The U.S. Department of Veterans Affairs (VA) and its mental health partners have been trying to keep up communication with veterans during the COVID-19 pandemic through online telehealth sessions. With an increase in anxiety and depression from social isolation and financial instability and job losses, keeping direct contact is essential. According to the VA, telehealth appointments rose from 20,000 in February to 154,000 by April.
In May, the VA launched a “Now is the Time” campaign to let veterans and their families know what kind of mental health resources are available to them. A White House task force was scheduled to roll out a report on a mental health “roadmap” that would help lessen the high rate of suicide among veterans.
But those efforts were sidelined this past March when the pandemic required stay-at-home measures. So far, the task force has given no definitive release date for the plan.
Other veteran advocacy groups have been working hard to pick up the slack. The Iraq and Afghanistan Veterans of America expanded their Quick Reaction Force Program to connect vets with resources on benefits, job issues, and other challenges.
Reaching Out to Vets in Isolation
The American Legion stepped up their Buddy Check program reaching out to vets in social isolation. The Wounded Warrior Project has awarded grants up to $1,000 for necessities like groceries, rent payments, and other monthly expenses to those vets injured in the line of duty who may be struggling.
Disabled American Veterans and The PenFed Foundation are following in Wounded Warrior’s steps with a $250 grant and $1,500 grant, respectively.
Soldier On in Pittsfield, Mass., has been working with homeless veterans since 1994 with transitional housing and supportive services. As CEO Bruce Buckley says, giving them the tools they need to get back on their feet is priority number one. But he views what they do as very different from what vets can expect at the VA.
“In the VA model, vets go to the service. We’re big on the service going to the vet,” he explained. “They’ve got a ‘here we are, come get us’ model and we’re going to come to you.”
The Use of Telehealth
Kevin Cahill, Ph.D., director of clinical services at Soldier On, added that one of the upsides to the pandemic has been utilizing telehealth. They use a Let’s Talk Interactive platform that is HIPA approved and encrypted.
While the organization has been using telehealth for a number of years, they now have to rely almost completely on it. But for Cahill, it has made things easier as a healthcare provider.
“I think it makes me a better therapist,” he said. “Oddly, I feel closer to the person than if we were sitting four feet away in an office. [Therapy] feels more formal in that setting.”
Cahill said he has definitely seen an uptick in anxiety, depression, and substance abuse. Of course, all of that is exacerbated by higher levels of PTSD. Add the social isolation and all of that gets much worse. Heather Flores, PsyD., PTSD program manager at Veterans Affairs Northeast Ohio in Cleveland, couldn’t agree more.
“Vets have higher rates of PTSD,” she said. “We’re seeing anxiety, fear about their financial situation or job loss, fear about being able to meet their basic needs, the impact of social isolation and depression. We tend to see substance abuse—drugs and alcohol—worsen in times of stress. We see an increase in partner violence. This is across the nation, not just in Ohio.”
Flores also discussed the VA’s Domiciliary Care Program, one of the longest running healthcare programs in the country giving vets a chance to avoid becoming homeless. Originally meant as a home for soldiers disabled in the Civil War, it has since become a clinical rehabilitation and treatment program for male and female veterans within their own communities.
“We’ve got great resources for mental health, outreach, and other services,” she said. “We do a lot of engagement, especially in this time of COVID. There are a number of different programs available and we strive to do the best we can.”
Flores also noted telehealth, which is something the VA provided long before the pandemic. The organization started home telehealth in Florida in 2000 with a pilot site, subsequently moving to video telehealth in 2002.
Northeast Ohio kicked off its telehealth in 2004, mostly focusing on remote chronic care management and increasing access to specialty care. So, converting to online mental health services this spring was a relatively smooth operation. Echoing Cahill, Flores said telehealth has its benefits.
“With telehealth, patients don’t have to come to the office,” she explained. “That may mean that they don’t have to worry about childcare or transportation issues. They can see their provider and the treatment is still effective.”