Gaps in Services for Homeless Veterans
by: Jeffrey L. Workman
Veteran’s Executive Committee to Organize, Rehabilitate and Service (V.E.C.T.O.R.S.), is an out-reach non-profit organization, designed to help homeless veterans who are aspiring to reestablish themselves back into society. A veteran is someone who has served in the armed forces of the United States for 180 days or longer and or was honorably discharged from active service (Department of Veterans Affairs, 2003). According to Gitterman (2001), approximately 65% of the veterans that apply for services suffer from substance abuse, alcoholism and other psychological problems. There is only one Veterans Administration (VA) Drug and Alcohol Counselor north of Sacramento, CA. This counselor represents seven Northern California Counties. His office is located in the VA Medical Outpatient Clinic in Redding, CA.
This project is to design a brochure with the services, locations and phone numbers of the facilities that provide the necessary treatment services for at risk homeless veterans. With this brochure, a veteran who is in need of psychological, or substance abuse treatment will be able to easily access this service information. This brochure will be made available for use at VECTORS.
Statement of Need
In California, there are approximately three million veterans (US Census Bureau, 2000). Currently, there are more than 250,000 veterans are homeless in the United States (Department of Veterans Affairs, 2002). In Butte County, there are approximately 23,000 Veterans. This is roughly 15% of the general population in Butte County (US Census Bureau, (2003). Of these, 65% suffer from some sort of psychological and or substance abuse problems (Gitterman, 2001). According to California Department of Veterans Affairs (2002), 50% of all homeless veterans suffer from alcoholism or drug addiction, and 45% of veterans that are homeless suffer from mental illness. This report indicated that 93% of the homeless veteran population has experienced alcohol, drug, or psychological health issues at some point in their lives.
According to Gitterman (2001), “Along with their housing, homeless people lose possessions, neighborhood, family ties, customary roles, status, daily routine, privacy, and ability to maintain or secure employment” (p. 635). These factors and stressors can contribute to the development of psychological problems. Additionally, when involved in war campaigns, military personnel can develop Posttraumatic Stress Disorder (PTSD), which can lead to the usage of drugs and or alcohol as a way to cope with the experienced trauma (California Department of Veterans Affairs, 2002).
Veterans who suffer from PTSD are six times more likely to be dealing with a substance abuse and or alcohol problem (Linblom, n.d.). In Butte County, a veteran can obtain services for PTSD at the Chico Veteran’s Center. On the other hand, in order to obtain treatment from a Veteran’s Center or county agency for a substance abuse problem and or alcoholism, the veteran has to leave the county and in some cases the state. Substance abuse is common among veterans who suffer from PTSD (California Department of Veterans Affairs, 2002).
On February 10, 2003, an interview was conducted with J.O, an employee of the Veterans Administration at the Veterans Outpatient Clinic in Redding, CA. He is the only drug and alcohol counselor north of Sacramento, CA. The purpose of this interview was to identify any gaps in services in drug and alcohol treatment for homeless veterans.
When questions about gaps in services were made, the response was that there were no services available. The VA does not have contracts with the state or county for substance abuse and alcohol treatment. There are services available through private treatment facilities, but only when funding is available.
The closest inpatient treatment facility for veterans is in Menlo Park, Palo Alto, which provides residential treatment for homeless and substance abusing veterans. Palo Alto has a detoxification center. After detoxification has been completed, the veteran can transfer to the Fort Miley Veterans Hospital in San Francisco CA. This hospital provides long-term inpatient drug and alcohol treatment for veterans (J. O, personal communication, February 10, 2003).
During the interview information was provided on a facility called White City VA Domiciliary, located in White City, Oregon (J. O, personal communication, February 10, 2003). This facility has an extensive inpatient drug and alcohol program and is the VA’s only freestanding treatment facility available to veterans. Of its 755 beds, 180 are set aside for the treatment of substance abuse and alcoholism (Facilities directory, retrieved on April 3, 2003).
On March 5, 2003, information was gathered at the Chico Vet Center, located in Chico CA, about drug and alcohol services available for veterans in Butte County. The information provided was that J. O evaluates all drug and alcohol services for Northern CA. at the Veterans Outpatient Clinic in Redding CA, that there was no drug and alcohol services available for veterans at the Chico Vet Center, only that they do treat veterans for PTSD and other psychological issues (D. F, personal communication, March 5, 2003).
On March 17, 2003, an appointment was made to talk with a drug and alcohol /mental health counselor at Butte County Mental Health. The information provided was that there are services available to veterans, but was limited to veterans that were mandated to counseling by the court system. All other veterans who seek services through Butte County Mental Health are referred back to Chico Vet Center for services (S. S, personal communication, March 17, 2003).
