VA mental health care found superior to care in the private sector

“In every case, VA performance was superior…”


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Psychiatric Services, a peer-reviewed journal of the American Psychiatric Association, has published a report showing that the quality of mental health care provided by VA is superior to that provided to a comparable population in the private sector.

According to the study, “In every case, VA performance was superior to that of the private sector by more than 30%. Compared with individuals in private plans, Veterans with schizophrenia or major depression were more than twice as likely to receive appropriate initial medication treatment, and Veterans with depression were more than twice as likely to receive appropriate long-term treatment.”

“The results of this study underscore how VA is providing the best mental care possible for the Veterans we serve,” said Dr. David Shulkin, VA’s Under Secretary for Health.  “It also provides another example of how VA health care is consistently rated higher than health care in the private sector in a number of health care areas.”

These findings were based on review of more than 836,500 Veterans and more than 545,400 patients seeking mental health care in the private sector. The authors computed VA and private sector measures related to medication evaluation and management.

They also estimated national-level performance by age and gender.  Patients in the study suffered from one or more serious mental health diagnoses including schizophrenia, bipolar disorder, posttraumatic stress disorder, major depression, and substance use disorder.

VA Performance has Important Implications

The authors conclude that “Findings demonstrate the significant advantages that accrue from an organized, nationwide system of care. The much higher performance of the VA has important clinical and policy implications.”

“The Quality of Medication Treatment for Mental Disorders in the Department of Veterans Affairs and in Private-Sector Plans” was funded by the VA with additional funding by the Agency for Healthcare Research and Quality and by RAND Health.

The study was conducted by experts with the RAND Corporation, IMPAQ International, the Institute for Health, Health Care Policy and Aging Research, Rutgers University, and the School of Social Work, Rutgers University.


Maureen McCarthyAbout the Author: Dr. Maureen McCarthy is the Assistant Deputy Under Secretary for Health for Patient Care Services

Author

VAntagePoint Contributor

— VAntage Point Contributors provide insight and perspective on a wide range of Veterans issues. If you’d like to contribute a story to VAntage Point, learn how you can submit a guest blog at http://www.blogs.va.gov/VAntage/how-to-submit-a-guest-post/

Comments

  1. Salvatore Franzi    

    I am under mental health care at Lake Nona and it is superb it has helped me a lot

    1. John perry    

      I’m 100% service-connected PTSD, and I don’t even have a psychiatrist at the VA.

    2. Bruce rigolizzo    

      Sal you and I know this BS. Just more Va propaganda.

    3. kim h lindley    

      I had been taking temazapam 30mg for many years for insomnia. The corpus christi va just decided one day I didn’t need them anymore and cut off my prescription instantly.. no weaning down just cut them off. I was married working going to college, doing good on the temazapam and since they just flat out cut me off I’m now divorced kicked out off school can’t sleep for days can’t work mhmr won’t help they said “no health care professionals would do that.. cut me off cold turkey” I’m skating thru life still trying but to read this article about va pysch care being so good it makes me sick to my stomach. I’m not exaggerating a damn thing I’m barely scratching the surface here my life is a living hell but I’m gonna keep living just quit the bs about the va care ok? They cut off all benzoids for vets here I know two that have committed suicide already over this…

    4. Chris Reder    

      All you have to do is look at the 22 vets a day committing suicide, the forwarded calls to voicemail on the hotline, the bonuses the execs get for horrible service and overall how the whole department is run to realize that this is not the case!!!

  2. Robert Arnold    

    My experience with mental health at Battle Creek VAMC was anything but helpful, councounselors just blew me off when I asked for help dealing with my wife’s alzheimer’s. The psychologist I was assigned cancelled three times, twice after I had driven an hour and was literally in sight of the fort. My opinion is biggest waste of money at Fort Custer, mi! Bob Arnold

  3. Presley Robertson    

    BS the Arkansas N.L.R V.A. is the worst place. Husband has been fighting depression for 2 years & they have NOT helped if anything he is getting worst

    1. Alix    

      I do to
      NP help
      Colorado is the worst

    2. Paul Coleman    

      I have experience the same issues with NLR VAMHC.

