Abstract
The Department of Defense (DoD) and the Department of Veteran Affairs (VA) spend billions of federal dollars on veteran healthcare and medical research each year. Thousands of healthcare facilities and research labs are funded with this budget to aid veterans in achieving and maintaining good health. Biomedical Engineering, specifically tissue engineering, is a rapidly advancing field and has made impactful progress in treating certain physical conditions that veterans are predisposed to, including Volumetric Muscle Loss (VML). However, this raises questions about the prioritization of physical conditions over mental conditions and the holistic nature of the care being provided by the DoD and VA.
While the United States has made significant strides in addressing and promoting mental health in the last two decades, millions still struggle with mental illnesses, including veterans who are at significant risk. Due to various barriers to mental health care, these brave men and women often return to civilian life with significant trauma, especially those who served in combat, resulting in Post Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI), and substance abuse. These cultural, financial, and institutional barriers to access proper care have led to extreme rates of veteran homelessness and suicide. Thus, the technical thesis presented will address improvements in tissue engineering practices for treating VML and the science, technology, and society (STS) thesis will discuss the system of veteran mental health care and analyze the causes and contributors to the mental health epidemic.
The STS thesis employs the framework of Actor Network Theory (ANT) to analyze how the DoD and VA build the network of veteran health support consisting of human and non-human actors. Non-human actors like policy, cultural stereotypes, financial resources, and institutional limitations are identified as barriers to accessible mental health care for veteran populations. Further, the military and medical professionals involved in mental health treatment and diagnosis are discussed in the context of a specific case regarding Richard T. Davis. The case highlights the current faults in the mental health practices and protocol within the military, leading to the murder of Davis by a group of his fellow infantry men. These faults are identified and analyzed through ANT and suggestions to policy improvement are made using research from veteran testimony, VA published statistics, and case study.
The technical project aims to improve current cell culture methods by introducing nanofiber membranes in cell culture inserts. The fibrous networks of these membranes attempt to create a more biomimetic environment in culture by establishing an extracellular matrix (ECM) like environment. Membrane chemistries are also selected to include a component of biodegradation. This allows for cells to begin producing their own natural ECM which will enhance the ability to mimic the in vivo environment. Cell viability assays are used to validate that these membranes are biocompatible and support cell growth and proliferation. The capstone project opens further avenues for study of three-dimensional cell culturing techniques. As cell culture becomes more biomimetic, the cells grown will be increasingly viable in vivo leading to more efficient and safe tissue grafts and implants like those used in VML treatment.
Although physical and mental conditions may be treated differently and independently, the two types of illnesses are highly connected. Concurrent symptoms are extremely common for veteran populations, prompting the need for a more holistic form of medical treatment. It is vital that we continue to fund biomedical research to advance health technologies and treatments available to civilians and veterans in the United States. However, it is also important that we invest in understanding how mental health is diagnosed and treated for military personnel. Breaking down barriers and promoting access to mental health care will, in turn, increase access to the physical treatments that are rapidly advancing due to federal funded research. If a veteran is experiencing debilitating mental illness like PTSD, depression, or anxiety, they may not be able to seek out treatment for their other conditions. The high incidence of mental illness increases risk of homelessness, suicide, and substance abuse. If a patient’s daily priority is finding food and shelter, they are highly unlikely to benefit from the state-of-the-art research and clinical trials like the technical project below aims to improve. We must equally prioritize diagnosing and treating both mental and physical conditions for our veterans to ensure access to proper holistic healthcare. Promoting education and awareness can end the mental health epidemic for our nation’s veterans and eventually lead to more equitable access to advancing medical technologies.
