Need critical as PTSD cases rise
By Gregg Zoroya, USA Today
As thousands of additional veterans seek mental health care every month, the Department of Veterans Affairs is short of psychiatrists, with 20% vacancy rates in much of the country served by VA hospitals, according to department data.
In Montana, where veterans wait an average of five weeks to begin counseling, an eight-bed wing of a mental health facility at Fort Harrison has been vacant for nine months because of a lack of psychiatrists, the VA says. The Rocky Mountain VA region needs to fill nearly one of four psychiatrist positions.
The vacancies occur at a time when the number of veterans with post-traumatic stress disorder is increasing by about 10,000 every three months, what experts say is the cumulative effect of a decade of war, VA data show.
More than 230,000 servicemembers have suffered traumatic brain injuries ranging from mild to severe since 2000, according to Pentagon data.
"Last year, VA testified that it has the resources to handle the influx of veterans suffering from the invisible wounds of war," says Rep. Jeff Miller, R-Fla., chairman of the House Veterans' Affairs Committee. "Now we learn from them there is a shortage. â€¦VA needs to quickly figure out what the problem is."
The VA needed to hire 266 psychiatrists last September and it was taking an average of eight months to fill each job, according to an internal report.
"When you ask those on the front lines of treating these veterans, they tell you that in many instances they are stretching just to manage the caseload, let alone treat all the veterans coming through their door," says Sen. Patty Murray, D-Wash., chairwoman of the Senate Veterans' Affairs Committee.
The VA has about a 20% shortfall in psychiatrists at hospitals throughout the Northwest, Deep South and Southern California, according to department data.
The problem persists in sparsely populated areas such as Montana, where even private hospitals cannot lure psychiatrists, says Trena Bonde, who heads VA care in that state.
Nationally, the VA psychiatric vacancy rate is 15%, down a percentage point from last year.
The VA has expanded its behavioral care staff by 50% since 2005 to nearly 21,000. Even so, it is difficult to attract psychiatrists to rural areas or places where the cost of living is high, says Mary Schohn, VA director of mental health operations.
Where it's tough to hire psychiatrists, the VA contracts with private physicians, relies on psychiatric nurses or physician assistants or uses teleconference sessions with psychiatrists in other VA hospitals, Schohn says.
Veterans who start therapy at nearly a third of VA hospitals wait longer than the department's goal of seeing patients in 14 days or less, according to a USA TODAY analysis last year.
Some of the longest wait times for one-on-one psychiatric care are in places facing staffing shortages. Veterans wait an average 37 days at hospitals in Alabama and 30 to 33 days at VA hospitals in Orlando and Miami, department data show.
"If VA is unable to provide the care for these veterans, they need to recommend a provider in the community who can see the veteran immediately," Miller says. "These are wounds that can't wait."
Of psychiatric positions within the Department of Veterans Affairs, 15.2% are vacant. The highest vacancy rates are in VA regions encompassing:
Utah and much of Montana, Wyoming and Colorado: 23%
South Carolina and much of Alabama and Georgia: 20%
Kentucky and Tennessee: 20%
Puerto Rico, Virgin Islands and much of Florida: 19%
Source: Department of Veterans Affairs