The Department of Veterans Affairs actively encourages veterans to enroll in VA health care, and officials, including VA Secretary Denis McDonough, voice pride in the department’s expertise treating combat-related mental health conditions. In 2023 alone, nearly 11% of the nation’s 18.1 million veterans sought mental health services at the VA, having 19.6 million behavioral health “encounters” with the VA, including appointments, walk-ins and emergency room visits.
But veterans say they often can’t get individual therapy appointments to accompany psychiatric medical care, and when they do connect, the treatment often is derailed by appointment cancellations and scheduling problems, according to more than a dozen veterans and current and former VA employees interviewed by Military.com.
They shared remarkably similar stories of working up the courage to seek help — something that historically has not been easy in a community skeptical of mental health treatment — and waiting months for sessions as multiple appointments were canceled, either at the start of a telehealth session or on arrival at a medical center or clinic.
Data provided by the VA showed that from 2020 through 2023, the cancellation rate for mental health appointments across facilities averaged 10.6%, with a high of 12.1% in 2020 early in the COVID-19 pandemic to 9.2% in 2023.
But individual medical centers may have bigger issues. Data obtained by the Americans for Prosperity Foundation through an ongoing Freedom of Information Act lawsuit showed that at 14 representative facilities across the U.S., from January 2020 to late May 2021, the cancellation rate was nearly double the VA provided figures, at 21%, although the time frame coincided with the height of the COVID-19 pandemic restrictions on non-urgent care.
Theories on the causes of cancellations vary. VA employees who spoke with Military.com said provider shortages are the root cause, while others point to the lack of a centralized scheduling system or pressure to keep veteran care inside the walls of a VA facility.
The VA has 32,199 mental health workers, including psychiatrists, psychologists, licensed professional mental health counselors, marriage and family therapists, peer support specialists, nurses and physician assistants, on staff, and officials say they are hiring more.
But the VA struggles to recruit clinicians, especially to rural locales and areas with underserved populations, and it competes with the private sector, where, in many places, quality care commands cash-only payments. According to the VA Inspector General in September, 66 of the VA’s 140 health systems reported severe shortages of psychiatric providers.
VA officials said patient requests for mental health care have grown steadily in the past 10 years at a rate that far exceeds demand for overall health services, and they have shifted toward a more proactive approach that includes case management, outreach and “stepped-care,” meaning it may begin a patient with group therapy, self-help or brief sessions and proceed to more intensive treatment as needed.
The VA also has hired more mental health providers — including 4,106 last year.
Read more at Military.com.
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