Actually having seen the way the VA operates I'd say NO, the suicide thinking person needs to see an outside doctor, The VA is woefully inadequate to even X-Ray and busted toe, with my X-Ray being put on hold due to a broken X-Ray machine, every 30 days per instruction I called and the machine was still Broken, 90 days later I went to an outside doctor. Then there is audiology, a broken hearing aid sent me to call Audio for help, eight calls long waits just to have the phone hung up.
I had to go to a Vets advocate to even get started and here I sit three months later without my left hearing aid. Calling to even make an appointment results in a long time ringing just to have the phone hung up, My family listened to this Charade on speaker phone during a two hour ordeal.
The VA cannot or will not handle Suicides.
Sorry, but all I use them for is Service connected services.
If reality is relative, perhaps VA should be judged by comparable civilian standards. In my state, if you find someone who needs care for addiction, the SOP is a bed will be available in 5 to 6 months. That is, relatively speaking, 30 days is a good deal better. I found it ironic to understand that a person who can wait upwards of half a year does not truly need care. The system generally - at least here - is badly failing. In rural parts of the USA, the SOP is to send the patient to a city. Indeed, in remote Alaska, the primary coping mechanism of a village is to put the patient on a plane with a one way ticket. The village is almost never going to be able to cope with local resources.
I am a veteran, registered for VA health services...and my own private health insurance, which these days is covered by Medicare.
I can call my primary care physician and someone answers the phone in the first or second ring. I can get an appointment in a couple of days. With the VA, I never got a phone call answered. NOT ONCE. So I have no idea how long it would take to get an actual appointment.
Having worked as a physician in the VA system (as a resident), well....I hope it's gotten better than it was.
Medicare may not be perfect but it is far better than the VA...
I just go through my health insurance through my work, I have nothing to do with the VA. I just don't need the headache, my time, effort, and hassle are commodities that I'm not going to spend freely with people that have no interest or incentive in helping me.
Sounds like a good idea. Don't mean to be a negative Nellie here. My concern would be staffing such a network. While there are plenty of decent mental healthcare workers out there, I doubt many would want to work as a contract employee at some regional clinic in a strip mall. Such entities tend to be set up by entrepreneurs who can submit a bid to .gov bean counters and HR/DEI screeners that looks good on paper. Where would all the qualified counselors come from? AA's in Social Studies, BA's in Psych or Sociology, degrees in Gender Studies, nurses, clergy? IMO, most of that is akin to voodoo and the money spent might just go down another black hole. The problem always seems to be with oversight and accountability. Wads of cash is .gov's fire & forget weapon.
It might work in cities that are large enough to already have large respected health care entities. Something like Kaiser or the Mayo. They already provide psychiatric care and counseling and have been vetted for standards.
That ain't gonna' help the veteran in the very remote rural areas, but it's something.
Healthcare is expensive. Someone pays. TANSTAAFL. Triage is gonna' happen too. It always does with a high volume thru-put. The sieves on this safety net will remain huge. What do we do? Re-train some of those 87,000 new IRS agents? Being a friend to a friend in need is the best first step.
The first problem with mental health care is that there are not enough mental health care professionals - the psych residency is 4 years long, after medical school, and residency slots are neither highly desired, nor available in high numbers - and those residency slots tend not to be utilized every year.
A psychologist cannot prescribe drugs, and are suitable for talk therapy anyway...perhaps.
The mid-level care specialists like MFSWs are underpaid, over utilized and not in sufficient numbers.
And the real hidden truth, is that we have no idea what the drugs do, the right doses for an individual, the right drugs for an individual, so it takes a long time to dial in the right medicine and the right dose - and over time, the need for the medication changes so what worked may stop working. Plus, some drugs have really bad side effects. It's not a simple matter of got this problem, take that pill and you're 'normal'.
Plus, the drugs and therapy are expensive: Someone has to pay.
As bad as the VA is, it is not the worst medical system in the US (that distinction belongs to the Indian Health Service)....but at least so far the VA is not treating veterans to suicide assistance like in Canada.
