WASHINGTON, D.C. – U.S. Senators Jacky Rosen (D-NV) and Catherine Cortez Masto (D-NV) joined Senator Richard Blumenthal (D-CT) and their Senate colleagues in a letter to the U.S. Department of Veterans Affairs (VA), urging the agency to develop and implement comprehensive mental health care plans to ensure veterans’ well-being during and after the pandemic, and in a letter to the U.S. Department of Defense (DOD), urging the agency to put in place a comprehensive mental health care plan to ensure the well-being of servicemembers and their families during and after the pandemic
“The stress, uncertainty, and isolation associated with the pandemic – all risk factors for suicide in a population where an estimated 17 veterans tragically die by suicide a day— will further increase demand for mental health care among our veteran population, necessitating a comprehensive plan to meet that need,” the Senators wrote in the letter to VA Secretary Robert Wilkie.
“We urge you to develop a plan to protect and promote mental health and wellbeing, assess and reform current policies, and conduct outreach to the military community to identify resources and TRICARE-covered services that are available to them during this stressful time,” the Senators wrote in the letter to DOD Secretary Mark Esper.
The full text of the letter to VA Secretary Wilkie can be found here and below:
Dear Secretary Wilkie:
We write to urge you to develop and implement a comprehensive plan to care for the mental health and well-being of our nation’s veterans throughout and following the novel coronavirus (COVID-19) pandemic. The pandemic will likely exacerbate symptoms of existing mental health conditions and create additional need from those who have not previously sought mental health care at the Department of Veterans Affairs (VA). While mental health is mentioned in the March 23rd COVID-19 Response Plan issued by the Veterans Health Administration, this critical issue requires a focused, designated plan.
While it may take years for the full impact of the COVID-19 pandemic on mental health to be thoroughly understood, early research paints a deeply concerning picture. According to a recent poll by the American Psychiatric Association, more than one third of Americans say the pandemic is having a serious impact on their mental health. As you know, roughly one in five veterans already experience mental illness. The stress, uncertainty, and isolation associated with the pandemic – all risk factors for suicide in a population where an estimated 17 veterans tragically die by suicide a day— will further increase demand for mental health care among our veteran population, necessitating a comprehensive plan to meet that need.
We were encouraged to hear that in March, VA mental health providers completed more than 34,000 VA Video Connect appointments with veterans, an increase of 70% from the previous month. In addition to such telehealth services, we urge you to meet the veteran population where they are. This includes moving peer-led support groups to phone or video conferencing, as has been done with most group counseling; forming additional public-private partnerships and expanding access to existing ones, such as the one that has made Portal video-conferencing available to veterans; and offering mental health counseling to the VA employees facing unprecedented levels of job stress as they work on the frontlines of the outbreak. We acknowledge that not all veterans have internet access and ask that you provide information on VA’s plan to leverage the authorities provided under the CARES Act to work with telecommunications companies in subsidizing internet and mobile broadband services for veterans, as well as an assessment of whether conducting mental health appointments via phone meets clinical needs. We urge you to conduct public outreach—the importance of which is recognized by the National Strategy for Preventing Veteran Suicide—focused on reaching veterans experiencing isolation, job stress, financial strain, and other pandemic-related pressures. We also ask that you provide information on any planned compassionate communication programs, such as the “Annie” text messaging system, aimed at connecting with and supporting veterans in their daily lives.
We recommend that a comprehensive plan also prepare for increased use of existing services, by hiring additional mental health care providers and providing these individuals, as well as the professionals who staff the Veterans Crisis Line, with training and support focused on the particular challenges of the current crisis, including managing isolation and grief for lost loved ones. Further, as you know, the suicide surveillance system operations of VA’s Center of Excellence for Suicide Prevention provide key analytical support to VA’s Suicide Prevention Program. VA must maintain vigilant surveillance of suicides and be prepared to address any spikes that may occur. We ask that you provide information on how the staff and capacity of this system may be impacted by the pandemic and how VA plans to meet these challenges.
The COVID-19 impact on mental health will be long-term, and immediate action as well as a long-term response plan are necessary to combat the mental health implications of this crisis. We look forward to your response and to working with you to ensure you have all the necessary authorities and resources to care for the mental health of our nation’s veterans throughout this crisis.
The full text of the letter to DOD Secretary Esper can be found here and below:
Dear Secretary Esper:
We write to emphasize the importance of mental health care for servicemembers – including National Guard and Reserve personnel – and their family members throughout and following the novel coronavirus (COVID-19) pandemic. While we acknowledge the Department of Defense (DoD) response to COVID-19 is multifaceted and the challenges unprecedented, mental health services are critical to preserving military readiness. We urge you to develop a plan to protect and promote mental health and wellbeing, assess and reform current policies, and conduct outreach to the military community to identify resources and TRICARE-covered services that are available to them during this stressful time.
While it may take years to fully understand the impact of the COVID-19 pandemic on mental health, early research paints a deeply concerning picture. According to a recent poll by the American Psychiatric Association, more than one third of Americans say the pandemic is seriously impacting their mental health. Servicemembers and military family members are already exposed to noted risk and socio-demographic factors for suicide, including reluctance to seek help, perceived stigma around treatment, and access to lethal means. Further, strong interpersonal connections–a protective factor against suicide—are being strained by essential social distancing measures necessary to combat the outbreak.
The social isolation and travel restrictions required to confront this pandemic disproportionately impact servicemembers and military families, and could quickly exacerbate the demands of military service and the symptoms of any underlying mental health conditions. Necessary travel restrictions and changing mission requirements have extended deployments and family separations. Some military families were caught in limbo between permanent changes of station and face continued uncertainty. These restrictions, as well as the potential loss of civilian spouse employment, have created financial hardships for some military families, which can significantly impact mental and behavioral health. All the while, servicemembers—including National Guard and Reserve personnel—are on the frontlines of fighting the outbreak, providing medical care and building much-needed infrastructure, among other critical roles. Military families also face significant stress when their servicemember is serving on a ship, at a base overseas, or in a unit with confirmed COVID-19 cases and the subsequent possibility of exposure. These stresses and challenges require increased and focused support from DoD.
The military community deserves a coordinated, comprehensive plan to ensure access to high-quality mental health care and continuity of care. We urge you to include in this plan a strategy to combat servicemembers’ existing stigma surrounding mental health conditions that deter individuals from seeking care, guidance on the mental health ramifications of this crisis to commanding officers at all levels, and additional training and support for mental health care professionals on supporting individuals concerned for the health of family members or grieving the loss of loved ones due to COVID-19. Within this plan, we encourage you to leverage telemedicine to the greatest extent possible. To this end, we request an assessment of existing TRICARE policies pertaining to the use of telemedicine for behavioral and mental health services to determine if updates are necessary to ensure that these policies meet military family needs and are on par with, or exceed, options and quality available in civilian health care. We also encourage the use of innovative family services policies and frequent communication with military families to highlight available services and to assess their needs.
The COVID-19 impact on mental health will be long-term, and immediate action as well as a long-term response plan are necessary to combat the mental health implications of this crisis. We look forward to your response and to working with you to ensure you have all the necessary authorities and resources to provide augmented mental health services for servicemembers and their families.