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This article reveals the relevance and possibilities of adopting the best practices of the United States in Ukraine in the process of conceptualizing the model of the state veterans policy's development. It provides historical analysis of the process of conceptualizing the updated models of veterans policy in the United States and Ukraine, with its key milestones highlighted. Major components of the latest model of the veterans policy have been defined, with the process of its development in the United States analyzed. The historical stages of conceptualizing the state veterans policy in the United States and Ukraine have been consistently studied, with milestone historical events and factors that had impact on its development in each of the countries defined. The findings of the research make us conclude that the United States have demonstrated a long-lasting evolutionary process of developing the concept of the latest model of the veterans policy. First of all, this concept offering a wide variety of veterans support programs is comprehensive and integrative; being human-centered, it is focused on the process of adapting former military personnel to civilian life. But in Ukraine, the veterans policy's development started only in the last decade. We make conclusions about the relevance of adopting the essential elements of the concept of the veterans policy's latest model at the state level in Ukraine in the context of the full-scale invasion of the Russian Federation. This makes it necessary to further study in detail the expertise of the United States and carry out comparative historical analysis of the processes of conceptualizing the state veterans policy in Ukraine and the United States in order to identify ways to effectively adapt the American best practices in the process of conceptualizing the veterans policy in Ukraine. [ABSTRACT FROM AUTHOR]

To inform the potential use of patient-reported depression symptom outcomes as measures of care quality, this study collected and analyzed longitudinal Patient Health Questionnaire (PHQ9) scores among 1,638 patients who screened positive for major depression according to a PHQ9 ≥ 10 across 29 Department of Veterans Affairs facilities. The study found baseline PHQ9, prior mental health visits, physical functioning, and treatment expectancy were consistently associated with subsequent PHQ9 outcomes. No facilities outperformed any others on PHQ9 scores at the 6-month primary endpoint, and the corresponding intra-class coefficient was ≤.01 for the entire sample (n = 1,214) and 0.03 for the subgroup of patients with new depression episodes (n = 629). Measures of antidepressant receipt, psychotherapy, or treatment intensification were not associated with 6-month PHQ9 scores. PHQ9 outcomes are therefore unlikely to be useful as quality indicators for VA healthcare facilities due to low inter-facility variation, and new care process measures are needed to inform care for patients with chronic depression prevalent in this sample. [ABSTRACT FROM AUTHOR]

Background: Veterans Affairs Farming and Recovery Mental Health Services (VA FARMS) is an innovative pilot program to provide supportive resources for veterans with interests in agricultural vocations. Implemented at 10 pilot sites, VA FARMS will provide mental health services and resources for veterans while supporting training in gardening and agriculture. As each pilot site project has unique goals, outreach strategies, and implementation efforts based on the local environment and veteran population, evaluating the pilot program provides a unique challenge for evaluators. This paper describes the protocol to evaluate VA FARMS, which was specifically designed to enable site variation by providing both site-specific and cross-site understanding of site implementation processes and outcomes. Objective: The objectives of this paper are to (1) describe the protocol used for evaluating VA FARMS, as an innovative Department of Veterans Affairs (VA) agriculturally based, mental health, and employment pilot program serving veterans at 10 pilot sites across the Veterans Health Administration enterprise; and (2) provide guidance to other evaluators assessing innovative programs. Methods: This evaluation uses the context, inputs, process, product (CIPP) model, which evaluates a program's content and implementation to identify strengths and areas for improvement. Data collection will use a concurrent mixed methods approach. Quantitative data collection will involve quarterly program surveys, as well as three individual veteran participant surveys administered upon the veteran's entrance and exit of the pilot program and 3 months postexit. Quantitative data will include baseline descriptive statistics and follow-up statistics on veteran health care utilization, health care status, and agriculture employment status. Qualitative data collection will include participant observation at each pilot site, and interviews with participants, staff, and community stakeholders. Qualitative data will provide insights about pilot program implementation processes, veterans' experiences, and short-term participation outcomes. Results: Evaluation efforts began in December 2018 and are ongoing. Between October 2018 and September 2020, 494 veterans had enrolled in VA FARMS and 1326 veterans were reached through program activities such as demonstrations, informational presentations, and town-hall discussions. A total of 1623 community members and 655 VA employees were similarly reached by VA FARMS programming during that time. Data were collected between October 2018 and September 2020 in the form of 336 veteran surveys, 30 veteran interviews, 27 staff interviews, and 11 community partner interviews. Data analysis is expected to be completed by October 2022. Conclusions: This evaluation protocol will provide guidance to other evaluators assessing innovative programs. In its application to the VA FARMS pilot, the evaluation aims to add to existing literature on nature-based therapies and the rehabilitation outcomes of agricultural training programs for veterans. Results will provide programmatic insights on the implementation of pilot programs, along with needed improvements and modifications for the future expansion of VA FARMS and other veteran-focused agricultural programs. [ABSTRACT FROM AUTHOR]

