Access to mental health services for veterans and their families has long been a priority for policymakers, but one area that has seen limited progress is the availability of Licensed Marriage and Family Therapists (LMFTs) through the U.S. Department of Veterans Affairs (VA). Recognizing this gap, Congresswoman Julia Brownley (D-CA) has introduced a new bill that seeks to make it easier for veterans and their families to access care from LMFTs, who specialize in helping individuals, couples, and families navigate the unique challenges they face, including those related to mental health, trauma, and relationship difficulties.
The bill, which is currently under consideration in Congress, would eliminate some of the restrictive licensing regulations that currently limit the number of LMFTs who can work at the VA. By expanding the pool of LMFTs available to veterans, the bill aims to improve the delivery of behavioral health services to this important group of individuals.
Current Restrictions and Challenges for LMFTs at the VA
Under the current framework, the VA is able to hire LMFTs who are licensed through specific programs, primarily those accredited by the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) or the American Association for Marriage and Family Therapy (AAMFT). However, there are stringent regulations that create barriers to career advancement for many LMFTs.
One key issue is that only LMFTs licensed through the COAMFTE program are allowed to hold supervisory positions within the VA. While this may sound reasonable on the surface, it creates a significant limitation for the vast majority of LMFTs, who are not licensed through COAMFTE. As a result, these therapists face career stagnation and are unable to pursue higher-level roles within the VA system, even though they may possess the requisite skills and experience.
This regulation prevents many highly qualified professionals from advancing in their careers, which can lead to high turnover rates and difficulty in retaining experienced therapists. Furthermore, the lack of advancement opportunities can contribute to burnout, which is a significant issue in the behavioral health field, particularly for those working with veterans and military families who often face complex and high-stress situations.
The Need for Change
The bill introduced by Congresswoman Brownley aims to address these issues by eliminating the restrictions that currently prevent LMFTs from advancing in their careers at the VA. According to Brownley, the current regulations are “overly rigorous” and not in line with industry standards, which has resulted in nearly half of the therapists working at the VA being “extremely restricted.”
Brownley emphasized that veterans and their families face unique challenges that require specialized care, and that improving access to highly qualified mental health professionals is essential to meeting those needs. By expanding access to LMFTs and eliminating career restrictions, the bill seeks to ensure that the VA can recruit and retain qualified professionals to provide the best possible care to veterans.
“The varied needs of our nation’s veterans and their families must be addressed through the recruitment and retention of highly-qualified professionals,” Brownley said in a statement. “My bill ensures that VA can significantly expand veterans’ access to therapists and that the delivery of quality and timely care continues to be the standard, not the exception.”
The Role of LMFTs in Veteran and Family Mental Health Care
Licensed Marriage and Family Therapists (LMFTs) are uniquely equipped to address the complex mental health issues faced by veterans and their families. LMFTs are trained to help individuals and families navigate relational difficulties, trauma, mental health disorders, and other challenges that impact family dynamics. This is particularly important for veterans, who often face mental health challenges related to their military service, such as post-traumatic stress disorder (PTSD), depression, and anxiety.
For veterans, mental health care is not just about individual therapy; it often involves addressing family dynamics, communication issues, and relational stress that can be exacerbated by military life. Marriage and family therapists are skilled at treating individuals and families as a whole, rather than focusing solely on one person, which can be critical for those who are adjusting to life after service or dealing with the aftermath of trauma.
For example, an LMFT can help a veteran and their spouse or children address communication difficulties that have developed over time, or work with a family to manage the effects of PTSD on family life. By providing care that addresses the family unit, LMFTs help create stronger support systems for veterans, which can contribute to better long-term mental health outcomes.
A Growing Need for Behavioral Health Services for Veterans
The need for accessible mental health care for veterans has never been more urgent. Veterans face an elevated risk of mental health challenges, including depression, PTSD, anxiety, and substance use disorders. According to the U.S. Department of Veterans Affairs, about 11 to 20 percent of veterans who served in Iraq and Afghanistan experience PTSD in a given year. Additionally, many veterans face challenges in transitioning back to civilian life, which can further strain their mental health.
Given these challenges, expanding access to mental health services is essential to improving the well-being of veterans and their families. The VA has made significant strides in providing mental health care to veterans, but access to care remains an ongoing issue. Wait times for appointments, limited availability of certain types of specialists, and difficulty accessing care outside of major metropolitan areas are just a few of the barriers that veterans often face.
The introduction of Brownley’s bill is a step in the right direction toward addressing some of these issues. By enabling the VA to hire a broader pool of LMFTs, the bill would help ensure that veterans and their families have access to qualified professionals who can provide specialized care. Additionally, by eliminating career restrictions for LMFTs, the bill would help retain experienced professionals in the VA system, improving the quality and continuity of care for veterans.
The Success of Recent Changes in Medicare
The bill comes at a time when the role of LMFTs in healthcare has been expanding across the United States. One notable example is the recent changes to Medicare regulations that now allow marriage and family therapists and mental health counselors to enroll as Medicare providers for the first time. These changes, which took effect in 2020, were hailed as a major victory for behavioral health advocates, as they provide greater access to care for Medicare beneficiaries.
Dr. Meena Seshamani, CMS Deputy Administrator and Director of the Center for Medicare, praised the changes, noting that they would make it easier for people with Medicare to access marriage and family therapy services, as well as other forms of behavioral health treatment. The new regulations also allow for greater access to culturally-sensitive care, care navigators, peer support workers, and primary care providers who can offer long-term, trusting relationships with their patients.
The success of these changes in Medicare demonstrates the positive impact that policy changes can have on increasing access to behavioral health services. By extending similar changes to the VA system, the bill introduced by Brownley could make a meaningful difference in the lives of veterans and their families.
Conclusion: A Step Toward Better Care for Veterans
The bill introduced by Congresswoman Julia Brownley represents a critical step in improving access to behavioral health services for veterans and their families. By eliminating the restrictive regulations that currently limit the career advancement of LMFTs at the VA, the bill would expand the pool of qualified professionals available to serve veterans, ultimately improving the quality and accessibility of care.
As the need for mental health services among veterans continues to grow, expanding access to care is essential. The bill’s focus on LMFTs is particularly important, as these professionals are uniquely trained to address the complex mental health and relational issues that many veterans and their families face. By making it easier for LMFTs to work at the VA and advance in their careers, this bill would help ensure that veterans receive the high-quality, comprehensive care they deserve.
In the coming months, it will be important to watch how this bill progresses through Congress. If passed, it could mark a significant turning point in the way that mental health care is delivered to veterans, setting a precedent for further improvements in the system. The ultimate goal is to ensure that veterans and their families receive the care they need, when they need it, in a way that supports their long-term well-being.
