IAVA Demands Accountability As VA Underreports Mental Health Care Delays
Posted by Moran Banai on April 25
On Monday, the Inspector General of the Department of Veterans Affairs released an alarming new report concluding that there were significant problems with VA mental health care access. The report, solicited at the request of Congress and the VA Secretary, found that wait times for veterans seeking mental health care were far longer than VA claims. It also raised serious questions about the reasons for the delayed care. After ten years of war, whose signature wounds are invisible injuries, namely Post-Traumatic Stress Disorder and Traumatic Brain Injury, it is absolutely unacceptable that our nation’s newest veterans are not receiving the mental health care they need in a timely fashion.
VA Failing to Meet Mandates
Bottom line: The IG report found that the VA is not meeting its own guidelines for veteran care. At each step in the process – initial evaluation, beginning of treatment, and ongoing care – the VA has 14-day requirements to ensure that veterans receive proper and timely care. While the VA claimed that in 2011 it met its own goals 95 percent of the time, the IG found that this was not the case. According to the Inspector General, only 49 percent of veterans received a full evaluation within 14 days of their first contact for mental health care. The other 51 percent had to wait an average of 50 days for their evaluations. It is important to note that this evaluation excludes those who are initially screened and flagged as needing immediate care.
The problems reached across the whole continuum of care and were sometimes hard for the IG to measure because of actions taken by VA employees. In some cases, the way the appointments were scheduled was misleading and made it appear as if veterans were getting care on time. In other cases, VA providers were scheduling appointments based on their availability rather than the needs of the patients.
Timely care is beyond critical for this generation of warriors. The IG report refers to studies that found that patient participation in mental health care drops the longer the wait between initial evaluation and first appointment for care. It suggested that in addition to the current measures being adhered to, there should be a broader range of measures to ensure that veterans receive care on time.
Reasons For Delayed Care
The report also raised questions about the reasons for delayed care. It highlighted the shortage of psychiatrists and mental health providers writ large in the system. In an informal survey of frontline providers, for example, the VA found that 71 percent did not think there were enough mental health providers in their facilities to meet demand. These results came despite the fact that the VA had already increased its mental health staff by 46 percent between 2005 and 2010 while treating 39 percent more patients. Part of the challenge is that there is a shortage of mental health providers nationwide—not exclusive to the VA. IAVA has long asked the president to issue a national call to service for mental health professionals, a critical step towards tackling this issue.
But the IG report also described the convoluted process through which productivity is measured at the VA and suggested alternative measures that would give decision makers much clearer understanding of staffing capabilities and needs. Right now, the metrics that decision makers need to make smart choices and provide the best care to vets are not readily available or easy to use.
Overall, the IG report paints a picture of a complex system that isn’t assessing its needs and capabilities adequately. Some parts work better than others, but overall, it is likely the system is not staffed correctly or sufficiently. The VA creates demands on its providers that are not met and may not be able to be met as currently staffed and managed. The IG made a series of recommendations in the report that were accepted by the VA, which described how it would implement the recommendations. Implementation of these recommendations would go a long way in ensuring that the VHA can provide veterans with the care they need. IAVA will continue to track on fallout from this report to ensure that the VA implements the appropriate changes in a timely and effective process.
If you are a veteran impacted by wait times or delays, contact our team and submit your story at mail[at]iava.org. If you require immediate assistance, contact the Veterans Crisis Line for free, confidential support 24/7 at 1-800-273-8255 (press 1 for Veterans). Chat online or send a text message to 838255.
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