Some correspondence with colleagues:
My opening comment: “Opportunities for upgrade in MH services might result…all depends upon who and how utilizes the $$$ and power.”
Unless we have a spontaneous zeitgeist or a challenge via the ‘external review’ aspect of the new bill I do fear the extra $$$ will buy sand boxes (yes, that is what an Air Force clinician was using) or more expensive, useless toys (how about that marvelous Virtual Iraq), as well as poorly trained, useless new clinicians. I keep hopeful and would love the opportunity to challenge the current ineptitude. However, it remains a dream without access to the very highest political processes. Sadly, that path is not viable within the conventional paths; had I taken the administrative route returning to VA I would have become another soulless zombie dithering over meaningless and phony measures (body count). I remain focused on the clinical art form which keeps me sane but I also remain hopeful that someday the spirit of the new law permit sane voices to determine how to better deliver the balanced and artful skill set our clients desperately need and deserve.
(This past Friday one of my clients came up to me and said about our VN Veterans PTSD group “I really wish we had the help we are getting now when we first came home; it would have made such a difference in how I treated my family, the first two women in my life, my kids, everything. I sure do hope these young guys are getting what we’re getting now.” I felt some pride he was progressing after 40 years of drifting but I could not give him the vapid reassurance that our systems and providers were delivering anything close to what he was wishing for younger vets.)
Would be so amazing if improvements would occur because of this…
I need to work on my attitude… I sadly feel like most veterans won’t get what they need just based on HX.
Keep the dream alive and keep moving forward- that is what will help change to occur!
I have to say I’m not hopeful it will do much more than increase “access” without improving quality or scope of practice and make our lives miserable with BS “accountabity” oversight that will result zero in improving real care for these guys and gals. I also don’t think the answer is simply hiring more and more staff… I think we must need a drastic revisionism of how recovery is conceptualized and implemented and an explicit articulation of moving away from a private practice model or standardized group heavy model with too many meds. I have never heard articulated what a systems based recovery model can look like… Interested at some point to talk with you about it. Maybe creation of small focused highly trained recovery teams that can be flexible, creative, comprehensive in a relatively short period of time. Maybe again going back to the idea of a boot camp equivalent but with recovery, readjustment, independent identity goals. I have to say its kind of a mess right now! Sorry, just thinking out loud right now ….
Your PTs are a few of the blessed soldiers who actually get quality, therapeutic care and their feedback to you is priceless, I am sure. That is why we are supposed to “show up” and I know that feedback is what pulls you along when the frustration is so awful. Thank you for what you do- there are not enough like you that are caring and conscious to the art of recovery!
Clinicians- email me your comments for potential posting…