Washington Update

Pressure increases on VA to improve mental health treatment

Scott Barstow & Art Terrazas June 1, 2012

The American Counseling Association has been fighting for years with frustratingly little success to get counselors hired as mental health clinicians within veterans hospitals, facilities and Vet Centers. It now appears that even the Department of Veterans Affairs’ (VA’s) own analysts are frustrated too. In a report released at the end of April, the Veterans Affairs Office of Inspector General (OIG) faulted the Veterans Health Administration (VHA) for providing highly misleading information that paints an inaccurate picture of veterans’ access to mental health services. The report was the subject of a hearing by the Senate Committee on Veterans’ Affairs.

The VHA has claimed that 95 percent of first-time patients receive a full mental health evaluation within 14 days. What the OIG discovered, however, was that the VHA was measuring how long it took to conduct the evaluation, not how long the patient waited to get the evaluation. Analyzing the data more closely, OIG found that only half of patients received evaluations within 14 days; for the other half of patients, the VHA took about 50 days to conduct a full mental health evaluation.

Similarly, although the VHA claimed that 95 percent of patients received appointments to begin treatment within 14 days of the desired date, OIG found that this happened for only 64 percent
of patients. The OIG report is available at va.gov/oig/pubs/VAOIG-12-00900-168.pdf.

The lack of adequate staffing undoubtedly is one source of the problem. According to an informal VHA survey, 71 percent of front-line mental health professionals reported that their facilities didn’t have enough staff to meet treatment demand. However, the OIG report concluded that the VHA’s data on staffing and productivity are too complex and unreliable to be of much use.

The VA has thus far responded to the report with press releases. On April 19, the VA announced that it would add 1,600 new mental health clinicians to its workforce. On April 24, another press release announced that the VA would be recruiting mental health counselors and marriage and family therapists to its workforce as part of the hiring for those new positions.

Although ACA is pleased with the VA’s announcement regarding the hiring of licensed professional mental health counselors (LPMHCs), we need action, not words. For the past three months, ACA has tracked VA mental health position postings on the USAJOBS.gov website. During that time, 350 positions were posted for social workers; only eight positions were posted for LPMHCs. In its initial press release touting the hiring of new mental health clinicians, the VA listed the new hires as consisting of “nurses, psychiatrists, psychologists and social workers as well as nearly 300 support staff.” The same day this release came out, VA Undersecretary for Health Robert Petzel wrote to our coalition, which includes ACA, the National Board for Certified Counselors and the American Mental Health Counselors Association, denying our request for counselor trainee positions because
“[i]t has been determined that at this time there is not a need to set up a training program for this discipline.”

The law establishing recognition of licensed professional counselors (LPCs) as mental health specialists (P.L. 109-461) was enacted five and a half years ago, and it has been over a year and a half since the VA adopted an occupational standard for LPMHCs. Yet counselors are still being told no positions are available for them at VA facilities. In addition to being trained and licensed therapists, many of these counselors are veterans themselves and are thus uniquely qualified to provide treatment and support to their fellow veterans. Counselors are an untapped resource for the VA — a resource veterans in need of mental health treatment could use desperately.

Congress is becoming increasingly frustrated with the VA’s failure to provide adequate mental health care, and ACA is working with members of the Senate and House of Representatives to let them know that opening the door to LPCs should be part of the solution. During the hearing on the OIG report by the Senate Committee on Veterans’ Affairs, Sen. Jerry Moran (R-Kan.) told VA officials that among other steps, he wanted to see the VA begin hiring more LPCs. He also expressed dismay that the VA has not done more to recruit counselors in recent years. The House Committee on Veterans’ Affairs is likely to hold its own hearings, and we will work with committee members to raise the issue of counselor hiring again.

Congress is likely our best hope for ensuring appropriate recognition of counselors within the VA. The VA central office can take several steps to begin recruiting and hiring counselors and incorporating the counseling profession into its mental health service delivery system. ACA will work both with the VA and Congress to see that these steps are carried out. Counselors can help in this effort by sharing their stories.Contact Art Terrazas with ACA’s public policy staff at aterrazas@counseling.org if you have any questions or concerns.

2 Comments

  1. John

    I am an Army Veteran and VA employee. The VA is the largest employer of social workers. I would not be suprised if the resistance from hiring LPC’s is not coming from the social workers not wanting to give up their professional “turf”.

    Reply
    1. Steven Bush, NCC, LPCC-Supv.

      John, I too work for the VA and can’t buy a Mental Health Counseling position here at the Dayton VAMC. You are exactly right in my opinion about the Social Workers blocking us out of jobs…Steven

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