The Secretary of the United States Department of Veterans Affairs ("VA") possesses one of the most challenging job descriptions in the executive branch of the federal government.1 To hold this position is to preside over the largest integrated healthcare system in the United States, one of the largest and most bureaucratically complex systems of benefits in the federal government, and a vast network of national cemeteries.2 Fulfilling this job successfully requires a high proficiency in medicine, law, technology, and military affairs, coupled with the organizational ability to manage all of the various moving parts within this sprawling agency to complete their duties efficiently and effectively.3 A delicate tightrope walk comes with every aspect of this post, safeguarding federal dollars while simultaneously ensuring that the agency carries out the mission assigned to it by decades of statutes and affirmed by decades of case law: providing a pro-claimant, non-adversarial system for veterans and their families to receive the benefits earned by virtue of their military service.4 Perhaps most challenging of all, stepping into this position means filling a seat that has been in the public eye throughout recent memory, attempting to reverse course and erase a troubled legacy of scandals, abuses of power, inefficiencies, and attempts to sweep under the rug systemic problems that directly contradicted the VA's duties of serving the interests of all who served in this nation's military. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented which discusses topics featured within the issue including the aftermath of World War I for Australia, the 1918-1919 Spanish influenza pandemic, and the availability of care for World War I veterans in Australia.

Australia's repatriation system was generally considered one of the most generous in the world when it was established during World War I, but the care it provided to veterans has been the subject of much debate since its inception. In the 1950s, the Repatriation Department faced specific criticisms from voluntary organisations, such as the Returned Services League of Australia and Edith Cavell Trust Fund, over access to repatriation hospitals and aged care for returned nurses of World War I. Focusing on these debates between the voluntary sector and the federal government around the care provisions for this group of veterans, the article explores the reactionary attitudes of the Repatriation Department to the needs of these women as they reached old age. It argues that returned nurses faced considerable disadvantages in accessing benefits from the department on the basis of gender, which were further accentuated as they aged. [ABSTRACT FROM AUTHOR]

With a mandate to globalize, business school educators have increasingly embraced global service learning as an important technique for creating global mind-sets and enhancing cultural understanding in students. While we applaud this movement from the domestic to the global and from the classroom to the field in business education, we raise a fundamental question that is seldom asked when global service-learning projects are chosen: "Are some cultural contexts better suited for effective cultural learning and the creation of a global mind-set?" To respond to this question, we present an exploratory study of culturally inexperienced non-U.S. business students at a U.S. university engaging in a service-learning project for U.S. military veterans. In this project, the veterans with disabilities were choosing entrepreneurship and self-employment as a way to rebuild their lives. From the qualitative data collected, we observed increases in the cultural intelligence of non-U.S. students, particularly in their development of metacognitive/cognitive strategies and the enhancement of their affective/motivational resources for learning across cultures. We examined characteristics of the cultural setting of U.S. military veterans with disabilities, and proposed that four characteristics facilitated the crosscultural learning achieved by the non-U.S. students. These include a moderate level of cultural distance, a tight culture, low context, and high moral desirability. While we hesitate to generalize beyond this cultural context and beyond culturally inexperienced students, we argue for further discussion about, consideration of, and research on the idea that cultural contexts may differ in their ability to stimulate cultural learning and global mind-set development [ABSTRACT FROM AUTHOR]

