WASHINGTON, D.C. - U.S. Senator Daniel K. Akaka (D-HI), Chairman of the Committee on Veterans' Affairs, today introduced comprehensive mental health legislation.  The bill, inspired by an April 25th Committee hearing on mental health care, would address the immediate needs of veterans by ensuring high quality mental health services at VA facilities and in their communities.  In testimony at the hearing, veterans and their family members told heart-wrenching stories of substance abuse, PTSD, and suicide, which exposed flaws in the current mental health care system for veterans.

"Servicemen and women return from war suffering from invisible wounds that are complicated and wide-ranging," Akaka said.  "The solutions put forth in this legislation will help lead to proper mental health care for our veterans."

Chairman Akaka's introductory floor statement can be found below:                            

Mr. President, today I introduce comprehensive legislation to improve the capacity of the Department of Veterans Affairs to care for veterans with invisible wounds.

For too many veterans, returning home from battle will not bring an end to conflict.  They will return home, but the war will follow them in their hearts and minds.  Just as we support our troops as they fight in Iraq and Afghanistan, we must support them when they return from war marked by their service.  Invisible wounds are complicated and wide-ranging, and our solutions must rise to the challenge.

What do we know about the scope of the problem?  A March 2007 study published in the Archives of Internal Medicine reported that more than one-third of war veterans who have served in either Iraq or Afghanistan are suffering from various mental ailments including post-traumatic stress disorder, anxiety, depression, substance use disorder and other problems.  According to the study, a disproportionate number of young soldiers suffer mental health problems.

There is no question that action is needed.  One in five Iraq War veterans are likely to develop PTSD, as studies have estimated, and this is but one aspect of the mental health challenges faced by veterans.

We also know that veterans suffering from physical and mental wounds use drugs and alcohol to assuage their pain.  Experts believe that stress is the number one cause of drug abuse, and of relapse to drug abuse.  Sixty to eighty percent of Vietnam veterans who have sought PTSD treatment have alcohol use disorders.  VA has been dealing with substance abuse issues for decades, but much remains to be done.

On April 25, 2007, I chaired a Committee on Veterans' Affairs hearing on veterans' mental health concerns and on VA's response.  We heard heart wrenching testimony from the witnesses.  Randall Omvig spoke of his son's suicide upon returning from Iraq.  Tony Bailey spoke of his son's struggle with substance abuse, and of his death.  Patrick Campbell shared his own experience with PTSD and the experiences of his close friends.  Witnesses urged us to learn, and they urged us to act.

The provisions of this bill are a direct outgrowth of that hearing and the testimony given by those who have suffered with mental health issues, and by their family members.

This bill addresses the immediate needs of veterans by ensuring high quality mental health services at VA facilities and in their communities.  The bill also looks to the future. 

Our legislation has eleven core provisions.  I will highlight some of them:

First, VA medical centers would be required to offer a minimum range of services for veterans in need of help to overcome their substance use disorders.  It would require programs to prevent relapse and to provide medical treatments to reduce cravings for alcohol and drugs, among others.  Many VA facilities have some of these programs but there is no universal minimum.

We know that there are large numbers of veterans suffering with a terrible confluence of substance use disorders and other mental health disorders.  The bill would require that both issues be treated by a well-qualified team of health professionals who would treat the disorders concurrently.

To ensure that innovative mental health services are tailored to individual communities, the legislation would create grants to enhance programs and fill holes.  VA facilities would compete for grants for various purposes, from increasing weekend and evening hours to creating programs which encourage urgent care physicians - who are often gateways for new patients - to quickly refer those whom they believe may have a mental health disorder.

Veterans with debilitating mental health issues, including substance use disorder and PTSD, may need inpatient care.  VA has moved rapidly to reduce their inpatient mental health capacity, but there is no doubt that inpatient stays are necessary for many veterans.  This legislation would require the VA Secretary to designate six inpatient facilities to provide recovery services for veterans with comorbid PTSD and substance use disorders.             

The legislation would also require a comprehensive review of VA's residential mental health facilities.  This provision stems directly from the hearing testimony of Tony Bailey, whose son suffered from PTSD and substance abuse.  Tony's son, Justin, died while in a VA domiciliary.  He overdosed on medications provided to him by VA.  Residential facilities are a necessary part of VA's effort to treat mental health problems and they must be up to par.

Mr. President, it has been made clear to me, by mental health experts and veterans experiencing mental health problems, that families need to be much more involved in the care of their loved ones.  Families are suffering in much the same way that veterans themselves are suffering.  They must have access to care which will aid in the effective treatment and rehabilitation of a veteran.  An existing provision of law allows such care for family members.  Our legislation simply restates this law and clarifies the type of services to which family members should have access.

Finally, our goal is to define the best possible treatments for veterans now and in the future.  To that end, this legislation sets up a mental health research program based on the successful pediatric oncology model.  We are proposing a network of sites with adequate patient flow and clinical and research expertise.  The goal is to promote rapid progress from research to therapeutic advancement and effective treatments for PTSD and PTSD in the presence of a substance use disorder.

An aggressive mental health agenda for veterans begins by providing VA with financial support.  Our comprehensive legislation authorizes the creation of new programs and expansion of existing ones.  While these changes amount to significant new funding, every dollar was included in our Committee's Views and Estimates Letter to the Budget Committee.  The Committee on Veterans' Affairs requested a $700 million dollar increase in FY 2008 for mental health programs, and the full Senate supported this level in the final Budget Resolution.  A similar level of funding was supported by the full Senate in the VA appropriation bill.

I urge all of my colleagues to support this innovative and comprehensive legislation, which will bring hope and progress to many veterans suffering from invisible wounds.  Thank you, Mr. President.

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