Monthly Archives May 2016

Care for Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers in developing this series.

Sanjai Rao, M.D., VA Medical Center, San Diego

In my previous post, I addressed the challenging state of mental health care for our nation’s returning veterans and their increased risk of suicide. It’s crucial that we step up and ensure that mental health care is available to all former servicemen and women who need it. Now, I propose some possible solutions.

First, a disclaimer: although I work for the VA, I am writing this post as a private citizen, not a VA employee. The views expressed here are entirely my own and not in any way meant to be reflective of those of VA leadership.

Expanding the VA
In order to ensure the best possible outcomes for veterans in need, the VA needs to grow. With more resources, we can hire and train more mental health professionals, and therefore treat more patients. As I discussed earlier, the VA is by far the best place for veterans to get state-of-the art, evidence-based mental health care, but the VA system doesn’t have the capacity to treat everyone as quickly as they need. We do the best we can with what we have, but ultimately Congress regulates our size and budget. It’s up to our elected officials to provide the funding we need to increase our capacity.

Read More

Care for Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers in developing this series.

Returning Veterans Face Many Mental Health Risks—We Need More Resources to Help Them
Sanjai Rao, M.D., VA Medical Center, San Diego

Of the 1.7 million Veterans returning from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), an estimated 30% are suffering from mental health issues. That’s hundreds of thousands of individuals in need of psychological care and, for those of us who work in Veterans Affairs (VA), it’s our responsibility to provide it.

I’m a psychiatrist at the VA Medical Center in San Diego, one of the busiest VA facilities in the country. San Diego has the largest population of returning Veterans of any city and we provide mental health care for thousands of them each year.

Read More

Several years after the end of the U.S. Civil War, Decoration Day was established by a group of Union Veterans who planted flowers on the graves of Union soldiers. In that same year a ceremony was held at what is now Arlington National Cemetery. Flowers were distributed on the graves of both Union and Confederate soldiers.

These ceremonies honoring fallen service members eventually became the modern Memorial Day. Though, many people believe that Memorial Day is a day to honor only active-duty service members who died on the battlefield, it is broader than that. There is no limitation on where that battlefield is or what it looks like: service members and Veterans continue to fight life-threatening battles every day right here on U.S. soil.

Read More

Funding local mental health and substance use disorder programs and services is an ongoing challenge. Although the federal government allocates money to support mental health care in the states, federal spending on public health has been eroded through funding cuts and budget caps. State governments haven’t done any better. However, over the past couple of decades, state legislatures have been empowering counties and municipalities to create their own revenue, whether through a local sales tax or property tax.

Sales tax in Washington State
Like many other counties in Washington State, Snohomish County adopted a 1/10^th of 1% sales tax to support mental health and substance use disorders services. Since 2010, these funds have been used to support a range of direct and wrap-around services for six target populations: youth, families with children, veterans and their families, the aging population, the most vulnerable, and the most costly (i.e., high utilizers).

Read More

Families for Depression Awareness

In the post above, we used the example of Snohomish County, Washington, of using a designated sales tax to fund mental health services. Here is an example of how funds are used and how they made the difference in one case.

Among many programs, the Snohomish County sales tax funds the Student Support Advocate Program, which provides “intensive case management services to at-risk middle and high school students to connect and engage students and their families with needed resources (mental health and substance use disorder treatment, housing resources and homeless prevention services, food and other basic needs, etc.).” In 2015, the results included the following:

Read More

Let’s look at Sarah, who lives in Tennessee, and Elizabeth, who lives in Kentucky. Both have major depressive disorder, but both are working the maximum number of hours allowed at a mega-store. Even so, they barely stay afloat financially. Their employer does not provide health insurance to them, although if the company made it available, Sarah and Elizabeth would not be able to cover the premiums and deductibles. But Elizabeth can get subsidized health insurance–and mental health care–while Sarah cannot. Why? Read about it in this third post in our series on funding mental health care.

Depression and bipolar disorder—the two most prevalent mental health conditions—affect more than 21 million Americans. Untreated, these and other mental health conditions can exact a huge toll on the American economy:

• Loss of productivity from mental health disorders costs $63 billion each year
• Unemployment rate for adults living with mental health conditions is 3-5 times higher than for those without a mental health condition
• Major Depressive Disorder is the leading cause of disability in the U.S.

Read More