On VA’s Mental Health Wait Times



When Brian Chevalier was killed in an explosion during a complex ambush, our platoon didn’t take it as an exception to otherwise professional soldiering, or as a mistake that could be corrected on the spot. Chevy’s death was a failure on our part, despite our training, our weapons, and our vigilance. It didn’t matter that the triggerman was hidden from view, or the massive bomb was concealed under concrete. We let him down, and he’s not here because we didn’t keep him safe.

Just like physical trauma, psychological trauma can occur in a matter of seconds, but the consequences are felt for a lifetime. We arm troops for conflict—we teach them to shoot, move as a team, and patch each other up—but there is no equivalent steeling once they become civilians. Part of that is the complex nature of mental health; you can protect flesh and organs with armor, but what can shield the mind from the horrors of war?


After more than a decade of conflict, the rising demand for mental health services—coupled with the tragedy of Veteran suicides—has shown we must do more. Just like our platoon couldn’t save Chevy, we fail when a Veteran turns to suicide instead of help, or leaves a VA facility because no appointments are available, or when the culture and language of the military creates a divide between clinicians and Veterans.

VA has taken steps to treat all aspects of the problem—from nightmares to short tempers to suicide—by increasing its mental health budget in the last three years by 39 percent. Additionally, the Department announced the hiring of an additional 1,900 mental health staffers across the country—an increase of nearly 10 percent. The boost will bring in what Vets need—over 1,600 nurses, psychiatrists, psychologists, social workers, licensed professional counselors, and marriage and family therapists, as well as 300 support staff to assist in the heavy lift. This is one boost in an ongoing assessment of all VA mental health operations that has been underway since 2011.

That would go far to ease what a recent VA Inspector General report identified as a major issue: Veterans are not being seen for mental health appointments as quickly as had been reported.

According to the investigation, the Veterans Health Administration met its goal of fully evaluating patients within 14 days only about 49 percent of the time. The remaining 51 percent waited an average of 50 days for full evaluations (though situations considered mental health emergencies are handled differently). For follow-up treatments, the report indicated an appointment is scheduled within 14 days about 88 percent of the time. When seconds and minutes count—as they do in combat—VA did not meet its own standard.

Many Veterans seek basic mental health care each day. That’s why the staff increase isn’t meant to simply prevent suicides before they happen. It’s about providing increased availability of appointments and resources. But more fundamentally, it helps VA build a community of care that includes trained mental health clinicians, peer support specialists, outreach workers, group support and more to promote the wellness of Veterans. It’s that kind of deep community involvement in mental health treatment—much like a military unit—that we hope improves lives.

When a Veteran calls and says he or she needs help, and we say the first available appointment is several weeks away, we have failed that Veteran by our own standard. It’s past time to say we will fix the problem, or that solutions are on the horizon. The best we can do now is to honor the living and the dead by being advocates and taking the failures we accumulate not as statistics, but scars. It should grind us up; eat at us and shock us. It should drive us. We must face the idea that thousands of returned Veterans need assistance every single day. Then we must look forward, anticipate their needs, and do better. Each of us owes that much to the Vet out there, in a dark place, looking to us to help heal the trauma inflicted on our behalf.

Chevy is not coming back. The failure to protect him haunts the men of second platoon, whose men can never say, “We’ll work to prevent this from happening in the future.” Like in war, future responses don’t make up for past failures. There are still men and women coming home healthy on the outside but eventually succumbing to mental wounds sustained in combat. Chevy’s death made us look sharper, shoot straighter, and move quicker. It’s our memory of failure that helped us protect each other’s life.

If you feel you need immediate help, call the Veterans Crisis Line at 1-800-273-8255. It’s open day and night, along with our online chat. If you prefer text messaging, send a message to 838255.

Author

Alex Horton

Comments

  1. Tom    

    I am a disabled PTSD vet in current treatment at the PCT at FT. mead, South Dakota. The wait time there is under 30 days and is first rate so when I hear all of these wait time stories, it is not like that all over. I think it is because those that have had good experiences with the VA never write so I am for those hundreds of thousands of vets that do receive good quality care. I for one do receive top notch care, Thank You VA

  2. Jason Kahl    

    60% of eligible Veterans in the United State either Pays someone else or goes WITHOUT rather than get Free or Reduced Government Run Health Care. If it becomes a Mandate in 2014 you can bet the other 14 MILLION veterans will sign up just NOT to pay the penalty. Last year VA spent 58.8 Billion on 8 Million Veterans; what will the tax bill be for 22 Million? What will the wait time be? How much MORE than 10% increases will be needed across the board…what will the wait time be if only a SMALL percentage of Veterans acttually started to USE SERVICES in 2014…I think you have TWO YEARS to increase EVERYTHING by at least 30-40% across the board…