After 26 years of service, my discharge physical after Desert Storm was done aboard a Destroyer Tender in Marseilles, France. My actual date of retirement was 3 weeks hence on the day of arrival stateside in Mayport. The doc said they could certify no VA disabilities, that I'd have to do it stateside at a Naval Hospital. All I wanted was OUT. Got 0% VA disabilities. No regrets. Three months after I retired, I got a letter from .gov telling me (essentially) that the "free healthcare for life" I had been promised over 26 years would now cost me a deduction from my retired pay. To me, the tone and tenor of that letter was "join this new HMO & pay up" or "go eff yourself". I joined. I paid. I was angry.
Some points. Many vets have valid needs. More than a few have bogus claims. (I know a Vietnam War draftee who is still getting a $50 check every month for jock itch.) Illegal aliens are getting Medicaid, so I hear. Many able-bodied people can get a Social Security disability retirement if they are persistent and hire a lawyer. Anyone can walk in to an ER and get treatment, sue if denied, or stiff the hospital when billed for care. Most of the good people I know have earned their healthcare through their job. But there are so many entitled parasites feeding at the trough. I do not count vets among them. My takeaway is that .gov simply doesn't care. It's root hog or die for the productive and freebies to the parasites who'll reliably vote to sustain the progressive kleptocrats. We are near or past the 51% tipping point. I don't see .gov rewarding vets or anyone else possessed of similar values with anything. Which is not to say we should give up. Geez, this is an emotional issue and depressing.
Final thought. What causes depression? Does a chemical imbalance in the brain cause depression? Does depression cause a chemical imbalance in the brain? Can medication help? Counseling? Is depression cyclic, just a part of life, afflicting people in different degrees? Is it genetic? Is one's PTSD caused by TBI or accumulated stress? We just went through a 20-year war with men doing back to back deployments. Their tribulations make my own seem very small. God bless those folks. We rehab our ships when they return, but our people? I do not think there is any settled science about depression. Psychology is not a real science IMO. A person in a low spot needs a good attentive friend, foremost. We can do that for one another.
Which came first, the imbalance or the depression? I don't know but I know two people who are no longer alive due to issues in their anti-depressant dosage. Each snapped back into deep depression and killed himself. One active Air Force, the other a civilian friend I have known since High School. I hear there are a lot more. I think the medical community needs to re-think what anti-depressants are all about and whether a different course of treatment is necessary.
From recent anecdotal info I have less trust in medicating for depression. Might be OK for schizophrenia and psychoses, maybe for catatonia or doping up a person with Thorazine to dampen the violence. Have similar views on counseling. Teaching/learning new coping skills is good, but you need a willing partner. Many of the worst mental illness seem not to be amenable to a "cure". And for the lesser neuroses, "cures" are usually declared when the insurance runs out. I mentioned the social sciences and voodoo elsewhere. I believe some of the lesser illnesses are learned behaviors owing to bad parenting, crappy childhood. We get set pretty much in our life patterns by age 6. There are so many "schools" of psychotherapy that scrutinizing their methodologies closely can only lead to the conclusion that "This is voodoo". Case in point, Rogerian Therapy. Carl Rogers pioneered this. Rogerian therapy consisted of "reflective listening" wherein the therapist listens to the patient and then reflects what was said back to the patient in similar words that convey what had been said. The theory was that after time the patient would gain insight into himself and eventually effect his own cure. (I am greatly simplifying this.) Carl Rogers and his LaJolla Institute was world renowned. One day Dr. Rogers came to the conclusion that "Nah! this just allows the patient to wallow in self-pity for a long, long time to no really good effect." LaJolla showed Dr Rogers the door. Some 40 years later Rogerian Therapy is still a thing. Don't get me started on Primal Scream, EST, Re-Birthing, Kirlian Auras, Wilhelm Reich's Orgone, repressed memory...∞ IMO Fritz Perls and Thomas Szasz get it right. But none of the above solves the vet's problem. It may highlight the difficulty of the problem though.
