7-2 Final Project Submission: Healthcare Delivery Systems Research Paper

A Gap in Equity Related to Mental Health Access for Veterans
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A Gap in Equity Related to Mental Health Access for Veterans
Introduction
The United States of America is undeniably one of the countries with the most significant army troop’s deployed and engaged in battlefields in different parts of the world. Besides the substantial financial implications of the active military participation to the federal government, immense losses are felt by the individual military personnel together with their family members. After the American government commitment towards the war against terror, reported cases of mental illness and trauma had increased continuously amongst the American veterans (Hester, 2017). Substance abuse disorders, anxiety, depression, and posttraumatic stress are among the most health issues affecting the veterans in the United States. Despite the continuous discussions and concerns being raised concerning this matter by several stakeholders in the military, government, non-governmental organizations, and the public there still exists a wide disparity in the access to mental health care services for the American veterans.
The Vietnam War experienced one of the largest group of American soldiers to be deployed to a foreign land for battle. However, the aftermath of the war has been attributed to some negative issues that have affected the men and women who served in this particular war up to date. With more than 6,600 American soldiers killed and 48,000 others seriously wounded, the war left the American soldiers with a huge health crisis that is yet to be addressed exclusively by the government and other stakeholders (Hester, 2017).

In most cases, homelessness, lack of employment opportunities and unstable families have left the veterans with significant health issues that have seriously affected their wellbeing. According to a study carried out by the American Public Health Association (2014), 56% to 87% of the veterans’ experience psychological distress after they are back from battle deployment.
Military culture plays an essential role in the mental health care access for the American veterans. Post et al. (2010) illustrate that the military culture tends to promote inner strength, self-reliance and stoic behavior which in turn influences great stigma against seeking medical assistance regarding issues affecting their health care. Secondly, lack of education among the veterans is the other issue that has caused the existing inequity among mental health care for the veterans. In addition to this, most of the veterans believe that there is exists no proven solution against mental disorders. Lack of understanding towards mental health hinders the veteran’s access to mental health care services. More specifically, access to mental health care is an expensive endeavor that makes it likely unattractive to the veterans who are always under financial crisis, homelessness and lack of job opportunities (Drapalski et al., 2008). As such, it becomes challenging for the army personnel to seek mental health care services.
The equity gap for veterans’ access to mental health care has a relatively direct consequence on the quality and effectiveness of the healthcare services delivered to the army men and women. In most cases, the veterans are unable to acquire timely and the most effective healthcare services. The equity gap regarding the mental wellness of veterans has an adverse implication on these individual qualities of health and their families. Increased suicide cases, family instability, homelessness are among the significant negative impacts of the equity gap to the access of mental health care for the American veterans.
Existing initiatives
In 2002, the American Federal Government commissioned the Veteran Affair initiative; it was mandated to assist with the brain diagnosis for the American veterans. Besides the brain diagnosis, the initiative was also required to look into health issues for the veterans. By the year 2014, 1.16 million veterans had registered for the program with more than 57.2% receiving the provisional diagnosis for mental health (Pickett et al., 2015).
First and foremost, the primary objective of the Veteran Affair initiative was to present complimentary service to the veterans and their relatives (siblings and spouses) as an appreciation for their service to the country. Secondly, the VA initiative was commissioned to adhere to the Promise of President Lincoln of caring for the American servicemen and women; orphans and the widows of the veterans who died during the war. Also, it was mandated to help eliminate homelessness and joblessness amongst the veterans. The VA initiative would also ensure economic security for the American veterans. Through the subsidization of healthcare for the veterans, the military personnel could channel their incomes to other family matters.
The commissioning of the VA initiative was as a result of issues that had been raised regarding the serious problems that American soldiers were subjected to after coming back from war. The Department Affairs (2017), stated that a large number of deaths of American veterans serving in different battles. Soldiers are coming back home with serious injuries which resulted in mental health issues, more specifically trauma. Lack of employment and homelessness are among the problems which promoted the development of Veterans Affair initiative. The federal government funds the initiative through taxes derived from the American citizens. In another case, the organization receives donations from several well-wishers towards the efforts of improving veterans’ mental health and wellbeing.
Besides the well-articulated goals and objectives of the VA initiative, the organization has performed poorly in its activities to improve the access the mental health care for the veterans. The timeline for healthcare service delivery to the veterans has been a significant issue of concern which affects the veterans’ access to effective mental health care. In several instances, the mental health care provided through the VA initiative has been ineffective leading to lack of proper mental health recovery for the veterans. Thus, the issue has greatly affected the families of the veterans’ to an extent they are forced to dig deeper into their pockets to finance costly mental health care services from private healthcare providers.
Regulation
In 2015, Senator Joni Ernest presented the Prioritizing Veteran Access to Mental Health Care Act of 2015. This bill influenced the development and enactment of new regulations which were set to ease veterans’ access to mental health care. Also, it resulted in the amendment of the veterans’ health raw through the removal of barriers that had been put in place to curb veterans access to mental health care. In this regulation, all the restrictions that had been enacted by the previous regulations were abolished and replaced with a more comprehensive regulation that sort to expand veterans’ access to mental health care services. The regulation proposes incentives to be provided to the veterans towards the hiring of mental healthcare professionals in the VA administration. However, if a veteran feels that he or she is not receiving adequate and on time mental health care at these centers, incentives through authorization of non-VA care ought to be ratified. Additionally, President Trump signed into law the Veterans Access, Choice, and Accountability Act of 2014, that authorized the VA to become the sole medical health care costs disbursing agency relating to mental health care issues suffered by the veterans (Hansler, 2018). These regulations are primarily mandated to ease access to mental healthcare services for the American veterans. Besides the development and formulation of these bills and regulations, access to mental healthcare services through the VA initiative is yet to address the health problems faced by the veterans. In several instances, the veterans have to wait up to 36 days to receive poor healthcare services in the VA centers. As such, this indicates that much needs to be done beyond formulation of regulations.
Conclusion
The American veterans have for an extended period experienced a disparity towards access to efficient mental health care services. It is relatively important to note that this particular gap is attributed to various factors which include but are not limited to, lack of education, joblessness, homelessness and the misleading military culture. In this case, the veterans are unable to acquire the most effective mental health care even after they have sacrificed their lives and those of the families to serve the American people. The commencement of the Veteran Affair initiative has tried to highlight some of the issues faced by the veterans over the years. However, much need to be done since a large number of these people require more advanced and effective access to mental health care providers. The existing regulations concerning the VA initiative have played a significant role in the expansion of mental health care access for veterans.

