published Monday, April 30th, 2012

The VA's broken promise

For years, the United States military and veterans establishment was reluctant to admit the presence of mental-health problems among those who served in uniform and who relied on the Veterans Administration for care and treatment. A scary rise in the number of suicides by combat veterans of the Iraq and Afghanistan wars prompted a welcome change in that attitude. Admission of the problem and public declarations to address it, however, have not translated into programs that provide timely mental-health treatment at VA centers.

The extent of the problem is greater than most Americans know and Veterans Affairs Department officials are willing to admit. A report from the department's inspector general last week revealed that almost half of the veterans seeking mental-health care for the first time waited about 50 days before getting a full exam and evaluation. That sharply contradicted long-standing claims from the VA.

The VA had been reporting that 95 percent of new patients seeking such help received it within 14 days, the VA goal. The agency, it seems, was more interested in making public pronouncements that made it look good than in providing the assistance the government promises those who serve.

That is a sacred promise. Those who risk their lives in the nation's service are promised certain benefits in return. Among those benefits is health care for physical and mental illnesses. The VA, according to its own IG's report, is unable to provide those services in a timely manner when it comes to mental-health care.

The problem is at least two-fold. First, the department "does not have a reliable and accurate method of determining whether they are providing patients access to mental health care services," the inspector general reported. The report cited poor record-keeping, schedulers who don't follow rules and other systemic problems that make it difficult to track patients and to provide a true assessment of the situation. Clearly, better tracking and reporting systems are needed. Whether the VA can provide them remains an open question.

Another issue is a lack of personnel. The VA has a problem hiring and retaining qualified psychiatrists and other mental health professionals. Salary, benefits and working conditions make it hard for the VA to compete with the private sector. The VA is working to resolve that issue, but it is tough going.

The department's roster of mental health care personnel nearly doubled from 2005 to 2010 and it currently has a recruiting program aimed at hiring nearly 1,900 more professionals. Given the high demand for trained personnel in the field, success in achieving that goal is not guaranteed.

The VA, to be fair, has been inundated with those seeking mental -health care. The old attitude was that military men and women are so tough, independent and self-sufficient that it made it difficult for them to accept the fact that an injury to the mind is just as damaging as one to the body. That mindset has shifted. Now, the VA must deal with the increased patient load that is the natural outgrowth of that change in attitude.

Prompt response to veteran's requests for a mental-health care is vital. A long delay can be a blow to a man or women who has summoned the courage to admit to a problem and the need for help. Indeed, timely treatment, as Sen. Patty Murray, D-Wash., and chairman of the Senate Veterans Affairs Committee, says, "can quite frankly be the difference between life and death."

The VA promises that those with service-related illnesses of the mind will be provided the same level of care as those whose wounds are to the body. It has failed, in large part, to do so. That is a shameful circumstance that should be remedied. The nation owes that and much more to its veterans.

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