VA Testimony of Antoinette Zeiss, Ph.D. before Congress on August 17, 2007

United States Department of Veterans Affairs

STATEMENT OF
ANTONETTE ZEISS, PH.D.
DEPUTY CHIEF CONSULTANT, OFFICE OF MENTAL HEALTH SERVICES
DEPARTMENT OF VETERANS AFFAIRS
BEFORE THE
SENATE VETERANS AFFAIRS COMMITTEE

August 17, 2007

Good morning Senator Murray, I am pleased to be here today to discuss how the Department of Veterans Affairs ( VA) is addressing the mental health care needs of our veterans.

We have seen returning veterans - from prior eras to the current Operation Enduring Freedom and Operation Iraqi Freedom ( OEF/ OIF) conflict - who have injuries of the mind and spirit as well as the body. Our goal is to treat a veteran as a whole patient-to treat a patient's physical illnesses as well as any mental disorders.

Since the start of OEF/ OIF combat, 717,196 service members have been discharged and have become eligible for VA care. Of those, 35 percent have sought VA medical care. Among those veterans, mental health problems are the second most commonly reported health concerns, with almost 38 percent reporting symptoms suggesting a possible mental health diagnosis. The diagnosis of post-traumatic stress disorder ( PTSD) topped the list for possible mental health diagnoses, and depression and nondependent abuse of substances also had high rates.

VA's data show that the proportion of new veterans seeking VA care who have a possible mental health problem has increased over the past two years. For example, the proportion with possible mental health problems at the end of FY 2005 was 31 percent, compared to nearly 38 percent in the most recent report released in April, 2007. PTSD diagnoses during this same timeframe went from 13 percent to almost 18 percent.

Funding resources are currently available for a VA Mental Health Initiative that supports implementation of our comprehensive Mental Health Strategic Plan that is based on the President's New Freedom Commission on Mental Health. Using Mental Health Initiative funding, we have improved capacity, access and hired over 3,000 new mental health professionals to date.

In addition to our mental health specialty care sites, we have expanded mental health services in Community Based Outpatient Clinics, with on-site staffing or by telemental health. We have enhanced PTSD, homelessness, and substance abuse specialty care services. We developed a Military Sexual Trauma ( MST) Support Team to ensure that VA fully implements MST screening and treatment. We are fostering integration of mental health and primary care in medical facility clinics and in the care of home-bound veterans served by VA's Home Based Primary Care program. Moreover, VA provides services for homeless veterans, including transitional housing paired with services to address social, vocational, and mental health problems associated with homelessness.

Focusing on concerns about suicide in veterans, we have funded a Suicide Prevention coordinator in every VA medical facility. A national hotline for suicide prevention is now available and functioning very effectively. VA sponsored its first Suicide Prevention Awareness Day, which included every VA facility, and will sponsor a VA Suicide Prevention Awareness Week September 9-15, in conjunction with National Suicide Prevention Awareness Week.

In addition to Mental Health services at VA facilities, VA's Vet Centers provide counseling and readjustment services to returning war veterans and, in some cases, their family members, in the community setting. These Vet Centers provide an alternative to traditional access for some veterans who may be reluctant to come to our medical centers and clinics. At Secretary Nicholson's direction, we have increased the number of staff in our Vet Centers by establishing outreach counselors, many of whom are Global War on Terror veterans, themselves.

VA continues to promote early recognition of mental health problems. Veterans are routinely screened in Primary Care for PTSD, depression, substance abuse, Traumatic Brain Injury, and Military Sexual Trauma. Screening for this array of mental health problems helps support effective identification of veterans needing mental health services, and it promotes our suicide prevention efforts, a major priority for VA.

VA will continue to monitor the mental health needs of our veterans through progressive, state-of-the-art programs. VA is approaching the mental health needs of veterans with an orientation that is designed to promote an optimal level of social and occupational function and participation in family and community life for our veterans.

Thank you again Senator for inviting me here today. I would be happy to answer any questions that you may have.