References
American Public Health Association. (2014). Removing barriers to mental health services for veterans. Policy statements and advocacy.
Department Affairs. (2017). History – VA History – About VA. Va.gov. Retrieved 11 February 2018, from https://www.va.gov/about_va/vahistory.asp
Drapalski, A. L., Milford, J., Goldberg, R. W., Brown, C. H., & Dixon, L. B. (2008). Perceived barriers to medical care and mental health care among veterans with serious mental illness. Psychiatric services, 59(8), 921-924.
Hansler, J. (2018, January 20). These are the bills Trump signed into law in his first year as President. Retrieved February 26, 2018, from https://edition.cnn.com/2017/06/29/politics/president-trump-legislation/index.html
Hester, R. D. (2017). Lack of access to mental health services contributing to the high suicide rates among veterans. International journal of mental health systems, 11(1), 47.
Pickett, T., Rothman, D., Crawford, E., Brancu, M., Fairbank, J., & Kudler, H. (2015). Mental Health among Military Personnel and Veterans. Retrieved 11 February 2018, from http://www.ncmedicaljournal.com/content/76/5/299.full
Post, E. P., Metzger, M., Dumas, P., & Lehmann, L. (2010). Integrating mental health into primary care within the Veterans Health Administration. Families, Systems, & Health, 28(2), 83.