New Innovative Ideas for Veterans’ Mental Health Care

How the “Welcome Back Veterans” campaign makes a difference

Welcome Back Veterans (WBV) is a unique program created in 2008 with funding from Major League Baseball Charities and the Robert R. McCormick Foundation. WBV has awarded grants to medical schools across the United States to implement programs that address the mental health needs of soldiers, veterans and their families.

Problem

Increased need for mental health treatment options

US soldiers and veterans returning from combat face an increased risk of mental health problems such as post-traumatic stress, depression and anxiety. 10-15% may have suffered a brain injury, and a significant proportion are at risk of drug and alcohol abuse.

Despite significant progress made by the military health system, the Department of Veterans Affairs, and community mental health providers, the mental health system for this population continues to face challenges in providing quality, collaborative systems to address veterans' mental health issues and finding ways to engage families in mental health care.

Achievements

WBV is working to fill gaps in care

Private sector programs, such as WBV, have been established to fill gaps in the current system. An earlier phase of RAND's monitoring of new WBV programs found them to be valuable and offered promising guidelines for similar efforts by other private entities.

The second phase of RAND's work found that grantee programs focused on aligning their services with WBV with the goal of creating sustainable programs that address the mental health needs of soldiers, veterans and their families through public-private partnerships. Funded programs have implemented activities in four areas: clinical service delivery, education, counseling and networking.

Provision of clinical services. Since 2010, WBV grantees have provided clinical services in the form of examinations, referrals, treatment or care to a total of 915 active duty service members, 3,771 veterans, 901 reservists or members of the armed forces, and 5,146 family members. The centres have also developed other clinical services targeted at specific mental health problems and different groups of service members, veterans and their families.

More service providers are being trained and cultural competencies are being improved. The WBV initiative will compete on the basis of the number of veterans trained and the number of people trained. Since its inception, the beneficiaries have delivered 564 training sessions, involving 28,736 trainers. The training has focused on expanding the pool of providers who can offer culturally competent mental health care to members of the armed forces, veterans and their families.

Approximately half of these sessions train health care providers. The remaining sessions are designed to train military and veterans, students, community members, families, friends, and legal representatives serving in the military. Grantees have also used their experience with evidence-based care to increase the number of mental health providers trained to provide this type of care.

Raising awareness and encouraging people to seek help. The programmes carried out information and counselling activities to raise awareness of mental health problems and encourage people with mental health problems to seek help. Beneficiaries participated in community events, organised activities for veterans, members of the armed forces and their families, met with key stakeholders and sent information about the programmes to target groups.

Some WBV centers have also partnered with other organizations to disseminate information and recruit people for training and clinical services. Many programs have also hired veterans as peer support specialists to engage other members of the armed forces and veterans and provide support in providing services.

Building referral networks. The WBV initiative has served as a safety net to help fill gaps for veterans, service members, and their families who are ineligible for care or do not wish to seek care elsewhere. When needed, WBV also referred eligible patients to VA, MHS, and private or community health care programs for long-term or more intensive care.

In this way, WBV partnerships and referrals helped individuals receive appropriate mental health treatment from the most appropriate system. In addition, WBV's efforts to raise mental health awareness and reduce mental health stigma have encouraged people in need to understand their mental health options and seek the treatment they need.

Since 2010, WBV beneficiaries have been providing clinical services:

• 915 active duty members
• 3,771 veterans
• 901 members of the reserve or guard
• 5,146 family members

Participating veterans' reception programs

Program name College of Medicine

• Emory Veterans Program (EVP), Emory University, Atlanta, GA
• Duke University Veterans Cultural and Clinical Competencies (V3C), Duke University, Durham, NC
• Red Sox Home Base Program, Massachusetts General Hospital, Boston, MA
• Home Base Program, Rush University, Chicago, IL
• Nathanson Family Resilience Centre (NFRC), University of California, Los Angeles, Los Angeles, CA
• Military Support Programs and Networks (M-SPAN), University of Michigan, Ann Arbor, MI
• Steven A. Cohen Military Family Clinic, Cohen New York University (NYU)
• Langone Medical Center (NYU Langone Medical Center), New York University, New York, NY

Moving Forward

Ongoing efforts

The WBV initiative has served as a safety net of sorts, helping to fill gaps for veterans, service members and their family members who are ineligible or choose not to seek care elsewhere.

The WBV has made significant progress in developing programs to address the mental health needs of soldiers, veterans and their families and has improved collaboration with local treatment systems. However, sustainability challenges remain significant.

As public and philanthropic support changes and resources diminish following the withdrawal of U.S. troops overseas, CBM grantees and other programs will need to adapt to maintain the supply of mental health services and meet the demand for care.

Negotiating third-party payments and expanding collaborative networks are opportunities to help private mental health programs, such as those participating in the WBV initiative, continue to build capacity and make changes for the future.

Organizations that support mental health programs for military personnel, veterans and their families should consider an approach that promotes better coordination and integration of programs and different systems of care to expand the reach of programs and strengthen their long-term sustainability.