Recent research has focused on risk factors for Veteran housing instability and programmatic responses. However, little is known about Veterans' experiences of becoming unstably housed and navigating available resources to resolve housing crises. This qualitative paper, based on open-ended interviews with Veterans (n = 60), presents the Journey to Home conceptual model, which offers a framework for understanding Veterans' journeys through housing instability, including the factors that contribute to vulnerability, the range of housing conditions that Veterans describe as inadequate, how Veterans connect to assistance through VA and community providers, and barriers and facilitators to connecting with and using available assistance, resulting in either continued housing instability or successful housing outcomes. Ongoing efforts to end Veteran homelessness should prioritize strategies that respond to complex vulnerabilities. [ABSTRACT FROM AUTHOR]

The article discusses the need to provide government-financed lawyers to help veterans in securing their disability benefits from the U.S. Department of Veterans Affairs (VA). Also cited are the failure by the government to fulfill its promised lifetime pensions to veterans, the opiates addiction of veterans due to the use of morphine as painkillers, as well as the government's elevated duty to provide sufficient veteran care.

This Article examines the stunning growth of specialized treatment courts for military veterans in the criminal justice system. The nation's first veterans' treatment court ("VTC") convened in Anchorage, Alaska, in 2004. Since then, a wholesale transformation of the nation's criminal justice system has taken place; there are now nearly 500 VTCs diverting veterans from traditional criminal prosecution and general drug courts. The institutionalization of VTCs offers valuable insights to those interested in criminal justice reform. Why did this reform movement flourish while so many others have floundered? In this Article, we argue that courts have not established VTCs because they work; indeed, there is limited evidence that they are more effective than the alternatives. Instead, we argue that VTCs take advantage of existing federal services that address the unique needs of veterans, thereby shifting some of the significant costs of caring for veterans with mental health and substance abuse problems from the states to the federal government. Moving forward, states must resolve a number of VTC eligibility issues that bring the rehabilitative mission of these courts into conflict with the potential for cost shifting. [ABSTRACT FROM AUTHOR]

This study explored how the U.S. Departments of Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program applies Housing First principles in the context of ten single-site programs. Focus group discussions with 64 HUD-VASH staff and community partners explored how the programs were influenced by Housing First principles and specific strategies to implement these principles in a single-site setting. Focus group respondents described resourceful ways that the principles of Housing First were implemented in their programs specifically related to (1) housing choice and structure, (2) separation of housing and services, (3) service philosophy, and (4) service array. Several of the Housing First domains cite the importance of integrated housing and the provision of services off-site; it was of particular interest to learn how single-site programs address these issues logistically. Lessons learned from this study include the importance of leveraging the independent yet overlapping tasks of case management and property management to ensure functional - if not geographic - separation of housing and services; maintaining staff on-site to address Veterans' needs; working with community service organizations to complement the array of service available to residents; and housing single-site programs in mixed-use buildings. [ABSTRACT FROM AUTHOR]

Objective: The study compared delay of treatment for posttraumatic stress disorder (PTSD), major depressive disorder, and alcohol use disorder among post-9/11 veterans versus pre-9/11 veterans and civilians.Methods: The 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), a nationally representative survey of U.S. noninstitutionalized adults, was used. Participants included 13,528 civilians, 1,130 pre-9/11 veterans, and 258 post-9/11 veterans with lifetime diagnoses of PTSD, major depression, or alcohol use disorder. Cox proportional hazard models, controlling for relevant demographic characteristics, were used to estimate differences in treatment delay (i.e., time between diagnosis and treatment).Results: Post-9/11 veterans were less likely to delay treatment for PTSD and depression than pre-9/11 veterans (adjusted hazard ratios [AHRs]=0.69 and 0.74, respectively) and civilians (AHRs=0.60 and 0.67, respectively). No differences in treatment delay were observed between post-9/11 veterans and pre-9/11 veterans or civilians for alcohol use disorder. In an exploratory analysis, post-9/11 veterans with past-year military health care coverage (e.g., Veterans Health Administration) had shorter delays for depression treatment compared with post-9/11 veterans without military coverage, pre-9/11 veterans regardless of health care coverage, and civilians, although past-year coverage did not predict treatment delay for PTSD or alcohol use disorder.Conclusions: Post-9/11 veterans were less likely to delay treatment for some common psychiatric conditions compared with pre-9/11 veterans or civilians, which may reflect efforts to engage recent veterans in mental health care. All groups exhibited low initiation of treatment for alcohol use disorder, highlighting the need for further engagement efforts. [ABSTRACT FROM AUTHOR]

