Improving DEI for Veterans Using the VA’s Strategic Plan

The U.S. Department of Veterans Affairs (VA) launched a strategic plan in 2022 that details how it plans to use DEI principles to improve the services it offers to Veterans in their care. Covering many challenges, this plan offers a great roadmap to improvement for both governmental and private sector healthcare organizations.

By understanding and addressing the unique challenges Veterans face — whether related to geographic location, gender-specific issues, or racial disparities — organizations and healthcare providers can create inclusive environments that prioritize the health and well-being of all Veterans. Through strategic initiatives such as reducing stigma, enhancing cultural competence, and implementing trauma-sensitive care practices, we can ensure that every Veteran receives the quality care they deserve.

Underserved, marginalized, and at-risk Veterans

Strategic Objective 2.1 in the VA’s plan outlines how it will better serve Veterans who are part of groups that have historically been marginalized and underserved by the American healthcare system. Specifically, the VA this initiative aims to improve “environments of care and addresses equitable access and the unique needs of LGBTQ+, women, racial, ethnic, religious and/or cultural minorities, those with physical and/or intellectual disabilities, American Indian and Alaska Native Veterans, and homeless Veterans to ensure all Veterans feel welcome and valued.”

In this section, we’ll examine how your organization  can better serve these populations.

Expand care to rural communities

The geographical isolation of rural areas poses a substantial barrier to accessing healthcare services and medications. Research underscores the difficulty rural residents face in reaching urban centers where medical care is more accessible. According to the U.S. Department of Veterans Affairs (VA), Veterans in remote rural communities encounter heightened travel costs due to their distance from healthcare facilities. These Veterans, typically older with poorer health and financial security, face compounded challenges compared to their urban counterparts.

According to the VA’s Strategic Plan, the VA is attempting to solve this issue by:

• Providing assistance to rural medical providers to increase their productivity
• Launching a formal study to better understand why rural healthcare desserts occur
• Expanding VA partnerships in rural or underserved areas to ensure access to quality care

If your organization provides care to Veterans in rural or other underserved areas, contact the VA to discuss how you can partner with them to improve the care you offer to your clients or patients.

Gender and identity dynamics

Female Veterans encounter distinct risk factors that contribute to health disparities, including military sexual trauma, childhood adversity, and intimate partner violence — often leading to higher rates of PTSD compared to male Veterans. Despite these challenges, female Veterans may hesitate to seek help due to concerns about workplace perceptions, stress-related dismissals, or feelings of isolation.

Similarly, LGBTQ+ Veterans, numbering over one million in the U.S., with more than 134,000 identifying as transgender or gender-diverse, confront elevated risks of behavioral health issues. These risks are exacerbated by experiences such as bullying, military sexual trauma, rejection, and discrimination within their families and communities, leading some to avoid VA services due to unwelcoming environments or harassment.

To address these concerns, the VA is actively transforming its culture to ensure “Veterans feel safe and welcome wherever they seek assistance and care.” To learn more about how to create a psychologically safe care environment for Veterans and other clients, see the section below, “Utilizing DEI best practices to foster psychological safety.”

Racial and ethnic discrimination

Veterans from marginalized racial and ethnic backgrounds encounter distinct barriers in accessing healthcare, including discrimination in healthcare settings, reluctance to seek behavioral health treatment, lower adherence to treatment recommendations, and disparities in care quality due to cultural mismatches with healthcare providers. Additionally, diagnostic biases rooted in predominantly white samples can lead to misdiagnoses among Black and Latinx Veterans, such as bipolar disorder being mistaken for schizophrenia.

To better serve these Veterans, your organization should seek to partner with more ethnically and racially diverse physicians, provide care in multiple languages, and work with other organizations in your area who provide DEI-informed services to Veterans to better understand any reluctance to seek treatment.

Accessibility as part of DEI for Veterans

Strategy 2.3.1 underscores the VA’s commitment to ensuring that all Veterans receive equitable access to healthcare and Veteran programs. This initiative involves expanding medical capacity and capability to meet the diverse health needs of Veterans across different demographics. By enhancing graduate education and leveraging innovative methodologies, the VA aims to stay responsive to evolving Veteran needs and address emerging challenges effectively.

