Bill Overview
Title: American Indian and Alaska Native Veterans Mental Health Act
Description: This bill directs the Department of Veterans Affairs (VA) to provide mental health and suicide prevention outreach to American Indian and Alaska Native veterans. Specifically, the bill requires that each VA medical center have a full-time minority veteran coordinator. The coordinator must receive training in the delivery of culturally appropriate mental health and suicide prevention services to American Indian and Alaska Native veterans. Further, the suicide prevention coordinator and minority veteran coordinator of each VA medical center must develop and disseminate a written plan for conducting mental health and suicide prevention outreach to all tribes and urban Indian health organizations within the area of the medical center.
Sponsors: Sen. Tester, Jon [D-MT]
Target Audience
Population: American Indian and Alaska Native veterans
Estimated Size: 150000
- The bill is specifically targeted at American Indian and Alaska Native veterans.
- According to the 2010 Census, there were approximately 150,000 American Indian and Alaska Native veterans living in the United States.
- Given the historical context and ongoing issues, American Indians and Alaska Natives face unique mental health challenges, which this bill aims to address.
- Veterans generally experience higher rates of mental health challenges, especially PTSD, due to their military service.
- The inclusion of a full-time minority veteran coordinator at each VA medical center indicates a nationwide implementation, but it only affects the specific demographic of American Indian and Alaska Native veterans.
Reasoning
- The target population for this policy is approximately 150,000 American Indian and Alaska Native veterans.
- The historical and current mental health challenges faced by this group make them a priority for targeted mental health services.
- Budget constraints mean the policy must focus on highly impactful and cost-effective initiatives to improve mental health and suicide prevention outreach.
- Cultural sensitivity training and recognizing the unique challenges faced by these communities are critical to the policy's success.
- There will likely be varying degrees of impact across individuals, with some experiencing significant benefits while others may see little change. To reflect this variability, interviews are simulated with different levels of policy impact.
Simulated Interviews
Retired Marine Veteran (New Mexico)
Age: 62 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- This policy finally addresses our unique needs.
- It’s hard to trust VA services, but if they can provide someone who understands our culture, it could make a huge difference.
- PTSD makes everyday life a battle, and talking to someone who understands isn't easy to find.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 6 | 3 |
| Year 3 | 6 | 2 |
| Year 5 | 7 | 2 |
| Year 10 | 8 | 1 |
| Year 20 | 6 | 1 |
Social Worker (Alaska)
Age: 35 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 3/20
Statement of Opinion:
- Seeing the VA take steps to reduce veteran suicides is encouraging.
- If implemented well, this could reduce barriers that my community faces in seeking help.
- There’s a mistrust of government services here; they need to build credibility.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 4 |
| Year 20 | 5 | 3 |
Student (Arizona)
Age: 29 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 3.0 years
Commonness: 12/20
Statement of Opinion:
- I am in a good place mentally, but this policy gives hope that others will get the assistance they need.
- My friends who have struggled can benefit if the services are truly accessible.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 7 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
School Teacher (Oklahoma)
Age: 47 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 6.0 years
Commonness: 8/20
Statement of Opinion:
- While I am a teacher and not directly impacted, my husband's wellbeing could improve given his hesitance to seek traditional VA services.
- Indigenous veterans face multiple layers of challenges. This specialized help could aid recovery.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 3 |
Rancher (South Dakota)
Age: 56 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 8.0 years
Commonness: 4/20
Statement of Opinion:
- There's hesitation in me about VA services but this brings a sense of cautious optimism.
- I want to see real commitment, not just words. If the coordinators are truly helping, it could change lives.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 3 |
| Year 10 | 7 | 2 |
| Year 20 | 6 | 2 |
Tech Specialist (California)
Age: 40 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- The use of technology in reaching remote veterans is crucial, and I feel this policy should leverage that.
- I’m in a good mental space, but more resources are always welcome for those in the community who struggle.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 5 |
Mechanic (Wyoming)
Age: 52 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 8.0 years
Commonness: 5/20
Statement of Opinion:
- After Vietnam, I've seen other initiatives come and go. Hopefully, this one sticks.
- Access to culturally relevant services is overdue. I hope it helps even after my time.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 3 |
| Year 10 | 6 | 2 |
| Year 20 | 5 | 2 |
Community Organizer (North Carolina)
Age: 60 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 2/20
Statement of Opinion:
- There has been a long-standing need for targeted mental health outreach.
- This policy could be transformative if implemented with the right adherence to cultural protocols.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 9 | 5 |
| Year 5 | 9 | 4 |
| Year 10 | 8 | 3 |
| Year 20 | 7 | 3 |
Firefighter (Montana)
Age: 31 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 6.0 years
Commonness: 7/20
Statement of Opinion:
- My line of work is stressful, and mental health support is important.
- I hope this policy adds to the resources available to veterans like me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 6 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Student (Washington)
Age: 28 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 10/20
Statement of Opinion:
- Mental health care has been a difficult system to navigate. This focus on Native veterans is welcome.
- It seems to be a step in the right direction for someone like me who’s new to civilian life.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 3 |
Cost Estimates
Year 1: $125000000 (Low: $100000000, High: $150000000)
Year 2: $130000000 (Low: $105000000, High: $155000000)
Year 3: $135000000 (Low: $110000000, High: $160000000)
Year 5: $145000000 (Low: $115000000, High: $175000000)
Year 10: $160000000 (Low: $130000000, High: $200000000)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- The policy targets a population with unique mental health service needs, requiring specialized training and outreach strategies.
- There is a need for significant coordination between VA medical centers and local tribes to ensure effective implementation of outreach programs.