Good points. Nationally, there is a significant shortage of all Tiers of Mental Health providers, from trained Social Workers to Clinical Psychologists to Nurse Practitioners/Physician Assents to MD/DO Psychotherapists/Psychoanalysts. So, many providers turn to pharmacological solutions. And therein lies a huge issue, as each person reacts differently to those and there seems to be a lack of close monitoring of patients in order to see what is working and not working.
Which leads to a hunch I have: How very, very many mass shooters seem to be reported as having pre-existing mental health issues and were on medications. I have a theory that if we go back through 20-years' worth of shooters, you'll find they were almost all on the same, related families of pharmacological treatments. The "cure" is worse than the disease.
So you are an A-6 guy? Wonderful platform that was. Knew a mustang LCDR A-6 guy who was an NFO BN. He had the best sea stories. Worked for and with EA-6B NFO EWO's. Smart as Navy Nukes.
Yeah, I was Whales (SIGINT & then pathfinder/tankers) and then made the transition to A-6's late in the game. Got to bag another 4 years in DIFOPS, so I can't complain! Most of my peers went Whale -> Prowlers, but a handful of us got BN seats.
Check out Charles Whitman and the Guy who shot up the San Ysidro McDonalds, James Huberty. Both had terminal levels of heavy metals in their bloodstreams. All we see know is 'Mental Health' problems, but I know damn well selenium was significant. Seems to be scrubbed now. Never was an investigation of just how these two unrelated characters managed to have lethal doses of the same element. Medication? Exposure on the job? One thing is for sure that both of those fools were living on borrowed time and had brains that were essentially shorted out on a biochemical level. If I were a conspiratorial sort I might think that someone decided to avoid making a connection somewhere. Otherwise we would see lawyers on TV pushing class action lawsuits with payoffs that would make asbestos look like pocket change
And it doesn't matter, really. If a service member suffers from such issues, it is pretty much incumbent on the US to heal them. That's the deal, the promise.
I injured my hand. As my wife drove me toward the VA hospital, I called Tricare to get a referral to Urgent Care. That was an exercise in futility, so we continued to the VA hospital. At the hospital I had trouble translating from bureaucratese to English. 'Are you here as a blah blah blah or a blah blah blah?' I impatiently answered "I'm here because I hurt my hand!" She figured it out, I guess.
Then my wife and I went back to the ER and waited. And waited. And then there was more waiting. Hours sitting on the comfy ER bed. I decided that (a) the cut on my hand had healed or at least closed up and (b) I was sick of waiting for nothing. So I tried to walk out. Oh, boy, was that a problem. I think the guy was ready to restrain me, just to keep me from walking out. I played nice and he promised to get a doctor to look at me right away. Then a few minutes of discussion and the doc looked at my hand and we were done.
Next time I'll pay out of pocket essentially anywhere to avoid the hassle.
One of the problems is our lack of understanding of suicide, with the exception of the real gesture or act, and then rarely other than the point of acting. Certainly a call for help needs immediate response and we are failing miserably at that, as recounted in the blog today. We seem to be limited to only a response at the point of crisis in most cases. Retired Army Major General Dana Pittard called out soldiers after a spate of suicides, and the call was personal accountability and resilience. He was attacked for that, being labeled as unsympathetic and not understanding to the war veteran community- himself a combat veteran who struggled with it himself, even as those he was speaking to were youngsters who had yet to deploy, in a force that was no longer deploying to high intensity combat. We saw that in Training and Education Command, a few infantry NCO combat veterans who were suffering (handled with a bag of prescription drugs), but generally Marines who had yet to complete Entry Level Training. It seems a mix of those who had genuine emotional and mental injury, and those who seemed fragile. The TECOM solution to failing the Airborne PFT for a future rigger being screened for Jump School was physical training remediation. The student opted for a shot gun in his mouth. It is hard to reconcile this phenomenon. I cannot recall a case that did not catch those closest to the Marine by surprise- not the command, but those within the command close to the Marine. We seem to chase symptoms. I cannot believe that is the best we can do.
