Madam Chair, and members of the subcommittee, thank you for inviting Iraq and Afghanistan Veterans of America (IAVA) to testify today, and for giving us the opportunity to present our views on H.R. 784, H.R. 785, H.R. 1211 and drafted legislation pertaining to emergency care. On behalf of IAVA and our more than 125,000 members and supporters, I would also like to thank you for your unwavering commitment to our nation’s veterans.

H.R. 784

IAVA is very concerned with the national shortage of mental health professionals, and in particular, how this shortage affects access to adequate mental health care for troops and veterans. The VA has already been flooded by new veterans seeking care for psychological injuries. More than 178,000 Iraq and Afghanistan veterans seen at the VA have been given a preliminary diagnosis of a mental health problem, about 45 percent of new veterans who visited the VA for any reason.

Although the VA was initially caught unprepared with a serious shortage of staff and an exceedingly inadequate budget, the Department has made significant progress in responding to the needs of new veterans. Thanks to a mental health budget that has doubled since 2001, the VA has been able to devote $37.7 million to placing psychiatrists, psychologists, and social workers within primary care clinics. While psychologist staff levels were below 1995 levels until 2006, the VA has recruited more than 3,900 new mental health employees, including 800 new psychologists, bringing the VA’s total mental health staff to about 17,000 people.  The VA is now the single largest employer of psychologists in the country.

That being said, access to mental health care, particularly for rural and female veterans, is still an issue, in part because of the continued shortage of mental health professionals.  As an example, Montana ranks fourth in sending troops to war, but the state’s VA facilities provide the lowest frequency of mental health visits.

H.R. 784 will establish congressional oversight over vacancies in the VA’s mental health professional positions, and the increased transparency will help improve staffing at VA hospitals and clinics. IAVA fully supports this legislation and looks forward to seeing its rapid implementation.

H.R. 785

With the passage of the historic “Post-9/11” GI Bill last year, there will be a flood of Iraq and Afghanistan veterans taking advantage of their new education benefits and attending universities across the nation. It is to be expected that many of these veterans will turn to their student health centers while attending school for medical care. This is an opportune time to advertise and extend VA mental health care services to new veterans.

H.R. 785 helps facilitate this by ensuring that student health centers and counseling services at universities have the appropriate support from the VA to provide the best services to our nation’s student-veterans. 

IAVA is pleased to support H.R. 785 and looks forward to working with Representative Tsongas to ensure that this legislation is enacted in a timely manner and does not contain any technical deficiencies.  It is our hope that language within the bill will be modified to clearly define what is termed as “large enrollment” in section 1 (b) (1).  It is critical that mental health services be available to all veterans no matter what school they attend.  Any university with Iraq and Afghanistan veterans should have the appropriate amount of counselors ready to assist veterans. If only schools with a very high veteran population are allocated these resources, veterans attending institutions with a smaller veteran population will continue to fall through the cracks. In addition, Section 1 (b) (1) (A) contains the following language:  “training for clinicians on treatment for mental illness commonly experienced by such veterans.”  IAVA would like to see this language more clearly defined to reduce the risk of certain illnesses going undiagnosed and untreated.

H.R. 1211

IAVA is pleased to see that the subcommittee is focusing on the unique needs of women veterans. Improvement of VA health care for women veterans is one of IAVA’s 2009 Legislative Priorities.  More than 11 percent of Iraq and Afghanistan veterans are women, and they deserve the same access to health care as any other American veteran.

The “Women Veterans Health Care Improvement Act” will help gather critical information on the quality of VA care provided to women veterans. By identifying barriers to care or gaps in services that women veterans are experiencing, the VA and Congress can better address these shortfalls.

With respect to Title II, Section 202 of the discussion draft, IAVA would like to see funding devoted to the study of the best evidence-based treatment and care for veterans suffering from post-traumatic stress disorder as a result of both sexual trauma and combat trauma, so that mental health care providers within the VA can be trained on these particular treatments. This combination of traumas has rarely been studied, but with more females serving in Iraq and Afghanistan, the possibility of both these traumas occurring in new veterans is significant.  The VA’s mental health providers must be prepared.

In addition to this recommendation, as part of IAVA’s 2009 Legislative Agenda, we have made multiple recommendations to adequately address the needs of women veterans. In particular, IAVA supports prioritized hiring of female practitioners and outreach specialists, increased funding for specialized in-patient women-only PTSD clinics, and significant expansion of the resources available to women coping with Military Sexual Trauma. 

While not all of these issues are addressed in the Herseth Sandlin bill, it is our hope that these provisions will be incorporated into future legislation. IAVA thanks the Chairwoman for her work on women veterans’ issues, and looks forward to seeing the final language of the bill.

Thank you for your time.  Semper Fi.