Student name

Capella University

NURS-FPX6026 Biopsychosocial Concepts for Advanced Nursing Practice 2

Professor Name

Submission Date

Letter to the Editor

To
Dr. Susan J. Wynn, Editor
Journal of Psychosocial Nursing and Mental Health Services

Subject: Advocacy for the Veteran Integrated Care Access and Equity Policy (VICEP) to Improve PTSD Outcomes Among U.S. Military Veterans

Dear Editor,
I support the adoption of the Veteran Integrated Care Access and Equity Policy (VICEP). VICEP will improve the care and health outcomes of veterans dealing with post-traumatic stress disorder (PTSD). Although there has been a great deal of research and clinical development, there remain great inequities in veterans’ timely access to mental health care that is culturally competent and coordinated.

Evaluation of Current State

PTSD is a psychiatric disorder that is common and highly disabling for many veterans who have experienced combat and other life-endangering situations. According to the U.S. Department of Veterans Affairs, between 11 and 20% of veterans from recent wars have PTSD (Al Jowf et al., 2023). In terms of level of preparedness, veterans have recently made some advances in the field of PTSD, evidenced by the application of Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR), though there are still existing treatment gaps from the stigma, geocentrism, shortages of practitioners, and cultural incompetence. Among veterans, perhaps the most vulnerable population is the veterans of ethnic minorities and veterans living in rural areas, made even more so by the scarcity of tele-mental-health resources and the long waiting times for appointments.

All of these factors ultimately have negative consequences for the mental health of the veterans and the general population. This negative state of affairs has resulted from an extensive lack of transport equity in mental health services and an overall lack of systemic equity in the provision of mental services for veterans (Harward et al. 2024). Deployed veterans with untreated PTSD have a greater chance of suicide and hospitalization than members of the civilian population. Improving the fragmented and inequitable state of mental health services for veterans is long overdue.

These flaws negatively impact veterans’ psychological health and increase the demand for more complex and expensive interventions within the healthcare system, including the increased burden on the system. Thus, the inadequate PTSD treatment services currently offered increase trauma and worsen veterans’ psychological health and general well-being, creating an unhealthy condition that poses a significant public health challenge.

Knowledge Gap

There is a notable absence of evidence pertaining to the effectiveness of integrated trauma-informed care over an extended period, making it difficult to address the needs of veterans suffering from PTSD. There is also a lack of evidence on the development of culturally responsive mental health services, and on the engagement and recovery of veterans from diverse and minority communities and backgrounds. Further research is also required to determine the best methods to enhance the accessibility and coordination of services for veterans suffering from PTSD.

Analyzing the Current State

The unequal distribution of PTSD services presents the opportunity to establish a policy for which there is a need. Current federal initiatives work on services primarily in the VA, but this narrows the focus on the veterans within the community and those in the private sector (Inoue et al., 2022). In addition, most primary care providers have not received training in trauma care, and there is no consistency in referrals/transitions between mental and physical care.

There is a need for policy change to ensure trauma care is delivered and practiced continuously. The process of developing a health policy like VICEP would lead to the integration of mental health services within primary care. In addition, the acceptance and support of the integration of trauma care would reduce the stigma of mental health and support the maintenance of health in the community (Inoue et al., 2022). There is a critical need to include nursing and other professions in the policy-focused advocacy to ensure the new policies/practices integrate trauma, deinstitutionalize mental health, and support the U.S. to reach the Healthy People 2030 Initiative in the elimination of health disparities. The need for policy advocacy to address the continuum of trauma care for veterans remains, as there is a lack of evidence on the impacts of trauma care on veterans’ participation in mental health care and the effects of culturally competent care on the participation of diverse Veterans in care there is a lack of information regarding the long-term impacts of caring for veterans suffering from PTSD and the integration of trauma-informed care models.

Justification for Developed Policy

The Veteran Integrated Care Access and Equity Policy (VICEP) provides excellent and timely solutions to veterans suffering from PTSD. With integrated behavioral and primary care, and the expansion of rural tele-mental care, along with all care providers being trauma-informed (and providing peer support specialists training), the goal of VICEP is to relieve veterans of the financial, emotional, and psychological burden of care. Integrated care has been proven to reduce the burden of care and costs, as well as decrease symptoms and improve treatment adherence (Pinho et al., 2021). The rural tele-mental health care service provides culturally responsive care and balances the need for ongoing and flexible care with respect to the privacy of the client; it remains responsive to client needs (Sun et al. 2025).

While many fear that the lack of a burden or cost to veterans, along with trauma-informed early interventions, will create a greater burden elsewhere, trauma-informed early interventions have been proven to cut costs associated with readmissions and long-term disability (Wong et al., 2022). VICEP takes an integrated approach to the complex nature of comorbid mental health (substance use, pain, insomnia) and incorporates the expertise of psychiatrists, psychologists, and primary care, as well as nurses, social workers, and case managers.

Advocacy for Policy Implementation in Diverse Systems

Extending the VICEP to non-VA populations is critical for addressing equity gaps for veterans with PTSD. Many veterans cycle through the VA, community, and private healthcare systems, which means that for services to remain cohesive, dispersed care must rely on the same trauma-informed care standards (Al Jowf et al., 2023). By extending VICEP to community health centers, academic clinics, and federally qualified health centers, veterans would receive evidence-based care no matter where they live or their socioeconomic status.

As trauma-informed care practices and services become foundational, national resiliency and trauma response systems will be better integrated and sustained. The implementation of PTSD screenings in emergency and primary care systems, coupled with added tele-mental health services, would address and greatly reduce barriers related to the localization of trauma care, as well as federal and civilian system integration and service coordination. Existing barriers to trauma care, such as funding, provider resistance, and infrastructure, may be addressed through federal funding, public-private partnerships, and the provision of care (Harward et al., 2024). Ultimately, the provision and availability of the VICEP would standardize trauma care, reduce the risk of suicide, improve the quality of life, and fulfill the ethical and moral responsibility of nursing as a social justice and equity-focused task.

Analyzing Interprofessional Aspects

The key to VICEP’s success is a thorough interdisciplinary collaboration. Primary care and mental health providers, nurses, social workers, and peer support specialists create individualized recovery-oriented care plans. Each discipline provides its specialty. Psychiatrists and psychologists provide their specialty around medication and therapy, respectively, while nurses create and provide an educational opportunity for continuity in care, social workers assist with social reintegration, and peer mentors provide experiential engagement.

This collaboration provides care that is more efficient and effective. The use of a shared electronic health record system ensures effective communication and promotes duplication and accountability. Frequent case reviews and cross-training help teams to work together to be more culturally competent. It has been shown that the use of multidisciplinary models reduces fragmentation and increases satisfaction in the treatment of PTSD (Inoue et al., 2022). There will always be some concern around cost and sustainability, but there will be adequate ways to address these concerns with the ongoing assessment and feedback provided by the veterans. Finally, the addition of trauma-informed collaboration will provide care to veterans that addresses their psychological, social, and physical needs and will restore dignity and stability to their lives.

Conclusion

The introduction of the Veterans in Crisis Extension Program (VICEP) will integrate innovative methods for the provision of equitable and high-quality mental health services for veterans suffering from PTSD. VICEP will work to dismantle the historical inequities in veteran care by incorporating trauma-informed care, tele-mental health, and cultural-competence, and interprofessional collaboration. It is the responsibility of nurses and healthcare leaders to advocate for and implement VICEP in all healthcare settings, in order to provide all veterans overdue, equitable, and humane care.