Thursday, May 10, 2012

VCS Commentary: VA Not Meeting Vets Mental Health Needs

This article originally appeared on the Veterans for Common Sense website on 8 May 2012.

From VCS Advocate and Purple Heart Iraq Veteran Christopher Miller

The majority of VA frontline service providers work hard every day to give veterans the care they have earned and need. Yet the VA admittedly continues to have problems providing care up to their own standards, especially when it comes to mental health care. This is a serious problem at a time when an American veteran takes their life every 80 minutes, usually more deaths per month than in combat in Afghanistan. Veterans for Common Sense continue to push for action on the issue.

In a report issued last month by the VA’s Office of Inspector General and in Congressional testimony, the VA admitted it is not properly meeting the mental health needs of veterans. When a veteran contacts the VA with a possible mental health issue they are required to be seen by a mental health care provider within 24 hours with a follow-up scheduled within 14 days. VA data reported it met that requirement in 95% of cases. However, the VA IG report found this was based on false data and estimated the actual rate at around 51%. Some veterans had to wait as long as 50 days to be seen. Those responsible for collecting the data recorded and reported false dates and wait periods.

Why was false data reported? In testimony before Congress, OIF Veteran and former-VA Mental Health Administration Officer Nick Tolentino offered from his experience that the VA mental health system, as hard as care providers work, is flawed because it is more focused on meeting data targets than it is on helping veterans. VA schedulers were not recording accurate data because administrators feared accurate reporting would show the requirements for timely access to mental health care were not being met. This has gone on for years. Had the data been accurately recorded, the depth of the problem could have been reported earlier. Tolentino’s statement also included stories of care providers being forced to find ways to meet numerical goals to the detriment of patient health.

The problem is deep and stems from staffing shortages and budgetary problems. The VA has had a shortage of mental health clinicians for several years now. In 2011, they had 1,500 open positions. In 2012 the VA increased the number of wanted hires to 1,900 mental health workers and support staff. Mental health staffing shortages stem from the fact that most of these open positions are described as ‘not to exceed one year’ or two years. Most professionals will not leave a current fulltime, unlimited position to come work for the VA in a job they may only have for a couple years, thus the continuing shortages.

So who is to blame for the mess? It would seem some of the blame lay with VA administrators focused on meeting numerical targets than providing accurate data that may improve care. If accurate data had been reported, perhaps the problem could have been addressed by now. But Congress also shares in the blame. The VA does not make its own budget and Congress must give the VA the funding it needs to ensure veteran’s health care needs can be met in the long term. Truly addressing the issue will require administrators focusing on veterans more and numbers less and Congress giving the VA the budget it needs to do its job.