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Office of Public and Intergovernmental Affairs

Remarks by Former Deputy Secretary W. Scott Gould

PTSD Meditation Demonstration Projects
Washington, DC
December 13, 2011

Good afternoon, everyone.

Greetings to our partners from the University of Rochester—Welcome to VA Central Office. We're very glad you're here with us today.

Thank you all for inviting me to join you in a dialog about a tradition that dates to the earliest days of recorded history and its application in treating the signature wound of 21st century combat—PTSD.

From the standpoint as COO of this department, the fact that good results have been reported in using it to treat our PTSD patients makes it professionally compelling. It some ways, it's a mental health breakthrough—albeit two-and-a-half millennia in the making—that reminds me of the truth in the saying, Everything old is new again.

And there's nothing so old—or so new—as meditation or yoga, or a host of other alternative practices to improve resiliency and to promote and restore good health.

Under our department's overarching transformation paradigm, recognizing and effectively treating mental illness—in all of its manifestations—is among VA's highest priorities. We are continuing to systemically retool our mental health structure, processes, policies, and protocols to make our services Veteran-centric, uniform, and accessible.

The fact is, the demand for our services is steadily increasing. From 2005 to 2010, the number of Veterans treated for any mental health diagnosis rose from a little over 1.4 million to just under 1.9 million. And we are seeing studies that link mental health with physical health issues. At the same time, the number of VA mental health staff rose from around 13,000 to over 20,000 nationwide.

Thanks in large measure to President Obama's unparalleled commitment to Veterans, and to Congressional support, our program funding also increased—from $2.24 billion in FY 2005, to $6.15 billion projected for FY 2012. That's just short of a three-fold increase.

But money alone is not the answer. What counts is what you do with the resources entrusted to you.

What counts are the results you get from investing those funds in effective treatments. By conducting forward-leaning research and targeting what looks promising. By effectively leveraging approaches that predict the biggest pay off for our Veteran-patients and, in turn, for Americans-at-large. By investing in our people—training them so that they are continually applying new knowledge and know-how. By investing in collaborations—like our partnership with the University of Rochester and DoD—if we are to advance our cause. And by putting our resources into clinical trials, pilots, and demonstration projects like the ones we'll be hearing about today.

Ultimately, what counts is the practical, concrete return on our investments of time, money, and human capital. For VA, that return on investment is measured by the best services, the best treatments, and the best personal benefits that accrue to Veterans and their families.

That's our bottom line. It's how we measure our success and keep our promise to the Veterans we serve.

But that is not enough for the nation's largest provider of mental health services—VA intends to press its mental health transformation even further. All of you in this room are a seminal part of that effort. As you all well know, there are already a few effective treatments for PTSD out there.

We can look to exposure-based therapies like Prolonged Exposure and Cognitive Processing Therapy, for example. But we also know that not everyone is willing to do exposure-based treatment; and even those who do, don't always recover fully. So, it's up to us to identify new ways to complement and enhance the evidence-based treatments we currently use.

Whether it's one or more of the three forms of meditation—or something else not yet under our microscope—we will continuously work to improve our ability to effectively treat PTSD, or, for that matter, any other mental health condition.

The job at hand is to set it right to get it right if VA is to align its 19th century mandate with its 21st century mission. And in the 21st century, alternative forms of medicine figure prominently. They are increasingly among the practices of the patients we treat and in the mainstream of healthcare solutions designed to serve them.

There is an immediacy to our work. We are a nation at war, and so, in my view, VA must cast a wide net when looking for answers to the scourge of PTSD. We must press forward in our efforts if we are to meet the tide of mental health challenges that is headed our way. DoD tells us that more than 20 percent of the men and women returning from Iraq and Afghanistan experience some degree of Post Traumatic Stress Disorder. Many more have PTS.

In FY11, VA treated almost a half million Veterans for PTSD. And although Vietnam Veterans still comprise the majority of the Veterans who received mental health treatment, the number of OEF, OIF, and OND Veterans receiving care for PTSD is growing with each passing quarter.

Those sobering statistics are the imperative to keep our minds open and receptive to new ideas wherever we may find them. In my view, nothing should be off the table if we are to exhaust all treatment possibilities, and, as important, to integrate those treatments into our standing arsenal of life-affirming protocols.

That's why I'm particularly excited to hear, first-hand, your feedback about the eight meditation pilot and demonstration projects—in addition to the three ORD-funded research projects now underway—there's no question that you are on the leading edge of VA innovation. And that you have an even larger role in directing our future-oriented CAM actions within the VA-DoD Integrated Mental Health Strategy as we evaluate and determine the evidence-based programs that will be translated into more effective treatments for service members and Veterans.

I want to personally thank each of you for your efforts to apply an open mind, a spirit of inquiry, and a scientific approach to the use of meditation as a means to address PTSD. And now, I look forward to your reports.