My old ship (George Washington, CVN-73) is setting all kinds of records for suicides. I'm glad I got off of there before it became the death-ship. That ship has 5600 people and roughly a dozen aboard to treat mental health. Good luck getting an appointment. A little bird told me that the current tactic is to set an appointment with them, which is like 90 days out. Then when you come in for your appointment, they're like, "Huh? Who are you? You never made an appointment here! We have nothing on record and no idea who you are!" Then when you are trying to explain why you're there, they interrupt you, "First step, you've gotta set an appointment. Be warned, nobody can see you for about 90 days." You'll get gray hair before getting help there. Meanwhile, the bodies pile up.... https://www.nbcnews.com/news/us-news/uss-george-washington-sailors-detail-difficult-working-conditions-stri-rcna25882
Can an entire class of ships get a VA appointment, or will it just become an Unauthorized Absence? Gallows humour is a military tradition, plus it helps to embrace the suck.
VA's are like other medical centers: No two are created equal. Which is sad in a way. As they say "If you've been to one VA Medical Center, you've been to one VA Medical Center." But the problem is that some a really dysfunctional, and every single one of them is understaffed in one way or another.
Some of the Porch know that my late spouse (Most know of her as "The Doctor") retired from 30+ years of private medical practice to achieve her dream of finishing out her professional career the way she started: Working with her fellow veterans (She started as a US Army doctor in the 80s. Many of her patients were retirees or VA referrals). In general, while there were many times she had to remind herself that the VA was *just* like the Army (Not in a good way) , at her VA Medical Center (Fargo, ND) the whole ethos there was "ownership" of "Our Veterans." They work closely with the two large healthcare entities in town and frequently referred their veterans out to those hospitals when necessary. Their reputation is such that they're often seen as a place other VA folks want to come to. I know there are a lot people just want to leave.
I will note that as a person "of a certain age" I get most of my medical care from the two outside facilities, but also have a VA Primary physician who can see my charts, etc. if necessary. But, in the 5 months since my wife's untimely and sudden passing, *none* of the many healthcare providers I've seen have done anything more than express their sympathy at my loss. ONLY the VA has been proactive, had some folks casually check in and chat with me and even give me contact info for an informal get-together of people in the same situation. No one else said a word. Only the VA. For that, I will always be grateful.
Indeed, that's across the entire health care industry; government, for-profit and non-profit. In the past 30+ years the growth of all tiers of actual healthcare providers, including ward staffs, nurses, PTs, doctors, etc. has grown at a steady pace. But the growth of "administrators," clerical staffs, pencil-pushers and folks who do nothing to actually care for patients (Or "customers" as certain people in suits with MBAs call them) has skyrocketed.
In my very limited experience with VA medicine, I got the feeling that they desperately wanted to treat me for PTSD for something...whether it be combat related (didn't see any), sexual assault (never happened) or whatever else they could convince me that I was suffering from. It was ridiculous. I went in for service connected spine issues and they are asking if/when I was sexually assaulted...
No doubt! I don't know what to think of that approach from Medical. It comes off like going to a doctor because your knee hurts and he keeps directing diagnosis toward your abdomen like he has a fetish for gall bladder surgery or something.
Actually having seen the way the VA operates I'd say NO, the suicide thinking person needs to see an outside doctor, The VA is woefully inadequate to even X-Ray and busted toe, with my X-Ray being put on hold due to a broken X-Ray machine, every 30 days per instruction I called and the machine was still Broken, 90 days later I went to an outside doctor. Then there is audiology, a broken hearing aid sent me to call Audio for help, eight calls long waits just to have the phone hung up.
I had to go to a Vets advocate to even get started and here I sit three months later without my left hearing aid. Calling to even make an appointment results in a long time ringing just to have the phone hung up, My family listened to this Charade on speaker phone during a two hour ordeal.
The VA cannot or will not handle Suicides.
