VA MISSION Act Fails to Address the Importance of Improving Mental Health Services

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Waiting room. Getty Images
Waiting room. Getty Images

Andrew Vernon is a former Department of Veterans Affairs employee and in 2017 was appointed by the Volcker Alliance as one of 41 rising Federal Government Leaders nationwide to discuss "Preparing Tomorrow's Public Service, What the Next Generation Needs."

On June 6, 2019, the Department of Veterans Affairs implemented the MISSION Act, which makes it a priority to offer veterans urgent-care services in the private sector when set criteria are met.

This has been one of the most visible pieces of the new law. However, what has not been well publicized are changes to the rules for those seeking mental health services. This is unfortunate, seeing how the VA has stated on several platforms that it is doing everything possible to improve mental health care and prevent veteran suicides.

According to the new rules, if a veteran experiences a 20-day wait time or longer at VA mental health facilities, a conversation can be held with the vet's Primary Care Provider (PCP) to allow access to mental health care in the private sector.

In addition, if the veteran must drive more than 30 minutes to the nearest VA facility, a conversation is encouraged during an appointment with their VA PCP to enter a consult for private mental health services.

But in some cases, even in rural areas, wait times to be seen in private mental health facilities can exceed the 20-day wait time at the VA. When considering the consult process and wait time to see a private mental health provider for an appointment, this part of the MISSION Act is only a bandage on a continuing, significant problem.

Timely and effective care matters when veterans are requesting assistance with their mental health concerns. Same-day access is offered at the VA. But how is same-day access defined?

Could it be that the VA uses the emergency department, Telehealth, social workers, nurse practitioners or mental health counselors to provide the initial consultation or appointment to fulfill the same-day access request? Those personnel are not well trained to adequately evaluate during an initial consult when compared to licensed psychiatrists or psychologists.

With a severe shortage of these providers in the United States, and a recruitment concern leading to the hiring of foreign providers at the VA, does this solve the cultural issue of understanding veteran military experiences and, most importantly, their individual experiences? After all, each veteran does have a different experience.

The VA serves more than nine million veterans out of approximately 20 million vets nationwide. Questions remain about why the rest opt out of receiving care at VA facilities.

Veterans are given the option to choose the VA for their health care services. If 14 out of the 20 veterans who take their lives everyday are not using the VA, the department needs to continue discussions with veterans and family members and do comprehensive analysis toward understanding the root cause of the lack of enrollment. The 14 out of 20 veterans may not seek care at the VA, but they are still veterans and still our responsibility.

Placing limitations and barriers on veterans to receiving care is not the answer. In no way should we privatize the department. We do need to open all doors to veterans when they need mental health services. Having the MISSION Act again place limitations on veteran mental health care could quite possibly answer the question as to why veterans do not choose the VA.

When veterans request help and have a preference to see a licensed psychiatrist or psychologist face to face, allow them to do so. This could have been written as a more simple and flexible law.

However, according to Rory Riley-Topping, a veterans law attorney who previously served as counsel to the House Veterans' Affairs Committee, "It is important to remember that all legislation is the product of compromise. Unfortunately, sometimes, a compromise that works well on paper in terms of satisfying legislative disagreements, such as the 20-day wait time for mental health appointments, does not always translate effectively into practice."

Money will not save lives. Delays in care will not save lives. Provider shortages and misunderstanding veteran culture will not save lives. Having the VA allow veterans to access mental health care when and where they need it most with zero limitations or barriers could be a solution to saving one life and then many more.

-- The opinions expressed in this op-ed are those of the author and do not necessarily reflect the views of Military.com. If you would like to submit your own commentary, please send your article to opinions@military.com for consideration.

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