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'Something is clearly missing' in VA mental health care

Eighty percent of veterans who attempted suicide and survived had received mental health care one month earlier from the Department of Veterans Affairs, underscoring the potential peril of 50-day average wait times they face in trying to access VA treatment, a suicide expert told a Congressional committee Wednesday.


“When they had contact a month prior, the question I ask is: How long was it until their next (VA) appointment? Was it scheduled six weeks out? Is that the problem? Or was it scheduled one week out?” David Rudd, head of the National Center for Veteran Studies, testified before the House Committee on Veterans’ Affairs.

“My concern is — from the individuals I talk with that we treat to surviving family members of those who have died — often times, it’s an issue of the (VA) system getting in the way to keep an appointment, to get an appointment, or to get to an appointment,” Rudd said. 


According to a VA report released earlier this month, 18 to 22 veterans commit suicide each day. And that rate “has remained steady” since the Iraq and Afghanistan wars began 12 years ago, said Veterans' Committee chairman Rep. Jeff Miller, R-Fla., who noted that during that same span the VA has increased its budget by 39 percent and its staffing by 41 percent.

“When a veteran is in need of care, the difference of a day or a week or a month can be the difference between life and death,” Miller said. “ ... Something somewhere is clearly missing.”

In his State of the Union address Tuesday night, President Barack Obama announced that 34,000 U.S. troops would head home from Afghanistan during the next year.

Given that mammoth flow of young veterans into an already-backlogged VA system, Miller questioned whether the agency’s “one-size-fits all approach” will leave thousands of ex-service members mired in a bureaucracy that “fails to recognize that addressing mental-health needs ... is a task that the VA cannot handle by themselves.”

“We’ve improved our services for veterans but we know there’s a lot more work to be done,” testified Dr. Robert A. Petzel, the VA’s undersecretary for health.

In 2012, for example, the VA’s 24-hour crisis line fielded 193,000 phone calls that resulted in more than 6,400 “rescues” of veterans who were threatening to hurt themselves or their family members, Petzel said.

While the volume of calls to the hotline is increasing, fewer of those calls are “acute” — or people making an imminent threat — “demonstrating that VA’s early intervention appears to be working,” Petzel added.

What’s more, in the past year, VA has hired 1,058 new mental-health providers and the agency expects to meet its hiring goal of 1,600 extra clinicians by June, Petzel testified, adding that last year 1.3 million veterans received mental-health care from the VA, up from 927,000 in 2006. That increase, he contends, shows that “proactive screening” is working to find and treat veterans for Post Traumatic Stress Disorder, depression, substance abuse issues, and the effects of military sexual trauma.

“Your focus is on the process, the number of people hired. Numbers, numbers, numbers,” Miller responded. “The most important number is the number of veterans getting healthy, healthier or helped.”

“It’s time for us not to do the same thing,” Rudd agreed. “More of the same thing isn’t working ... The way we’ve (tried to address these problems) over the years since the start of these wars is we’ve made the VA larger. I think the evidence would suggest the VA does not need to be larger. I was not encouraged when I heard they’re hiring over 1,000 individuals.”

Instead, Rudd testified, VA should partner with the Department of Defense’s health system TRICARE “because their providers are already in those small communities and available."

“That means shifting money to a non-traditional model,” he added. “But that’s how you connect people to people” instead of linking individual veterans into a vast system.

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