San Francisco VA Medical Center

 

Did you know, at any given time, of all people in prison nationwide, 9.3 percent are Veterans? That’s per the most recent U.S. Department of Justice Bureau of Justice Statistics survey of inmates in local jails data.

In California, a disproportionate percentage of Veterans (30-50 percent) are in the justice system, according to Christina Kim, NP, San Francisco VA Medical Center (SFVAMC) staff nurse practitioner. “The state of California has the highest prison rate in the nation, 30,000+, and Veterans in the justice system are in the thousands,” she said. Good news is, 82 percent of these incarcerated Veterans are eligible for VA services.

To help a troubled population of Veterans get the services they need instead of ending up in prison, the Veterans Justice Outreach (VJO) initiative was created as part of the Secretary of Veterans Affairs’ vision for ending homelessness among Veterans within five years.

VJO’s purpose is to educate the legal system, law enforcement, and jails on unique issues facing today’s Veterans. Once Veterans enter the legal system, VJO specialists identify Veterans who are not fully-assessing VA services, and provide assistance to divert them from unnecessary incarceration through integration into VA substance and mental health treatment programs. VJO specialists meet with judges and local law enforcement to educate and inform them about Veterans issues such as post traumatic stress disorder, traumatic brain injuries, military sexual trauma, and suicide.

To locally support VJO efforts, we opened the very first VA Justice Clinic based out of our VA Downtown Clinic in San Francisco. The clinic is staffed by Eric Hung, MD, psychiatrist and Associate Chief of Mental Health for Community Based Outpatient Clinics for SFVAMC; nurse practitioner Christina Kim; and VJO social worker Elizabeth Brett.

“We’re a pilot program,” said Kim. “We hoping to conduct a program review soon and model this for other VA systems.”

“We wanted to create a clinic with wrap-around services—social work, mental health, and medical services—for Veterans coming out of county jail,” said Hung. “Our purpose is to ensure no Veteran falls through the cracks. We help clients gain access to services with a goal to divert them from the criminal justice system. We offer treatment vs. containment.” Since the clinic’s opening, over 60 Veterans in the justice system have received Justice Clinic services.

“Our Justice Clinic allows us to be a ‘one-stop shopping’ referral source for Veterans within the criminal justice system,” said Hung. “We provide a tight linkage and follow-up. We initiate treatment services for Veterans, and provide a liaison between the VA and local police, sheriff’s department, probation, parole, and any of the justice courts (behavioral, health court, drug court, etc.).”

Who benefits from the Justice Clinic? “Our customers are homeless Veterans, most presenting with substance abuse or severe mental illness, and who have no access to VA treatment before incarceration, or have been unable to get the VA services they need after parole,” said Hung. “This population has a lot more going on than the average Veteran. Their issues are housing, addiction, HIV, Hepatitis C, depression, bipolar disorder, and schizophrenia.”

One of the services offered by the Justice Clinic is a practical tool for re-entry into everyday living. “We teach life skill classes,” said Kim. “Our Veteran clients have no idea how society works; they don’t know what to do with themselves. We’re their first point of contact after release. We’re like the ‘welcome wagon’; we engage them, work with them where they’re at, and help them with their reintegration.”

The Justice Clinic collaborates with the local community, including Swords to Plowshares. “In partnership with San Francisco mental health professionals, we developed training classes for the San Francisco Police Department (SFPD) to better respond to a mental health crisis,” said Brett. “The Crisis Intervention Team teaches SFPD officers to ask (when apprehending a suspect), ‘Have you served in the US military?’ and if they have, use a different technique.

Brett also works with the COVER (Community of Veterans Engaged in Restoration) Program in SF. “There’s a Veteran’s pod in the SF county jail (an isolated area for Veterans only) that houses 48 Veterans,” she said. “We provide services for Vets on the pod. It gives them hope that things can be different. Some of the services we provide include: Seeking safety, acupuncture, meditation, yoga, music group, and dialectical behavioral therapy. We visit the Veterans and have a huge Veterans Day celebration with food, and (formerly incarcerated) Veterans tell their story.”

“The cool thing is, now people are noticing us,” said Kim. “Now we can organize for the ‘big program’ picture. My favorite part about this is being in a team collaboration; knowing we’re helping to ensure a ‘safety net’ support system for these Veterans.”

Next step? “We’re also looking for volunteers to be an outreach worker—a peer outreach worker “buddy” who can help released Veterans reintegrate into society,” added Kim. For more information about the Justice Clinic, call VJO social worker Elizabeth Brett at (415) 489-3306.