Making Health Care Better Series

Bess, thank you for that kind introduction.

On behalf of America’s Veterans, my deep thanks to everyone who has made this second event in the Making Health Care Better Series possible. 

Let me acknowledge our Veterans Service Organizations and their leaders who help bring the challenges of Veterans mental health needs to national attention, the diverse group of researchers and leaders gathered here to discuss quality care for Americans suffering from mental health conditions, and all of the other stakeholders in the fight for better mental health care.

Elevating the conversation on mental health means finding solutions. It means getting to the tangible outcomes that are truly transformational—for our Nation’s Veterans and for all Americans. Mental Health is a national problem that has to be solved collaboratively. And that’s why we’re here.

At VA, we’re privileged to have a truly exceptional mission we take from President Lincoln’s Second Inaugural Address—to care for those “who shall have borne the battle,” and their families. We also have exceptional institutional values—Integrity, Commitment, Advocacy, Respect, and Excellence. We know them by their acronym, I-CARE, and they are the foundation on which all of our efforts are built.

Our mission at VA is noble. I’m proud to be a part of it. But it’s not just my mission—not just VA’s mission. Taking care of America’s Veterans is a mission so important and so broad that no single agency can do it all. When we work together and collaborate to best serve Veterans we’re all answering President Lincoln’s charge for those who have “borne the battle.”

The costs of war endure far longer than wars themselves. After more than 15 years at war, more and more Servicemembers are surviving combat. Many of them live with both the visible and invisible wounds of war. We anticipate that the demands for VA mental health care will continue to grow as active duty personnel continue to return from service in the Middle East. Their mental health needs are no less important than their need for physical wounds—both deserve the same high standards of excellent clinical care and treatment.

To serve the growing number of Veterans seeking mental health care, VA has deployed significant resources and increases in staff, and we’re working closely with the Department of Defense and Health and Human Services through the Interagency Task Force and Cross-Agency Priority Goal for Servicemembers and Veterans Mental Health.

Through these efforts, we are implementing President Obama’s 2012 Executive Order and 2014 Executive Actions to improve access to mental health services and quality of care for Servicemembers, Veterans, and their families.

We’ve also integrated mental health services into primary care in the new Patient Aligned Care Team model—PACT teams. We’ve learned that providing mental health care within the primary care clinic minimizes barriers and reduces stigmas that sometime discourage Veterans from seeking needed care. This has increased the number of Veterans whose mental health needs are recognized and treated early in the course of illness. 

In fact, the number of Veterans receiving specialized mental health treatment from VA has risen each year, from over 900,000 in Fiscal Year 2006 to more than 1.6 million in Fiscal Year 2015.

Addressing mental health issues is not just about the number of people treated and how quickly they are treated. It’s also about ensuring that individuals facing mental health challenges and their families know that help is available and treatment is possible.

In addition, VA has programs for Veterans who, due to symptoms related to mental health conditions, have interactions with the Justice system. Given their high rates of mental health conditions and substance use disorders, VA places special emphasis on outreach to Veterans who are homeless or at risk for homelessness. We owe it to them to save them from the worst possible outcomes and help them find productive alternatives to incarceration and life on the streets. We are proud to be working with over 400 Veteran Treatment Courts and other Veteran-focused courts across the country. The number of those courts has grown dramatically over the past eight years.

VA is working to fulfill our commitment to Veterans by putting their needs, expectations, and interests first. That’s what our five MyVA transformation strategies are about. We’re modernizing VA by improving the Veteran experience, improving the employee experience, improving internal support services, establishing a culture of continuous improvement, and expanding strategic partnerships.

And that fifth strategy—expanding strategic partnerships—involves all of you. Best serving Veterans and their families depends on networks of collaborative relationships generating the greatest innovations—strategic partnerships that drive important advances in health care and research.

VA spends $1.8 billion annually on research, leading to major breakthroughs in medical science. Our research initiatives, outcomes, and honors are tremendous. Few know that VA researchers have received three Nobel Prizes and six prestigious Lasker awards. VA researchers pioneered electronic medical records and bar-code software to safely administer medicines, developed the implantable cardiac pacemaker, proved an aspirin a day reduces risk in heart patients, conducted the first successful liver transplants, created the nicotine patch, and demonstrated that patients with total paralysis can use their minds to control robotic arms.

And we’re pioneers in mental health research—discovering effective, evidence-based treatments, including state-of-the-art psychotherapies and biomedical treatments for the full range of mental health conditions, including PTSD.

Almost everything we do on behalf of Veterans is related to other things we do. None of VA’s initiatives and programs exist in a vacuum. Mental health issues, including PTSD and depression, are often a contributing factor to a variety of other problems some Veterans face. These issues, perhaps in combination with other physical injuries—including TBI, substance abuse, and relationship issues—sometimes lead to a downward spiral that can lead to homelessness, incarceration, and, in some cases, suicide.

Anybody read the comic strip “Doonesbury”? Remember the character B.D.?  B.D. suffered from both physical wounds and mental health issues. The situation Gary Trudeau portrayed could have had a very different ending. But in Trudeau’s column, B.D. got the help he needed—early intervention and friends at a VetCenter. B.D.’s problems, as in the case of many Veterans, were clearly evident to those around him—but not to B.D. himself. Gary Trudeau did a great service taking a serious and all-too-real situation for many Veterans and making it understandable for a larger audience.

That’s education.  

I am not a doctor or clinician, but I believe early diagnosis and treatment of mental health needs can produce positive results for many Veterans. As with homelessness, our requirement for resources is much greater once Veterans enter the downward spiral I described. Early intervention, diagnosis, and treatment can prevent greater tragedy, and perhaps save a life. What do any of us do that’s more important than saving the life of a loved one or a Veteran?
 
I count myself blessed to be working full-time for Veterans. We’ve made a lot of progress, but we still have much work to do. If we are going to best serve Veterans—who have put so much on the line for all of us—then we must work together to see that they have the services and health care they have earned and deserve. The goal of today’s dialogue, and the Making Health Care Better Series, is about achieving transformational outcomes for Veterans and for all Americans.

Together, we can make a difference.

On behalf of VA, thank you for all you are doing to better serve America’s mental health care needs.