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Veterans with less than honorable discharges can now access emergency mental health care

On Wednesday, the Department of Veterans Affairs began offering urgent mental health care to former service members with other-than-honorable discharges.

"Suicide prevention is my top clinical priority," said VA Secretary David Shulkin in announcing formalized plans for the new initiative last week. "We want these former service members to know there is someplace they can turn if they are facing a mental health emergency — whether it means urgent care at a VA emergency department, a Vet Center or through the Veterans Crisis Line."

The VA estimates that there are about 500,000 former service members with other-than-honorable discharges. This kind of discharge usually makes service members ineligible for most benefits provided by the VA. Under the new initiative, they may receive up to 90 days of inpatient, residential or outpatient care for a "mental health emergency."

During that time, VA officials will also work to determine if the mental health condition is a result of a service-related injury, according to a news release from the department. Research shows that post-traumatic stress disorder and other mental health disorders can lead to bad behavior such as self-medicating or going AWOL, which, in turn, can result in an other-than-honorable discharge.

The VA's new initiative comes after efforts on the national and state levels to raise awareness about this population of service members, and how to better care for them.

"This is a good first step toward giving all veterans the care that they need, but we're still far from the finish line on this issue," Steve Kennedy, Connecticut team leader for Iraq and Afghanistan Veterans of America, said in an email.

He added, though, "The new policy still waits until they're suicidal to give them treatment."

Kennedy, who served as an Army infantryman, filed a class-action lawsuit in April over the Army's alleged failure to address the so-called "bad paper" discharges that he and tens of thousands of other service members received after showing signs of post-traumatic-stress disorder and other mental health disorders.

U.S. Sen. Chris Murphy, D-Conn., also doesn't think the initiative goes far enough.

"I'm glad the VA is going to start providing some care to these veterans next week, but I still don't understand why they're choosing to limit that care to just 90 days. Ninety days is not a number based on any scientific evidence or best medical practices, and it's unacceptable that we're shutting them off from care they need," Murphy said in a prepared statement.

He is pushing for passage of legislation he introduced related to this issue. The Honor our Commitment Act would require the VA to provide mental health and behavioral services to former service members who served in combat and who received an other-than-honorable discharge, and who have post-traumatic stress disorder, a traumatic brain injury or other mental health disorder.

Other-than-honorable discharges are on the rise. The percentage of these discharges being issued has increased from 2.5 percent during the Vietnam War era to nearly 6 percent in the post 9-11 era, according to a June 2017 report from The Watson Institute for International and Public Affairs at Brown University.

The report points out that an other-than-honorable discharge is a type of an administrative discharge given by a commanding officer without the legal representation or medical evaluation that might accompany bad conduct or dishonorable discharges. It argues that the VA's initiative is far too limited, 'focusing solely on emergency mental health services and simply codifying a number of things the VA already informally does for veterans experiencing mental health crises.

It calls for more expansive changes such as altering the way the armed services discharges people, specifically de-incentivizing commanding officers from giving administrative discharges, and changing the VA's criteria for assistance, which, it says, are much more stringent than congressionally stated policies for veterans' care.


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