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Michael E. DeBakey VA Medical Center - Houston, Texas

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Houston VA Striving to Meet Mental Health Needs of Returning Troops

April 10, 2007

HOUSTON - The Michael E. DeBakey VA Medical Center (MEDVAMC) has developed and expanded several programs to provide mental health screening, counseling, and early treatment to meet the needs of our nation's newest veterans — the men and women who have served in Operation Enduring Freedom in Afghanistan (OEF) and Operation Iraqi Freedom in Iraq (OIF).

Combat veterans are at higher risk for psychiatric problems than military personnel serving in noncombat locations, and more frequent and more intense combat is associated with higher risk. Many of the challenges facing these service members are stressors that have been identified and studied in veterans of previous wars.  In response, VA has developed world class expertise in treating chronic mental health problems, including post-traumatic stress disorder (PTSD).

An OEF/OIF combat veteran’s first contact with the MEDVAMC consists of two screenings: 1) a medical appointment with a general practitioner in a Primary Care Clinic; and 2) an appointment with a mental health professional to be checked for symptoms of a variety of mental health complaints including depression, PTSD, anxiety disorder, substance abuse/dependence, and adjustment disorder.

If a diagnosis is made, the veteran is referred to the appropriate Mental Health Care Line program, service, or professional.  As of March 2007, 86 percent of veterans who were referred have accepted mental health treatment.  One critical challenge faced by mental health care professionals is reducing the stigma of mental health care.

The MEDVAMC recently conducted a survey of OEF/OIF veterans titled, “Tell Us How We Can Better Serve You.”  One veteran wrote, “I think counseling is needed for all soldiers returning. Even though they may not think so, the soldier may need to talk through some things.”

The MEDVAMC Mental Health Care Line offers full interdisciplinary assessments of all patients and provides on-site treatment and referrals as needed, medication management, individual and group therapy, PTSD education groups, PTSD and substance abuse dual diagnosis groups, an intensive day hospital program, a sexual trauma track, a trauma recovery program, applied research such as medication trial and psychotherapy, specialized smoking cessation program, alumni peer support groups, and coordination and formal consultation with the Houston Vet Centers.

Vet Centers provide readjustment counseling and outreach services to all veterans who served in any combat zone in consumer-friendly facilities apart from traditional VA medical centers. Services are also available for their family members for military related issues. In Houston, one Vet Center is located at 701 N. Post Oak Road, (713) 682-2288, and the other at 2990 Richmond Avenue, Suite 225, (713) 523-0884.

In response to the special needs of OEF/OIF veterans, the MEDVAMC has recently added new programs to facilitate a positive mental health experience and additional staff including a psychiatrist, a psychologist, a social worker, and a program support assistant. The Moving Forward Program focuses on OEF/OIF veterans who do not require treatment for mental illness, but need assistance with coping with stress, vocational counseling, and information about education opportunities. The Reintegration Program provides care to those veterans requiring mental health intervention and uses individual/group/family therapy and medication referrals as the situation requires.

The MEDVAMC is also expanding outreach efforts to military units in southeast Texas. The OEF/OIF Coordinator Fern Taylor, along with health care professionals from the Mental Health Care Line, proactively meet with local Reserve and National Guard Units before and after they deploy in order to brief them about available VA benefits, placing special emphasis on mental health screening and counseling. Staff members regularly attend meetings of various community and veterans groups in an attempt to contact eligible veterans who have not yet enrolled for VA care.

While homelessness in the OEF/OIF population has not yet become a perceptible problem, the Health Care for Homeless Veterans (HCHV) Program at the MEDVAMC is committed to assisting homeless veterans with chronic mental illnesses to reach their highest level of functioning. HCHV staff assists veterans with securing safe housing reflective of their abilities and preferences, as well as assistance with obtaining desired skill development services. Treatment goals for each veteran through HCHV are individualized and may include meeting their immediate basic needs of food and protective housing; stabilization of mental health problems including substance abuse treatment and sobriety maintenance; individual and group psychotherapy; evaluation for financial disability benefits; vocational assessment; gainful employment; and schooling or a training program.

Houston is one of 30 communities where the VA will take its substance abuse services directly to the area’s homeless. Under its HCHV Program, the MEDVAMC will hire an addiction therapist to work directly in homeless shelters, counseling veterans with substance abuse problems.

MEDVAMC’s goal is to ensure every seriously injured or ill serviceman and woman returning from combat receives easy access to benefits and world-class service.  Combat veterans have special health care eligibility.  For two years after discharge, these veterans have special access to VA health care, even those who have no service-connected illness.  Veterans can become "grandfathered" for future access by enrolling with VA during this period.  This covers not only regular active-duty personnel who served in Iraq or Afghanistan, but also Reserve or National Guard members serving in the combat theaters.  Veterans with service-related injuries or illnesses always have access to VA care for the treatment of their disabilities without any time limit, as do lower-income veterans.  Additional information about VA medical eligibility is available at http://www.va.gov/healtheligibility. To contact the MEDVAMC OEF/OIF Coordinator Fern Taylor, call (713) 794-7034. Her alternate is Vickie Toliver at (713) 794-8825.

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