  3. thanh lap cong ty    

    43 Vietnam veterans seeking psychological services at a VA medical center were assigned to positive and negative groups of posttraumatic stress disorder (PTSD) based on the DSM-III. The average S was a 33-yr-old White male with 13 yrs of education. Ss were extensively assessed to examine the relative contributions of premilitary adjustment, military adjustment, and extent of combat exposure to the development of combat-related, chronic PTSD. In addition, groups were compared on profiles from the MMPI and a psychological problem checklist. Results of multiple regression analyses demonstrated that combat exposure and, to a lesser degree, military adjustment were significantly related to PTSD symptomatology, whereas premilitary adjustment was not. Discriminant function analyses showed that the MMPI had moderate ability to correctly classify Ss on the basis of PTSD diagnosis. However, problem checklist items indicative of anxiety-based disorders, particularly generalized anxiety and pervasive disgust, formed a discriminant function that correctly classified more than 90% of Ss. Results are discussed in terms of complications for an empirically derived conceptualization of PTSD. (22 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)

  4. Rick Mowles    

    The problem is NOT be dealt with by the VA. Not only does it need to hire more mental health care providers but mental health care providers who are QUALIFIED to deal with the mental issues of combat veterans. A health care provider with a diploma doesn’t necessarily qualify that individual to interact with combat veterans. In a lot of cases, the experience can make a lot of combat veterans leave and not return for any type of treatment. In some cases, these professionals who aren’t trained can make the veteran’s combat stress worse. This is a very serious problem in the VA system that doesn’t seem to be addressed.

    1. mike    

      i agree , it is a problem. they need to be trained more about the effects the war can cause etc. not just learn what mental health care is. they need to know exactly what vets endured while serving there country combat and noncombat related. someone cant help someone if they dont know exactly what transpired during that war time. it truely makes things run alot better when they know what the vet has endure without having to explain every single thing in full drawn out details.

  5. JOHN HUME    

    FUCK THE V.A., ITS ALL A LIE I HATE THESE MOTHER FUCKERS!

  6. david waegele    

    I have been waiting to get mental health care for a long time, my last doc in Albq. NM treated me blindly but my new doc in white city OR has stopped my meds & said I have to wait till a psychologist is avail.

  7. Dan F    

    How and when you get treatment is specific to the VA hospital where you happen to land. I have been a patient at three VAMCs for treatment of PTSD. Without naming them, the first was a model of obtaining care. The first day I walked in, I saw a Psychologist within an hour and had an appointment with a counselor within a few days. After the first counselor appointment, I received a follow up phone call where I was told of the Vet Center program. The MH unit at this VAMC was professional and staffed. My care was well managed by a very competent Psychiatrist and Vet Center Counselor.

    Unfortunately, I moved and the second VAMC couldn’t have been worse. I walked in to MH after an urgent care visit and was told that I could see someone in 20 minutes. An hour later, the therapist walks into the waiting room and tells me, “You will have to wait, I broke my eyeglasses.” I asked him how long it would be and his remark was I don’t know, I don’t fix glasses. I then told this moron that I had been at the VA that day for since 8 AM (it was now noon). His comment was, “well you haven’t waited for me all that time.” At that point I lost it and gave him a few choice words of what I thought of his professionalism and his status at birth. Well because he was the only one there, they told me I would have to come back in 10 days for the first appointment they had open. When I returned, I talked to a social worker, who told me that she didn’t treat PTSD patients, but would talk to me so I could see a nurse practitioner to get my meds. I was then told that another nurse practitioner would be my assigned MH professional but, it would be 5 weeks before I would be able to see her. When I did see her, she told me, unless you are hospitalized, you will not see a psychiatrist…in fact (get this) the head of the psychiatry department wasn’t even a Board Certified Psychiatrist.

    The third VAMC (where I am now) has a better track record of being able to see a psychiatrist or other care giver (nurse practitioner, psychologist). But to be honest, VA psychiatrists seem focused on one thing, what kind of pill can I give you?

    I got off all the pills, don’t see a psychiatrist at all anymore and have kept in weekly contact with my first Vet Center counselor through a telephone call each week. The local Vet Center counselor is a nice guy, just that I think I am his therapist and he is as screwed up as me – well almost ..he’s 70% PTSD and I am 100%.

    The second VAMC had many openings for both MH and regular care physicians and nursing staff. How…

  8. charlie    

    Will any of these 1600 people be hired in to help out with the backlog of all these C/P claims for PTSD, so that vets dont have to wait 2-5years for any C/P claim is to be awarded? If we get counseling ect for PTSD, how are we suppose to support our self and families during this time of need, when vets are having to wait years before a C/P claim for PTSD is processed. The claim sits in stage one for way over a year. Im sure waiting years for C/P doesnt help someone recover very well from PTSD and the added stress waiting to hear anything. Not only do they need the medical help and support but they also need compensation to live and not have to wait years for it. I can only hope that some of these 1600 are included in the C/P part of it.

  9. Carl Wren    

    hiring new mental health personnel is a small part of the supposed “fix”. Will these new people have any idea of the complex relationship between PTSD and Parkinson’s, will they understand the severity of combat related issues? From what I have experienced and seen the answer is NO. How can they teach, counsel, etc coping skills when all they know about mental health issues is from a textbook…the war still rages in the hearts and minds of many vets and the mental health staff doesn’t have a clue of how to help….

