SKW5002 Week 4 Assignment Policy Selection and Background

Policy Selection and Background

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Capella University

SWK5002

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Submission Date

Policy Selection and Background

The issue is that returning veterans have serious mental health crises, and they need to cope with post-traumatic stress disorder (PTSD), depression, and substance abuse. These problems are not only common, but they are also inherent in the trauma of war and readjustment problems. Unfortunately, such mental disorders are often further complicated by structural obstacles in the healthcare system, including wait times, geographical inaccessibility, and bureaucratic incompetence at the organizational level.

To address all such disparities, the VA MISSION Act of 2018 was signed to expand access to timely and quality mental health care among veterans. The Act targets directly underserved and marginalized groups of veterans, such as those residing in rural areas, and racial and ethnic minorities, and members of the lesbian, gay, bisexual, and queer communities to have more access to telehealth care, be able to access care within the community, and have the veterans more accessible to care outside of the traditional VA settings. It is one of the most important policies to be undertaken in terms of correcting the current imbalance in offering healthcare services to veterans.

Purpose of the VA MISSION Act

The passed federal policy, the VA MISSION Act of 2018, is a policy that discusses the prevailing social justice concern of the disparity in the provision of mental health care services to U.S. military veterans. The reason behind the enactment of this bill is that the Department of Veterans Affairs (VA) has been experiencing numerous failures, which include prolonged wait times and difficulties in accessing culturally competent care, especially in rural and minority, as well as/and LGBTQ + veterans. The central concept of the MISSION Act is to enhance accessibility, quality, and timeliness of healthcare services to the veterans by enabling the latter to receive healthcare services from community-based providers in instances where VA care is not readily accessible.

This change had been catalyzed by the realisation that the systemic barriers, including geographic isolation, shortage of providers, and bureaucratic delays, were adding to poor mental health, including rising suicide rates and post-traumatic stress disorder that was not treated (Rasmussen & Farmer, 2023). The growth of tele-mental health services through the Act, as detailed by McBain et al. (2023), was the key to increasing mental health care accessibility to underserved groups of veterans, which demonstrates the significance of the Act in the achievement of social justice goals.

In the case of the VA MISSION Act, various key programs and services have been established to ensure that the veterans are able to access care. The establishment of the Community Care Network (CCN), where qualified veterans access medical and mental health benefits offered by non-VA providers, is one of the most crucial ones. Moreover, the Act contributed to enhancing the use of telehealth technology that allowed veterans to access mental health services remotely, which is highly relevant among veterans in rural or underserved communities with limited medical care (McBain et al., 2023). This policy also incorporates the caregiver support services, including financial stipends, training, and access to healthcare, for the family members of the seriously injured veterans. Additionally, the MISSION Act allows the VA staffing and infrastructure to be enhanced and overcome the lack of human resources and modernize the facilities. All these services signify the ultimate aim of the policy to render the veteran healthcare more adaptable, receptive, and equitable (Rasmussen & Farmer, 2023).

Programs and Services Provided

The VA MISSION Act of 2018 mandated several programs and services to expand and improve access to care among the U.S. military veterans, especially those who are geographically, culturally, or systematically disadvantaged in accessing care. One of the major parts of the policy is the Community Care Network (CCN). It allows the qualified veterans to get care in the private sector when the VA lacks the services that are within the scope of a reasonable time or distance. The rural veterans are also particularly important to the program as they are usually in remote geographical locations from VA facilities. Besides, the Act increased the use of telehealth technologies, which enabled veterans to receive mental health services remotely. This trend has contributed majorly to the decrease in access inequalities in the sense that VA tele-mental health visits have risen by over 300 per cent between 2020 and 2022, according to McBain et al. (2023), and according to the data, veterans within underserved regions have access to care in more meaningful ways.

Another impact associated with the MISSION Act is that it implemented more support services to the caregivers, which entailed financial stipends, training, respite care, and mental health services to family members who offer long-term care to the severely injured veterans. These advances appreciate the role of the caregivers in both overall health and the healing of veterans. There has also been the provision of measures under the policy to overcome the scarcity of the workforce in VA, especially with regard to mental health care, by investing in provider recruitment, retention, and training.

The second goal is the modernisation of the VA infrastructure that is expected to aid the quality of services, as well as reduce administrative delays. The target population of such programs should be all eligible U.S. military veterans, especially those who reside in rural regions, veterans of colour, veterans who are also transgender and/or gender nonconforming (LGBTBQ +), veterans with severe mental health issues, i.e., with Post-Traumatic Stress Disorder and depression. These groups have traditionally been the most vulnerable to care, and thus, the MISSION Act is a valuable policy instrument that can be utilized to increase health equity and social justice in veterans.

