SWK 5002 Week 4 Assignment Policy Selection and Background

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Policy Selection and Background

Student Name

Capella University

SWK5002

Prof. Name

Submission Date

Policy Selection and Background

The issue is that returning veterans who have been in the military face a severe mental health crisis and must struggle with post-traumatic stress disorder (PTSD), depression, and substance use disorders. These problems are prevalent, but more so, they are heavily ingrained in the trauma of war and readjustment issues. Unfortunately, these mental illnesses are often compounded by the structural obstacles within the healthcare system, i.e., wait time, lack of accessibility, and bureaucratic inefficiency.

To address these gaps, the VA MISSION Act of 2018 was signed to ensure more veterans have timely, quality mental health care. The Act directly targets the underserved and marginalized groups of veterans, such as those who live in rural areas, racial and ethnic minorities, and lesbian, gay, bisexual, and transgender communities, to increase the utilization of telehealth services, granting access to care in the community, and simplifying access to care by veterans outside of the traditional VA facilities. This policy marks one of the greatest steps in the correction of the current differences in delivering healthcare to the veterans.

Purpose of the VA MISSION Act

One of the past federal policies is the VA MISSION Act of 2018, which brings up the existing social justice concern of inequality in the provision of mental health care services to U.S. military veterans. This bill was introduced as a result of the numerous malfunctions in the Department of Veterans Affairs (VA) in terms of extended wait time and difficulties in accessing culturally competent care, especially among rural, minority, and/or LGBTQ + veterans. The core concept of the MISSION Act is to enhance access to timely and quality healthcare services among veterans through permitting them to gain healthcare services in neighborhood-based providers where VA care cannot be readily attained.

The actualisation that systemic barriers (e.g., geographical isolation), shortage of providers, and excessive bureaucracies were causing poor mental health (e.g., higher suicide rates, untreated post-traumatic stress disorder) had driven this transition (Rasmussen and Farmer, 2023). According to McBain et al. (2023), the growth of tele-mental health services offered by the Act played a crucial role in the growth of mental health care access in underserved groups of veterans, demonstrating the significance of the Act towards social justice goals.

Different programs and services that are essential have been established with the aid of the VA MISSION Act to enable access to care among veterans. The development of the Community Care Network (CCN) is one of the most significant as it enables qualified veterans to receive medical and mental health services at non-VA providers in case VA providers are unable to give them services on time. The Act also contributed to the rise in the usage of the telehealth technology that allowed veterans to access mental health services remotely, which is highly significant in the case of veterans living in rural or medically underserved areas (McBain et al., 2023).

The policy also improves the support services of caregivers, including money as financial stipends, training, and access to healthcare for the family members of seriously injured veterans. Further, the MISSION Act allows for improving the VA staff and infrastructure to address the shortage of human resources and renovate the facilities. All of these services signify the larger objective of the policy to make the veteran healthcare more flexible, responsive, and equitable (Rasmussen and Farmer, 2023).

Programs and Services Provided

The VA MISSION Act of 2018 recommended several programs and services that will augment and improve care access to U.S. military veterans, and especially those with geographic, cultural, or systemic obstacles to care. Community Care Network (CCN) is also a major aspect of the policy. It helps the veterans who are eligible to access treatment in the private world in case the VA is not able to provide the services that are available within the reasonable time and distance requirements. The program is particularly relevant to rural veterans since they are usually geographically far away from the VA facilities.

Moreover, the Act resulted in the growth of the use of telehealth technologies, through which the veterans were able to obtain mental health services remotely. This pattern has contributed to a reduction in access inequalities in that more than 300 percent more VA tele-mental health visits have occurred in 2020-2022, according to McBain et al. (2023), and according to the data, veterans in underserved regions can access care at higher levels. The Act also offered the funds and guidance to enhance the communication of VA and non-VA providers that aided in further delivery of consistent and timely care (Rasmussen & Farmer, 2023).

The MISSION Act came with another advantage of an increase in the number of support services to the caregivers, which include financial stipends, training, respite care, and mental health services to family members who offer long-term care to severely injured veterans. These advancements acknowledge the significance of the caregivers in the overall health and recovery of the veterans. In addition, the policy has measures that fight the workforce shortage in VA, particularly in mental health care, by investing in provider recruitment, retention, and training. The next goal is the modernisation of the VA infrastructure, which is likely to contribute to the improved quality of services and the reduction of administrative delays.

The main group to be targeted in such programs is all qualified U.S. military veterans, especially those who reside in the country, veterans of colour, veterans who are also transgender and/or gender nonconforming (LGBTBQ +), and veterans with severe mental health issues, such as Post-Traumatic Stress Disorder and depression. This is because such groups have always been the most barred from care; therefore, the MISSION Act is a crucial policy tool that can be utilized in an effort to improve health equity and social justice among veterans.

