What is the Crisis Gap? The Crisis Gap is a consequence of military to civilian transition. It is the point where services and support from the Department of Defense ends and the services and support from the Department of Veterans Affairs (VA) begins. In an ideal setting, support should be continuous and the transition should be seamless. In practice, the system is not continuous and rarely seamless. Too often, military service ends and the burden falls to the Veteran to search, discover, and ultimately wait for services from the VA. If that Veteran has unmet health needs – PTS, TBI, anxiety or other related disorders – as a consequence of their service, the gap in support spirals the Veteran into crisis. Alone and isolated from a network of support, Veterans get lost in this Crisis Gap. Unable to transition to a healthy life after service, many Veterans choose withdrawal, self-medication, unhealthy diversions, or suicide. Is this the fault of the Department of Defense, the Department of Veteran Affairs, or both? Although fault for the Crisis Gap may not rest with any one institution, we all share the responsibility and urgency to solve this problem because the Crisis Gap is destroying the lives of far too many Veterans and their Families.
Should We Blame the Department of Defense?
Well . . . not necessarily.
As a former battalion commander, the preeminent issue for force management has always been deployment readiness. Why? Well, the size of the military may be shrinking, but our global responsibilities are not. In many cases, they are increasing. For military units, authorizations for people is based on the absolute bare minimum to accomplish the intended mission, but the actual mission demands the unit to do more than that for which they were intended – or resourced. I experienced this in each of my deployments. Therefore, my top priority in garrison was to optimize the readiness and deployment posture of my Soldiers.
Unfortunately, Soldiers who seek behavioral health support risk a non-deployable status. As a result, the climate implicitly discourages these resources. If the unit struggles to meet the full-scope of their responsibilities at 100% strength, how can they meet their objectives with only 85% of their strength? Leaders tell the truth and report 85%, but the problem for the Army is that there is nobody else to send! So, you will still go. You will still be expected to do your mission, but with less capability and greater risk. This is why readiness is the number 1 priority for the Army. It has to be. Above all else, we need a fighting force to protect ourselves and our way of life. Could we accept failure? More personally, how could I look into the eyes of the family of a fallen Soldier and tell them I did everything I could to mitigate the risk and protect their loved one knowing I deployed into harms way without the necessary people to accomplish my mission? This is a personal burden, and one I struggled with most often as a battalion commander.
So, readiness is #1, and in the message from the Chief of Staff of the Army, taking care of the troops falls to the #3 priority. When this trickles down to my level, commanders can push and drive their unit (sometimes to toxic levels) to achieve readiness (the priority with the “1” by it) at the expense of the service member (the priority with the “3” by it). I don’t say this with bitterness or criticism, but rather as a natural consequence of asking the military to continue to do more and more with few and fewer. So, the climate either explicitly or implicitly discourages resources like behavioral health because those resources could make Soldiers non-deployable. It impacts the readiness. Furthermore, if I don’t meet the standard of readiness – but my peers can meet that standard – am I putting my own career and livelihood in jeopardy?
The impact on the service member is pernicious. Option Number 1: They can self-select for the health services they need. That decision opens them up to widespread scrutiny and judgment from every level of the chain of command because of the readiness impact. Leaders will assess your personal risk factors and enumerate you on a chart. In meetings with people you may have never met, they will report your condition (not the specifics, for the sake of privacy, of course) up the chain of command so everyone knows at least some of the details of your struggle. Should your condition require dedicated services that occupies time from the duty day, you become a burden to your unit because you can’t contribute to the fullest measure. When that happens, leaders isolate you – by setting you to the side to accomplish additional, non-mission related duties. Leaders separate you from the only support structure you trust – your fellow Soldiers – until they can get rid of you. Burden and isolation – the two most common factors for suicide. Still wonder why the suicide numbers aren’t going down? Of course, the service member can always choose Option Number 2: Continue suffering in silence. You can be a “Good Soldier” and bury your struggle, infecting those you lead and the people you love.
What does this have to do with the Crisis Gap? When a Soldier becomes non-deployable, they become a liability to the mission. We can’t receive a replacement Soldier while the non-deployable Soldier is on the books, so the unit eliminates them from service to open up that slot for someone who can deploy. Retirement, end of service, legal issues, health issues – doesn’t matter. Because of the urgency of readiness imperative, the military has grown increasingly fast and remarkably efficient at separating Soldiers. Readiness problem solved. Leaders are not discouraging the service member from getting the health services they need, so the “taking care of the troops” problem is solved. After all, the service member can always get care through the VA, right?
