VA ARTICLE ON MENTAL HEALTH WAIT TIMES

FROM:  U.S. VETERANS ADMINISTRATION
On VA’s Mental Health Wait Times
April 24, 2012 by Alex Horton
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.