Military vets and families need to know your rights with PTSD

STATEMENT OF
STEPHEN T. MOLNAR, MSW, MA
TEAM LEADER,
HONOLULU VET CENTER
DEPARTMENT OF VETERANS AFFAIRS
BEFORE THE
UNITED STATES
SENATE COMMITTEE ON VETERANS' AFFAIRS
AT THE OAHU, HAWAII FIELD HEARING

January 10, 2006

Aloha Senator Akaka and other members of Congress. It is an honor to have this opportunity today to testify at these important congressional hearings on "The State of VA Care in Hawaii." I still vividly recall when I had testified before you at the Senate Veterans Affairs Committee hearings in Washington, DC in 1993 to address concerns about "VA Mental Health Programs."

As a result of those hearings, Public Law 104-262 was passed in 1996, thereby expanding eligibility for Vet Centers and authorizing the extension of readjustment counseling to all combat veterans and their families. This landmark legislation made it possible for combat veterans, and their families, to receive free counseling in convenient locations at 207 Vet Centers nationwide. More importantly though, it helped to eliminate the stigma often associated with mental health care. Public Law 104-262 was a critical step towards the development of seamless and comprehensive care for our returned war veterans.

At Vet Centers, veterans receive counseling for war-related issues, including Post-traumatic Stress Disorder (PTSD), in a comfortable community-based setting that is confidential, private, and without stigma or embarrassment.

The law authorized the Vet Centers to provide family therapy as a core component of readjustment counseling. As provided at Vet Centers, family counseling is available as necessary in connection with any psychological, social, or other military-related readjustment problem, whether service-connected or not.

As a special authority in the law, veterans' eligibility for readjustment counseling is determined by military service in a combat theater and does not require the veteran to go through the enrollment procedure. Additionally, providing family services at Vet Centers is not time limited, but rather available as necessary for the veteran's readjustment throughout the life of the veteran. Veterans' family members are included in the counseling process as necessary to address the whole range of family adjustment issues stemming from the veterans' military experience and post-military readjustment.

Early intervention via outreach and preventive family counseling services help returning veterans stabilize their post-military family and work lives, thereby reducing the risk of subsequently developing more chronic forms of PTSD and associated family problems.

As you know Senator, I am one of the original hires in the Vet Center program. For over 25 years, I have had the opportunity and unique privilege of serving Hawaii's combat veterans, and their families, in the sometime difficult readjustment process. The Honolulu Vet Center has served over 10,000 veterans and their families since opening in 1980. Our clients range in ages from 19 to 90 and reflect the diversity that distinguishes Hawaii from any other place in the world. For example, 47% of our caseload is composed of Asian Pacific Islander veterans and a full two-thirds of our caseload lists their ethnicity as "other than Caucasian."

In addition to readjustment counseling for combat-related issues, the Honolulu Vet Center provides assessment and counseling for PTSD, sexual trauma, family counseling and employment. The Vet Center provides services and referral to homeless veterans and does extensive outreach, education and networking to ensure that veterans have access to comprehensive care and assistance within their community.

In 2003, the Secretary directed that Vet Centers be the focal point for delivery of bereavement counseling to families who lost a service member while on active duty. To date, we have provided 11 families with bereavement counseling and support. As you can imagine, these have been amongst our most difficult cases. The pain of these families runs deep. However, I know that our efforts have made a difference.

Our most recent annual workload data reflects that we have served 628 unique veterans, recorded 5500 visits and opened 250 new cases. At present, the approximate breakdown of new clients who have served in a combat theater are 40% for Vietnam, 30% for WWII, 15% for OIF/OEF and 15% for Other Combat Ops. With the anticipated return of soldiers from Iraq and Afghanistan, and the recent hiring of our OIF/OEF outreach worker, we expect our proportion of OIF/OEF clients to rise accordingly.

While all clients are offered individual counseling, we also provide group counseling. Group counseling is an extremely effective therapeutic modality as well as an efficient one. At present, the Honolulu Vet Center offers 10 different groups. These include groups focusing on combat, sexual trauma, bereavement, family members, life skills, meditation, and POWs. Many of these groups are held in the evenings to better accommodate our veterans and their families.

As you know Senator, Vet Centers are community-based counseling centers with a small core staff of 3 or 4 employees. At the Honolulu Vet Center, we have four full-time staff: a team leader, two counselors (a social worker and psychologist) and an office manager. In addition, we have a part-time sexual trauma social worker. In November we hired a recently returned Iraqi veteran to serve as our outreach worker. His role is to be the bridge for our returned OIF-OEF veterans and their access to Vet Centers, the VA and other community resources. In addition, we have augmented our Vet Center with a comprehensive employment program through the State of Hawaii Department of Labor Disabled Veteran Outreach Program (DVOP). A full-time DVOP counselor out stationed on site provides veterans with immediate access to a full-range of computerized job listings and placement services geared to the needs of veterans.

I am deeply proud of our dedicated and committed staff, Senator. Through their efforts in serving Hawaii's veterans, the Honolulu Vet Center has received both local and national recognition. Two of our counselors have been awarded the VA Secretary's prestigious "Hands and Heart Award" that is presented annually to an employee involved in direct patient care who does the most to exercise professional expertise, to provide emotional support, help and guidance to patients. I have no doubt that the staff will continue to provide the same level of dedication and commitment to ensuring that our returning OIF-OEF veterans receive the best possible care and support.

As you know, the 1996 legislation (Public Law 104-262) expanded eligibility from a single group of war veterans (Vietnam) to all war zone veterans. This resulted in a significant increase in eligible veterans without increasing staffing, and, recently, VHA authorized 100 additional outreach specialists, themselves veterans of OEF/OIF, to enhance the Vet Center program's ability to extend timely services to this new era of war veterans. The dedication and can do attitude of the Vet Center staff ensured that combat veterans of all wars received complete and comprehensive care and services. Similarly, the recent addition of bereavement services required a deep commitment of the staff to ensure that families were provided with immediate and sensitive assistance as well as a full-range of comprehensive services and care which the staff undertook willingly in a professional and compassionate manner. As already noted, with the increased success of our OIF-OEF outreach worker, we anticipate added demands will be placed upon our current counseling staff.

The additional number of veterans who we anticipate may reside in Hawaii after discharge from their OIF-OEF service will add to the Vet Center's demand. As a result, the role of the Vet Center will likely continue to be significant in providing for their readjustment needs.

In closing, I would like to thank you for this opportunity, Senator Akaka, to be able to address those issues facing Hawaii's veterans; particularly those who have served in combat, as well as those still deployed in combat areas. Your willingness to identify the problems facing our veterans, and your commitment to finding appropriate solutions is deeply appreciated.

Senator Akaka, this concludes my statement. I will be glad to answer any questions that you or other members of the Committee may have.

http://www.va.gov/OCA/testimony/svac/060111SM.asp


If they tell you that they do not have to take care of the whole family as well as all veterans, copy and print the above and hand it to them. See what excuse you get after that. If there are not enough mental health providers, get it in writing and pass it onto Senator Akaka.