National Alliance on Mental Illness
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July 25, 2002

Senate Holds Hearing on VA's Ability to Deliver Mental Health Care

On July 24, the Senate Veterans' Affairs Committee held a hearing on the Department of Veterans Affairs (VA) ability to deliver quality mental health care to our nation's veterans with mental illness. Testifying on behalf of NAMI was Moe Armstrong, MBA, MA and Fred Frese, PhD - both spoke of the VA's need to improve services and expand evidence-based programs to effectively meet the capacity requirements for veterans with mental illness mandated by Congress. At the hearing, Chairman Rockefeller (D-WV) stated that while mental health parity continues to be debated in Congress there does "on the surface" appear to be parity for mental health in the VA. However, the Chairman remarked that while veterans may not be subject to arbitrary limits on the number of mental health visits-the Senate Veterans' Affairs Committee is worried that the VA may not be doing all it can to help those veterans suffering from severe mental illness.

Members of the Senate Veterans' Affairs Committee who attended the hearing were very interested to hear how the VA is maintaining capacity to treat veterans with mental illness. Senators also questioned the VA on the extent to which resources from closing inpatient facilities have been reinvested in quality community based services and supports and the implementation of the VA's guidelines on prescribing antipsychotic medications.

Also testifying at the hearing was Dr. Robert Roswell, the VA Under Secretary of Health and Dr. Miklos Losonczy, the co-chair of the VA's Committee on Care of Veterans with Serious Mental Illness. [The Committee on Care of Veterans with Serious Mental Illness was established by Congress to assess the VA's capability to effectively meet the treatment and rehabilitation needs of veterans with severe mental illness.]

NAMI's testimony before the Committee focused on an acceptable continuum of care for veterans with severe mental illness and what that should include. Stressed at the hearing was the availability and accessibility of physician services, state of the art medications, family education and involvement, inpatient and outpatient care, residential treatment, supported housing, assertive community treatment, psychosocial rehabilitation, peer support, vocational and employment services, and integrated treatment for co-occurring mental illness and substance abuse. Further, NAMI member Dr. Fred Frese stated that all services should be available without waiting lists or other barriers to accessing needed treatment and services and that to be a comprehensive system of care-the VA must have the capacity to provide such services.

In NAMI's opinion, the lack of access to treatment and community supports for veterans with severe mental illness is the greatest unmet need of the VA. It is estimated that 454, 598 veterans have a service connected disability due to a mental illness. Of great concern to NAMI are the 130,211 veterans who are service connected for psychosis, 104,593 of whom were treated in the VA in FY 1999 for schizophrenia.

NAMI believes that while treatment is central to recovery, it is not an end in itself. Housing, psychosocial rehabilitation and supports provided by the VA play a critical role in this process. NAMI board member Moe Armstrong told the Committee that psychosocial rehabilitation and peer support have been key to his recovery and that the VA must do a better job in providing peer education, as well as expanding the use of evidence based models in psychosocial rehabilitation, supported employment and family involvement. NAMI will continue to advocate that the VA improve and expand the provision of specialized services for veterans with severe mental illness. Our nation's veterans deserve the best treatment, including access to the highest quality care, supports and services.

Testimony of Fred Frese

Testimony of Moe Armstrong