Monday, November 15, 2010

Serving the Veterans Who Serve Us

As the daughter of a U.S. Army Veteran, I was raised with a keen awareness of the sacrifices our military men and women make for our country. Last week, on Veteran's Day, I was driving back to work after lunch when I went past the local funeral home that was conducting the services for a local fallen soldier. I drove past just in time to see the casket exiting the building. The gleaming hearse was open and waiting. Hundreds of people hovered nearby, including the dedicated motorcycle riders who stood as silent guard, giving the family privacy. News helicopters hovered in the air. Throngs of people lined the streets for miles, silently waving American flags. Children carried signs, thanking this young man for his ultimate sacrifice.

Tears were abundant...my own included.

The irony did not escape me when I remembered that I would be giving a presentation on a new project for work. The funding would go to serve U.S. Military veterans who are homeless and mentally ill. This is a general transcript of my presentation:


Good afternoon, my name is Martha and I’m the Director of Behavioral Health at [x] Services. I’d like to thank everyone here today for the opportunity to present our proposal for a new project.

Some of you are familiar with [x]’s Behavioral Health program, but for those of you who aren’t, our department serves individuals who are homeless and mentally ill. Many of these individuals also have substance abuse treatment needs. These individuals have long, often decades long struggles with their illnesses and have lived in shelters and on the streets, have gone un-medicated or under-medicated, with long histories of psychiatric hospitalizations. Some individuals go years without even being diagnosed, until perhaps some type of tragedy or near-tragedy occurs and they are hospitalized. Many have been institutionalized or have been served in nursing homes.

Part of this population that we serve includes U.S. Military Veterans. These veterans struggle with the same issues that I just mentioned, but their struggles are unique, in that they’re often accompanied and compounded by service-connected disabilities, as well as combat-related traumas. Historically, this has been an under-served population—lack of funding, lack of available local resources and services. Many of us have seen and worked with older veterans. It seems like there’s a stereotype of Vietnam veterans struggling with their illnesses, but the truth is that it goes far beyond a stereotype. Years go by and, we see the need for services continuing to increase, from veterans who fought during the Persian Gulf War, as well as now, as our veterans return from overseas assignments, including Iraq and Afghanistan. Individuals may not be getting mental health services for any number of reasons, including fear of stigma and lack of available services. Waiting lists for medical care, substance abuse treatment and mental health care are common.

For this new project, we are proposing to serve additional veterans in our program. We have a history of cooperative relationships with [y] Substance Abuse Treament Facility, the Veterans Assistance Commission and Hines VA Hospital. We receive referrals from these agencies, but we also get referrals from community outreach and shelters, as well as cold calls from individuals who desperately need services.

As part of this project, we will provide rental assistance, along with mental health and rehabilitation services. We have solid working relationships with over 70 landlords in the [z]County area, who provide us with safe and appropriate housing for the individuals served in our programs. The individuals we hope to serve in this project will have an opportunity to select a home—it may be an apartment, a duplex, townhome or house, depending on the needs and choice of the individual. Their choice may be related to wanting to be close to family, close to transportation, close to work, or any other number of factors. Once they select their home from what is available at that time, they’re provided with necessities upon moving in, including furniture, bedding, kitchen and bath items, toiletries and other items they may need to get started in their new home.

All of this is fantastic, but it’s not just about four walls and a roof. While we believe that having a home is an integral part of managing symptoms and recovering from the effects of long-term mental illness, we do recognize the actual value of housing stability and what it brings—a permanent address, in some cases reuniting families, and the comfort of actually having a place to call home. We also know that services are critical in ensuring the success of the individuals we serve. Veterans served in this project will have a case manager and case worker who provide case management services—assistance with benefits and entitlements, assistance in accessing medical and dental care, accessing educational and vocational resources, as well as any other resources the individual may need.

Additionally, veterans will also have access to an array of mental health services that are tailored to their individual mental health needs. There’s no cookie cutter treatment. We serve individuals, and as such, their treatment plans are individualized. We recognize that mental illness doesn’t occur exclusively in-office between 8am and 4:30pm. That’s why our staff provide community support and in-home services. We work with people on everything they may possibly need—independent living skills (budgeting, cooking, home care, personal hygiene, time management); we work on symptom management (recognizing triggers, identifying and coping with symptoms), managing psychotropic medications (understanding what they’re taking, what it’s for, how to self-administer, understanding dosages, storage and safeguarding of medications), socialization skills (communication, assertiveness, building relationships), adaptation and functional skills (problem-solving, stress management, anger management, self-esteem managing feelings), and also education and work-readiness. We will help them with transportation, making and keeping appointments and we will strive for them to be as stable, independent and self-sufficient as possible—and we provide the services to get them there.

In addition to those services provided by our staff, veterans will also have the option of therapy and psychiatric care. While some of our veterans choose to receive their services through Hines VA, they are aware of and always have the option to access our on-site therapists and consulting psychiatrist.

Another unique feature is that veterans may also choose to participate in our on-site PSR program (psychosocial rehabilitation, which is psychiatric day treatment). PSR staff will help these veterans with the same issues that our CH staff work on in their homes, but these services are more intensive and provided in a group setting by trained staff. The peer support is valuable, and for many individuals, including those we hope to serve with this new project, it helps in avoiding psychiatric hospitalizations, as they are receiving daily psychiatric treatment, but in an OPT setting.

Our agency also provides crisis intervention services and all individuals, including these veterans that we're hoping to serve, can access a crisis worker or our consulting psychiatrist after-hours through our department’s crisis line.

That’s a summary of we already do, and what we hope to continue to do with this new project. Our new project includes leasing and operational costs. Support services will be provided through DMH funding/MRO billing—so we are not asking for any administrative costs as part of this proposal.

We already serve a population of veterans and it would be an honor to serve additional veterans, especially considering all that they have done to serve us.


I'm proud to say that we're getting the funding. Here's to our veterans!

(I encourage you to scroll down on the left side of my blog to pause the music, and then watch this video. Many thanks to the veterans who made the ultimate sacrifice for our freedom.)

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