Senators slam VA on mental health appointments

Posted : Wednesday Nov 30, 2011 14:50:02 EST

Concerned with continuing problems faced by veterans in obtaining timely mental health care appointments, senators plan to ask the Veterans Affairs Department’s Inspector General to examine the issue and requested that VA conduct a complete audit of the $5.7 billion marked for mental health care in its fiscal 2011 budget.

Stymied by what Senate Veterans’ Affairs Committee Chairwoman Sen. Patty Murray, D-Wash., called a “disconnect between the provided data and the testimony” of VA officials at a hearing Wednesday, senators chided VA for providing vetted answers that centered on policy improvements and staffing but didn’t address the core problem — a recent survey showing that 70 percent of VA health care providers say they have inadequate staff to provide patient services, and that just half of veterans who seek VA mental health care complete their treatment.

Michelle Washington, coordinator of post-traumatic stress disorder services and evidence-based psychotherapy at the Wilmington, Del., VA Medical Center, who was speaking on behalf of a government employees union and not VA, expressed frustration that she could not treat some patients because the therapy they need requires weekly visits, and she’s not able to schedule them.
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“These treatments are highly effective if done within a limited scope of time, just 10 to 12 visits,” she said. “But if they can’t get an appointment for six weeks, there’s a chance the patient loses motivation. Or I’m told the patient can’t get weekly appointments, so I end up not actually prescribing the therapy.”

According to the survey of VA mental health practitioners, nearly a third of veterans seeking appointments wait longer than 14 days and in some cases more than two months for a first visit.

Washington noted that the first appointment often is just an administrative visit — and the follow-up that is usually the first therapeutic appointment is also difficult to get. “It can be another four to six weeks,” she said.

VA officials pointed to past successes, including increasing mental health staff by 47.8 percent, from 14,207 to more than 21,000; expanding tele-health services; offering smartphone applications for tracking and managing PTSD; and helping veterans transition to civilian life.

“We believe people are receiving an enormous amount of service from VA,” said Antonette Zeiss, chief consultant for the department’s office of mental health services.

Lawmakers disagreed. They were unhappy with VA’s response and said they planned to step up hearings and oversight.

“The way this works is you should be able to tell us this isn’t working … we’re having a horrible time trying to be helpful to you,” Sen. Jay Rockefeller, D-W.Va., said.

Sen. Richard Burr, R-N.C., demanded a full accounting for the $5.7 billion provided in the fiscal 2011 budget for mental health.

“In my first hearing on this committee [in 2005], the issue that was raised is, ‘Veterans can’t get appointments.’ It still doesn’t happen today. Don’t overthink this,” Burr told VA officials. “Civilian health facilities have figured it out. It’s not rocket science.”

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