Sorry, but all I use them for is Service connected services.
If reality is relative, perhaps VA should be judged by comparable civilian standards. In my state, if you find someone who needs care for addiction, the SOP is a bed will be available in 5 to 6 months. That is, relatively speaking, 30 days is a good deal better. I found it ironic to understand that a person who can wait upwards of half a year does not truly need care. The system generally - at least here - is badly failing. In rural parts of the USA, the SOP is to send the patient to a city. Indeed, in remote Alaska, the primary coping mechanism of a village is to put the patient on a plane with a one way ticket. The village is almost never going to be able to cope with local resources.
I am a veteran, registered for VA health services...and my own private health insurance, which these days is covered by Medicare.
I can call my primary care physician and someone answers the phone in the first or second ring. I can get an appointment in a couple of days. With the VA, I never got a phone call answered. NOT ONCE. So I have no idea how long it would take to get an actual appointment.
Having worked as a physician in the VA system (as a resident), well....I hope it's gotten better than it was.
Medicare may not be perfect but it is far better than the VA...
I just go through my health insurance through my work, I have nothing to do with the VA. I just don't need the headache, my time, effort, and hassle are commodities that I'm not going to spend freely with people that have no interest or incentive in helping me.
The only rational decision....
Seems like perhaps an interim contracted service with regional specialists would help everyone. (Who lives within reasonable access.)
Sounds like a good idea. Don't mean to be a negative Nellie here. My concern would be staffing such a network. While there are plenty of decent mental healthcare workers out there, I doubt many would want to work as a contract employee at some regional clinic in a strip mall. Such entities tend to be set up by entrepreneurs who can submit a bid to .gov bean counters and HR/DEI screeners that looks good on paper. Where would all the qualified counselors come from? AA's in Social Studies, BA's in Psych or Sociology, degrees in Gender Studies, nurses, clergy? IMO, most of that is akin to voodoo and the money spent might just go down another black hole. The problem always seems to be with oversight and accountability. Wads of cash is .gov's fire & forget weapon.
It might work in cities that are large enough to already have large respected health care entities. Something like Kaiser or the Mayo. They already provide psychiatric care and counseling and have been vetted for standards.
That ain't gonna' help the veteran in the very remote rural areas, but it's something.
Healthcare is expensive. Someone pays. TANSTAAFL. Triage is gonna' happen too. It always does with a high volume thru-put. The sieves on this safety net will remain huge. What do we do? Re-train some of those 87,000 new IRS agents? Being a friend to a friend in need is the best first step.
The first problem with mental health care is that there are not enough mental health care professionals - the psych residency is 4 years long, after medical school, and residency slots are neither highly desired, nor available in high numbers - and those residency slots tend not to be utilized every year.
A psychologist cannot prescribe drugs, and are suitable for talk therapy anyway...perhaps.
The mid-level care specialists like MFSWs are underpaid, over utilized and not in sufficient numbers.
And the real hidden truth, is that we have no idea what the drugs do, the right doses for an individual, the right drugs for an individual, so it takes a long time to dial in the right medicine and the right dose - and over time, the need for the medication changes so what worked may stop working. Plus, some drugs have really bad side effects. It's not a simple matter of got this problem, take that pill and you're 'normal'.
Plus, the drugs and therapy are expensive: Someone has to pay.
What do you suggest?
IDK. Even saying that veterans should be on 100% civilian mental health care is not ideal - there are not enough resources there, either.
My suggestion was to use civilian resources only for when the VA has shortfalls.
As bad as the VA is, it is not the worst medical system in the US (that distinction belongs to the Indian Health Service)....but at least so far the VA is not treating veterans to suicide assistance like in Canada.
Until they can get them two small systems up to snuff, anyone who thinks government-run single-payer system is our salvation is nukin futts.