So . . . We Should Blame the VA, Right?
Um . . . not entirely.
When the VA scandal broke back in 2014, the wait times for Veterans seeking appointments was already unacceptable. Despite all the metrics the VA uses to show how service is improving, despite the investment of programs like the Choice Act and the Clay Hunt Act that provide more resources, the constraints of the bureaucracy adversely impact the induction of and scheduling for health services from the VA. You can provide more resources, but Veterans need to navigate through the bureaucracy and administration to access these services. Why the bureaucracy? Because we are talking about federal dollars in a politically charged issue, and the health costs to post 9/11 service members are soaring. Politicians demand accountability. Accountability in government means more bureaucracy . . . more administration . . . more reporting . . . more of everything that has nothing to do with service delivery to the Veteran.
These systems require time for processing, and the demand for services is unprecedented. As more members depart the military, more people funnel into this system. Reports at the end of last year indicate that wait times have not been improving. Why? Clearly, the demand exceeds the capacity. We can’t add capacity fast enough, and all the accountability and public scrutiny requires us to demonstrate progress. One consequence, as reported in the New York Times, is to restrict the demand – lighten the load. Moreover, the longer people wait, the more we encourage alternative sources to healthcare outside of the VA. Out of sight, out of mind. Today, the VA reports that only 40% of Veterans use VA Healthcare. If only 40% enroll, is that the fault of the VA? After all can we really hold the VA accountable for the other 60% who may or may not qualify for services from the VA if these Veterans have not enrolled? More importantly, who can report on the wellness of the other 60% of Veterans not connected to VA care? Who is looking out for them?
To review, on the one end we have military members being launched from service with a priority on readiness and deployability. At the other end, we have a VA system that continues to restrict entry under the urgency of accountability and capacity limitations. Where does that leave our Veterans and their Families? Between these two juggernauts with varying levels of responsibility is the Crisis Gap. If we want to eliminate the Crisis Gap – maybe we need to partner both organizations and rely on the leadership from an outside source. Maybe we need to rely on ourselves.
We Can Find the Solution to Eliminate the Crisis Gap
Why worry about blame, when we can join the solution to this problem?
A better program of transition with continuity can eliminate the Crisis Gap. This program needs to begin when service members start their transition process and should continue for a period of time after they become a Veteran. Think of it as a reverse boot camp – the initial program provides renewal, healing, and conditioning for mind, body, and spiritual wellness. The advanced program provides education and professional credentials to compete for employment opportunities. The continuity – your drill instructor. Well, not a drill instructor, but a life and transition coach who connects and maintains contact with the Veteran through their military transition, provides career services and facilitates professional networking, and ensures the Veteran lands in the programs with the VA to continue their growth to become an empowered Veteran. Because we are proactive in our support for the Veteran, I believe we will learn that this program is actually cheaper than what we pay now in dollars and lives destroyed from the current, fragmented program. By working together, with our political leaders and our institutions, we transform our Veterans into the most productive, most empowered citizens across our communities.
What I just described to you is our strategic vision at Stop Soldier Suicide. We are committed to discovering and building this transition plan. It consists of a system of programs that enables atonement, transformation, and growth. For those service members and Veterans who struggle, we are here to provide support. Our case management service lasts for 2 years and is dedicated to help all Veterans from any service era discover empowerment. We help our struggling heroes in the Crisis Gap emerge from the abyss and into the light. We are building partnerships with programs to create a model of transition toward empowerment, and we will advocate for this program’s implementation with the help of state and federal institutions.
We need the help from both the Defense Department and the Department of Veteran Affairs to solve this problem for the long-term. At Stop Soldier Suicide, we are working for a solution, but we need these agencies for successful implementation. In the meantime, we cannot sit idle. We all can do something. Help us discover this solution by donating to our cause. Run a campaign. Connect Veterans to our service. If you offer a program for Veterans, partner with us – you may have a critical link in this model for healthy transition. If you transitioned from service or are a family member who watched a loved one struggle – share your story. We can reach a better solution – faster. Let’s commit to eliminate this Crisis Gap. We have at least 22 advocates and their families every day counting on us to discover this solution.