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The Department of Veterans Affairs--the VA--operates the nation's largest and most diverse health care system. How many physicians does it need to carry out its principal mission-related responsibilities of patient care, education, and research? This book presents and demonstrates by concrete example a methodology to answer this basic, but extraordinarily complex, question. The heart of the methodology is a decision-making process in which both statistical and expert judgment approaches can be used separately or in concert to calculate the number of physicians required, by specialty, for any facility in the VA system. Although the analyses here focus entirely on the VA, the methodology could be used to determine physician staffing for a wide range of public and private sector health care organizations.
Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.
Scholars have argued about U.S. state development - in particular its laggard social policy and weak institutional capacity - for generations. Neo-institutionalism has informed and enriched these debates, but, as yet, no scholar has reckoned with a very successful and sweeping social policy designed by the federal government: the Servicemen's Readjustment Act of 1944, more popularly known as the GI Bill. Kathleen J. Frydl addresses the GI Bill in the first study based on systematic and comprehensive use of the records of the Veterans Administration. Frydl's research situates the Bill squarely in debates about institutional development, social policy and citizenship, and political legitimacy. It demonstrates the multiple ways in which the GI Bill advanced federal power and social policy, and, at the very same time, limited its extent and its effects.