SWK 5002 Week 4 Assignment Policy Selection and Background

SWK 5002 Week 4 Assignment Policy Selection and Background

 

Student Name

Capella University

SWK5002

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Submission Date

 

Policy Selection and Background

The problem is that veterans coming back after military service have a severe mental health crisis and have to deal with post-traumatic stress disorder (PTSD), depression, and substance use disorders. Not only are these problems widespread, but they are also embedded right into the trauma of war and readjustment problems. Regrettably, these mental disorders are frequently complicated by structural barriers in the healthcare system, such as wait time, geographical inaccessibility, and inefficiency at the bureaucratic level.

To take care of all these disparities, the VA MISSION Act of 2018 was signed to increase access to timely and quality mental health care for veterans. The Act directly focuses on underserved and marginalized populations of veterans including those living in rural regions, racial and ethnic minorities, and those who are members of the lesbian, gay, bisexual, and queer communities by increasing the use of telehealth services, allowing access to care in the community, and making it easier for veterans to receive care outside of the traditional VA facilities. This policy is one of the most significant steps towards the rectification of the existing disparities in the provision of healthcare to veterans.

Purpose of the VA MISSION Act

The VA MISSION Act of 2018 is a passed federal policy, which addresses the current social justice issue of disparity in the delivery of mental health care services for the U.S. military veterans. This bill was enacted due to the many failures in the Department of Veterans Affairs (VA) concerning long wait times and challenges in receiving culturally competent care, particularly in rural, minority, and/or LGBTQ + veterans.

The main idea of the MISSION Act is to improve the timeliness, quality, and access of healthcare services to veterans by allowing them to access healthcare services within the community-based providers in cases when VA care is not available easily. This transition had been spurred by the realisation that systemic barriers, such as geographic isolation, provider shortage and bureaucratic delays, were contributing to poor mental health, including increased suicide rates and untreated post-traumatic stress disorder (Rasmussen & Farmer, 2023).

As McBain et al. (2023) explain, the expansion of tele-mental health services provided by the Act was crucial in the expansion of mental health care access among underserved veteran groups, showing the importance of the Act in reaching social justice objectives.

With the VA MISSION Act, different programs and services that are important have been created to facilitate care access among veterans. One of the most important is the creation of the Community Care Network (CCN), which allows qualified veterans to obtain medical and mental health benefits from non-VA providers when VA providers cannot provide services promptly.

Also, the Act helped in increasing the implementation of telehealth technology that enabled veterans to use mental health services remotely, which is very important in the case of veterans in rural or medically underserved communities (McBain et al., 2023). The policy also enhances the support services of caregivers, such as financial stipends, training and access to healthcare for the family members of seriously injured veterans.

Moreover, the MISSION Act enables the improvement of the VA personnel and infrastructure to overcome human resources deficits and upgrade the facilities. All these services are indicative of the greater goal of the policy to make the veteran healthcare more flexible, responsive and equitable (Rasmussen & Farmer, 2023).

Programs and Services Provided

The VA MISSION Act of 2018 prescribed several programs and services to increase and enhance access to care for U.S. military veterans, particularly those who face geographic, cultural or systemic barriers to care. The Community Care Network (CCN) is a significant component of the policy. It enables those veterans who qualify to receive treatment in the private sector when the VA does not have the services that are available within reasonable time or distance parameters. The program is especially significant to the rural veterans because they tend to be geographically remote from VA facilities.

Also, the Act led to an increase in the application of telehealth technologies, which allowed veterans to access mental health services remotely. This trend has played a significant role in reducing access inequalities in that between 2020 and 2022, VA tele-mental health visits have increased by more than 300 per cent according to McBain et al. (2023), and according to the data, veterans in underserved areas have access to care in more significant ways. The Act also provided funds and directions to improve the coordination of VA and non-VA providers, which helped in the further provision of consistent and timely care (Rasmussen & Farmer, 2023).

The MISSION Act also brought with it an increase in support services to the caregivers, which include financial stipends, training, respite care and mental health services to family members who provide long-term care to severely injured veterans.

These improvements recognise the importance of the caregivers in general health and the recovery of veterans. Also, measures are in place under the policy to combat the shortage of the workforce in VA, especially in relation to mental health care, through investments in provider recruitment, retention, and training. Another objective is the modernisation of the VA infrastructure, which should help to increase the quality of services and minimise administrative delays.

