Senators tell VA to speed up care for mentally ill vets

McClatchy NewspapersNovember 30, 2011 

WASHINGTON — Senators gave a public scolding Wednesday to the director of mental health operations for the nation's veterans, saying the federal government must speed up services for those with post-traumatic stress disorder and other afflictions.

Faced with a 34 percent increase in the number of veterans who have sought mental health services since 2006, the Department of Veterans Affairs has not kept pace, said Democratic Sen. Patty Murray.

As a result, too many veterans are waiting far too long to get help, which is leading to a rash of suicides, increased drug abuse and other problems, said Murray, who heads the Senate Veterans' Affairs Committee.

Offering an example from her home state of Washington, Murray said veterans seeking psychiatric help in Spokane have had to wait an average of 21 days for an appointment, with a maximum wait time of up to 87 days.

"We need to fix this now," Murray said at a committee hearing that she called to examine the topic.

Senators were irked with the results of a survey of VA health care providers released last month; nearly 40 percent said they cannot schedule an appointment in their own clinics within two weeks, as the government's guidelines require.

The survey, requested by Murray, found that 70 percent did not have adequate staff or space to meet the mental health care needs of veterans they serve, and 46 percent said they needed to provide more off-hour appointments to reach veterans.

Noting that the U.S. is already witnessing a record suicide rate among veterans, with as many as 18 veterans killing themselves every day, Murray said: "We need to meet the veterans' desire for care with the immediate assurance that it will be provided — and provided quickly. We cannot afford to leave them discouraged that they can't find an appointment."

Sen. Richard Burr of North Carolina, the top-ranked Republican on the panel, said the survey results were "simply unacceptable."

"The men and women of the armed forces suffering from the invisible wounds of war deserve better," he said.

Mary Schohn, head of the VA's mental health operations, told the panel that more than 1.2 million veterans sought mental health care in 2010. She said the number of mental health professionals assigned to veterans ballooned by 48 percent from 2006 to 2010, growing from 14,207 to more than 21,000.

She said the department has made mental health care a high priority but added that "we recognize we have much more to do."

"Put simply, our work to care for America's veterans' mental and overall health can never stop, and we must continually improve," she said.

One witness, Michelle Washington, a PTSD specialist at the Wilmington VA Medical Center in Delaware, said veterans sometimes must wait for two months to get an appointment. And she said the center doesn't even have a PTSD treatment team because of lack of staffing.

Washington said that VA employees at the Wilmington center are overworked and that more than a dozen resigned recently after being admonished for speaking up for patients. She told the panel that she feared retaliation by VA management for participating in the hearing.

Burr said Congress has done its part to help, providing $5.7 billion for mental health services for veterans this year, an increase of 136 percent since 2006. He asked Schohn to provide a detailed audit of how the money has been spent.

"What has VA been doing with the resources Congress has provided over the years? ... Why haven't these staffing increases been effective?" Burr asked.

Schohn said the VA has been busy hiring more staff, studying space shortages, beefing up its veterans crisis line and homeless call center, trying to reach more veterans online with "telemental health psychotherapy services" and making sure that veterans start treatment within 14 days of seeking an appointment.

She said the department wants to make sure that veterans from Afghanistan and Iraq with PTSD will receive at least eight sessions of psychotherapy within 14 weeks. And any veteran flagged as a high suicide risk will be eligible for four visits within 30 days, she said.

In addition, Schohn said, the VA plans to complete 10 focus groups by the end of January to better understand "perceptions on mental health care" by the VA's providers.

Democratic Sen. Jon Tester of Montana said the VA had made strides in improving mental health care, but he added that conducting focus groups and issuing new guidelines "ain't good enough" for the nation's veterans.

"They need care — and there's no ifs, ands and buts about it," he said.

Following Tuesday's announcement that another 33,000 troops will come home from Afghanistan by the end of next year, Murray said, "The demand for care will only swell.

"This should not come as a shock to VA," she said. "And it should not cause the waiting line for care to grow. ... VA has had a decade to prepare."

Burr said that if the VA cannot provide timely care to veterans, the department "should consider sending veterans to someone who can help them promptly." He criticized the department for emphasizing focus groups in its plan of action, saying it does nothing to provide immediate help to veterans. And he noted that Wednesday's hearing followed a similar committee hearing on the topic in mid-July.

"I had expected that four and a half months would be enough time for VA to come up with solutions, but it appears that is not the case," Burr said.

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McClatchy Newspapers 2011

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