Research limiting veterans' treatment

VA study finds mental-health care is lacking
Research limiting veterans' treatment
By Steve Liewer
UNION-TRIBUNE STAFF WRITER

September 5, 2008

Top mental-health officials for the VA San Diego Healthcare System are spending little time treating the burgeoning caseload of stressed-out war veterans because they are immersed in research, according to a new internal investigation by the Department of Veterans Affairs.

The medical director of the two main treatment programs for post-traumatic stress disorder “did not substantively participate in (their) operations” because of research work, said the report, which was issued last week by the VA's inspector general.

Other administrators are so tied down with research that they have been forced to work overtime and/or hand over certain patient-care duties to assistants.

“The people who do the PTSD clinical work are very, very good, but they are swamped,” said Bill Mahedy, a chaplain and former psychologist at the hospital whose complaint prompted the investigation. “Good leadership would have made sure the research tail isn't wagging the clinical dog.”

The imbalance may have contributed to delays in treatment for some veterans at peak times, the report said. Staff shortages also prevented follow-ups or caused poor follow-up with more than 80 percent of Iraq and Afghanistan war veterans who failed to make their appointments.

Young veterans frequently miss daytime appointments because of their work duties, said Bill Rider, a Vietnam War veteran who mentors local service members through the nonprofit group American Combat Veterans of War.

In the new report, investigators said they couldn't accurately track the nearly 1,200 PTSD cases diagnosed since 2003 among veterans of the Iraq and Afghanistan wars because of a chaotic record-keeping system.

They also said each of the local VA health system's three case workers for Iraq and Afghanistan veterans handled 120 patients, far above the VA standard of 25 to 30 cases.

“This is not the way to deal with these heroes coming home,” said Rep. Bob Filner, D-San Diego, chairman of the House Committee on Veterans' Affairs.
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