IG: VA lags on meeting own care standards - Military News | News From Afghanistan, Iraq And Around The World - Military Times

IG: VA lags on meeting own care standards

Veterans Affairs Department hospitals and clinics are moving slowly to implement standardized policies for treatment of mental health disorders and substance abuse disorders, according to a new report by VA’s inspector general.

The result is hurting veterans, said Christina Roof, assistant national legislative director with AmVets, one of the major veterans service organizations. “Findings in this report are quite disturbing,” she said, especially given that mental health problems are a significant concern among Iraq and Afghanistan veterans, and the suicide rate among service members and veterans remains high.

“They have a plan, they just have not gotten around to fully implementing it,” Roof said. “I am not saying the VA isn’t trying, just maybe not hard enough or not staying focused. However, the rates of suicide have been going up for five years.”

The report focuses on implementation of the Uniform Mental Health Services Handbook, developed by VA in 2004, which contains about 200 specific guidelines for treatment programs. It includes things like kinds of treatment, the duration of treatment, staffing, and analysis. The idea was that the guidelines would be implemented, over time, in veterans facilities large and small to provide standardized care, a way to track what does and doesn’t work, and to allocate resources so veterans could expect the same type of help to be available throughout the U.S.

Among the problems cited in the report:

Large community-based mental health facilities and medical centers — required to have specialized outpatient programs for veterans with post-traumatic stress disorder — do not all meet the handbook’s requirement of having cognitive processing therapy, which is a series of short therapy sessions over a long period, or prolonged exposure treatment. Less than half of the medical centers have actual PTSD clinics, the report says.

Evening hours are supposed to be available at all mental health clinics at least one day a week, but the report found they are provided at only about 43 percent of community-based outpatient clinics. Ninety-four percent of medical centers are meeting the requirement, the report says.

Deficiencies were also found in the availability of secure places for women to receive in-patient mental health service, in the coordination of PTSD and substance-abuse treatment, and in treatment for people with serious mental illnesses at major medical centers.

In a formal response to the IG report, VA health care officials said they agree with specific recommendations on implementation, and they hope to meet some of the requirements by this summer, while others will take longer.

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