After 26 years of service, my discharge physical after Desert Storm was done aboard a Destroyer Tender in Marseilles, France. My actual date of retirement was 3 weeks hence on the day of arrival stateside in Mayport. The doc said they could certify no VA disabilities, that I'd have to do it stateside at a Naval Hospital. All I wanted was OUT. Got 0% VA disabilities. No regrets. Three months after I retired, I got a letter from .gov telling me (essentially) that the "free healthcare for life" I had been promised over 26 years would now cost me a deduction from my retired pay. To me, the tone and tenor of that letter was "join this new HMO & pay up" or "go eff yourself". I joined. I paid. I was angry.
Some points. Many vets have valid needs. More than a few have bogus claims. (I know a Vietnam War draftee who is still getting a $50 check every month for jock itch.) Illegal aliens are getting Medicaid, so I hear. Many able-bodied people can get a Social Security disability retirement if they are persistent and hire a lawyer. Anyone can walk in to an ER and get treatment, sue if denied, or stiff the hospital when billed for care. Most of the good people I know have earned their healthcare through their job. But there are so many entitled parasites feeding at the trough. I do not count vets among them. My takeaway is that .gov simply doesn't care. It's root hog or die for the productive and freebies to the parasites who'll reliably vote to sustain the progressive kleptocrats. We are near or past the 51% tipping point. I don't see .gov rewarding vets or anyone else possessed of similar values with anything. Which is not to say we should give up. Geez, this is an emotional issue and depressing.
Final thought. What causes depression? Does a chemical imbalance in the brain cause depression? Does depression cause a chemical imbalance in the brain? Can medication help? Counseling? Is depression cyclic, just a part of life, afflicting people in different degrees? Is it genetic? Is one's PTSD caused by TBI or accumulated stress? We just went through a 20-year war with men doing back to back deployments. Their tribulations make my own seem very small. God bless those folks. We rehab our ships when they return, but our people? I do not think there is any settled science about depression. Psychology is not a real science IMO. A person in a low spot needs a good attentive friend, foremost. We can do that for one another.
Which came first, the imbalance or the depression? I don't know but I know two people who are no longer alive due to issues in their anti-depressant dosage. Each snapped back into deep depression and killed himself. One active Air Force, the other a civilian friend I have known since High School. I hear there are a lot more. I think the medical community needs to re-think what anti-depressants are all about and whether a different course of treatment is necessary.
From recent anecdotal info I have less trust in medicating for depression. Might be OK for schizophrenia and psychoses, maybe for catatonia or doping up a person with Thorazine to dampen the violence. Have similar views on counseling. Teaching/learning new coping skills is good, but you need a willing partner. Many of the worst mental illness seem not to be amenable to a "cure". And for the lesser neuroses, "cures" are usually declared when the insurance runs out. I mentioned the social sciences and voodoo elsewhere. I believe some of the lesser illnesses are learned behaviors owing to bad parenting, crappy childhood. We get set pretty much in our life patterns by age 6. There are so many "schools" of psychotherapy that scrutinizing their methodologies closely can only lead to the conclusion that "This is voodoo". Case in point, Rogerian Therapy. Carl Rogers pioneered this. Rogerian therapy consisted of "reflective listening" wherein the therapist listens to the patient and then reflects what was said back to the patient in similar words that convey what had been said. The theory was that after time the patient would gain insight into himself and eventually effect his own cure. (I am greatly simplifying this.) Carl Rogers and his LaJolla Institute was world renowned. One day Dr. Rogers came to the conclusion that "Nah! this just allows the patient to wallow in self-pity for a long, long time to no really good effect." LaJolla showed Dr Rogers the door. Some 40 years later Rogerian Therapy is still a thing. Don't get me started on Primal Scream, EST, Re-Birthing, Kirlian Auras, Wilhelm Reich's Orgone, repressed memory...∞ IMO Fritz Perls and Thomas Szasz get it right. But none of the above solves the vet's problem. It may highlight the difficulty of the problem though.
