Psychological Medication Still a Problem at the VA

Mitch is a homeless 45 year old veteran I met in the high desert. He has a heartbreaking story that has affected his life. He was betrayed by his parents who traded him for drugs, during that time he was sexually molested from ages 5-8 before being placed in the foster care system. He has struggled his whole life because of it. When he aged out he went in the Army hoping to gain a better life. Like many veterans he joined the military to escape the situation he was in, the problem is his past followed him. He was sexually assaulted in the Army too but like many did not report it to his command. During his life he continued to excessively drink alcohol to numb his pain so he could deal with the shame of being molested and raped. Many people don't realize that in 2012 an estimated 13,900 men were sexually assaulted in the military. Men are less likely to report the sexual assault, therefore this is probably a low number. Imagine what it was like over 25 years ago. Mitch received an honorable discharge from the Army, but it was "highly suggested" he not attempt to re-enlist by his Commanding Officer due to his substance abuse.

One of the biggest problem clinicians are struggling with concerning veterans is duel diagnosis. Duel diagnosis is a combination of a diagnosable psychological disorder and comorbid substance abuse. Mitch has a duel diagnosis. He has Post Traumatic Stress Disorder (PTSD) from his molestation and sexual abuse and alcohol abuse because he was trying to deal with his PTSD. In a report published in 2009 an estimated 29% of veterans with mental health problems were diagnosed with duel diagnosis and 33% of those were diagnosed with 3 or more diagnosable disorders. I have worked with several clients that have duel diagnosis and it is troublesome to say the least.

The more I work with veterans on their mental health issue the more I see them refusing to work with the Veterans Administration’s (VA) mental health system. Mitch didn’t file a claim because of the shame. He tried to get services but he struggled to make his appointments. Most veterans who don’t trust the VA don’t file a claim and continue to self-medicate to deal with their pain, creating and maintaining their duel diagnosis. Some veterans are scared to get help or file a claim because of the VA’s reputation of giving them psychiatric drugs and sending them out the door. Some fear being forced to take medication or be denied their claim. I have talked to several veterans who have refused to get mental health assistance through the VA because of their reputation of drugging them instead of helping them with counseling. Some have been to the VA and been given medication, but stopped taking it because it made them feel worse. There are several reasons some veterans don’t seek mental health help, the fear of being catatonically medicated is one of them. The VA doesn’t feel there is a drug problem, but some veterans I talk to disagree. Whether it is the truth or not, veterans are scared to seek help due to their perception, what they read, and what they hear from other veterans.

In some VA locations a medication approach is being taken because they are overwhelmed. Between 2007 and 2013 there was a 40% increase in the number of veterans seeking mental health care in west LA alone. Where this is a huge increase in clients the number if psychologist and psychiatrists only increased by 12%. A RAND Corporation study anticipates a 30% of all Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) will meet the full criteria for PTSD, depression, substance abuse, or anxiety disorders. That is about 810,000 Soldiers, Sailors, Airmen, and Marines. There is a real problem within the VA concerning mental health issues that is not being addressed properly. The information in the media about the VA fuels veteran’s fears and feeds into their paranoia that the VA just wants to drug them and send them on their way. Many are scared to go to the VA for obvious reasons.

Fortunately, local community organizations have taken up the slack in some areas. Some states like California have mental health programs for veterans. These programs have been put into place because the VA is overwhelmed or ill prepared for today’s veterans. Also, these programs are in place to catch those who don’t trust the VA or meet their criteria for VA services. Often these services include the families of the veteran in the mental health treatment process. Also, there are multiple non-profit agencies available for services. Look at your local community for help if you do not trust or are not near a VA facility.

For questions or comments, I can be reached at bo@afterdutyvets.com or visit our website at afterdutyvets.com.