A newly released report found that hundreds of thousands of veterans experience excessive delays in trying to obtain mental health services from the Veterans Administration (VA). This is especially sad to consider today, both because May is Mental Health Month and the President has just renewed our troop commitment to Afghanistan.
William Hamilton was a 26 year old Iraq veteran when he died in May 2010.
One of five siblings, he joined the army when he was nineteen.
He experienced his first symptoms of mental illness while serving a tour in Iraq in 2005. He was diagnosed with PTSD and an anxiety disorder.
He was discharged honorably later that year and sought treatment at a VA Center.
For four years, as his condition worsened, Hamilton bounced from one VA treatment setting to another.
In 2006, he was diagnosed with major depressive disorder. Chemical dependency complicated his treatment. He was hospitalized at the VA on several occasions over the next two years, and had several unsuccessful VA transitional housing placements.
In 2009, he was diagnosed with schizoaffective disorder. He had two extended stays at the VA hospital and another at a rehabilitation center.
In 2010, he was also diagnosed with psychosis, and by then it seemed to his parents that the VA didn’t want to see him anymore.
Three times in 2010, his parents contended, Hamilton was denied admission to a VA medical center.
The first was early in the year after he was found running in and out of traffic and hospitalized in a community hospital. The second was after he was hospitalized a month later after being found walking the streets naked.
In both instances, hospital personnel documented that the VA center reported that there were no beds available those days.
The third was a few days before he died in May. Community hospital personnel said that when they spoke by phone with the VA center at 4:20 p.m. they were told that the VA did not accept transfers that late in the day. So they found a Department of Defense hospital to admit him. His parents expected him to be transferred to the VA center from there, but instead he was released three days later.
His parents said that he was unstable. He died four hours later when he stepped in front of a train.
Did the VA center’s failure to accept and treat William Hamilton contribute to his death that day?
His parents thought so, and the Office of the Inspector General of the Department of Veterans Affairs agreed to investigate. It released the report of its findings a little over a month ago.
It determined that the VA center did have beds available on the first two dates in question, and should have admitted him. However, it could not determine whether he had been denied admission in May, too.
That’s because when it tried to verify the 4:20 pm phone call, the VA center records showed that “no outgoing calls were recorded from any VAMC extension to anywhere on the subject day.” No one could say why, but the OIG suggested that “it would not be plausible” that no outgoing calls were made during that entire day.
This tragic case is an exclamation point on a bigger story.
According to a new report issued by the OIG just last week, hundreds of thousands of veterans experience delays in obtaining mental health evaluations and care from the VA.
The VA mandates that all initial mental health evaluations for veterans seeking mental health care from the VA for the first time be completed within fourteen days.
Over 373,000 veterans sought such care in FY2011. Only 49% had their mental health evaluations completed within 14 days. An estimated 28,000 evaluations were never completed at all.
The VA also mandates that patients new to a specific mental health clinic be granted appointments within fourteen days of when the veteran wants to be seen.
Out of 262,000 appointments, only 64% met this deadline. 94,000 veterans waited longer.
In Denver CO, the average wait was 19 days. In Milwaukee WI, it was 28 days. In Spokane WA, it was 80 days, and in Salisbury NC, it was 86.
One of the things that jumps out at me about William Hamilton’s tragedy is that as his symptoms of mental illness became more and more serious, his treatment never seemed to catch up with his disease.
And what jumps out at me about the VA data is that where veterans’ mental health is concerned, playing catch-up seems to be the norm.
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