[Congressional Record Volume 153, Number 155 (Monday, October 15, 2007)]
[Senate]
[Page S12872]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. AKAKA:
  S. 2162. a Bill to improve the treatment and services provided by the 
Department of Veterans Affairs to veterans with post-traumatic stress 
disorder and substance use disorders, and for other purposes; to the 
Committee on Veterans' Affairs.
  Mr. AKAKA. 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. Mr. President, 60 to 80 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.
  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 fiscal year 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.
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