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Report: VA failing to provide timely mental care

Federal investigators reported Monday that nearly half of the veterans who seek mental health care for the first time waited about 50 days before receiving a full evaluation, a much longer lag-time than cited by the Department of Veterans Affairs.

The VA has been saying that 95 percent of new patients seeking mental health treatment get a full evaluation within the department's goal of 14 days. But an inspector general's report said that the department's tracking is flawed and that the VA was overstating its success when it comes to how quickly veterans get care.

The department has greatly beefed up staffing in recent years, but the report also confirmed that many of the VA's doctors and other medical officials don't believe they have the manpower necessary to handle the ever-growing veteran caseload.

"This report confirms what we have long been hearing, that our veterans are waiting far too long to get the mental health care they so desperately need," said Sen. Patty Murray, chairman of the Senate Committee on Veterans' Affairs. "It is deeply disturbing and demands action from the VA."

The report comes just days after the administration announced it was increasing its staff of mental health workers by roughly 1,900. The department has been adding staff at a brisk pace in recent years. Staffing is up 45 percent since 2005, but the increase in patients has gone up by almost that amount. VA officials said the announcement had been months in the making.

In response to the report, the department released a statement saying that it was committed to ensuring that veterans had access to quality mental health care and that it would review the IG's findings.

"We have made strong progress, but we need to do more," the statement read.

Doctors and other mental health staff told investigators that they're particularly having trouble hiring and retaining psychiatrists. Investigators visited four medical centers. At a medical center in Salisbury, N.C., investigators found that patients had to wait an average of 86 days to see a psychiatrist. Staff told investigators that the hospital was trying to replace three psychiatrists who had moved to the private sector within the past year.

The department plans to add about 1,600 clinicians, including psychologists, psychiatrists, nurses, social workers and professional counselors, and about 300 support staff to an existing mental health staff of roughly 20,590. Still, the inspector general is recommending that the department undertake a comprehensive staffing analysis to determine just how much vacancies are hurting its ability to meet its standards for timely mental health care.

The department says that analysis has been underway since last year, leading to the decision to increase its workforce.

Under the VA's protocol, patients seeking mental health care are supposed to get an initial evaluation within 24 hours in case care is urgently needed. Barring an emergency, the department seeks to provide a full evaluation within 14 days. However, the VA measures how long it took to conduct the evaluation, not how long a patient waited to receive an evaluation. For example, if a patient is referred on Sept. 15 and the evaluation is scheduled and takes place on Oct. 1, then the VA would show that the veteran waited zero days, when in reality the patient had waited 15. Investigators called the VA's tracking as "having no real value."

Investigators said that the VA also overstated how long it took to treat new patients after they got an evaluation. Such treatment is supposed to take place within 14 days of the date sought by the patient, but only two-thirds of veterans were are treated within that timeframe. The remaining third waited 40 days on average.

The record was better for follow-up treatments. About 88 percent get follow-up appointments within 14 days of the desired date, but that still leaves about 1.2 million appointments during the year that exceed the timeframe. The department has been reporting that 98 percent of veterans were getting timely follow-up appointments.

"Clearly the VA scheduling system needs a major overhaul," Murray said. "The VA also needs to get serious about hiring new mental health professionals in every corner of the country."

Murray's committee is conducting a hearing on the inspector general's report on Wednesday morning. The VA said it concurred with the findings and has already begun taking steps to address the findings, including establishing a new office with oversight of the mental health program.

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