[NYAPRS Enews] UT: New VA Study Finds MH Care Is Lacking

[Matt Canuteson]

VA Study Finds Mental-Health Care Is Lacking

Research Limiting Veterans' Treatment

By Steve Liewer  San Diego Union-Tribune   September 5, 2008

 

Top mental-health officials for the VA San Diego Healthcare System are
spending little time treating the burgeoning caseload of stressed-out
war veterans because they are immersed in research, according to a new
internal investigation by the Department of Veterans Affairs.

 

The medical director of the two main treatment programs for
post-traumatic stress disorder "did not substantively participate in
(their) operations" because of research work, said the report, which was
issued last week by the VA's inspector general.

 

Other administrators are so tied down with research that they have been
forced to work overtime and/or hand over certain patient-care duties to
assistants.

 

"The people who do the PTSD clinical work are very, very good, but they
are swamped," said Bill Mahedy, a chaplain and former psychologist at
the hospital whose complaint prompted the investigation. "Good
leadership would have made sure the research tail isn't wagging the
clinical dog."

 

The imbalance may have contributed to delays in treatment for some
veterans at peak times, the report said. Staff shortages also prevented
follow-ups or caused poor follow-up with more than 80 percent of Iraq
and Afghanistan war veterans who failed to make their appointments.

 

Young veterans frequently miss daytime appointments because of their
work duties, said Bill Rider, a Vietnam War veteran who mentors local
service members through the nonprofit group American Combat Veterans of
War.

 

In the new report, investigators said they couldn't accurately track the
nearly 1,200 PTSD cases diagnosed since 2003 among veterans of the Iraq
and Afghanistan wars because of a chaotic record-keeping system.

 

They also said each of the local VA health system's three case workers
for Iraq and Afghanistan veterans handled 120 patients, far above the VA
standard of 25 to 30 cases.

 

"This is not the way to deal with these heroes coming home," said Rep.
Bob Filner, D-San Diego, chairman of the House Committee on Veterans'
Affairs.

 

The heavy emphasis on studies and clinical trials is tied to the VA's
partnership with the University of California San Diego, a research
institution.

 

Gary Rossio, chief executive officer of the local VA health system,
defended the collaboration. The main VA hospital is adjacent to UCSD's
Thornton Hospital in La Jolla, and many VA doctors work for both
institutions.

 

Such partnerships are common around the country and typically benefit
the VA by attracting top-notch researchers and giving patients access to
innovative technologies, Rossio said.

 

Overall, the inspector general's report points out problems that VA
leaders have been struggling to fix for years - and are finally making
progress because of a big funding boost in 2008, he said.

 

"They're really not telling us anything we don't already know," Rossio
said.

 

When the Iraq war began more than five years ago, he said, no one in the
VA or other agencies expected such a long conflict involving hundreds of
thousands of troops serving multiple combat tours.

 

Rossio said he has been asking for several years for more money to
expand his staff. The local VA health system's patient load has grown
from 36,000 in 1998 to 60,000 this year. Each week, Rossio said, the
system enrolls 45 Iraq and Afghanistan war veterans.

 

Last year, Congress approved legislation that boosted the local VA
health system's current budget by $50 million - to $374 million. Rossio
said some of the money was used recently to hire more case workers and
three psychiatrists whose full-time job is to treat PTSD in veterans of
the Iraq and Afghanistan wars.

 

And last week, the system added an experienced combat psychiatrist to
run its main PTSD programs.

 

"We will absolutely implement every suggestion in this report," Rossio
said. "This is a work in progress."

 

http://www.signonsandiego.com/news/military/20080905-9999-1m5va.html 





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