The Post-9/11 GI Bill brought about the largest expansion in veteran education benefits since the end of World War II, increasing annual benefit expenditures from $3 billion to more than $13 billion. Leveraging variation over time, geography, and type of veterans, I explore the effect of financial aid on degree attainment. I find that the aid expansion increased degree attainment by 5–6 percentage points (25%), roughly 0.4 percentage points per $1,000 of additional maximum aid. These findings indicate that financial aid can increase degree attainment, even for individuals with high levels of initial support. [ABSTRACT FROM AUTHOR]

The article discusses the factors that legal advisors need to consider when processing the eligibility and post-separation character of service upgrades of veterans in the U.S. Topics mentioned include the barriers associated with the entry to U.S. Veterans Affairs services, the implication of the Fairness for Veterans Act, and the understanding of the military about the symptoms and prevalence of post-traumatic stress disorder.

Background: The ability of timely access to mental health care is very important for combat veterans that are facing many barriers such as living in rural and remote areas and the lack of integration. Telemental health services improve the veterans' health situation by providing mental health care from a distance. We aimed to identify the telemental health service requirements for Iranian veterans and validate them from the perspective of the statistical population. Methods: This descriptive cross-sectional study was conducted in 2018. In the first phase, a review was conducted in relevant databases, such as PubMed, Scopus, Ovid, Ebsco, and Web of Science. In the second phase, veterans, mental health providers, and telemedicine experts were consulted to validating of the identified telemental health service requirements by a researcher-made questionnaire. Analysis of collecting data was done using SPSS software. Results: By full-text reviewing of 15 related articles, the identified elements were justified in 2 main categories and 24 subcategories including telemental health services (17 items) and telemental health requirements (7 items). According to the findings, the highest score was related to "save health-care costs" (4.47) and "reduce transportation-related problems" (4.47). Moreover, the "feasible alternative to face-to-face care" (2.22) obtained the lowest score from the perspective of the statistical population. Conclusion: Due to the importance of accessibility and patient-based mental health services, more studies are needed to investigate the point of views of patients and specialists to better understand the concerns and barriers to the implementation and use of telemental health services. [ABSTRACT FROM AUTHOR]

The article presents an interview with Jerry Lembcke on war veterans. Topics discused include emergence of the idea of reticent veteran, gaps in the literature to introduce the concept of the reticent veteran, ways through which veteran's memory constitutes a form of criticism, and persistence of the reticent veteran as a trope in popular culture.

Few studies have focused on within-group differences in the well-being of veterans in later life. We use data from the 1995 and 2015 Current Population Surveys to examine the retirement and socioeconomic characteristics of veterans aged 55 or older. We explore indicators of family structure, work, income from Social Security and other sources, and economic security. We investigate differences in educational attainment and race/ethnicity within and across the veteran and nonveteran samples. To account for age and cohort effects, we separately analyze three age groups: 55-61, 62-69, and 70 or older. We find important within-group differences among aged veterans across education and racial/ethnic groups and over time. We discuss the implications of our findings as veterans in the all-volunteer force era approach retirement age. [ABSTRACT FROM AUTHOR]

Purpose: Although suicide risk in veterans has been widely studied, there is little information on the risk of non-fatal self-harm in this population. We used data from the Scottish Veterans Health Study to conduct an epidemiological analysis of self-harm in veterans, in comparison with people who have never served.Methods: We conducted a retrospective, 30-year cohort study of 56,205 veterans born 1945-1985, and 172,741 people with no record of military service, and used Cox proportional hazard models to examine the association between veteran status and cumulative risk of non-fatal self-harm, overall and stratified by birth cohort, sex and length of service. We also examined mental and physical comorbidities, and association of suicide with prior self-harm.Results: There were 1620 (2.90%) first episodes of self-harm in veterans, compared with 4212 (2.45%) in non-veterans. The difference was statistically significant overall (unadjusted HR 1.27, 95% CI 1.21-1.35, p < 0.001). The risk was highest in the oldest veterans, and in the early service leavers who failed to complete initial training (unadjusted HR 1.69, 95% CI 1.50-1.91, p < 0.001). The risk reduced with longer service and in the intermediate birth cohorts but has increased again in the youngest cohort.Conclusions: The highest risk of non-fatal self-harm was in veterans with the shortest service, especially those who did not complete training or minimum engagement, and in the oldest birth cohorts, whilst those who had served the longest were at reduced risk. The risk has increased again in the youngest veterans, and further study of this subgroup is indicated. [ABSTRACT FROM AUTHOR]