    3. Steve Dunn    

      The government conspiracy and lies continue I see. The VA has a “I can see you when I can” rather than “I can see you when you need help” kind of system in my area. I have medicare and tfl where others don’t, so I’m extremely fortunate to have access to great care from local civilian specialist who are injured Vietnam veterans who specialized in trauma. I found the VA a joke at best. I’m talking about my area, so if you’re getting great service that’s wonderful!!!!

      1. Robin Mitchell    

        Steve Dunn, same here. My husband is 100% service connected for TBI..not PTSD because he is former career Special Operations and he will not tell him his stressors as they are still CLASSIFIED and the VA ignores SOCOM’s SOF confirmation under Fast Letter 09-52.
        When he qualified for Medicare and Tricare For Life I found him great outside doctors. He gets vision therapy, can see a doctor the same day, and appropriate care in the private sector.He is the veterans Rep Lee Zeldin asked Dr. David Shulkin about at a hearing on 4/19 as to why the VA is denying him aid and attendance even though 8 doctors are on the record as saying he needs it. Four separate 21-2680’s filed out.
        Every veteran deserves the care the rest of America gets. Especially the VA workers that have federal Cadillac insurance.

  4. Michael Osgood    

    The VA needs quality trained counselors and therapist, who can understand PTSD, Depression and Veterans Mental Health Care Needs. Going to the VA for this Medical Condition has left many Veterans filled with Anxiety, because the present care providers do not really understand what the Veterans have seen and experienced. In talking with the providers that are 20 and 30 somethings, with no military experiences of their own, Veterans are finding these therapist as only trying to be a “Friend”! This has left many Veterans with the same issues and conditions that they went to the VA for help with.

    1. DWIGHT KINKEAD    

      I agree with Osgood I go to mountain Hom e and can,t get nothing but n.p. that don,t know what war is need to let them watch HOME OF THE BRAVE staring Jackson ,real and maby they and their boss will understand just maby some of what to look for most ETSU students and won,t retire ,I know more about my counsler and her 2 kids age 27 girl & boy 31 still at home , WHO NEEDS HELP THE MOST CAN SHE HELP WHICH ONE.

    2. Anna Proper    

      The VA needs male counsellors for the men. Do you really think a man soldier is going to tell a female counsellor, that he raped his fellow female soldier and abandoned any children they produced while at war… Many of the vets that get the disability quit even going to treatment because the VA mental health is more about keeping the war vets mouth shut because the military really does not want to be held responsible for the fact that the military just doesn’t teach these men to kill, but to rape and torture, than they release these men into the general public and it is women and children that have pay the price for these war vets anti-social dehumanized behavior… That is why wars vets commit sucide… The war vet goes for help and experiences musical chairs with counsellors with no PTSD experience and lots of drugs… The military releases the monster than has no methods of getting rid of the monster that lives inside them… They can’t live with the monster…

  5. Patrick jahnke    

    Will my case va doctor are moving nonstop, u see one , I was told I was unable she her no more because I can not control nerve pain on burn area after va gave me drug to resparked the nerves in that area, pin and needles, burn feeling!!!! Don’t give me the bs va are better, a veteran can not get proper care if the doc refused or he she moves get a new primary doctor start all over, know wait cc her in Aug ghost doc until Aug. Part time green doctor in va system, and thier big brother watch over sorry we can give uuu antidepressants drugs, put no narcotics drugs but laws change u just cc doc monthly to refill it under the new laws…. So I’m back in the basement with va heath care, hug a tree, put bag frooze peas on pins needle. So who ever type this up needs check here facts out, !!!!!!!

    1. Ann Larson    

      I agree that VA care sucks! It is better than none most times but sometimes it is worse! The last visit to VA Nashville was horrifying for me! My husband was scheduled to see a psychologist which he did. God only knows what he told the psychologist! I am sure he did not tell him we lived separately because I woke up three times with him trying to choke me to death while he was having a flashback as he slept! Guess what? I never told that to the psychologist either! My husband tells me he is angry 90% of the time and it takes all he has to hold it in! What kind of a psychologist tells the spouse/significant other of a person with PTSD to describe that persons symptoms and behaviors in front of the patient? I can only believe this so called psychologist got his degree from a Cracker Jack box because the psychologist said that if I had anything to say I MUST say it in front of my husband! Hell no! I prefer living!

