To make medical services more accessible to growing numbers of female veterans, Veterans Administration hospitals should reform therapy access policies and adjust physical layouts of wards.
Over the past decades, women have joined the branches of the United States military at higher rates than ever before, with females comprising 14.6 percent of active duty forces. Specifically, women comprise 13 percent of veterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn. While women do not serve combat roles in the U.S. military, women still suffer from physical and psychological injury. In 2009 and 2010, post-traumatic stress disorder (PTSD), hypertension, and depression were the three categories diagnosed most frequently among female veterans. In addition, approximately one in five women seen by Veterans Administration (VA) hospitals respond “yes” when screened for Military Sexual Trauma (assault or harassment experienced while in the military). While significant cuts to the VA budget in 2009 slowed programming in 2010 and 2011, increased prioritization of female veteran health care was achieved in 2010 with the Caregivers and Veterans Omnibus Health Services Act.
The Act created the first comprehensive study in recent years of barriers to health care for female veterans, designed pilot programming for group therapy for female veterans no longer on active duty, and created a two-year pilot program assessing feasibility of offering childcare to veterans.
It is vital that the VA adapt to meet the needs of increasing numbers of female veterans. While VA services in recent years have increased their emphasis on mental health services, logistical aspects of many hospitals can make accessing care challenging for patients, particularly for women. Women may be barred from group therapy sessions dealing with issues of PTSD because spots are reserved for those who saw combat. Even female veterans decorated for their performance in combat may be prohibited from group therapy for this reason. While appeals processes exist, they are slow and unknown to many veterans. Making these groups available to all veterans diagnosed with PTSD will increase the speed with which veterans access group therapy services. VA hospitals may also not be physically laid out to provide comfortable access to mental health services.
Creating specific exam rooms and separate clinic entrances for women attempting to access female health services (i.e. gynecological services) or mental health services may prevent harassment and discomfort experienced by women, who otherwise must walk through wards of physical care services full of older, largely male veterans. In addition to the provision of childcare, these minor policy changes will make health care more accessible to female veterans and will ease their search for treatment.
The simplest solution to gaining access to therapy for all those facing post-combat trauma would be for the military to acknowledge that women deployed in Iraq and Afghanistan have already experienced combat, regardless of official policy. In spite of potential political opposition, the VA should amend therapy eligibility to include all patients diagnosed with “combat-related” PTSD; this will include female veterans whose combat experience is unofficial. Individual hospitals should create separate waiting rooms, entrances, and exam rooms for female veterans, particularly when their diagnosis may be more sensitive (i.e. mental health services or Military Sexual Trauma). No veteran should face harassment in his or her search for treatment.