The article discuses the legal and practical issues involving the operations of Veterans Treatment Courts in various U.S. states, particularly the differing eligibility categorizations used by each state. Other topics include the Fourteenth Amendment of the U.S. Constitution on equal protection of the laws and its impact on the alleged discrimination in said courts, as well as the perceived increasing Equal Protection Clause violations by said courts.

Objectives: The authors examined whether the rate of preventable hospitalizations among veterans with mental illness changed after implementation of the Department of Veterans Affairs (VA) primary care medical home-Patient Aligned Care Teams (PACT).Methods: A 12-year retrospective cohort analysis was conducted of data from 9,206,017 veterans seen in 942 VA primary care clinics between October 2003 and March 2015. Preventable hospitalizations were those related to ambulatory care-sensitive conditions (ACSCs), identified with ICD-9 codes. Changes in rates of ACSC-related hospitalizations were compared between patients with and without mental illness in two age groups (<65, ≥65). Patients with mental illness diagnoses were grouped as follows: depression, posttraumatic stress disorder, anxiety, substance use disorder, and serious mental illness. Interrupted time-series analysis was used to model long-term trends and detect deviations after PACT implementation.Results: There was an overall increase in mental illness diagnoses across both age groups. Among older veterans (≥65) with any mental illness, the rate (per 1,000 patients) of ACSC-related hospitalizations was five fewer in the post-PACT period, compared with the pre-PACT period. Among younger veterans (<65), there was a slight increase in ACSC-related hospitalizations in years 3-5 post-PACT if they had any mental illness (.6 per 1,000 patients), depression (.3), anxiety (1.4), or a substance use disorder (.6).Conclusions: In this retrospective, observational study examining large systemwide changes in clinical practice, mental illness was more likely to be diagnosed after PACT implementation, compared with before, and results suggested a benefit of PACT implementation among older veterans in terms of a reduction in ACSC-related hospitalizations. [ABSTRACT FROM AUTHOR]

Focuses on the fight of the British veterans for compensation for their participation in hydrogen bomb tests. Experiences of British serviceman as H-bomb participants; Refusal of the British government to accept liability for the damages caused by the testings.

Background: With suicide rising in the United States, identifying and preventing suicides is increasingly important. To provide a valuable step toward achieving effective suicide risk assessment, this study examines the agreement between self-report measures and psychiatrist documentation of suicidal ideation and behaviors (SI) at a Veterans Administration (VA) psychiatric emergency clinic.Methods: A total of 377 veterans presenting at a VA psychiatric emergency clinic completed a self-report survey on SI and other acute risk factors for suicidal behavior. We examined agreement between veterans' self-reported SI and psychiatrists' clinical notes regarding SI.Results: A total of 199 veterans (53%) self-reported SI; 80 psychiatrist notes (21%) indicated SI. Psychiatrists and veterans differed in 44% (164/377) of cases. Among the discordant cases, the veterans' self-report was more severe than the psychiatrists' in 97% of cases. Of the 120 veterans with SI and documented as having no SI by psychiatrists, 31 (26%) reported having a suicide plan and 18 (15%) plan preparations. Findings were similar when controlling for presenting problem, current depression, presence of a standardized suicide risk assessment, psychiatrist training level, past suicide attempt, homelessness, diagnosis of personality, or substance use disorder.Conclusions: Agreement between veterans' self-reports and psychiatrists' documentation of SI was generally low, with veterans self-reporting SI significantly more often than psychiatrists documented SI in their clinical notes. This suggests that inclusion of a self-report questionnaire provides an additional source of data to complement information gleaned from the clinical interview for a more comprehensive risk assessment, but only if actually examined by the clinician. [ABSTRACT FROM AUTHOR]