  6. Simon Ortiz    

    Thanks for the awesome help at the Dallas VA Mental Health. I am still going!!

  7. Philip Lockit    

    Hello: I have been diagnosed with PTSD since returning from Vietnam 1968 to 1969 I was a Combat Medic with C Company 1st Calvary Division (Air Mobile).

    I was returned to the United States on a litter. I was wounded with 6.5 lbs of Shrapnel and a blood loss of over 2.5 pints. It was noted by my Vocational Rehabilitation Counselor.

    That I exhibited lots of anger and would sometimes by Depression. He had me see the Head of The Mental Health Department. I had been diagnosed with PTSD in 1969 after I had retraining to go back to school.

    I was told I would be discharged from active duty in 1970 with a 2% Disability Rating. I was an E4 at that time. During that time from 1968 to 1970 little was known about PTSD. I was able to reenlist and went about my duties.

    As the years rolled by my PTSD seemed to get worse as well as my anger issues. And the pain I have had to endure.

    I have been through a pain management program about 6 years ago at James A. Haley VA Medical. The program is designed to help veterans get off of Narcotic medication. It was 15 years that I was on Narcotic meds and on active duty with Narcotic meds I was unable to function in my job description. 91B10 after many years and finally a promotion to E6 I had met the qualifications to be promoted. I was one day away from being dischared from not being able to get a promotion. I had a P3 Physical limitations Profile and was not able to function due to my heavy medications that I had to relieve my pain. It still goes on today. I have Type II Diabetes and Neuropathy . Which I still suffer from and it is getting worse. It took me 18 years to get 100% Disability from my injuries. I can say more but it is quite a long story. I found my local VA to be very helpful any was able to see a Mental Health Counselor every 1. Now I can be seen every 2.5 months. I am retired in Colorado Springs, Colorado and am seen at the VA Centennial Clinic which was rated the worsed clinic for appointments.

  8. HERE    

    Sad, Facts aren’t TRUE FOR MOST Veterans !!! Only seen Once Every 2 months for an 30 minute session ,HOWs that HELP ANYONE, But the VA Dr. get Paid ?? NOT, VETERAN GETTING ANY HELP ?? While you go to a local V.A. Center & By; the Time you Sit Down & Say Anything Your 30/ 20/ 15 minutes is OVER & WAIT ANOTHER 2 -MONTHS ??? ( WHATs WRONG with THIS PICTURE ??? NOONE GETS HELPED THERE , UNLESS YOUR AN OFFICIER !! Then They Salute You TOO… SAD ,BUT TO TRUE in MOST V.A. Operated Clincs they call Mental Health ,But ONLY THE Dr.s ARE GETTIN FAT Off The GREAT PAY & NO WORK !! Whom wants to Travel Hours Every 2 months for a less than 30 minute session ?? Maybe ,THEY NEED “MORE-TIME” & HELP Not Just WORDS & HOPING That Things will workout !! I’ve seen Many Dr. s on Powertrips of Control Over How Patients are Treated ..That’s a Pshyc Dr.s ,Patients WORST NIGHTMARE ,They ENJOY MAKING YOU “SUFFER -MORE” Than you have to Go AWAY FOR 2 MONTHS Till you Return, if you Bother Too….Its just NOT WORTH IT .

  9. michael allen    

    Are you kidding me? The VA studied itself and decided it was better? 22 Veterans a day commit suicide rather than go to the VA and the VA says that they provide the best mental health care.

    1. Ann Larson    

      Exactly the kind of mental health treatment the VA offered my husband! Absolutely none that would help!

