Psychologist cites waits at Wilmington VA

WASHINGTON -- Short staffing is making it hard for veterans to get a appointment for mental health care at the Wilmington VA Medical Center, undermining the effectiveness of treatment, a psychologist at the center told a Senate panel Wednesday.
Michelle Washington told members of the Senate Veterans' Affairs Committee she tries to book weekly psychotherapy appointments for patients with post-traumatic stress disorder if appropriate. But she said she is told "too often" that a patient will have to wait as long as six weeks to start treatment.
"After waiting that long, many patients lose their motivation for treatment or their PTSD worsens while they're waiting," said Washington, who coordinates PTSD services for the Wilmington VA. "Sometimes I find it better not to start evidence-based psychotherapy because the harm of waiting outweighs the benefit of the treatment."
Washington, testifying on behalf of the American Federation of Government Employees, gave a provider's perspective on a national problem.
VA hospitals across the country are experiencing similar problems providing mental health treatment for veterans.
New mental health patients at about a third of VA hospitals wait longer than the department's goal of seeing patients in 14 days or less, a USA Today analysis found. The findings contrast with the VA's assertion that fewer than 5 percent of patients wait too long.
In a Veterans Health Administration survey of 272 VA mental health providers in August, nearly 40 percent said they can't schedule appointments within the VA's 14-day window.
Seventy percent of providers also said they didn't have adequate staff or space to meet veterans' mental health care needs, and 46 percent said lack of off-hour appointments prevents veterans from accessing care.
Veterans' Affairs Committee Chairwoman Patty Murray, D-Wash., who requested the survey, said demand for care will only increase as 33,000 troops return soon from Afghanistan.
Mary Schohn, director of mental health operations at the Veterans Affairs Department, said the VA has hired more mental health care professionals and expanded its use of technology to reach veterans in rural areas.
"I promise you we will continue to do more," she testified.
The committee's top Republican, Sen. Richard Burr of North Carolina, requested a detailed audit of how the VA is spending the $5.7 billion Congress provided for mental health services in fiscal 2011, a 25 percent increase over the previous year's budget.
Washington said she was hired as a PTSD specialist but, because of staffing issues, treats patients with any mental health condition, delaying PTSD assessments. Poor staffing makes it difficult for her to refer veterans for ongoing mental health services, she said.
She said veterans need quicker access to both mental and medical care. Many of her patients have extensive medical conditions as a result of their PTSD.
Asked how her managers have responded to her concerns, Washington said they tell her in some cases they're looking into the problem. "And in some cases, it's just flat-out denial that there is an issue," she said.
In written testimony, Washington said she feared retaliation from her bosses for participating in Wednesday's hearing. In an interview, she said she was proved correct when she received an "unsatisfactory" rating on her performance review shortly after being told the review would say "fully successful." She said the words "fully successful" had been crossed out.
Charles Quesenberry, Wilmington VA Medical Center spokesman, said he couldn't comment on a specific human resources issue. But he added, "The VA does not retaliate against its employees. It's just not done."


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