AMES, Iowa – Tasked with leading an independent evaluation of Veterans Affairs mental health services has given Alicia Carriquiry a new perspective as to the challenges veterans and their families face.
It’s an issue the Distinguished Professor of statistics at Iowa State University was aware of before being appointed chair of the Institute of Medicine committee conducting the review. But she never fully understood the need for better mental health services until listening to parents, spouses and veterans’ advocates testify about their situation – stories she will never forget.
“We heard from the parents of one veteran who teetered on the edge for years, never getting the type of care that he needed until he took his own life. It’s these stories that just break your heart,” Carriquiry said.
The personal testimony is one piece of information the committee is collecting as part of its four-year review. Carriquiry, who has been part of Institute of Medicine panels in the past, says it is emotional work, but they must put emotion aside to look at the issue objectively. Committee members are also surveying veterans, visiting hospitals and clinics in each of the VA’s 21 geographic regions and reviewing the published work of other researchers, as part of their evaluation.
It is up to Carriquiry and her colleagues to identify roadblocks and recommend solutions for the VA to improve access to mental health care for veterans who served in Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn. But not all roadblocks are a result of institutional problems. In some cases, veterans opt not to seek help because of the stigma, Carriquiry said.
“Some veterans don’t want to get mental health care for fear of other people or even their superiors thinking they have some character flaw,” Carriquiry said. “Many of these veterans truly need mental health care. They may be homeless or suffer from dependencies, such as alcohol and drugs, and those are the veterans we want to reach to understand why they are not using the VA services.”
There are several issues for the committee to consider. Many veterans live in communities or rural areas in which there are no mental health care providers. According to a study by the RAND Corp., service members and their families are less likely to get the care they need if they have to travel 30 minutes or more. This affects nearly 36,000 active service members, more than 230,000 National Guard or Reserve members and around one million family members, the study found.
“The sheer number of individuals who have come back from the war with needs is astounding,” Carriquiry said. “We don’t always understand the toll that war takes on individuals and their families, unless you know a veteran. If you don’t know a veteran, you simply don’t understand how hard it is for people to be deployed two, three or four times.”
The 18-member committee includes veterans, psychiatrists, psychologists, statisticians, nurses and former VA professionals. Now in its second year, the committee is visiting VA facilities and conducting the survey. The group will submit a final report in 2017.