The primary population that should be the focus of these programs is all eligible U.S. military veterans, particularly those who live in rural areas, veterans of colour, veterans who are also transgender and/or gender nonconforming (LGTBQ +), and veterans with severe mental health problems, such as those with Post-Traumatic Stress Disorder and depression. Such groups have historically faced the most barriers to care, so the MISSION Act is an important policy tool that can be employed to enhance health equity and social justice for veterans.

Connection to the Social Justice Problem

There are still a lot of systemic obstacles to mental health services that are experienced by many veterans, especially those living in rural communities, and those belonging to the lgbtq + groups, and racial and ethnic minorities. These barriers include shortages of providers, long waiting times, lack of transportation means, and geographic isolation from VA facilities. Also, stigma towards mental illness and behaviour that seeks help is powerful in military culture, and it makes the veterans reluctant to seek the care that they require.

The lack of culturally competent and trauma-informed care also acts as a way to further vilify veterans of colour and the veterans of the LGBTQ + community who are frequently misdiagnosed, under-treated, or lose interest in the medical system (Bartlett et al., 2022). Such inequalities have resulted in alarming mental health disparities such as high levels of untreated post-traumatic stress disorder, substance use and suicide in these groups.

Some of these disparities are resolved in the VA MISSION Act, which fits perfectly into the principles of the social work profession. The policy plays a role in eliminating geographical and logistical barriers that have traditionally left underserved veterans out of care by boosting access to care through community-based providers and telehealth.

The addition of caregiver support services, workforce development, and digital health expansion also helps to see to it that more veterans get the personalised, culturally sensitive care that they deserve. Such measures underpin the social work principles of social justice, service and dignity and worth of all persons. Furthermore, the focus of the Act on improving access to the marginalised groups is also an indicator of adherence to the concept of equity and inclusion, the principles that social work practice should be ethical and practical.

Historical Context and Policy Development

The VA MISSION Act of 2018 was the result of increasing pressure by the public and the political establishment after a 2014 healthcare scandal in the VA in which veterans died waiting to receive care due to administrative inefficiencies and long-term resource shortages in the Department of Veterans Affairs. In response to this, Congress first passed the Veterans Choice Act of 2014 to facilitate limited access to community-based care, but the program was castigated as being divided and ineffective.

The MISSION Act was a further expansion of these first attempts at reform, and attempted to introduce a unification and simplification in the process by which veterans achieved care in the private sector, as well as redressing historic structural inadequacies.

The bill had high rates of bipartisan support, and was supported by many veteran service organisations (such as the American Legion and Iraq and Afghanistan Veterans of America (IAVA) whose lobbying efforts influenced the policy objectives and helped to pass the bill. The Act is indicative of a broader political and social movement to enhance accountability and increase the care options to veterans by means of a coordinated public-private effort.

Impact of Historical Events on Implementation

Although the VA MISSION Act of 2018 has led to a significant increase in tele-mental health services to veterans, with the reported growth of over 300% between 2020 and 2022 (McBain et al., 2023), there is still a large number of veterans reported to experience a critical lack of access to such services.

The technological issues that the older veterans, those who are rural, are facing are a lack of a firm internet connection, low digital literacy, and a lack of access to essential devices. Moreover, mental health providers within the community are unevenly distributed, and not all regions will be well covered with increased eligibility. These restrictions defeat the purpose of the policy and continue to create inequality of access, especially to the most vulnerable groups.

In addition to the technological and provider constraints, the structural issues that have existed all along are dominant as barriers to the full implementation of the MISSION Act. Variability in service delivery is caused by inconsistent application of enforcement across states and VA facilities, chronic underfunding and lack of oversight.

Moreover, most mental health professionals do not receive training in cultural competence and trauma-informed care, and it is critical to the success of treating veterans of colour, veterans who are also members of the lesbian, gay, bisexual, and/or transgender community, and other individuals with unique lived experiences.

Such insensitivity and lack of understanding will discourage some veterans from getting help and may result in poor clinical outcomes. These gaps are an indication that it is necessary to continue the work on refining the policies, training the providers, and advocating to provide all the veterans with equal and effective care. Bottom of Form

Conclusion

The VA MISSION Act has made mental health care more available to veterans in an objective way by expanding the scope of services, promoting the use of telehealth, and facilitating community-based care. Such advances are a significant step in the right direction, especially for the veterans who were in the past left with no hope of receiving the treatment due to insurmountable obstacles.

But, despite these achievements, there are still serious issues left, the most prominent of which are the areas of fair implementation, cultural competence, and consistency of service delivery. No equity in care to veterans who belong to marginalised groups, persistent provider shortages and technological impediments still limit the full potential of the policy.

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