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A review of veteran care finds "world class" mental care, but veterans have a hard time accessing it

Over half of those who need care don't know that they do

CNN  — 

Thomas Burke Jr., a Marine who returned from tours in Afghanistan and Iraq to attend Yale Divinity School, has also done three tours in the Veterans Health Administration for mental health care and says he’s experienced mixed results.

Burke, 28, served in the infantry. He said his first counselor, in 2011, didn’t have much experience with combat veterans and wasn’t much help. In 2012, he clicked with his second counselor, who “really cared and took time to get to know me and gave me enough of a baseline to productively go through my academics.”

Before becoming a minister and providing mental care of his own, he tried to get back into counseling. But it was a “very negative experience,” he said.

“I went in, being vulnerable and laying out my problems, and they were dismissive and condescended to me and treated me like I am some victim and were not getting to the bottom of the problem and essentially said ‘thanks for telling us,’ ” Burke said. “Imagine what damage that can do to veterans who seek help.

“It’s hard for me to badmouth the VA, because there are a lot of good people there who are trying to help and do care about vets, but a lot of people I talk with do badmouth them,” Burke said.

Many Americans who served in the Iraq and Afghanistan wars need mental health care, but they aren’t always getting enough from the Department of Veterans Affairs’ Veterans Health Administration, according to the results of a congressionally mandated investigation released Wednesday.

About 4 million people have served in Iraq and Afghanistan, the longest sustained US military operations in history. A disproportionate number have come back with mental health challenges like anxiety, depression and post-traumatic stress disorder, research shows. The number of suicides for veterans of these wars has reached a record. The VA has not always been able to handle this crushing need for services.

But when veterans get mental health care from the VA, it is of “comparable or superior quality” to the kinds of care available elsewhere.

According to the new study, nearly half of American veterans who need mental health care don’t get it. Also, more than half of those who would benefit from care don’t know they need it, the research by the National Academies of Sciences, Engineering, and Medicine found.

The majority of those who could use these services don’t know whether they are eligible, don’t know how to get the services and don’t even know that the VA provides mental health care, according to the report.

That’s “one of the things the report pointed out that I found the most distressing,” said Louis Celli, national director of the American Legion’s veterans affairs and rehabilitation division, which was not involved in the new report.

Celli said the VA does a “herculean job through social media campaigns and outreach with their partners” to let veterans know about the care it provides. “It’s hard to imagine more you could do, short of knocking on everyone’s door,” but he believes the lack of care is a “failure on the community’s part.”

One workaround that the American Legion has found successful is enlisting veterans’ families to help them get the care they need.

That’s what helped Seth Robbins. An Army veteran who was stationed predominantly in Korea, the 40-year-old has gotten his health care through the VA for more than a decade, but he sought help for anxiety only after his wife gave him an ultimatum.

“As soldiers, sailors, Marines and airmen, we are taught to ‘suck it up and drive on.’ We heard that on a regular basis, and it gets into your head,” Robbins said.

He also hesitated to seek treatment because he had concerns that were shared by veterans in the report.

For instance, Robbins worried that his rifles would be taken away if he talked about his anxiety. “There’s also the stigma or the feeling that something is broken and I’m not the normal one or that they’ll lock you up,” he said. “But I’ve got a job and a family to support and a house.” The VA has helped him “get to a place where I can manage.”

Veterans also find the VA’s appointment system “burdensome” and “unsatisfying,” the report said. Robbins agrees and says he’s lucky his father, a Vietnam veteran, showed him how to navigate the system.

He also feels lucky to have a federal job that gives him the freedom to go to appointments that can take hours out of his day. Other veterans said transportation challenges and the distance to the VA from their homes can be a huge obstacle to getting care, according to the report.

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    For veterans like Robbins who succeed in getting treatment, the report found that they encounter “tremendous mental health care expertise” and that the system can deliver care in a “truly integrated and strategic manner.” But the report added that chronic staffing challenges and confusing procedures and policies continue to be a challenge.

    The American Legion’s Celli said that along with the new report, he thinks it’s important to note that the system has improved amid the extra scrutiny of the agency over the past several years. Robbins, for one, has noticed a change in 15 years – a “vast improvement.”

    Celli said that he knows the system isn’t perfect but that the American Legion will continue to fight to improve it.

    “We are not VA cheerleaders, but we do work with them every day to make sure they do rise to the occasion and take care of veterans,” he said. “We’ve seen the progress, and we hope more veterans will seek out this care.”