The Department of Veterans Affairs (VA) is failing to provide veterans with adequate mental health care and leaving many without treatment for their serious mental illnesses for months, according to a review by the Atlanta Journal-Constitution. The waiting periods have been so long in some cases that patients with depression and Post-Traumatic Stress Disorder (PTSD) have committed suicide while waiting for an appointment.
The VA has been under no small amount of scrutiny in recent months. A federal report issued in March concluded that the agency’s attempt to care for the 44 percent of American service members returning from Iraq and Afghanistan with a physical or mental health problem “has been slow and has not matched the magnitude of this population’s requirements as many cope with a complex set of health, economic, and other challenges.” The department currently has over 900,000 unprocessed medical claims for veterans and their families.
Auditors cite a lack of adequate staffing and high patient loads as major obstacles to timely care. One way that VA offices have tried to deal with the overload is by contracting with local treatment facilities known as “community service boards,” or CSBs, that can provide veterans with outpatient counseling, treatment for substance abuse, crisis intervention, and other mental services.
But, because of under-staffing, the VA’s communications, referral, and payment systems to these contractors have been muddled and confusing. Many sick veterans are simply falling through the cracks and getting lost in the system. In effect, many patients have simply been taken off the VA’s waiting list just to be placed on a CSB one instead.
The consequences of that wait, which federal auditors pegged at around three months on average (and up to a full year) for veterans seeking mental care, range from the frustrating to the fatal. One Iraq war veteran suffering from PTSD cycled between the CSB he was referred to and the VA for over three months before finally giving up and relying on money from his mother to seek a private therapist.
The Journal-Constitution also found that at least two veterans referred to CSBs in Atlanta committed suicide without ever receiving the treatment they were supposed to get. Auditors who reviewed the Atlanta clinic’s referrals found that 20 percent of veterans referred to an outside clinic never got care from a CSB or received a followup from the VA.
Shortcomings in the veteran health care safety net will likely be exacerbated by the increasing number of veterans returning from the Iraq and Afghan wars. At least 15 percent of service members returning from those conflicts suffer from PTSD, and the group at large is struggling with sky-high rates of suicide and homelessness.
Some states have resorted to offering veterans free mental health care in an effort to bypass the claims processing that can hold up treatment for sick patients. Military leaders have warned that cuts included in the budget sequester could end up forcing massive layoffs to civilian Defense Department mental health care workers, who make up over half of the Pentagon’s mental service specialists.