Good points. Nationally, there is a significant shortage of all Tiers of Mental Health providers, from trained Social Workers to Clinical Psychologists to Nurse Practitioners/Physician Assents to MD/DO Psychotherapists/Psychoanalysts. So, many providers turn to pharmacological solutions. And therein lies a huge issue, as each person reacts differently to those and there seems to be a lack of close monitoring of patients in order to see what is working and not working.
Which leads to a hunch I have: How very, very many mass shooters seem to be reported as having pre-existing mental health issues and were on medications. I have a theory that if we go back through 20-years' worth of shooters, you'll find they were almost all on the same, related families of pharmacological treatments. The "cure" is worse than the disease.
So you are an A-6 guy? Wonderful platform that was. Knew a mustang LCDR A-6 guy who was an NFO BN. He had the best sea stories. Worked for and with EA-6B NFO EWO's. Smart as Navy Nukes.
One of my top 10:
https://www.amazon.com/Flight-Intruder-Danny-Glover/dp/B00CTUHM9G/ref=sr_1_1?crid=2RYCM7N3LMM4N&keywords=flight+of+the+intruder&qid=1681947689&sprefix=flight+of+the+intruder%2Caps%2C122&sr=8-1
Yeah, I was Whales (SIGINT & then pathfinder/tankers) and then made the transition to A-6's late in the game. Got to bag another 4 years in DIFOPS, so I can't complain! Most of my peers went Whale -> Prowlers, but a handful of us got BN seats.
Started at the far end of the spectrum as an E-3 RD-0334 in 1966. AN/BLR-1, AN/WLR-1 operator. 2 week school, $75 pro-pay.
Check out Charles Whitman and the Guy who shot up the San Ysidro McDonalds, James Huberty. Both had terminal levels of heavy metals in their bloodstreams. All we see know is 'Mental Health' problems, but I know damn well selenium was significant. Seems to be scrubbed now. Never was an investigation of just how these two unrelated characters managed to have lethal doses of the same element. Medication? Exposure on the job? One thing is for sure that both of those fools were living on borrowed time and had brains that were essentially shorted out on a biochemical level. If I were a conspiratorial sort I might think that someone decided to avoid making a connection somewhere. Otherwise we would see lawyers on TV pushing class action lawsuits with payoffs that would make asbestos look like pocket change
That's interesting, I hadn't heard that.
We don't know.
And it doesn't matter, really. If a service member suffers from such issues, it is pretty much incumbent on the US to heal them. That's the deal, the promise.
I injured my hand. As my wife drove me toward the VA hospital, I called Tricare to get a referral to Urgent Care. That was an exercise in futility, so we continued to the VA hospital. At the hospital I had trouble translating from bureaucratese to English. 'Are you here as a blah blah blah or a blah blah blah?' I impatiently answered "I'm here because I hurt my hand!" She figured it out, I guess.
Then my wife and I went back to the ER and waited. And waited. And then there was more waiting. Hours sitting on the comfy ER bed. I decided that (a) the cut on my hand had healed or at least closed up and (b) I was sick of waiting for nothing. So I tried to walk out. Oh, boy, was that a problem. I think the guy was ready to restrain me, just to keep me from walking out. I played nice and he promised to get a doctor to look at me right away. Then a few minutes of discussion and the doc looked at my hand and we were done.
Next time I'll pay out of pocket essentially anywhere to avoid the hassle.
One of the problems is our lack of understanding of suicide, with the exception of the real gesture or act, and then rarely other than the point of acting. Certainly a call for help needs immediate response and we are failing miserably at that, as recounted in the blog today. We seem to be limited to only a response at the point of crisis in most cases. Retired Army Major General Dana Pittard called out soldiers after a spate of suicides, and the call was personal accountability and resilience. He was attacked for that, being labeled as unsympathetic and not understanding to the war veteran community- himself a combat veteran who struggled with it himself, even as those he was speaking to were youngsters who had yet to deploy, in a force that was no longer deploying to high intensity combat. We saw that in Training and Education Command, a few infantry NCO combat veterans who were suffering (handled with a bag of prescription drugs), but generally Marines who had yet to complete Entry Level Training. It seems a mix of those who had genuine emotional and mental injury, and those who seemed fragile. The TECOM solution to failing the Airborne PFT for a future rigger being screened for Jump School was physical training remediation. The student opted for a shot gun in his mouth. It is hard to reconcile this phenomenon. I cannot recall a case that did not catch those closest to the Marine by surprise- not the command, but those within the command close to the Marine. We seem to chase symptoms. I cannot believe that is the best we can do.