  10. Still Waiting    

    Just because the VA hands out more medications than civilian behavioral health providers does not mean the outcomes are better. So the VA has high measures of medication management. It is most definitely not great at improving a veterans mental health. From the comments, it seems there are pockets of excellence and some vets are getting care they feel is helpful and appropriate. However, my experience has been far less than helpful. Handing me a prescription without appropriate indicators or follow up is not helpful. Counting active antidepressant prescriptions within the VA system does not measure appropriate care or good outcomes. Other comments, and valid objective studies, seem to indicate there are more pockets of failure than pockets of excellence. The measures in this study are not appropriate measures to say the VA provides “superior” mental health care than the private sector. Handing out pills is not quality. Quality and quantity are not interchangeable measures. Ridiculous…..

  11. Chuck hayes    

    This is pure B.S.!!! If V.A. Psych care is so great, why are so many vets committing suicide??? The suicide rate among service people is far greater than in the civilian world! Is it any wonder why so few vets no longer trust the V.A.? Quit lying, and do your jobs!!! (And by the way, I believe, along with many other vets, that V.A. Counsellors should come from a military background.) No offense to civilian counsellors, but combat vets with PTSD should at least be afforded counsellors who have something in common!

    1. Megan Moloney    

      While any suicide is one too many, research does show that for those receiving care from VA, the suicide rate is lower than for those who are not. You can read more about that here: http://www.blogs.va.gov/VAntage/20612/study-shows-risk-for-suicide-lower-among-men-and-women-veterans-who-use-va-care/. Here’s the full study: http://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201400031

      And, as you suggest, many of the counselors at VA’s Vet Centers are combat Veterans themselves. You can find out more about Vet Centers here: http://www.vetcenter.va.gov/index.asp.

      1. Anna Proper    

        Really Megan Moloney. You use more biased VA research to make your point. Do you work for the VA?

  12. Alix    

    Colorado is the worst in the nation

  13. Thomas Painter    

    I went to VA mental health to learn to deal with stress. I was told by several counsellors that they wouldn’t d treat me unless I was taking tranquilizers. I would not have been able to do my job at ATT on tranquilizers, nor would I pass random drug testing. I was left to just deal with it.

  14. S. Withrow    

    Wow, wow. I cannot believe this at all. Talk about biased. I’m a disabled veteran and VA retired. It wasn’t long ago when the mental health services at the VAMC Huntington WV claimed that they can cure PTSD! Yes, cure! Of course management at the VARO in Huntington had some issues with that and I guess it made a detour. I will say that I’ve seen several files including my own that a mental health professional says quite often there “patient over exaggerates symptoms” and she doesn’t provide very much after that… GAF scores and etc. That is her nice way of stating malingering. I was told by the chief at that time of the service that she didn’t know how I could have PTSD because she once worked in an ambulance as part of her training. She told me that she was just fine. How I as a combat medic could suffer from PTSD was beyond her! That has been quite a number of years ago and I am satisfied and haven’t missed seeing my outside mental health care provider. So VA, you need to do more serious research and interviews before you go tooting your own horn!

  15. Chad Weatherford    

    Thank you!! I needed a good laugh!

  16. Gary Johnson    

    I hear people talking about being diagnosed with PTSD in the late 60’s. This is absolute Bull____. I worked at Atascadero State Hospital from July 1979 to Dec 1985. We had a patient on our ward the had returned from Nam and had terrible problems from his yet to be diagnosed PTSD. We had a Psychologist Intern on our ward studing combat stressors in the early Eighties. Finally, he was diagnosed with PTSD, the first diagnosis of this kind I ever heard of. I myself wasn’t diagnosed until about 1997, thirty years after coming home from Vietnam. I was a Psychiatric Technician and later became a Certified Reality Therapist. A friend of mine was in Operation Phoenix and wasn’t diagnosed until 1996 and was denied at first. Upon a records check by the VA, he was awarded 100% disability, no further hearing were required. It,took me 3 (THREE) years fighting to get mine disability. I am 70% PTSD and recently was reevaluated recently to 100% after an incompetent Primary Care Physician ignored a report from Nuclear Medicine that I had a Massive infection in my right foot. She completely ignored the report and ignored emails from my Podiatrist to have me placed in the Hospital. Well, when I finally arrived at the Hospital, I had a Systemic Spetic infection and was told by the Doctor’s that had I been two days later, they doubted I would have survived thst infection. OK, they amputated my right foot immediately and I received 5 (five) liters of antibiotics a day from about 3 weeks. When you added up all my percentages, they add up to 300%. Unfortunately, the VA has these incompetent Doctor’s and they are protected by the VA.