Connection to the Social Justice Problem

Systemic barriers to mental health care that are faced by many veterans continue to exist, especially for those who live in rural communities, lgbtq +, and racial and ethnic minorities. Such obstacles comprise an inadequate supply of providers, long queues, no means of transport, and physical seclusion of VA centers. More so, the stigma associated with mental illness and behaviour in which people seek help is a formidable force in the military culture, and this has rendered the veterans unwilling to receive the care they need. The absence of culturally competent and trauma-informed care is also one of the methods to further demonise veterans of colour and LGBTQ + veterans who are often misdiagnosed, under-treated, or disinterested in the medical system (Bartlett et al., 2022). The outcome of such inequalities has led to distressing mental health inequalities, including excessive cases of untreated post-traumatic stress disorder, substance use, and suicide among these populations.

Some of these discrepancies are addressed in the VA MISSION Act, which perfectly fits in the principles of the social work profession. The policy helps in eradicating geographical and logistical barriers that have historically left underserved veterans without care by increasing access to care by using community-based providers and telehealth. Caregiver support services, workforce development, and digital health expansion additions also contribute to ensuring that more veterans receive the personalised, culturally sensitive care that they deserve. The social justice principles of social work include such measures as social justice, service, and dignity and worth of all persons. Moreover, the emphasis on the Act towards the enhanced accessibility of the marginalised groups is another pointer to ensure compliance with the notion of equity and inclusion, the postulates underpinning the ethicality and practicality of the social work practice.

Historical Context and Policy Development

The VA MISSION Act of 2018 was the culmination of the mounting pressure from the people and the political right after a 2014 healthcare scandal in the VA, where veterans had to die during the waiting period in the Department of Veterans Affairs because of administrative inefficiencies and ineffective allocation of resources over time. In reaction to this, Congress initially enacted the Veterans Choice Act of 2014 in order to enable restricted access to community-based care, although the program was criticized for being divided and ineffective.

The MISSION Act was an extension of these initial reforms, and tried to bring a harmonization and streamlining in how veterans accessed care in the private sector, and remedied structural gaps of the past. There were great levels of bipartisan support on the bill and support among many veteran service organisations (including the American Legion and Iraq and Afghanistan Veterans of America (IAVA) whose lobbying efforts impacted the policy goals and assisted in passing the bill. The Act reflects a larger political and social agenda of improving accountability and offering the veterans more options of care through a coordinated effort between the government and the private sector.

Impact of Historical Events on Implementation

Even though the number of tele-mental health-related services to veterans has increased significantly in 2018 due to the VA MISSION Act of 2018, approximately 300 percent of the growth in this area was registered in the period of 2020-2022 (McBain et al., 2023), there are still many veterans who are reported to face a critical shortage of tele-mental health services. The technological challenges that the older veterans who are rural are grappling with are poor internet connectivity, low digital literacy, and inaccessibility of required gadgets. In addition, mental health providers in society are not evenly allocated, and not every part of society will be adequately covered as more people become eligible. Such restrictions are a failure in the intent of the policy, and they still serve to establish inequality of access, particularly to the most vulnerable groups.

The structural problems that have been prevalent throughout are also prevailing barriers to the total implementation of the MISSION Act, in addition to the technological and provider strains that have been there all along. Lack of uniformity in service delivery is due to inconsistent use of enforcement by the states and VA facilities, chronic underfunding, and poor oversight. Furthermore, the vast majority of mental health practitioners lack cultural competence and trauma-informed care training, and it is a major factor contributing to the success of the treatment of veterans of colour, veterans who are themselves part of the lesbian, gay, bisexual, and/or transgender population, and other people with distinct lived experiences. This insensitivity and ignorance will make some veterans unwilling to seek help, and poor clinical outcomes may be experienced. These gaps can provide evidence that it is required to proceed with the work on the policies refinement, training the providers, and advocacy to give all the veterans equal and effective care. Bottom of Form

Conclusion

Mental health care has become more accessible to veterans objectively through the VA MISSION Act by broadening the range of services, advocating the application of telehealth, and enhancing the utilization of community-based care. These developments are a major leap in the right direction, particularly for the previously disapproved veterans who had no hope of receiving the treatment because they were faced with overwhelming odds. However, even with these accomplishments, there are serious gaps that remain, with the most noticeable being the areas of fair implementation, cultural competence, and consistency of service delivery. The policy is yet to reach its full potential due to the lack of equity towards veterans who are members of the marginalised population, chronic shortages, and technology-related barriers to care delivery.

Related Sample for this class: SKW5002 Week 3 Assignment