An Assessment of Mental Health Services for Veterans in the State of Texas

This report describes the complex challenges faced by veterans and their families in seeking, navigating, and attaining adequate mental health care in Texas. There are 1.7 million veterans in Texas, comprising 8.6 percent of the adult population. According to the U.S. Department of Veteran Affairs (VA), the number of veterans requiring mental health services has grown dramatically and will continue to increase, making veterans’ mental health care an urgent issue in Texas. The federal agencies responsible for military and veterans mental health care, the U.S. Department of Defense (DoD) and the VA, have created new programs and invested significant financial and staff resources. Despite barriers to addressing veterans mental health needs. Texas state agencies have increased funding and instituted new mental health programs supporting returning veterans. Nonprofit agencies focused on veteran’s mental health have multiplied across Texas and the U.S. over the past decade to fill gaps in care. While these organizations provide a growing and increasingly diverse set of resources for veterans to extend the scope of support, volunteer efforts can suffer from fragmentation and overlap. The report identifies current practices, challenges, and opportunities within and across each group of service providers. The report draws on government reports, scholarly literature, and agency websites, as well as interviews with counselors, Veteran Service Officers, nonprofit providers, state officials, and veterans themselves. This report offers five recommendations toward the goal that veterans’ mental health care in Texas become comprehensive, inclusive, effective, and efficient. First, there is a need for greater inter-agency communication across organizations, improved outreach efforts, and increased services for hard-to-reach populations, such as homeless veterans. Second, federal agencies ought to address staff shortages, improve the transition from DoD to VA care, and increase feedback. Third, at the state level, specialized services are needed to address unique veterans’ needs concentrated in cities across Texas as well as those dispersed in rural areas. Fourth, providers can improve mental health care by integrating social services and law enforcement. Fifth, both veterans and providers can benefit if they recognize opportunities for cooperation and coordination and work towards long-term goals that emphasize outcomes that improve the lives of returning veterans. This research was funded in part by the Jack S. Blanton Research Fellowship and the George A. Roberts Research Fellowship of the IC² Institute.IC2 Institut

A policy analysis of Chagas disease in the U.S. and Texas

Chagas disease is an emerging public health issue that affects as many as 300,000 to 1 million people across the nation. The objective of this project was to examine and prioritize possible policy actions to address Chagas disease in the U.S. so that health authorities, and Texas officials in particular, can better address this emerging health threat. The methods included a literature review, interviews with key informants, and policy analysis. Research revealed several existing federal and state policies that currently address Chagas disease in the U.S. and the organizations involved in addressing the public health threat. The literature and key informants also identified eight federal and five state policy proposals that could further address Chagas disease. The 13 proposed policies were evaluated and ranked using three criteria: level to which they fill gaps identified by the scientific community, level of practicality in the policymaking sphere, and level to which they align with current CDC objectives for addressing neglected parasitic infections. Three policy recommendations for federal and state policymakers emerged from this work. Federal policymakers should pursue (1) FDA drug approval, (2) legislation on neglected tropical diseases, and (3) organ donor screening. Texas state policymakers should consider (1) state-recommended targeted screening, (2) Local health department policies, and (3) state legislation on neglected tropical diseases. In addition, I also describe non-government objectives and strategies that advocates should consider to immediately increase the response to Chagas disease in the U.S

Classifying Mixing Regimes in Ponds and Shallow Lakes

Lakes are classified by thermal mixing regimes, with shallow waterbodies historically categorized as continuously mixing systems. Yet, recent studies demonstrate extended summertime stratification in ponds, underscoring the need to reassess thermal classifications for shallow waterbodies. In this study, we examined the summertime thermal dynamics of 34 ponds and shallow lakes across temperate North America and Europe to categorize and identify the drivers of different mixing regimes. We identified three mixing regimes: rarely (n = 18), intermittently (n = 10), and often (n = 6) mixed, where waterbodies mixed an average of 2%, 26%, and 75% of the study period, respectively. Waterbodies in the often mixed category were larger (≥4.17 ha) and stratification weakened with increased wind shear stress, characteristic of “shallow lakes.” In contrast, smaller waterbodies, or “ponds,” mixed less frequently, and stratification strengthened with increased shortwave radiation. Shallow ponds (\u3c0.74 m) mixed intermittently, with daytime stratification often breaking down overnight due to convective cooling. Ponds ≥0.74 m deep were rarely or never mixed, likely due to limited wind energy relative to the larger density gradients associated with slightly deeper water columns. Precipitation events weakened stratification, even causing short-term mixing (hours to days) in some sites. By examining a broad set of shallow waterbodies, we show that mixing regimes are highly sensitive to very small differences in size and depth, with potential implications for ecological and biogeochemical processes. Ultimately, we propose a new framework to characterize the variable mixing regimes of ponds and shallow lakes