Feature

More than 80 legislators, congressional staffers and others attended a May congressional briefing sponsored by APA to learn how psychologists at the Department of Veterans Affairs (VA) and the Department of Defense (DoD) are meeting the mental health needs of veterans and their families.

The briefing, organized by the Public Policy Office of APA's Science Directorate, was part of a larger APA advocacy effort. The Science Directorate, along with the Practice Organization and Education Directorate, have organized advocacy that has included oral testimony from APA staff and other psychologists and detailed letters from APA President Ronald F. Levant, EdD, to the chairs of the House and Senate appropriations committees. The goal of the letters, testimony and briefing is to support adequate mental health funding at the VA and DoD, says APA science policy staffer Heather Kelly, PhD, who organized the congressional briefing.

"The VA is unique because it has a strong clinical services and training component and also a strong research program," Kelly says, noting that all of the APA directorates work together to advocate for funding.

Bringing information to Capitol Hill

At the briefing, Terence Keane, PhD, the associate chief of staff for research and development at the VA Boston Health Care System, discussed VA research on psychological treatments for post-traumatic stress disorder (PTSD) and other combat-related conditions.

"The take-home message today is that the VA is the international leader in evaluating and treating PTSD," he said. "Yet more can still be done." Keane highlighted the treatments that are now available for PTSD, such as cognitive therapy and selective serotonin reuptake inhibitors. He also discussed future directions for research, including telehealth and using the Internet to promote and monitor therapy.

Two other psychologists also spoke at the briefing. Antoinette Zeiss, PhD, the director of psychology training at the VA Palo Alto Health Care System, explained that the VA's internship program trains psychologists to work directly with returning veterans. In fact, she pointed out, the VA provides 327 internships each year--15 percent of all APA-accredited internship slots. Funding for these internships ensures a steady supply of psychologists who are trained to serve veterans.

Harold Wain, PhD, chief of the Psychiatry Consultation Liaison Service at Walter Reed Army Medical Center, discussed psychologists' use of a bio-psychosocial approach to help traumatically injured soldiers.

"We want to give patients back power and control," he said, by working with them in all aspects of their life--including family counseling, vocational counseling and any other areas where they might need help.

Two congressmen who are also psychologists, Ted Strickland, PhD (D-Ohio), and Brian Baird, PhD (D-Wash.), spoke at the briefing as well. Baird, in fact, once worked as a VA psychologist in Washington State.

"Anyone who's worked with vets, in or out of the VA system, could share countless stories of men and women and their families carrying around scars," Baird said. "Happily, we can also share stories of healing those scars. If we send men and women into harm's way, we owe it to them to provide the very best care possible."

Bolstering veterans' quality of life

The briefing followed other APA advocacy efforts on behalf of veterans' mental health funding.

APA's Practice Organization has urged Congress to provide adequate funding for veterans' mental health. Staff for the organization have collected information about psychologists' roles at the VA, and that information was included in Levant's May 16 letter to the House Appropriations Committee and May 31 letter to the Senate appropriations committee. In the letters, Levant discussed the many roles that psychologists play in assisting returning veterans.

VA psychologists, he wrote, are working in medical units to aid the recovery of service members with permanent physical injuries--of whom there are many more than in previous wars, as better body armor has allowed more people to survive what would have been fatal injuries.

He noted that other VA psychologists are helping patients with traumatic brain injuries through neuropsychological assessment and cognitive rehabilitation, as well as aiding soldiers with PTSD, anxiety and depression.

"As Operation Iraqi Freedom and Operation Enduring Freedom continue in the coming months and mental health issues emerge for soldiers in the field and returning home," Levant wrote, "we urge Congress to ensure that appropriations for mental health care are sufficient to meet the need for services."

Levant's letters to the committees were timely, because shortly after they were sent VA officials found a 2005 budget shortfall for service needs for troops returning from Iraq and Afghanistan. This news sent the House and Senate scrambling to plug the gap shortly before the July 4 recess, and negotiations to address the shortfall will likely continue into the fall.

Meanwhile, APA's Science Directorate has urged Congress to continue to fund research at the VA. In April, APA Executive Director for Science Steven J. Breckler, PhD, testified before the House Appropriations Committee's Subcommittee on Military Quality of Life and Veterans Affairs. He asked the committee to increase its fiscal year 2006 funding for the VA's research arm, the Medical and Prosthetic Research Program, after several years of flat funding and a funding cut in 2005.

"With reports of increasing cases of suicide, domestic violence and significant mental health problems--particularly trauma-related anxiety disorders, depression and substance abuse--among post-deployed military and veteran populations, the impact of potential cuts to the psychological research program would be especially dangerous," he said.

Finally, APA's Education Directorate has been advocating for funding to train psychologists to serve U.S. soldiers in conflict and when they return home. This year, the directorate had a success when the House Defense Appropriations Subcommittee proposed allocating $4 million to establish the first ever Defense Graduate Psychology Education Program. The funds would be used to train more military and civilian psychologists to meet the mental and behavioral health needs of military personnel and their families. The bill has passed the House and will be taken up in the conference between the House and Senate later this year.

Overall, all of APA's directorates will continue to push for adequate government funding for veterans' mental health, says Douglas Walter, legislative counsel in the APA Practice Directorate's government relations office. He explains: "We view this as an ongoing effort, as long as we're in these conflicts and these troops are returning. We need to help Congress and the administration understand the issues, to make sure these veterans are getting the treatment and services they need."