  17. David Todeschini    

    Suicide is a big problem with veterans, and there seems to be nothing that works despite really valiant efforts by the VA. Perhaps the solution is for the US to get out of all this middle east.

    Editor’s note: Portions of this comment were edited per VA’s social media policy.

  18. Scott Smallwood    

    The V.A. mental health care is the worse I’ve ever seen. They don’t hire good psychiatrist & try to cover up their poor care by medicating us patients too heavily. If their is so good why are so many veterans killing themselves. The V.A.’s doctors work for the V.A,. not for the VFW’s , it’s pathetic.

  19. Michael D Turner    

    I can say that it has been better for me than the several attempts I did outside the VA before I knew I was eligible for care. It is not perfect because the lack of personnel able to care for us, but I will also say that those I have seen and know are doing the best they can. I learned that some of my treatment results are because I bought into self-management that I was taught here at my VA. I have tried and sometimes I forget to do all the things I am suppose to do to remain healthy. I do feel that I do suffer from some things that I have experienced in life and the military, but I am dealing with them in a more healthy way now. There is no magic cure for Mental Health or Illness, so it takes many different steps like medicine, self-management, and advocating for oneself in a correct manner. I support my fellow Veterans as much as I can, I advocate for Veterans Mental Health programs not staff also I try to educate all about Veterans Mental Health programs or issues. I do the best I can each day, I reach out when I find myself slipping or slipped, also I have others who keep me grounded. The VA is not perfect and I hate to hear that my fellow Veterans need better service, help or care; I want us all be in the best place we can but also realize life deals us many different hands throughout our life.

  20. NAM VET    

    One of the biggest lines of B/S I’ve heard since the beginning of my PTSD. The non-VA theropist I see does me more good than the professional shrink I see at the VA. All I get from the professional is more drugs.

  21. Paul Coleman    

    Only a screwed up, dysfunctional agency like the VA would try to convince Us of how great they are.

    If the VA was great We would already know this so they would need to lie to Veterans.

  22. james yancey    

    My location practice reverse discrimination.PTSD inpatient program VAMC Dublin, Ga
    .

  23. lee    

    I have had excellent care from the VA Loma Linda facility. They saved my life. Thanks Dr, White.
    My only real beef is that I didn’t even know I was eligible for care until I really needed it. Must have missed it at separation.

  24. Kevin Fisher    

    I have received the best treatment and customer care at our Colorado Springs VA
    Thank you for helping our veterans in need

    Kevin Fisher

  25. Anna Proper    

    Here is another lie of the VA. Family support for families living with a war vet with PTSD.. Many of the war vets that get their disability abandon their families. The VA does absolutely nothing for helping wives of vets and their children when the vets use their PTSD as an excuse to bale on their families… In a divorce court the vets disability is not income, so a wife is left high and dry and will not get any financial support for child support with a vet who is 100% disabled. A wife who invested years of her life caring for a disabled vet gets nothing in a divorce situation. It is not just the vets and the disabled vets that are being victimized here…

  26. Combat Vetern    

    You (the VA) must be kidding.
    The VA judges itself and then pats itself on the back (A pat on the back is EXACTLY one Foot from a kick in the ASS).
    I’ve been fighting the VA for benefits for which I qualify for more than 6 years. It sure seems to me that the VA is just waiting for me to die so they don’t have to award me my EARNED benefits. Further, the “mental health” part of the VA is probably the worst section of the VA. The benefits section runs a close race to being the worst. When I have a problem and try to get the VA to do something (anything), it takes forever if it ever does get done. However, the VA tells me I have a deadline to do things and it constantly tells me if the deadline passes, it will deny my claim. As for the VA’s claim that it is superior to outside the VA health care facilities, I do not know one VET that is happy with its service. The only reason the VETs I know go to the VA is because they are so broke, they can’t afford decent health care. The “Choice” program sound like a good idea. However, the VA has managed to make it near impossible to use it.

