During my years of working exclusively with disabled veterans, my work brought me to homeless shelters, drug courts, veteran’s courts, prisons and county jails, and working with prison re-entry. My travels brought me to small towns, rural counties and larger municipalities. The most difficult cases involved veterans who had experienced combat injuries from explosions, falls and a variety of head injuries from not normally questioned situations. Through these experiences it became increasingly clear that veterans experiencing Mild Traumatic Brain Injury (mTBI) were becoming the most difficult cases to work.
Recently an article came across my desk describing U.S. Congressman Mike Coffman. Representative Coffman is a member of the US House, Armed Services Committee and has submitted a recommendation for the establishment of a commission to conduct a comprehensive study of whether the Department of Defense’s mechanisms for disciplinary action adequately address the impact of service-connected mental disorders and TBI on the basis for the disciplinary action; and whether the disciplinary mechanisms should be revisited in light of new information regarding the connection between PTSD, TBI, and behavioral problems.
One of the biggest hurdles being experienced by the veterans I served was addressing “Less than Honorable” discharges, to qualify for Veterans Administration (VA) assistive services. Even though a veteran may not qualify for VA services due to “Other Than Honorable” type discharges, our job case-managing disabled veterans directed us to work with ALL veterans with anything but “Dishonorable” type discharges.
Through the case-management intake process, many of the “Other Than Honorably” discharged combat veterans could identify war related events that led to their “Less Than Honorable” discharge circumstances. Veterans who could make that connection would be directed to Veterans Service Officer (VSO) to start a lengthy process of appeal of their original discharge. In the mean time, without VA services as an option, their case-management opportunities had to re-directed to state, local or other non-veteran federal programs.
Andre’ Carson, another representative of the US House Armed Services Committee, has also submitted House Resolution 1464 titled the Military Mental Health Empowerment Act. The bill directs the Secretaries of the military departments to ensure that information concerning the availability of mental health services to members of the Armed Forces (members), as well as privacy rights related to the receipt of such services, is provided to all members of the military. One of the primary focuses of the resolution is to eliminate perceived stigma associated with seeking and receiving mental health services.
According to the February 5, 2013, study of “US Military Casualty Statistics” report from the Department of Defense (DoD), there were 253,330 Traumatic Brain Injuries reported from FY 2000 through the 2nd quarter of 2012. Of those totals the number of reported incidents by year were 23,174 in 2007, 28,567 in 2008, 29,255 in 2009, 31,407 in 2010, and 33,149 in 2011. Coincidentally, during this same period the number of “Less Than Honorable Discharges” has increased 25%.
Per a December 2012 Homeless Veterans report based in the bi-annual HUD point in time counts, 62,619 veterans are homeless on any given night (which constitutes 13% of the total adult homeless count). Fifty one percent of homeless veterans have disabilities, 50% have serious mental problems and 70% have substance abuse problems. Approximately 12,700 are current war veterans of the Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF) and Operation New Dawn (OND) campaigns. According to the report, the numbers of OEF, OIF and OND homeless veterans were on the rise over previous years.
The most recent statistics on incarcerated veterans from the Bureau of Justice Statistics (BJS) are almost 10 years old. In 2004, 10% of the State prisoners reported prior service in the U.S. Military. 140,000 were being held in prisons nationwide, 62% reported having an Honorable Discharge. A majority of veterans in State (54%) and Federal (64%) reported they served during a wartime period. At that point in time veterans of the Iraq-Afghanistan era comprised 4% of incarcerated veterans in both State and Federal prison.
The principles of the proposed Military Mental Health Empowerment Act help define the cultural changes and address the magnified stigmas of seeking assistance for TBI as well as mental health in the US Military. Ignoring the symptoms along with the cause through the current “Less Than Honorable” process does not make sense in many different ways. It also places more burdens on already strained or depleted Medicaid TBI waiver programs, local healthcare programs and services. Trending and analysis of the number of homeles or incarcerated veterans and veterans facing legal issues, which would include statistical information of medical, mental health and type of military discharge, could be key measures of the financial impact of combat trauma to local and state economies.