Oxford University Press's
Academic Insights for the Thinking World

Step 4 to end military suicides: Expedite treatment

This week is National Suicide Prevention Week, and we’ve invited John Bateson to write a series of articles on one group that is particularly vulnerable: military service members. Read Step 1, Step 2, and Step 3 of 5.

In 1789, President George Washington said, “The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional to how they perceive the veterans of earlier wars were treated and appreciated by their nation.” Judging by this standard, we are failing.

In 2014, stories of long waits at hospitals and clinics run by the Department of Veterans Affairs domi­nated the news, along with accounts of veterans killing themselves in dismay because they couldn’t see a doctor. The former Secretary of Veterans Affairs, Eric Shinseki, was forced to resign; a new secretary, Robert McDonald, was hired; and numerous other VA health officials were let go. Problem solved? Not exactly.

In June 2015, the New York Times reported that more veterans were on waiting lists than a year earlier. Also, the VA was facing a $3 billion budget shortfall, leading to the prospect of even longer delays. The worsening problem wasn’t due to ineptitude or negligence; it was due to sky­rocketing demand. In the past year, VA doctors and nurses handled more than 7 million patient visits—2.7 million more than they handled in any previous year. In addition, they authorized outside referrals for 900,000 other patients. If that was the peak it might be manageable, but the workload continues to soar. Not only are new veterans from Iraq and Afghanistan flooding VA hospitals and clinics but they tend to have multiple needs that can’t be treated quickly or easily.

The VA has a big mandate. Among other things, it’s the largest health care provider in the country. That doesn’t excuse the fact that many veterans still wait months for their claims to be processed, however, or to get a medical appointment.

Many veterans who served their country with pride now feel abandoned. The biggest impediment for them in transitioning to civilian life is receiving health care and compensation for injuries they suffered that are related to their military service. Both must be provided sooner rather than later. If nothing else, first-time claims should be handled before second-, third-, and fourth-time claims, and veterans claiming 100% disability should have their cases reviewed before those who are claiming 10 or 20% disability, although the latter can’t be ignored. Veterans who have reapplied either because their initial claims were denied or because they are seeking increased benefits as a result of their condition worsening need to be cared for as well.

Prior to 1990, Congress considered closing down the whole VA health care system and giving veterans vouchers to use at private facilities because of substandard treatment at VA hospitals. Over the next 15 years, changes were implemented that resulted in improved care, greater consumer satisfaction, and a 2006 award from Harvard University for “Innovations in American Government.” Today, though, the onslaught of new patients is taxing the VA far beyond its current capacity. Perhaps it’s time to reconsider the idea of a different system of care for veterans, one in which treatment and claims can be expedited so that needs are met promptly. It won’t be cheap, but then the VA with its total budget of $140 billion and 335,000 employees, including 22,000 mental health specialists, isn’t cheap, either.

Feature Image: American flags by Lipton Sale. CC BY-SA 3.0 via Wikimedia Commons 

Recent Comments

There are currently no comments.

Leave a Comment

Your email address will not be published. Required fields are marked *