VA Program Helps Veterans with Severe Mental Health Challenges Remain in the Community

She’s grateful for her job as a cashier at a local supermarket and for her own apartment. She’s grateful for having earned her Associate of Arts degree in Computer-Aided Drafting and Design or CAD.. She is grateful for her beagle named Sky and to be able to volunteer to give back to the Baltimore community. While many people take things like this for granted, for Beaver, each of these represent large triumphs for achieving goals she set for herself along with help from the VA Maryland Health Care System despite having a serious mental health condition that debilitated her ability to function after experiencing trauma while in the military.  She medically retired from the Navy after 25 months.  “I used drugs and alcohol to cope with past experiences,” she said. She moved to Baltimore to stay with a close friend where she continued “to blame myself for what happened.”  And she began having suicidal thoughts. 

Recognizing that she needed help, she found it at the VA Maryland Health Care System, which offers Veterans with serious mental health challenges programs that provide intensive services that help them thrive in their communities. “It’s been almost ten years and now I’m drug, alcohol, and tobacco free and I’m setting and reaching my long-term goals.”

Similarly, David Foskey, 55, an Army Veteran on the Eastern Shore, who lives with a serious mental health challenge, also is grateful for his home, his two pups Itsea and Tucker, the handful of people on whom he can count, his sense of humor, and his love of music that enables him to sing karaoke at home. Mostly he’s grateful for being self-sufficient, independent and able live a normal life within the community without any setbacks in 13 years. “My life is manageable,” he said. 

After a decade in the Army—he enlisted in August 1988—he was diagnosed with a serious mental health challenge and honorably discharged in 1999. Since then, he has been in and out of residential treatment programs. Like many with serious mental health challenges, he relied on drugs and alcohol to cope with the symptoms. “I was my own worst enemy,” he said. At one point he became homeless due to using substances to cope and then transitioned to the VA’s program to establish housing.

The program that helps and supports Beaver, Foskey, and other Veterans with serious mental health challenges, including Post-Traumatic Stress Disorder, Mood Disorder, Schizophrenia, and Schizoaffective Disorder, to live their best lives in the community is known as the Mental Health Intensive Community Model (MHICM).  The Mental Health Intensive Community Model (MHICM) is a treatment program designed to address 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.  Their core service elements include psychosocial rehabilitation services, community integration, and high frequency/complexity of care.  The care is individualized, with a focus on incorporating the Veteran’s goals, preferences, and strengths. To qualify for the program, Veterans must have a SMI diagnosis and within the past year three or more psychiatric hospitalizations or one hospitalization lasting a minimum of 30 days. Veterans with a SMI diagnosis who have difficulties connecting with traditional outpatient mental health services are also treated by MHICM. MHICM is a voluntary program, and Veterans must have the availability and willingness to participate in this type of intensive program for an extended period of time.

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

This MHICM model of care has demonstrated significant positive outcomes, including but not limited to reduction of inpatient mental health hospitalizations, improved patient satisfaction with care, increased housing stability, and improved treatment retention. Veterans can be referred to the program by their primary care or mental health providers though they still must volunteer to participate in the intensive outpatient treatment. 

“I use humor a lot and music and also learned coping skills through continuous years of counseling and self-reflection,” Foskey said, noting that he relies on this clinical team from VA to keep 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 the VA, balanced medications, along with continued counseling and lots of coping skills. Of course, there's my fur babies, always there for support,” he said and added. “VA saved my life.” 

Story on VA’s serious mental illness program was also covered on Channel 2 News.