    The VA has lied to me, mis-diagnosed my health problems, mis-quoted me, doubted me, made entries in my health file that were untrue, disrespected me, etc. I could go on about this, but why bother? The VA has not read or ignored most of my documentation I have submitted to support my claim.

    I am a combat veteran. I volunteered to risk my life to fight for my country ( I flew more than a 100 combat missions). I submitted my official USAF military documents to support my claim. One of the reasons the VA denied my claim was it doubted if I was in combat. Most of the other reasons the VA used to deny my claim was just as bad.

    If any VET reads this and has experienced the same kind of treatment from the VA, please send your story to the VA.
    I have found the enemy and it is the VA !!!

    When I volunteered to fight for my country, I didn’t know that I would be fighting my country for VA benefits I earned.

  27. L B Greer    

    My husband died in W. Germany from depression (his family caused horrible crisis) almost 30 years ago, and I never remarried. I raised our 2 small daughters alone. All our lives were changed for the worse because my E-6 husband wasn’t seen by a psychiatrist, but a junior enlisted person. He felt bad enough without being shuffled off to somebody who couldn’t prescribe anti-depressants.

    In 2003 my oldest daughter at age 20 and 8 months pregnant was murdered (the grand daughter died as well). My remaining daughter is estranged, and I thankfully have a phone number–no physical address nor her married name. She gave up parental rights for my only grandson years ago.

    I often wonder how much better and richer our lives would have been had he lived. My family has been torn apart because my husband didn’t get to a psychiatrist in time.

    1. Anna    

      You have my heartfelt sympathy L B Greer. Your experience is one of many wives and children who have been victimized by the military. You do realized you have PTSD and your children have PTSD from your experience. It is called secondary PTSD and the VA should be helping you!! You know in the civilian mental health industry, all therapist have to have liability insurance, in case they get sued for negligence, or wrongful cause of death. Where are the laws to hold the government and the VA system accountable??

  28. john e, duncan    

    I am a vet I was hit from behind by a marine with a cast on his arm an for years I have tried to get help I had a good jobs in my fell now I have to take what I can fine .my case was cover up because of what happen /it was about race an when I try to tell about it I get cut off or when I say I hate people of the white race but put up with some things an how I have nightmares /an headack no one don’t won’t to here yes (3)white marines did it an no one won’t to no (why)

  29. WE7B    

    My husband is 83 yrs. old and is now in an assisted living facility. There is no planned activity, they have a sitting area where all the patients go for the day to sit until lunch then back to sit until dinner and then until bedtime. My husband was stationed in England during the Korean war – he was an air traffic controller. Would he be eligible for any type of assistance and if so, how do I go about signing him up to participate in this program? Thank you
    Bradine L Tyner for Wade Hampton Tyner, Jr.

  30. David Robb    

    I can’t see my doc because she refuses to see me after 11 am and I refuse to get up extra early to drive an hour to she her in her new multi million dollar palace that remains mostly empty of vets but with great facilities (fancy restaurant, gym and stuff) for the staff but no vets.

    I though that they were the service providers and the vets were the customers. I guess that’s only for the media reports. They have no interest in accommodating me I have to jump through their hoops. After working night watch most of my life I no longer jump out of bed to fit into their schedule. At my age there is no point in getting mad but maybe I could get even. Not really, I wrote Congressman Mica for help a couple of years ago for some help, I am sure I will hear from him soon.

    David Robb

  31. R Skerrett    

    VA hospital r full of BS from day one that I went to them for help about my headache back problems depretion my mind FWM wanted to take my life I was told to return back in a month so you can tell them u problems and to see what medication u will need is nothing but FOS because they change u Dr every 2-3 months so you can start all over again and no medication to help u with want ever problem u been having. Shame on them for not helping us

  32. R Skerrett    

    Veteran not happy with they Svc and is a shame because I did serve with pride so they can do what ever they feel like to do with us

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