Transition from military to VHA care: Psychiatric health services for Iraq/Afghanistan combat-wounded

The Quality of Mental Health Care for Veterans of Operation Enduring Freedom/Operation Iraqi Freedom

“…This, combined with their status as new veterans and thus gaining familiarity with navigating the VA system, raise questions about whether they are at risk for experiencing lower quality of MH/SUD care than other veterans. 12 Although we did not find such differences, our adjusted and unadjusted comparisons by OEF/OIF status suggest how one might target quality improvement strategies that would benefit OEF/OIF veterans with MH/SUD conditions. Given our findings and others showing that utilization is explained in large part by age and comorbidity 2 plus the differences by OEF/OIF status with respect to these characteristics, implementing tools like patient-tracking systems and reminders might well-suit younger and relatively physically healthy OEF/OIF population, for whom seeking MH/SUD care is less likely to coincide with physical health utilization.…”

“…11 One study found delays in development or recognition of psychiatric conditions among combat-wounded veterans transitioning into VA care, suggesting the need for additional attention to psychiatric conditions among veterans transitioning into VA such as OEF/OIF veterans. 12 Numerous studies have documented the "quality chasm" between effective versus delivered care. 13 Even within the VA, where many studies suggest that medical care is better than in the public or private sector, there are gaps between the care that is available and what veterans receive.…”

Glasgow Coma Scale scores, early opioids, and 4-year psychological outcomes among combat amputees

“…Specifically, military and VA providers should use routine healthcare visits (e.g., primary care) as an opportunity for regular and proactive screening for mental health disorders for several years after injury. One explanation is that new postinjury stressors or trauma [28][29] caused new cases of PTSD with delayed onset. Most amputees leave military service within the first year or two after injury [6,24] and typically make substantial and sometimes difficult lifestyle changes as civilians.…”

“…They typically discharge from military service within the first 2 yr postinjury [6,[24][25] and may receive postinjury care from military and/or Department of Veterans Affairs (VA) healthcare systems [26]. Separation from supportive military amputee care [27] presents new social, financial, and occupational challenges of long-term disability [28][29][30][31]. These challenges may exacerbate prior symptoms and contribute to new PTSD cases several years after injury [29][30].…”

Predictors of Army National Guard and Reserve Members' Use of Veteran Health Administration Health Care After Demobilizing From OEF/OIF Deployment

“…Copeland et al(18) examined 994 service members (Active Duty, Guard, and Reserve) who were traumatically injured and medically discharged from one inpatient DoD trauma treatment facility. The service members were followed to determine the rate, predictors, and patterns of subsequent VHA utilization, even though not all were discharged from the military.…”