Two veterans sought psychiatric care at a VA clinic in Chico, California. They were bounced between virtual providers and struggled to get support in the threadbare system. A staffer worried, “We are going to kill someone.” Then tragedy struck.

From the outside, it looked like a haven for heroes: a state-of-the-art building with a gleaming atrium, a large American flag flying out front. But the clinic hadn’t had a full-time, on-site psychiatrist in five years. A single nurse was responsible for connecting hundreds of veterans, some with serious mental illness or active suicidal thoughts, with an ever-changing lineup of telehealth providers in different time zones.

The military has long drawn recruits from remote towns across America, promising them a lifetime of health care in return for their service. But the VA has seldom staffed those same communities with the mental health professionals needed to help them once they return home. Two decades of war in Iraq and Afghanistan have turned this chronic shortcoming into an emergency. The demand for mental health care has grown at a rate that’s triple the rate of growth for all VA medical services. Anguished employees, doing what they can with threadbare staffing and glitchy technology, are burning themselves out trying to avert disasters that feel inevitable. In Chico, nurses and social workers cried after their shifts, and the new site manager, a veteran and longtime health care administrator, had made a grim prediction: “We are going to kill someone,” she told colleagues.

If hindsight is 20/20, agency officials should have exquisite vision by now. Their files are littered with cautionary tales of missed screenings and insufficient follow-up; in at least 16 instances since 2019, veterans who received inadequate care wound up killing themselves or other people; an additional five died for reasons related to the poor quality of care. Each time, investigators with the VA’s Office of Inspector General swooped in to determine whether the system failed; each time, they concluded it had.

Archived at https://web.archive.org/web/20240110132241/https://www.propublica.org/article/when-veterans-cant-access-the-psychiatric-care-they-need

  • givesomefucks@lemmy.worldEnglish
    52·
    10 months ago

    Just that morning, when her latest crisis began, a nurse at the local VA clinic in Chico, California, had told her mother to bring her in. When they arrived, a telehealth provider was too busy to see Julia. A social worker asked questions to gauge her risk of suicide or violence; even though Julia refused to answer, she was sent out into the world and told to return for the next available appointment, in 11 days.

    It was at a small rural clinic, patient still saw a health professional, but refused to answer any questions.

    What should the VA do?

    Hold the patient against her will for not cooperating?

    The family would have to initiate that, and it sounds like they just didn’t.

    It might be a good thing because I have experience, might be a bad thing because I’m biased. But I’ve been using the VA for all my medical care for over a decade.

    They do a great job, but they’re the largest healthcare provider in America. Statistically speaking some people will fall thru the cracks. But that doesn’t even sound like the case here.

    This was someone refusing treatment, and her family not thinking it was serious enough to request an emergency hold against the patients wishes.