Despite significant strides, challenges persist in ensuring universal access to Veteran programs. Many Veterans continue to experience barriers such as inadequate transportation options, limited awareness of available services, and cultural insensitivity within healthcare settings. Addressing these issues requires sustained efforts to promote inclusivity and accessibility, eliminate systemic biases, and foster a welcoming environment for all Veterans seeking support from the VA.

A critical component of Strategy 2.3.1 is the expansion of partnerships and the adoption of innovative approaches. Collaborating with community organizations, non-profits, and private sector entities allows the VA to extend its reach and offer tailored services that cater to specific Veteran populations. Further, leveraging technological advancements and emerging methodologies enables the VA to improve healthcare delivery, streamline administrative processes, and enhance overall service quality.

Enhancing accessibility to Veteran programs not only addresses immediate healthcare needs but also contributes to improving Veterans’ long-term outcomes and quality of life. By removing barriers to care and expanding service options, the VA empowers Veterans to actively engage in their health management and overall well-being. This proactive approach not only benefits individual Veterans but also strengthens communities and promotes national health equity goals.

Utilizing DEI best practices to foster psychological safety among Veterans

Stewardship Objective 4.1 of the VA’s strategic plan states that the VA:

“Will transform its human capital management capabilities to empower a collaborative culture that promotes information sharing, diversity, equity and inclusion and a competent, high-performing workforce to best serve Veterans and their families.”

Achieving genuine inclusion and psychological safety within an organization is a challenging yet rewarding journey, especially when employing effective DEI practices. By establishing a secure environment where employees feel valued, you can bolster their careers, reduce turnover rates, and cultivate a healthier organizational culture. However, embarking on this path can be daunting without clear guidance.

The initial crucial step involves a collective commitment from both leadership and staff. Creating psychological safety through DEI principles hinges entirely on active engagement from all team members and robust organizational support. To guide you through this process, consider adopting the following strategies.

Practice inclusion

Cultivating a DEI-driven culture and psychological safety entails fostering a sense of belonging and acceptance among all staff members and patients. When employees feel included, they are more inclined to share diverse perspectives and skills, contributing significantly to organizational success.

Foster inclusion through empathetic leadership that:

• Ensures fair treatment of employees
• Cultivates a sense of belonging
• Promotes a joyful, inclusive workplace environment at every level
• Builds an inclusive organizational brand through self-awareness
• Authentically communicates personal experiences

Promote growth and learning

Irrespective of your organization’s size, structured DEI programs and inclusive training initiatives benefit all team members. These efforts are essential for fostering growth, innovation, and a culture of learning throughout the organization.

Encourage growth and learning by:

• Supporting success, innovation, and creativity
• Sharing DEI knowledge and experiences
• Enhancing employee engagement, networking, and empowerment
• Valuing differences and fostering intercultural curiosity
• Facilitating constructive dialogue during difficult conversations
• Understanding and addressing sources of intergroup conflict

Make communication a priority

Transforming into a DEI-driven environment that promotes psychological safety necessitates a cultural shift supported by transparent communication at every organizational level.

Effective communication strategies include:

• Active listening with patience and attention
• Seeking clarification when needed
• Communicating to foster mutual understanding
• Taking personal responsibility for dialogue, events, actions, and changes
• Affirming others and enhancing their communication skills
• Facilitating dialogues as a neutral moderator
• Maintaining honesty, clarity, and transparency

Champion self-improvement

Achieving DEI goals and psychological safety requires active participation from everyone, starting with a commitment from organizational leaders to continuously improve.

As a leader, engage in productive conversations by:

• Acknowledging and rectifying mistakes
• Recognizing the presence of privilege within systems
• Cultivating self-assurance when discussing sensitive topics
• Approaching difficult conversations with empathy
• Reflecting on personal social group privileges
• Taking ownership of contributions, both positive and negative
• Identifying triggers of discrimination and bias
• Building trust and rapport with colleagues
• Expressing personal feelings while considering others’ perspectives

By implementing these strategies, organizations can foster an inclusive environment aligned with DEI principles, ensuring psychological safety and empowering all employees — including Veterans — to thrive.