U.S. Sen. Bill Cassidy convened a Senate Veterans' Affairs Committee field hearing Thursday in Metairie, Louisiana, to discuss gaps in mental health care for Louisiana veterans, from long wait times and rural isolation to provider shortages and the stigma that keeps many from seeking help.
Mental health challenges are prominent among veterans, with approximately one-third of all VA users having at least one mental health visit in a given year. But the situation for Louisiana's 262,000 veterans is especially dire, witnesses said.
Based on initial data from a survey conducted by the University of Louisiana at Lafayette, PTSD rates among Louisiana veterans could be as high as 45% -- more than twice the national average. Forty-two percent of veterans who were surveyed live more than an hour from a VA clinic, and many face transportation gaps, rural poverty and food insecurity.
Louisiana Department of Veterans Affairs Secretary Charlton Meginley, who presented the findings, called them "deeply concerning."
"Veteran mental health is not just a VA issue; it is a national security issue," Meginley said, pointing out that if veterans aren't taken care of, it could discourage people from joining the military at all.
Cassidy, a physician, convened the panel at Delgado Community College, calling it a chance for veterans to speak directly to decision-makers and to make sure "that the veteran transitions from serving our country in the battlefield" to "serving our country, their family and themselves here in society."
'A Fatal Gap'
The shortage of providers and long wait times for appointments were repeatedly pointed out by experts and community leaders as roadblocks to care.
"Unless you're going to commit suicide, you're not going to be seen right away," said audience member Belinda Hill, national service officer with the Disabled American Veterans.
A veteran seeking help for substance use disorder often faces waits of more than 30 days, said Emily Meyers, chief executive officer of Long Branch Recovery and Wellness.
"It can be a fatal gap," said Meyers, given the risk of overdose, especially from fentanyl-laced street drugs.
A new VA Office of Inspector General report released Monday showed Louisiana's veterans hospitals are struggling with staffing, with the deepest gaps being felt in mental health and nursing.
In 2025, VA hospitals across the country said they were struggling to fill 4,434 types of critical jobs, which is 50% more than the 2,959 they reported in 2024, according to the report.
The New Orleans VA had 30 types of occupations in "severe shortage," which means there are far too few qualified candidates to fill critical jobs, making it hard for the VA to hire and keep enough staff to meet veterans' needs. Shreveport had 23 and Pineville had 20, according to the report.
"There's a shortage," said Fernando Rivera, director of the Southeast Louisiana Veterans Health Care System and interim head of VA's multi-state VISN 16 network. "We can't get around the fact that ... in our state, we don't have an overabundance of mental health providers."
'Eyeball-to-Eyeball' Care
Veterans in Louisiana are able to get referrals for same-day care to a virtual mental health provider, but community leaders said many veterans may not want virtual care, and high turnover among providers can abruptly end hard-won therapeutic relationships.
"I have been that lonely veteran, and I have gotten on the app, and I was as lonely when I got off," said Jackson Smith, a Marine combat veteran and executive director of Bastion Community of Resilience.
Smith held up a photo taken during his service in Afghanistan with a platoon of 78 as he described the injuries and mental health issues following service.
"Over those eight months I watched virtually every one of those Marines experience multiple, in some cases dozens, of brain-injuring events like land mine explosions and fire planes," Smith said.
Smith advocated for expansion of the Fox Suicide Prevention grant program to fund smaller, local organizations positioned to deliver "eyeball-to-eyeball" support, and called for reinstating the VA's assisted living traumatic brain injury pilot program, which ended in 2017 without replacement.
Louisiana only has seven residential beds for those needing intensive mental health or substance use care. While screening across the VA's multi-state network has sped up admissions to out-of-state facilities, the small number of in-state beds makes it challenging for people to get seen quickly, Rivera said. A $1.5 billion investment in President Trump's 2026 budget is expected to expand those beds nationwide.
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