VA to increase mental health staff

The Department of Veterans Affairs announced April 19 that it plans to hire 1,900 new mental health positions. In its press release, VA said it would add about 1,600 mental health clinicians – to include nurses, psychiatrists, psychologists, and social workers – as well as nearly 300 support staff to its current work force of 20,590 mental-health staff, as “part of an ongoing review of mental health operations.”

“By authorizing nearly 2,000 more staff to help with their mental health services and treatment, VA is demonstrating its commitment to provide timely and high-quality health care to our nation’s veterans,” said Fang A. Wong, national commander of The American Legion.

Verna Jones, director of the Legion’s Veterans Affairs & Rehabilitation Division, said the announcement of the new positions “goes a long way in reassuring our veterans and the public that VA stands behind its commitment to provide the best care for those who have served in uniform. We urge VA to fill these new positions quickly.”

The staffing increase comes at a time when the Legion and Congress have shown concern over VA’s capabilities for mental health care. Last year, Sen. Patty Murray, D-Wash., chair of the Senate Committee on Veterans’ Affairs, directed VA to conduct a survey of its mental health professionals. VA developed a web-based survey that was sent to 319 mental-health providers in August 2011; it received 272 responses.

Seventy percent of the respondents believed their VA facilities lacked adequate mental health staff; the same percentage also felt their facilities needed more space for mental health services. Fifty percent of the respondents felt the growth in patient numbers contributed to mental health staffing shortages.

After the survey findings were released, VA’s national mental health staff investigated the areas of concern, visiting VA facilities to assess staffing and spacing needs, as well as waiting times for patients. They also looked at other specifics, including review of scheduling practices, development of improved performance measures and staffing guidelines, development of expanded policies for off-hour care delivery, and balancing the demand for compensation and pension exams with clinical services.

While VA’s mental health staff has increased from 13,566 in fiscal 2005 to 20,251 in fiscal 2011, the number of veterans being treated for post-traumatic stress disorder (PTSD) has increased dramatically. Last year, VA treated 438,091 veterans for PTSD, and mental health disorders remain the second-leading diagnosis among returning servicemembers.

“We have heard from many veterans that they receive their initial mental health appointments at VA facilities within the 14-day requirement,” said Jacob Gadd, VA&R deputy director of health care. “But for cognitive processing therapy and prolonged exposure therapy treatment – these treatments generally take several appointments – this is where enough appointments may not be available because of understaffing, or a greater influx of mental health patients.”

In an August 2011 study, VA found that most veterans with new diagnoses of PTSD did not receive adequate specialty treatment (defined as nine or more clinic visits in one year). The study recommended future research on why veterans are not receiving enough treatment.

The American Legion established an ad hoc committee in 2010 to study the science, treatment and best practices for PTSD and traumatic brain injury (TBI). The committee’s final report, to be released in May, will include recommendations to Congress, DoD and VA on the best ways to ensure the proper care of servicemembers and veterans suffering from TBI and PTSD.