Serving Veterans with severe mental health challenges

Remaining in communities

Veteran Lyndsey Beaver, 41, a Maryland transplant from New Jersey, counts her blessings each day. She appreciates her job as a cashier at a local supermarket and her own apartment. She takes pride in having earned an Associate of Arts degree in Computer-Aided Drafting and Design. She finds joy in her beagle, Sky, and in volunteering to give back to the Baltimore community. While many people take these things for granted, for Beaver, each accomplishment represents a significant triumph toward achieving her goals, thanks to support from the VA Maryland Health Care System (VAMHCS).

This is especially meaningful given her serious mental health condition, which troubled her ability to function after experiencing trauma during her military service. She medically retired from the Navy after 25 months.

“I used drugs and alcohol to cope with past experiences,” she explained. “I moved to Baltimore to stay with a close friend, but continued to blame myself for what happened and began experiencing suicidal thoughts.”

Recognizing her need for help, she turned to VAMHCS, which offers Veterans with serious mental health challenges access to intensive programs that help them thrive in their communities. “It’s been almost 10 years and now I’m drug, alcohol and tobacco-free, and I’m setting and reaching my long-term goals,” she proudly shared.

Life is manageable

Similarly, David Foskey, 55, an Army Veteran on the Eastern Shore, is also grateful. He appreciates his home, his two pups, Itsea and Tucker, the handful of people he can count on, his sense of humor, and his love of music, which allows him to sing karaoke at home. Mostly, he is thankful for being self-sufficient, independent and living a normal life within the community without any setbacks for 13 years. “My life is manageable,” he said.

Foskey spent a decade in the Army, enlisting in August 1988, but was diagnosed with a serious mental health challenge and honorably discharged in 1999. Since then, he has navigated in and out of residential treatment programs. Like many with serious mental health challenges, he turned to drugs and alcohol to cope. “I was my own worst enemy,” he admitted. At one point, he became homeless due to substance use but then transitioned to VA’s program aimed at establishing housing.

Meeting unique needs

The program supporting Beaver, Foskey and other Veterans with serious mental health challenges—including Post-Traumatic Stress Disorder, Mood Disorder, Schizophrenia and schizoaffective disorder—is the Mental Health Intensive Community Model (MHICM), which is designed to meet the unique needs of Veterans with serious mental illness (SMI).

Interdisciplinary MHICM treatment teams provide high-quality, recovery-oriented care to Veterans who experience serious mental illness, significant functional impairment and high utilization of inpatient mental health services. Core service elements include psychosocial rehabilitation services, community integration, and high-frequency, complex care. The care is personalized, focusing on the Veteran’s goals, preferences and strengths.

To qualify for the program, Veterans must have an SMI diagnosis and, within the past year, have experienced three or more psychiatric hospitalizations or one hospitalization lasting a minimum of 30 days. Veterans with SMI who have difficulties connecting with traditional outpatient mental health services are also treated by MHICM. Participation in MHICM is voluntary, and Veterans must be available and willing to engage in this intensive program for an extended period.

“We focus on helping Veterans set and achieve their personal recovery goals,and to thrive in the community setting of their choice,” said Jessica Campbell, MHICM program coordinator. “MHICM coordinates primary and mental health care for Veterans, provides illness management education, assists with medication management, and helps with problem-solving and coping skills,” she added.

The MHICM model of care has demonstrated significant positive outcomes, including reduced inpatient mental health hospitalizations, improved patient satisfaction with care, increased housing stability and enhanced treatment retention. Veterans can be referred to the program by their primary care or mental health providers, although they must volunteer to participate in the intensive outpatient treatment.

“I use humor a lot, music, and learned coping skills through years of continuous counseling and self-reflection,” Foskey said, noting that his clinical team from VA keeps him on track and are among the only people who regularly visit him at home. “What has changed this time, as far as staying out of mental health facilities, is the support I have with VA, balanced medications, along with continued counseling and lots of coping skills. Of course, my fur babies are always there for support,” he said, adding, “VA saved my life.”

It’s never too late to apply for VA health care you’ve earned. If you are a Veteran or know a Veteran who has not yet applied for their VA health care benefits, learn how to get started.