Continuous Care for Mentally Ill Veterans is a Matter of Life and Death

Veterans with serious mental illnesses (SMIs) are more likely to die prematurely than civilian individuals with SMIs. Studies have shown that mental issues often occur along with other health problems such as cardiovascular illness. Among the general population and the veterans sampled with SMI, heart disease is the leading cause for premature death. For veterans who are already at increased risk for mental health problems, receiving and maintaining proper psychological care is literally a matter of life and death. In recent years, the Department of Veterans Affairs (VA) has made great strides in recognizing limitations of care and has worked hard to develop plans to address these challenges.

As recently as 2010, the VA concluded a long-term improvement program that focused on identifying veterans who had stopped receiving mental health services and offering them continuation of care in order to decrease their risk for premature mortality. Chester L. Davis of the Veterans Health Administration, Office of the Medical Inspector in Washington, D.C., analyzed the data obtained from the program that focused specifically on veterans with a history of bipolar or schizophrenia. Davis found that of all 3,306 veterans who had received care in previous years, only 72% returned for care in the following year after receiving services. The study also revealed that the mortality rate for the veterans that returned for continuous care and follow-up was over five times lower than it was for veterans with SMIs who stopped their care altogether.

The data representing veterans with bipolar and schizophrenia are particularly relevant to continuous care, as this segment of clients with SMIs often have other mental health issues that co-occur and require particular attention to medication adherence and effectiveness. In sum, the study revealed that the veterans with SMIs who stopped their care prematurely were much more likely to die than those who maintained clinical contact with their mental health providers. Davis believes that the findings of this study emphasize the importance of this innovative program and the need for further efforts to help our mentally ill veterans. He added, “Proactive outreach might result in patients returning to care and should be implemented to reengage this vulnerable group.”

Davis, C. L., Kilbourne, A., Blow, F. C., Pierce, J. R., Winkel, B. M. (2012). Reduced mortality among Department of Veterans Affairs patients with schizophrenia or bipolar disorder lost to follow-up and engaged in active outreach to return for care. American Journal of Public Health, Supplement, S1 102.1, S74-S79.

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  • Cal


    May 8th, 2012 at 3:50 PM

    Just look at the lower mortality rates for the vets who receive consistent follow up care and those who do not.
    It is a no brainer that it is critical to get those who need the treatment actively involved in their treatment plan and committed to receiving care for the amount of time that is necessary for them.
    they need to know that good health care is not only available to them but is vital to their consistent well being.



    May 9th, 2012 at 4:13 AM

    Someone is going to have to do a stronger outreach effort among this veteran population to see to it that they are receiving that help.

    You know as well as I do that this is a proud bunch, and to admit that they need some help just doesn’t seem to be something that many of them are able to face.

    The thought of asking for additional help, well that is just unheard of in many circles. Families need to keep a close eye on these veterans and ensure that they are taking the appropriate steps to help them get treatment.

    These are people who have given far too much to our country through their courage and their service to be allowed to fall under the radar.

  • Miles2go


    May 9th, 2012 at 2:17 PM

    These are pretty proud and sometimes stubborn men and women that we are talking about.
    To make them come in and get some help, this has to be a total family effort and commitment.
    You have to make the process of getting healthy again an appealing one, show them everything that they could be missing out on by choosing not to come on for treatment and stick with it.
    This is going to be a tough journey for many of them, but we have to be clear that the process of working through these problems is far more appealing than the alternative, which is ignoring them and then facing some very difficult choices later on.

  • Faith


    May 10th, 2012 at 4:24 AM

    Getting my father to go to the dr even when he knows something bad is going on, that he is really sick. getting him to go if there were any kind of mental disturbances would be next to impossible.

  • mood4amelody


    May 12th, 2012 at 10:05 AM

    Why is it that those who so often most need the treatment are the ones who are the most resistat to trying it? For these veterans they have access to care that many families only have to dream of having. They have counselors, insurance, and case workers who are all working together to ensure that they have the very best treatment which is available. That’s why I have a hard time grasping why they would not take advantage of this especially as so many Americans don’t have that same access to care and would do anything for the chance to be treated. This is such a huge problem for the entire population. Obviously these veterans are owed this kind of treatment given that many of them have risked life and family for protecting the rest of us. But I still have a hard time not getting a little aggravated about what so many others would die to have and they kind of take it all for granted and don’t use the resources that they have at their fingers.

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