Senate Veterans Affairs Committee Chairman Jon Tester, citing ProPublica reporting on barriers to mental health care for veterans, urged Veterans Affairs Secretary Dennis McDonough to improve mental health care in rural areas of the country. He called for an increase in the number of care providers.
Mr. Tester sent a letter to Mr. McDonough this month expressing concern about the national mental health workforce shortage. In it, he cited a ProPublica investigation into a Veterans Affairs clinic in Chico, Calif., which had not had a full-time psychiatrist for five years and also offered same-day appointments for patients in crisis. It is said that he was unable to do so. In January 2022, two veterans who were struggling to receive treatment there killed their mother during an acute mental health episode.
“It is our understanding that Chico (clinic) currently has several full-time mental health care providers and is accepting same-day appointments, but given the Department of Veterans Affairs mental health care provider shortage, this is “I am concerned that this is not an isolated issue,” Tester wrote.
Tester asked McDonough how many VA clinics currently lack in-person mental health providers and how many are equipped to facilitate telehealth appointments. He also asked how the Veterans Administration ensures same-day mental health visits are available at all facilities.
“I applaud all of the department’s efforts to reduce barriers to mental health care for veterans and strengthen suicide prevention efforts,” he wrote. “Yet, the VA must continue to lead efforts to increase the number of mental health providers and ensure those providers are placed where veterans need them most.”
In a statement to ProPublica, VA spokesman Terrence Hayes said the VA appreciates Tester’s letter and will respond directly.
Hayes noted that the agency is taking several initiatives to increase its mental health care capabilities, including expanding virtual services and a new team focused on growing the talent pipeline. “One of our top priorities is to provide veterans with the world-class mental health care they deserve, whenever and wherever they need it,” he said.
ProPublica’s reporting grew out of an investigation by the VA’s inspector general into one of the two Chico cases. The inspector general concluded that the clinic mismanaged patients’ medications and failed to schedule appointments with prescribing providers when patients came to the clinic in crisis.
The patient, a 27-year-old Navy veteran named Julia Larsen, was diagnosed with post-traumatic stress disorder and had psychotic symptoms, ProPublica said. Larsen couldn’t make her appointment that day, so he returned home with her parents and fired a handgun inside her home. One of the bullets she fired hit her mother in the thigh, killing her mother.
ProPublica reported that a second veteran receiving mental health treatment at the clinic also shot his mother in the same week. Andrew Isles had been diagnosed with schizoaffective disorder and believed his relatives were plotting against him. The day after Larsen’s shooting, he called a Chico clinic to speak with a mental health doctor. Instead, he was referred to a pharmacist. The next afternoon he murdered his mother. Both Mr. Larsen and Mr. Ailes were found not guilty by reason of insanity and committed to a state-run psychiatric hospital.
ProPublica found evidence of systemic staffing problems in the clinic’s mental health department. The Veterans Administration tried to plug the hole by using telehealth providers, but some quit or stopped seeing Chico patients. Employees begged local leaders for more staff and resources, they told ProPublica. One said he warned his colleagues: “We’re going to kill people.”
ProPublica also found deficiencies in mental health care at VA clinics across the country. Since 2019, at least 16 veterans who received substandard treatment have killed themselves or others, records review shows.
After ProPublica’s findings were released in early January, McDonough visited Chico and promised to increase staffing in the clinic’s mental health department. “We have a rapidly growing veteran population here in Chico,” he told local reporters. “We have to make sure that we grow in proportion to that population so that they can receive timely care and timely access to the benefits that they have earned.”
Tester’s letter continued to raise concerns. He noted that the Department of Veterans Affairs’ 2023 2023 numbers show that the number of mental health outpatients and treatment visits has soared from 11.4 million in 2008 to 21.8 million in 2019, and staffing shortages continue. pointed out the month’s report. Tester also noted that while in-person mental health services tend to be concentrated in large urban VA medical centers, nearly one-third of veterans enrolled in VA health care are located in rural areas. He pointed out that he lived there.
In rural areas, “the loss of just one or two providers can have a significant impact on essential access to mental health care, and once those providers are gone, there are It can take years to recover, and even longer to encourage patients to return,” Tester wrote. to care about. ”
Mr. Tester acknowledged the Department of Veterans Affairs’ recent progress in improving access to mental health services. But he urged McDonough to move forward.
“More needs to be done, especially in rural areas, to meet the increased demand and prevent the lack of care that can have a devastating impact on veterans and their families,” he wrote. There is.
