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.
Comments are welcome on this and other columns. If you have questions about this column or would like to receive an email notifying you when new OHPM columns are published, please email gionfriddopaul@gmail.com.
This is a great snapshot of universal healthcare. I served in the Marine Coprs in the early 90s. When I came home and attended college, the only healthcare I had access to was through the VA. I used it sparringly b/c I knew that a trip to the VA was an all-day event. Unfortunately, I was in the minority. Many vets are simply lonely older guys that use these services as a means of getting out and socializing with other vets b/c hey...its free. You add in those with false or exaggerated claims who are seeking a disability rating and those like me who were recently retired with no other options and this is what you see. I think the VA does a great job with what they've got especially when you consider that they don't have access to the talent a private hospital might have. It is human nature to take advantage of free stuff so take a good look. This is where we are going.
ReplyDeleteTelemedicine under the MD247 program could end with a patient getting to talk to a nurse to reassure themselves over a course of treatment, but the telemedicine program takes things to the next level by also providing prescription refills.
ReplyDeletetelemedicine