Connection to the Social Justice Problem

Mental health services are still facing numerous systemic barriers that many veterans, particularly residing in rural communities, and the lgbtq +, racial, and ethnic minorities face. These impediments are the lack of providers, long waiting times and queues, inability to access transportation, and geographical remoteness to VA facilities. Moreover, mental illness and behavioural stigma that seek help are potent in military culture, and they render the veterans unwilling to seek the care that they need.

The absence of culturally competent and trauma-informed care also serves as the means of further vilifying the veterans of colour and the veterans of the LGBTQ + community who are often misdiagnosed, under-treated, or lose interest in the medical system (Bass & Nagy, 2023). These inequalities have caused the most startling mental health disparities, including high rates of untreated post-traumatic stress disorder, substance use, and suicide among these populations.

The VA MISSION Act can solve some of these gaps, and it best fits the principles of the social work profession. The policy contributes to eradicating geographical and logistical barriers that have historically excluded underserved veterans who were out of care from accessing care by increasing access to care via community-based providers and telehealth. New support services provided to caregivers, workforce development, and expansion of digital health functions also contribute to ensuring that even more veterans receive the personalised and culturally sensitive care they deserve.

These provisions are the pillars of social justice, social work principles of service and dignity, and the worth of all persons. Moreover, the very fact that the Act is aimed at the enhancement of the accessibility of the marginalised groups serves as another sign of compliance with the notion of equity and inclusion, and the fact that the social work practice ought to be both moral and feasible.

Historical Context and Policy Development

The VA MISSION Act of 2018 was the outcome of the growing pressure of the populace and the political elite on the result of a 2014 healthcare scandal in the VA, where veterans were dying on the waiting lists because of administrative and other inefficiencies in the Department of Veterans Affairs, and because of the lack of long-term resources. To this, the first attempt by Congress to facilitate access to community-based care was the Veterans Choice Act of 2014, which, however, was labeled as a divided and ineffective program.

Another broadening of these early reforms was the MISSION Act, which also sought to bring a degree of unity and streamlining to the mechanism by which the veterans gained care in the civilian sector, not to mention correcting structural failures in the past. Bipartisan support of the bill was high, and it had the backing of several veterans service organisations (including the American Legion and Iraq and Afghanistan Veterans of America (IAVA) whose lobbying efforts affected the policy goals and contributed to the passage of the bill. The Act represents one of the many political and social movements aimed at making the veterans more accountable and creating more care options available to them through the coordinated public-private initiative.

Impact of Historical Events on Implementation

Despite the increase in the number of tele-mental health services offered to veterans sparked by the VA MISSION Act of 2018, with the number of reported cases of the issue growing by over 300 percent since 2020 (McBain et al., 2023), the number of veterans reported to face a critical shortage of such services remains large.

The lack of a firm internet connection, low levels of digital literacy, and the absence of necessary devices are the technological problems that the older veterans, who are also the rural type, face. Additionally, there is also an uneven distribution of mental health providers in the community, and increased eligibility will not enable all areas to be adequately covered. Such restrictions will nullify the aim of the policy and still introduce inequality of access, particularly to the most vulnerable segments.

Along with the technological and provider limitations, structural problems that have been prevailing throughout the years are, of course, dominant as an obstacle to the full execution of the MISSION Act. The inconsistency in enforcement of the various states and VA facilities, chronic underfunding, and lack of oversight are what create variability in service delivery. In addition, the majority of mental health workers are not trained in cultural competence and trauma-informed care, and it is crucial to the success of treating veterans of colour and veterans belonging to the lesbian, gay, bisexual, and/or transgender community, among other people with unique lived experiences.

This indifference and inability to understand will make certain veterans unwilling to receive help and can lead to negative clinical outcomes. Such loopholes are a pointer that there is a need to go ahead with refining the policies, training of the providers, and advocating to ensure that all the veterans receive equal and effective care.

Conclusion

The VA MISSION Act has addressed the causes of mental health care being more accessible to the veterans in an objective manner by increasing the range of services, encouraging the utilization of telehealth, and streamlining the community-based care. This is a great move towards the right direction, particularly for the veterans who at some time were left without any hope of getting the treatment because of the insurmountable barriers.

Nevertheless, with all these accomplishments, there are still some critical areas that are yet to be addressed, with the most notable ones being the fair implementation aspect, cultural competence, and consistency of service delivery. The policy is yet to realise its full potential because there is no equity in care access to the veteran under the marginalised groups, chronic provider shortages, and technological barriers.