Social Work at the US Department of Veterans Affairs
A Leader in Providing Seamless, Quality Social Work Care for Veterans
Steve Bailyn, LCSW, Chief, Community and Social Services, VA NY Harbor Healthcare System
Through the years numerous cases of veterans with multiple needs have come to the attention of VA social workers in various settings. Hearing first hand the unique examples of experiences underscore further the particular importance of social work at this time working with veterans. One example is that of a veteran who was in his twenties. He was a combat veteran from Iraq who came to the VA for help and now was tearful because he could not remember how to travel home from our local VA facility. Along with PTSD, he was presenting with symptoms of the signature wound from America’s latest war: Traumatic Brain Injury. His social work case manager, based in our facility’s Seamless Transition Clinic, moved rapidly to ensure his safe return to his home. In addition, the case manager arranged for ongoing travel services for this combat veteran and mobilized his community supports. She has also maintained frequent contact to encourage him, and ensure that he follows up on a wide range of appointments for evaluation and treatment. Furthermore, she works to keep his care coordinated.
VA social workers play important roles in the VA’s commitment to meet the needs of both special veteran populations as well as all veterans eligible for VA services. This includes the elderly, homebound WWII veteran and his spouse counseled by a social worker in their home; the homeless veteran receiving outreach services by a VA social worker in a municipal shelter or park and the veteran with serious mental illness receiving intensive case management at home. It also includes the veteran re-learning job skills after years of unemployment due to addiction or mental illness; and the newly returned combat veteran overwhelmed with adjustment, marital, housing, and employment issues.
From 14 social workers in 1926, to over 5600 professional social workers who are currently employed nation-wide, VA social workers have significant roles in the delivery of healthcare to veterans. All VA social workers must have an MSW from a school of social work accredited by the Council on Social Work Education, and must obtain state licensure. VA social workers also operate the largest and most comprehensive training program for graduate social work students, having affiliations with over 100 graduate schools of social work.
The mission of VA Social Work is to eliminate psychosocial complications as significant barriers to healthcare interventions for veterans and families. VA social workers have long been key members of the interdisciplinary teams in more traditional healthcare settings, such as inpatient acute units, emergency rooms, long term care facilities and outpatient mental health clinics. Like their counterparts in non VA healthcare facilities, these social workers have provided crisis intervention, discharge planning, individual, group, and family treatment, and individual treatment coordination.
VA social workers have also been leaders in the development of programs as healthcare has shifted from inpatient care to outpatient primary and community-based care. Many of the programs addressing special veteran populations, such as, homeless, spinal cord injured, former prisoners of war, visually impaired, homebound, unemployed, recently returned combat veterans—are coordinated and staffed by social workers who bring the systems perspective, understanding of community resources, and direct clinical skill needed to meet the needs of veterans.
VA has recognized that recently returned combat veterans need the social work skill set that combines expertise in clinical treatment, care coordination, clinical case management and systems negotiation. As a result, VA has funded the creation of social work case manager positions at all VA healthcare facilities for outreach, treatment, and coordination of the care of our newest generation of veterans. These VA social workers are members of interdisciplinary teams of VA staff who travel to nearby military bases and “welcome home” events to provide information regarding adjustment or health issues, as well as VA services to returning soldiers and their loved ones. VA social workers conduct outreach that encourages the use of VA and community services, and they offer case management services to the more seriously ill or injured veterans who may have a range of barriers to treatment that need to be addressed.
Since 2004, over 5000 veterans who served in Iraq or Afghanistan have enrolled for services at the VA NY Harbor Healthcare System, which, along with the James J. Peters VA Medical Center in the Bronx, provide services to veterans within New York City.
Given their ability to work in so many dimensions, VA social workers will continue to play pivotal roles as the VA strives to meet the complex needs of this country’s veterans.