Background: Planning for the future needs of Canadian veterans requires comprehensive and detailed data on the size of the Canadian veteran population and their health. This article describes current veteran population estimates and examines the health of two eras of veterans compared with the health of Canadians in general Data and methods: This study describes the size and age structure of the Canadian veteran population forecasted by Veterans Affairs Canada (VAC). Veteran health was examined for two eras of Regular Force veterans. The health of earlier-era veterans (released between 1954 and 2003) was examined using the 2003 Canadian Community Health Survey. The health of recent-era veterans (released between 1998 and 2012) was examined using the 2013 Life After Service Survey. Health indicators for veterans were compared with the Canadian general population using age- and sex-adjusted rates and confidence intervals. Results: The VAC forecast points to a stable population of about 600,000 veterans for the next decade, but a growing proportion will be older than 70 years old. Regular Force veterans of both eras had a higher prevalence than the Canadian general population of activity limitations and back problems, a lower prevalence of low income, and a similar prevalence of life stress and heavy drinking. Recent-era veterans had a higher prevalence than the Canadian general population of many more indicators--in particular, arthritis, self-rated mental health, depression and anxiety. Interpretation: Veterans differed from the Canadian general population in many areas of well-being, and recent-era veterans differed in more areas than earlier-era veterans. These results highlight the need for forecasting and planning, and for policy that is sensitive to these differences and incorporates health status changes as veterans age. Multiple data sources will be required to describe the future health needs of the entire Canadian veteran population. [ABSTRACT FROM AUTHOR]

Veterans with mental health problems are a high-risk group for substance misuse difficulties and are over-represented in forensic settings. Yet, there are few substance misuse services available for this population. Evidence suggests that case management can provide effective interventions for veterans with substance misuse problems. However, there is little research to show its effectiveness in the UK. The present study reported on the implementation and preliminary outcomes of the Veterans Forensic Substance Misuses Service (VFSMS), piloted within a prison setting, to demonstrate the feasibility of the service. The VFSMS operated in four stages: Assessing needs, developing case management plans, providing bespoke support and developing discharge plans. Case studies were used to demonstrate this process, with measures of alcohol use and recovery showing outcomes for each case. Findings from three case studies suggested that case management was a feasible approach, with a range of interventions being used, including substance misuse and mental health services, plus housing and employment services. Outcome measures suggested that alcohol and substance misuse recovery improved following the VFSMS intervention. While the scope of the findings is limited, they suggested that case management is a feasible substance misuse intervention, with preliminary findings showing improvements in substance misuse outcomes. [ABSTRACT FROM AUTHOR]

Highlights • Prior to treatment, dysfunctional trauma-related cognitions were associated with PTSD and depressive symptoms, and trauma-cued craving. • Following treatment dysfunctional trauma-related cognitions, PTSD and depressive symptoms, and trauma-cued craving decreased. • Decreases in dysfunctional trauma-related cognitions mediated the corresponding improvement in treatment outcomes upon program completion. • Reductions in maladaptive trauma-related cognitions appear to play an important role in recovery from PTSD. • CPT-based interventions that modify trauma-related cognitions can lead to desirable outcomes among veterans with co-occurring PTSD and SUD. Abstract Dysfunctional trauma-related cognitions are important in the emergence and maintenance of posttraumatic stress disorder (PTSD) and the modification of such cognitions is a proposed mechanism of trauma treatment. However, the authors are not aware of any research examining trauma-related cognitions as a treatment mechanism in a sample of individuals with comorbid PTSD and substance use disorder (SUD). Accordingly, the present study sought to address this gap in the literature and examined the relationship between trauma-related cognitions and treatment outcomes within a sample of seventy-two veterans diagnosed with PTSD and SUD. Veterans completed a 6-week day CPT-based treatment program that included cognitive processing therapy as a central component. Measures of trauma-related cognitions, PTSD symptoms, depressive symptoms, and trauma-cued substance craving were completed at pre- and post-treatment. As expected, trauma-related cognitions were associated with several PTSD-related variables prior to treatment. Furthermore, results of a within-subjects mediational analysis indicated that maladaptive trauma-related cognitions decreased during the treatment program and accounted for a significant portion of the variance in the reduction of PTSD and depressive symptoms at post-treatment. This study provides support for the position that attempts to modify dysfunctional trauma-related cognitions among veterans with co-occurring PTSD and SUD can lead to desirable treatment outcomes. [ABSTRACT FROM AUTHOR]