My old ship (George Washington, CVN-73) is setting all kinds of records for suicides. I'm glad I got off of there before it became the death-ship. That ship has 5600 people and roughly a dozen aboard to treat mental health. Good luck getting an appointment. A little bird told me that the current tactic is to set an appointment with them, which is like 90 days out. Then when you come in for your appointment, they're like, "Huh? Who are you? You never made an appointment here! We have nothing on record and no idea who you are!" Then when you are trying to explain why you're there, they interrupt you, "First step, you've gotta set an appointment. Be warned, nobody can see you for about 90 days." You'll get gray hair before getting help there. Meanwhile, the bodies pile up.... https://www.nbcnews.com/news/us-news/uss-george-washington-sailors-detail-difficult-working-conditions-stri-rcna25882
Can an entire class of ships get a VA appointment, or will it just become an Unauthorized Absence? Gallows humour is a military tradition, plus it helps to embrace the suck.
https://www.navytimes.com/news/your-navy/2023/04/19/future-lcs-cleveland-launches-strikes-tugboat/
VA's are like other medical centers: No two are created equal. Which is sad in a way. As they say "If you've been to one VA Medical Center, you've been to one VA Medical Center." But the problem is that some a really dysfunctional, and every single one of them is understaffed in one way or another.
Some of the Porch know that my late spouse (Most know of her as "The Doctor") retired from 30+ years of private medical practice to achieve her dream of finishing out her professional career the way she started: Working with her fellow veterans (She started as a US Army doctor in the 80s. Many of her patients were retirees or VA referrals). In general, while there were many times she had to remind herself that the VA was *just* like the Army (Not in a good way) , at her VA Medical Center (Fargo, ND) the whole ethos there was "ownership" of "Our Veterans." They work closely with the two large healthcare entities in town and frequently referred their veterans out to those hospitals when necessary. Their reputation is such that they're often seen as a place other VA folks want to come to. I know there are a lot people just want to leave.
I will note that as a person "of a certain age" I get most of my medical care from the two outside facilities, but also have a VA Primary physician who can see my charts, etc. if necessary. But, in the 5 months since my wife's untimely and sudden passing, *none* of the many healthcare providers I've seen have done anything more than express their sympathy at my loss. ONLY the VA has been proactive, had some folks casually check in and chat with me and even give me contact info for an informal get-together of people in the same situation. No one else said a word. Only the VA. For that, I will always be grateful.
One of the biggest problems with the VA is the non-medical care staff is 2x the actual treating staff... So far too much money is wasted on overhead
Indeed, that's across the entire health care industry; government, for-profit and non-profit. In the past 30+ years the growth of all tiers of actual healthcare providers, including ward staffs, nurses, PTs, doctors, etc. has grown at a steady pace. But the growth of "administrators," clerical staffs, pencil-pushers and folks who do nothing to actually care for patients (Or "customers" as certain people in suits with MBAs call them) has skyrocketed.
I read a VA claim that of their 400K employees 90% are direct healthcare providers.
In my very limited experience with VA medicine, I got the feeling that they desperately wanted to treat me for PTSD for something...whether it be combat related (didn't see any), sexual assault (never happened) or whatever else they could convince me that I was suffering from. It was ridiculous. I went in for service connected spine issues and they are asking if/when I was sexually assaulted...
That is odd....
Maybe it's a the woman version of 'when did you stop beating your wife?'
No doubt! I don't know what to think of that approach from Medical. It comes off like going to a doctor because your knee hurts and he keeps directing diagnosis toward your abdomen like he has a fetish for gall bladder surgery or something.