mental health services had diagnosed more than 130,000 Afghanistan and Iraq veterans with a mental health disorder.

The United States cannot ensure future readiness of her military forces if the mental health of the veterans and servicemen are not safeguarded. Recent times have witnesses an increase in public disquiet concerning the way that war veterans are being cared for. According to CBS News investigation, 120 veterans of all wars commit suicide every week (Keteyian, 2007). These statistics raised concerns about how the government cares for war veterans. In light of this public concern, the United States government instituted reforms aimed at improving care of the war wounded. Even then, these reforms still fall short of providing quality health care for the veterans.

The drive for policy change has outgrown the knowledge required to inform solutions. There are still some gaps when it comes to understanding mental health and cognitive needs of United States troops returning from Iraq and Afghanistan, the costs of cognitive conditions and mental health, and the available healthcare systems for delivering treatment.

A question that one is bound to ask after reviewing reports and statistics of veterans having mental health problem is whether there are programs and services designed to meet the needs of returning troops who have these conditions. In order to address this issue, there is need to assess the care system and identify the gaps and barriers in care.

In the recent past, the Department of Defense and VA has increased their capacity to provide healthcare especially in areas of mental health. However, there are still gaps in quality and access. The gap between the need for mental health services and how these services are to be used is still wide. The pattern emanate from structural factors that range from availability of providers to personal, cultural and organizational factors. The department of Defense Mental Health Task Force (2007) reported that there are few mental health professionals as compared to when the United States first invaded Iraq in 2003. This shortage in mental health professionals implies that veterans who need and seek mental healthcare did not receive quality care. In other words, the demand for mental health services for troops returning from war is more than the supply of professionals.

Apart from this mismatch between the number of those seeking mental healthcare and the mental healthcare professionals, there are also other factors that bar veterans from seeking care. Reports indicate that there are fears among the veterans concerning the negative effects of using mental health services (Brown, 2008). Survey results from Center for Military Health Policy Research (2008) indicate that the majority of these concerns are founded on career and confidentiality issues and are therefore specifically applicable to individuals on active duty.

There are various challenges faced by VA when it comes to the provision of access to services to returning combatants. These returning members of military service sometimes have to contend with long waiting appointment times especially in facilities that are fundamentally equipped to meet the needs of older veterans.

These access flaws translate into inadequate provision of care services. A survey conducted by Jaycox   Tanielian (2008) discovered that out of all the returning troops who satisfied the criteria for post traumatic stress disorder or major depression, only 53 percent seek help from a provider. Delivery of quality care is also another major issue that the United States still has to grapple with. Only 50 percent of veterans who sought treatment received a minimally adequate treatment. There is high likelihood that the percentage of veterans who receive high-quality care is smaller.

There are also flaws in the ability of the care system to promote and monitor quality healthcare. Specifically, the organizational tools and incentives that support the delivery of high quality mental health care cannot meet the current demands. In the absence of institutional supports, the dream of providing oversight to guarantee high quality care may not be achieved. Even though the Department of Defense had started to offer training in evidence based practices, these attempts are yet to be completely incorporated into a larger system redesign that provides and value incentives for quality of care.

The VA has tried to promote quality of healthcare and is likely to offer a credible model for the improvement of quality of mental health care within the Department of Defense. There are documentation of significant improvement in the quality of care that is being provided by the VA for  depression. However, there has not been an assessment of the quality of care that VA provides for post traumatic stress disorder patients.

Mental health problems may have damaging consequences unless they are treated. Individuals who have such conditions are often at a higher risk of developing other psychological problems. These conditions may harm social relationships. Mental conditions have also been associated with homelessness. The devastating consequences arising from lack of treatment or inadequate treatment indicate that the victims together with the society would reap much benefit if more have access to quality health care.

The outcomes of mental health conditions may also pose high economic toll. However, attempts  to quantify the cost of these conditions only consider the how much the interventions and treatments will cost the government. Direct costs of treatment only makes up a fraction of the total cost that is related to cognitive conditions and mental health. It is therefore important to deliver effective care and restore veterans to complete mental health. This will have the potential of significantly minimizing the longer term costs.

From every dimension of analysis, it becomes clear that returning United States veterans do not have quality mental health care. The capacity of mental health care system in the United states is not adequate enough to handle evidence based care.  There exist substantial needs among the returning veterans that have not been met. The capacity of the Department of Defense to provide treatment for returning veterans is still wanting. Therefore they will need new programs in order to recruit and train more professionals throughout the entire united States health care system.

The existing policies also fall short of encouraging returning soldiers to seek relevant health care. The majority of veterans who require care are normally reluctant to seek it. Unless a way is found for the veterans to obtain confidential services without any discrimination or fear, then it cannot be said that returning United States soldiers are receiving quality health care.

Meeting healthcare requirements of veterans who suffer from mental conditions has proven to be quite challenging. The conditions are highly prevalent and are likely to grow with the ongoing conflicts in Afghanistan. Even though the systems designed to meet these needs have improved, there are still very important aspects that are missing. The conditions may bear serious long term costs in the absence of proper treatment. This matter transcends the department of Defense and the VA and directly impacts on the general United states health care system and the entire society. The majority of veterans normally seek private  care through health plans sponsored by the employer and within the public sector. The United States health care system must adapt to the needs of the veterans if it is to realize its obligations to them now and in the future.