Testimony to
NYS Assembly Standing Committee on Veterans’ Affairs and the NYS Assembly Standing Committee on Women Veterans

ISSUES RELATED TO THE TRANSITION OF WOMEN VETERANS
RETURNING FROM A COMBAT ZONE TO CIVILIAN LIFE AND
THE STATE ACTIONS THAT MAY ASSIST THIS PROCESS

October 2005

Thank you very much for the opportunity to address this pressing issue at what is truly an important time in our nation’s history.

For those unfamiliar with our organization, the Mental Health Association in New York State, Inc. (MHANYS), represents individuals living with mental health needs and is dedicated to ensuring that public mental health policy is fair, just and promotes equality and opportunity. Just as MHANYS is an affiliate of the National Mental Health Association, based in Washington, D.C., there are 31 individual Mental Health Associations throughout New York State providing a broad range of services in 56 of the 62 counties.

In the past 50 years, the science and technology surrounding the diagnosis and treatment of mental illness has advanced at an incredible pace. For many years, we, as a society, had no better answer for people living with mental health needs than to place them into psychiatric hospitals where they would remain for many years. With advances in medical science and the availability of medications, the state’s inpatient census has declined from a high of nearly 95,000 in the 1950s to approximately 4,000 today. These advances in treatment technology continue today with new advances being made at seemingly light speed. However, despite all the medical advancements, the stigma associated with a psychiatric diagnosis can have as negative an impact on the lives of individuals living with mental illness as the illness itself, often times causing people not to seek treatment.

50 years ago, for veterans returning from war, there were few good options for those facing mental illness upon returning to our society. The most common of the diagnosed disorders for veterans are anxiety disorders, such as post-traumatic stress disorder (PTSD). “PTSD is a psychiatric disorder that can occur following the experience or witnessing of life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or violent personal assaults like rape. People who suffer from PTSD often relive the experience through nightmares and flashbacks, have difficulty sleeping, and feel detached or estranged, and these symptoms can be severe enough and last long enough to significantly impair the person's daily life” (National Center for Post-Traumatic Stress Disorder (NCPTSD)).

However, as a February 28, 2005 USA Today article, "Trauma of Iraq war haunting thousands returning home; A new generation of vets is seeking help for stress disorder," points out, “Comparisons to past wars are difficult because emotional problems were often ignored or written off as ‘combat fatigue’ or ‘shell shock.’ PTSD wasn’t even an official diagnosis, accepted by the medical profession, until after Vietnam.”

Today, we not only have the ability to properly diagnose such illnesses, but a wide array of treatment regimens are available as well - typically including counseling, often accompanied by medication. Yet, as mentioned before, many people living with mental illnesses are reluctant or resistant to seek treatment due to the stigma associated with the illness.

The US Defense Department recently released a study of soldiers returning home from the war in Iraq which found that those soldiers in the greatest need for mental health services were the least likely to seek treatment based on stigma. Taking this into consideration, it is understandable how some contend that the NCPTSD’s estimates that 18% of soldiers who have served in Iraq are at risk for PTSD and 11% for those who have served in Afghanistan are low ("A Brief Primer on the Mental Health Impact of the Wars in Afghanistan and Iraq", NCPTSD).

Even so, in February, USA Today reported that, “Of the 244,054 veterans of Iraq and Afghanistan already discharged from services, 12,422 have been in VA counseling centers for readjustment problems and symptoms associated with PTSD.”

The article continued, saying, “A report this month by the Government Accountability Office said the VA ‘is a world leader in PTSD treatment.’ But it said the department ‘does not have sufficient capacity to meet the needs of new combat veterans while still providing for veterans of past wars.’ It said the department hasn’t met its own goals for PTSD clinical care and education, even as it anticipates ‘greater numbers of veterans with PTSD seeking VA services.” This obviously gives us reason for concern, especially given the continued cuts to Federal governmental funds for VA hospitals.

As we at MHANYS and other mental health advocates throughout the state have maintained for years, the greatest chances of recovery from mental illness occur when the illness is caught early. This is the crux of preventative medicine that all medical professionals embrace – from dentists, to cancer specialists, to psychiatrists. As the NCPTSD notes, this is no different for those in the military.

“For soldiers who don’t recover, the most troubling aspect of military-related PTSD is its chronic course. There is evidence that once veterans develop military-related PTSD their symptoms remain chronic across the lifespan and are resistant to treatment that have been shown to work with other forms of chronic PTSD. Thus, it is vitally important to provide early intervention to reduce the risk of chronic impairment in veterans,” (NCPTSD).

Recently, the PBS program NOW featured a gentleman living in Buffalo, NY who served in the Gulf War and then again in this most recent war in Iraq. Upon honorable discharge, he returned to his home in Buffalo and returned to his job as a truck driver. Shortly after his return, he started to experience the symptoms of post-traumatic stress disorder caused by exposure to several traumatic events while in Iraq. He explained how on his route from Buffalo to Cleveland, he found himself panicked in heavy traffic and re-living scenes of exploding roadside bombs.

While in Iraq, he learned that insurgents often used heavy traffic to their advantage when attacking US convoys. In addition, his convoy was ambushed and attacked after a roadside bomb exploded, killing several in his convoy.

Recognizing these thoughts as abnormal, he sought treatment through the VA in Buffalo. However, due to cutbacks in funding for services for veterans at the federal level, this veteran’s wait for access to mental health services through the VA was several months long. As a result, he has been unable to continue at his job driving truck and has subsequently had to leave the employment rolls and turn to governmental programs for financial support.

As mental health advocates have explained to government policy and budget makers both here in New York and at the Federal level, mental health is a matter of paying now, or paying more later. The nature of mental illness, just as any other illness, is that if it is not diagnosed and treated early, the problem dramatically increases and is ultimately costlier financially and has a much more significant impact on the individual.

Therefore, we urge the state to specifically identify programs to help the growing number of veterans returning from overseas to help deal with any mental health needs they may have. This will require additional resources for the Office of Mental Health, which we hope would be used to develop and maintain programs designed specifically for veterans in conjunction with the Division of Veteran’s Affairs.

Secondly, we urge the state to pass Timothy’s Law. Timothy’s Law would end the discriminatory health insurance policies that limit the amount of coverage for mental health and addictions services. Such limitations only place artificial roadblocks in the way of those on the road to recovery by preventing them from accessing mental health services and treatments. The potential impact of such legislation on veterans could be great, especially given the cutbacks in the services veterans will have available to them through the VA.

In closing, our country has a less than stellar record when it comes to taking care of needs of veterans who have nobly served this country, especially those with mental health needs - many of whom we see without homes and living on the streets. New York State has the ability to help correct that trend for New Yorkers returning from active duty by helping to ensure the availability of mental health services to those who need them.