According to California Department of Veterans Affairs (2002):
Even though there is state funding available for people suffering from mental illness and substance abuse under Proposition 36 and under AB 2034, veteran-specific homeless service providers are ineligible to use that funding because counties feel that veterans have access to VA hospitals and should not be accessing county services, so veteran-specific homeless service providers have been excluded from use of those statewide funds. Yet, only about 10 percent of veterans use VA facilities.
Description of the Intervention
During my internship at VECTORS, it was observed that a majority of the homeless veterans who came in for service seemed to be suffering from substance abuse or psychological problems. While enquiring about treatment services available in Butte County for homeless veterans, I was informed that there were no services available. This prompted me to call and arrange interviews with various agencies in Northern California. Information was obtained on the process and location of treatment services necessary for homeless veterans to gain entrance into a substance abuse managed facility. In each location, information pertaining to drug and alcohol services for veterans was obtained. This information was then transferred onto a brochure and made available for veterans at VECTORS.
Evaluation of the Intervention
In evaluating the effectiveness of this intervention, I generated a questionnaire with the following questions: A. Most helpful; B. Somewhat helpful; C. helpful; D. Not helpful at all. Then I distributed the questionnaire to VECTORS staff with the brochure and asked them to evaluate its effectiveness. Four out of 4 evaluated the brochure as most helpful. I then made the brochure available to a veteran in need of drug and alcohol services, who used the brochure to access treatment information. The veteran stated that with the brochure he was able to attain the required information he needed for treatment.
Reflections on the Project
As a certified addictions treatment specialist, I started my internship in Glenn County, but for reasons out of my control, I needed to relocate to a different agency. This agency turned out to be VECTORS in Butte County. At the beginning of this assignment my original purpose was to identify gaps in services to homeless veterans. During my exploration of the different agencies that should be in a position to provide services to veterans, I found that services are limited in drug and alcohol treatment not only at the veteran medical level, but at the county level as well.
With the knowledge that services were limited to veterans in this county, I wondered if I could bring the necessary information together, put it on a brochure and provide it in a central location for homeless veterans. I believed it would allow a veteran who was in need of treatment services to have direct access to treatment information. It sounded like a good idea.
I had never designed a flyer let alone an informational brochure. So the development of the brochure was challenging to say the least. The information I collected would fit on two sheets of paper. I needed it to fit on one, both sides. I did not have a computer program that would do this so I looked around and used my resources to locate one that would allow me to develop the brochure.
I found a fellow classmate, who with my design helped me by allowing me to use their software publisher program. This was great, but it had its fallback. I had to travel fifty miles just to use it - a major inconvenience. I did not give up I continued to look for more resources.
I called my vocational rehabilitation counselor to see if he would purchase the program for me and was told he could not. I then verbalized my dilemma to the VA office on campus and one of the work-study students overheard me and stated he had the program I needed. He loaned it to me, which allowed me to complete the brochure in the comfort of my home.
The brochure took me approximately one week to complete, but the information it provides, will help many veterans who are in need of treatment services to easily access the information needed to obtain desired services. Once the brochure was developed there needed to be a way to measure its effectiveness. I acquired the advice of one of my professors who suggested I administer a simple questionnaire to the staff at VECTORS with a copy of the brochure for their evaluation. And I provided the brochure to a needy veteran that gained access to treatment information with the brochure provided.
I think that services for veterans should be made available no matter where veterans are. To find that a veteran cannot obtain drug and alcohol services through Butte County Behavioral Health, unless mandated by the court system is deplorable. Services, no matter what or where they are, should be made available to all eligible veterans.
In evaluating my experience I found I became frustrated in trying to obtain appointments with some of the service providers in Butte County. I wanted thirty minutes of their time for an interview and all they would give me was five minutes on the phone.
It was not as easy as I believed to design an informational brochure. I thought all I had to do was develop it, but I found just obtaining the computer program turned out to be a job. My biggest assets turned out to be my own resourcefulness, utilizing my resources, personal tenacity, computer programs, the internet and being willing to follow the suggestions of others.
Note: (I have VECTORS permission to use their name in writing).
Department of Veterans Affairs, (2003). Feature items and information. Retrieved April 24, 2003, from http://www.va.gov/OPA/feature/index.htm
Lindblom, E. N. (n.d.). About homeless veterans. The Journal of the California Alliance for the Mentally Ill, (4) 3. Retrieved April 24, 2003, from http://www.awvh.org//aboutvets.html
Gitterman, A. (2001). Handbook of social work practice with vulnerable and resilient populations. New York, Columbia University press.
Department of Veterans Affairs, (2002). Homelessness among veterans. Retrieved April 4, 2003, from http://www.va.gov/homeless
State of California Department of Veterans Affairs, (2002). Veterans Service Division, A study on the status of homeless veterans in California. Sacramento, CA: U.S. Government Printing Office.
United States Bureau of the Census, (2000). Retrieved April 4, 2003, from http://www.va.gov/vetdata/Census2000/cendata/CALIFORNIA_2000.xls