NAMI Veterans Testify Against Erosion of VA Psychiatric Care

Posted on October 7, 2003

Arlington, VA - The Veterans Committee of NAMI, the Nation’s Voice on Mental Illness, testified today before the Department of Veterans Affairs (VA) Capital Asset Realignment for Enhanced Services (CARES) Commission that lack of capacity and access to treatment represents "one of the greatest unmet needs" of the VA health system for military veterans with severe mental illnesses.

NAMI National Board member Roscoe Swann, a veteran of the Vietnam War with 30 years military service, warned the Commission that "Across the nation, the VA has undertaken elimination of critically needed services and supports for our most vulnerable veterans, yet there has not been an appropriate increase in community-based treatment and programs needed to address the needs of veterans."

"The VA should not make the same mistakes that so many states and communities have made over the past quarter century," Swann declared at the hearing, held in the Russell Senate Office Building on Capitol Hill.

Specifically:

• Twenty percent of veterans in the VA health care system need mental health treatment. Approximately 455,000 veterans have service-connected disability due to a mental illness. Approximately one-quarter have been treated for schizophrenia, one of the most disabling brain disorders.

• VA mental health services are "far below the expectations" of the 2001 VA Health Care Programs Enhancement Act (P.L. 107-135) requiring maintenance and improvement of services in the current system and replacement of lost capacity.

• In FY2002, the VA spent only 77% of the amount in FY1996 for veterans with serious mental illnesses: a decrease of almost $480 million annually, despite Congressional mandates that the VA focus on high priority veterans, including those with mental illnesses.

• Only 20 percent of veterans with mental illnesses are receiving in-patient care. From FY 1994 to FY2001, the number dropped from 58,000 to 36,000 as the result of a limited number of inpatient beds and dramatic shift to outpatient treatment.

• FY1998 data revealed that almost 40,000 veterans with severe mental illnesses require intensive community case management services, but only 8,000 receive it. Furthermore, only 2,000 are enrolled in treatment programs that meet standards set by the federal Substance Abuse & Mental Health Services Administration (SAMHSA).

"Decisions to close psychiatric services at one or more centers have frequently resulted in hardships for veterans trying to remain compliant with their outpatient regimen of appointments and medication," Swann warned. "The results are predictable—more frequent relapses and homelessness."

Swann’s testimony coincides with National Mental Illness Awareness Week (MIAW), October 5-11.