Emerging Social Work Crisis for Veterans and Their Families Term Paper

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careers, many social workers will encounter individuals who are veterans of active duty military service. Like other client populations, veterans may experience issues with their day-to-day living requirements that require assistance, but these individuals may also experience a wide range of problems that are unique to service in the armed forces. This paper reviews the relevant literature to determine how current social work policies in the United States address issues of inequality, oppression or social justice for military veterans, the social work staff's ability to provide quality social work services, and ethical issues that affect social work values and practice in this area. An analysis concerning alternative approaches that social work and others could advocate or organize on behalf of veterans is followed by an assessment of which models of advocacy (Jannson or Hayes & Mickelson) are currently being used with this client population. Finally, a summary of the research and important findings concerning social work policies and veterans are provided in the conclusion.

Review and Analysis

Irrespective of their primary area of practice, many social workers will encounter individuals who are either actively serving in the U.S. military or who are veterans of service in the armed forces (NASW standards for social work practice with service members, veterans and their families, 2012). Social workers are in a good position to assist members of this client population deal with the challenges in their lives by drawing on their professional expertise in assisting other individuals and families across the lifespan from diverse cultural backgrounds (NASW standards for social work practice with service members, veterans and their families, 2012). Moreover, social workers have a long history of providing services to veterans that dates back to 1926 when the original social work program was developed by the then-Veterans Bureau with 36 hospital-based social workers (Franklin, 2009). By 1930, the number of social workers serving the veteran population had more than tripled to 97 (Franklin, 2009). At the time of the designation of the VA as a cabinet-level agency in 1989, the VA employed more than 3,000 social workers in 175 VA medical centers across the country (Franklin, 2009).

Currently, more than 500 social workers serve in the U.S. military, and hundreds more work with the U.S. Department of Defense to provide social work services to this client population (NASW standards for social work practice with service members, veterans and their families, 2012). According to the National Association of Social Workers, "Service members [and] veterans sacrifice much and have earned [the] respect and resources necessary to help them live productive and healthy lives. They have great strengths, including resilience, perseverance, courage, and critical problem-solving skills, yet they may also face significant challenges" (2012, p. 8).

Indeed, innovations in body armor have helped military troops survive combat experiences that would have killed their predecessors just a few years ago, but these experiences may leave emotional and psychological scars that are difficult to discern. For instance, Franklin (2009) reports that, "Nearly all U.S. soldiers wear 16-pound Interceptor body armor, and as a result, 15 out of 16 seriously wounded service members survive injuries that would have been fatal in previous wars. New casualties are emerging in the form of veterans with mental health conditions and cognitive health impairments" (p. 165). Likewise, extended combat tours of duty and less frequent breaks between combat tours further exacerbated the mental health and physical disability conditions that have been experienced by many American troops in recent years (NASW standards for social work practice with service members, veterans and their families, 2012). Significant percentages of veterans in general and combat veterans in particular suffer from post-traumatic stress disorder (PTSD) and the proliferation of improvised explosive devices in the Middle East theatre of operations has resulted in large numbers of severe traumatic brain injuries (STBIs) among this population (Rubin, 2012).

Approximately 2.5 million members of the U.S. military served combat tours of duty in Iraq and Afghanistan, and about one-third of this total were assigned to more than one combat tour of duty (Adams, 2013). Although precise numbers of difficult to come by, the results of a recent Pew survey determined that more than one-third (37%) of all U.S. combat veterans experienced some degree of PTSD, meaning that at least 800,000 veterans have returned from service in the Middle East suffering from some level and type of psychological trauma (Rubin, 2012). Besides STBIs and PTSD, as many as 20% of all veterans and their families are expected to experience one or more of the following conditions following their return home from a combat tour of duty in the Middle East: substance use disorders, suicide, problems in emotional control, family violence, mental health problems of military children, and family disruption (Rubin, 2012).

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In this context, social work services for veterans and their families include but are not limited to the following:

Mental and behavioral health services,

Health services;

Social support;

Case management;

Care coordination;

Children and family services;

Administration, and,

Advocacy (NASW standards for social work practice with service members, veterans and their families, 2012, p. 11).

In addition, social work services are typically provided to family members and loved ones of veterans as well (NASW standards for social work practice with service members, veterans and their families, 2012).

One agency that is committed to assisting veterans with their problems is the U.S. Department of Veterans Affairs or VA, the nation's largest healthcare provider. For example, the Oklahoma City's Department of Veterans Affairs Medical Center (OKC VAMC) social work service provides a wide range of services to veterans and their families to facilitate their transition to civilian life and address the other problems this population is experiencing in their day-to-day lives. According to the OKC VAMC's Web site:

The social worker is involved in helping the patient resolve problems and concerns which interfere with a satisfactory life adjustment and maximal use of available treatment. Assistance to Veterans also involves activity with families and with community agencies, as well as close collaboration with the interdisciplinary staff of the Medical Center. (OKC VAMC social work, 2014)

In addition, the VAMC OKC's social work services provides veterans with discharge planning services, psychosocial treatment, interpersonal relationships, adjustment to medical conditions, counseling related concerns about family issues, economics, housing, as well as advanced directives and care coordination (OKC VAMC social work, 2014). Further, this VA social work agency provides services to clients in community-based settings including home-based care and Vet Centers (OKC VAMC social work, 2014). The social work service also provides specialized assistance for veterans who have recently returned from combat tours of duty, homeless veterans and women veterans (OKC VAMC social work, 2014).

Notwithstanding the commitment of the OKC VAMC social work service to helping their veteran clients, some analyst argue that this approach is inadequate for the broad-based needs of this client population. In this regard, Rubin (2012) reports that, "In light of our professional expertise and values, social work practitioners and educators have both the capability and obligation to do more than the general public to support and meet the needs of our returning troops and their families" (p. 294). Despite the significant numbers of Department of Defense and Department of Veterans Affairs social workers that have been deployed to help this client population in recent years, Rubin and like-minded social workers believe that other resources need to be brought to bear on this problem -- and the sooner the better. For instance, in his "call to action," Rubin (2012) emphasizes that:

Although military personnel, veterans, and their families have been served by social workers throughout the history of our profession, perhaps never before has the call for social workers to help this target population been as compelling as it is today. And this help is needed not just from uniformed military social workers or from social workers employed by the Veterans Administration. It is also needed from civilian social workers. (p. 295)

This point is also made by Mendoza (2013) who suggests that the VA's social work services may not be readily available to veterans or veterans may have some issues with dealing with yet another government-operated bureaucracy in order to receive help for their mental health and physical disability problems. In some cases, veterans may turn to social work or other community-based assistance programs that may lack the specialized expertise needed to treat this client population effectively. In this regard, Mendoza advises that, "Even though there are countless organizations, nonprofits and government programs that offer assistance to vets and their families, they are mostly run by volunteers or personnel with no professional training in how to truly reach and help veterans" (p. 25).

The recent resignation of the director of the Phoenix VA Medical Center over allegations of "cooking the books" to conceal lengthy waiting periods for veteran health care appointments makes it clear as well that veterans may not have the ready access to the social work services they need despite the obligations of the VA to provide them.….....

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