    1. charlie    

      I totally agree with you. They also need to be able to understand the different levels of PTSD and to be able to know there is a difference in treatment for someone who has been suffering in silence for many years from the past wars , verses example the iraq and afgan war. Every situation has to be handled differently and the recovery will be different as well. To be able to understand all the wars , im sure for most they will have no clue.

      1. vets wife    

        Im not sure if this is the place to express my concerns about PTSD but hiring all these mental health staffers might be a good thing if they can truely understand PTSD from all wars. I could write a book about my husbands PTSD from the Vietnam War but i will try to make it short hoping that it might help in someway or somehow. He was Honorably discharged under medical psyche problems(personality disorder) Well let me say this in regards to that misdiagnosis, we went to a private MD doctor showed him my husbands medical discharge papers, saying Honorable Mental Problems but here is the key words (personality disorder), When i married my husband 20years ago, i knew nothing about his fire fights in vietnam but i did know one year into our marriage his mental state was not right. To make the story short as possible, when i asked him about his time in vietnam , he simply said if you seen what i did in vietnam, there is nothing in my life now that will ever be as traumatic as what i seen. Within 5mins. of our conversation he started getting very angry with just simple small talk about the war. He explanned about his best friend dieing in his arms, then he started banging his head against the wall, he screamed out , he said this is exactly why i dont want to talk about vietnam to anyone and stormed out of the house. That conversation was 19years ago and I learned from that day forward not to mention the war. In my mind for years , I knew he needed help , but the question was how,when,where do i turn. Now 20years later, with the help of this private MD which we pay for, he is helping my husband with counseling,meds, etc. His recovery has been very slow but im sure with him holding all this in for years and years not knowing he had PTSD, it will take along time before he will live a functional life as he so deserves. If the army would have diagnosed him properly, all these years of suffering in silence and affecting not only his life but family and friends as well, we would not have had to endure so much in our life time. I sure hope when these staffers are trained that they really understand what PTSD is when it comes to vets. Before we went to a private MD, the VA said my husband has PTSD but no stressors, imagine that and was Denied but amazingly the Private MD found so many stressors he wrote 2papers of them. We are currently still in the appeals process 1 1/2 years now it sits in stage one. How can you have a Honorable discharge and not get the benefits you so deserve. It doesnt not say a (general) honorable discharge anywhere on his seperation paperwork…

    2. vets wife    

      I agree with you Carl. It seems to us that unless you have lived through these wars, its hard and complex to understand unless you explain every single thing in complete detail and for alot of vets thats not always a easy thing to do. My husband is currently seeking help through a Pysche MD who has served time in the vietnam war. Its like he gets it before we even have to explain anything, which makes things run alot easier and smoothier for my husband.

  10. Shannon Smyth    

    Great article, Alex.

    We’re seeing a lot of the lack of mental health care by VA out here in Oregon. Our VISN seems to be deaf to the needs of veterans with mental health issues. Keep up the good fight at the VA and being a great representatives of veterans in our government.

    Shannon

  11. Barbara Hunt    

    When all else fails, there are Military and Family Life Consultants on almost every
    U.S. and European post and base. Seeing one will not go on your record. Also,
    don’t forget to call Military One Source, or Give An Hour, or use, if you have them,
    your Tricare benefits.

  12. Jim Starowicz    

    It all comes down to this, same as the preceding decades since Korea:

    No Revenues = No Sacrifice = No Support = DeJa-Vu all over again!. Now a decade and counting, told to go shopping, added to the previous decades of under funding the VA, while the peoples reps Still try and lay blame on the Agency, after rubber stamping wars and costs of and those represented cheer on these wars!

    While the wealthy and other investors garner their booty, still, from both and many have the chutz·pa to call themselves more patriotic{?} then others wrapped in those false flags, using false slogans and various cheap symbols of and then seek one day events or parades to wave all that patriotism, call it “Supporting the Troops”, then go home and either ignore or forget about those that actually sacrificed for the country!

    USN ’67-’71 All Shore GMG3 Vietnam In Country ’70-’71

  13. Tim    

    I wonder how many of the 1900 new mental health professionals will be veterans.

    1. Norm    

      I am a clinical social worker for the VA and out of staff of about 70 I am the only combat veteran. 1900 new clinical staff throughout the country adds to approximately 1 person per discipline per VA facility. Semper Fi. Norm.

  14. John Mooney    

    Will the hiring of 1,900 new VA staffers for Mental Health include Clinical Chaplains?

    1. Jim Starowicz    

      None mentioned, and frankly while chaplains can be easy to talk to it comes to similar to a Catholic priest giving marriage counseling to married couples. But this was released yesterday:
      VA Adding Family Therapists and Mental Health Counselors to Workforce
      Follows Announcement of Additional 1900 Mental Health Staff Nationwide
      http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2303

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