Politics is a Part of the VA Mental Health System
Jose was discussing his dealings with the VA during one of our sessions. He is a Vietnam veteran with a Purple Heart and finally sought help after 30 years of self-medicating with alcohol to relive his Post Traumatic Stress (PTSD). Vietnam veterans are starting to age and the wounds are becoming more prevalent and life altering so they have finally started seeking help. Jose was one of many Veterans that is trying to get the help he has earned.
Jose discussed his mental health experience with the VA and was not happy. After waiting 2 months he was finally called for a counseling group at the VA. He started group sessions and completed a 16 week program but felt he needed more. It is improbable to expect someone to become whole after years of living with PTSD or multiple deployments in 16 weeks. But that is the VA system they said he was done and was removed from the group. He started working with me because he was still struggling with his PTSD and the firefight where he was wounded and lost 2 buddies. He lives with this every day and his memories have become a bigger part of his life as he ages.
Jose is not alone. Recent combat veterans as well as Vietnam veterans are coming forward in droves seeking mental health help. As a counselor at a local college veteran center I hear a lot about the Veterans Administration (VA). The complaints and skepticism have increased since the exposure of the systemic problems in the scheduling system a couple years ago. The disclosure of the VA issues has managed to piss off veterans more than they already were. The fact that the VA had problems was not a shock, the severity of the allegations was the shock. Part of the backlog in the mental health field at the VA is their hiring policies for mental health professionals.
The VA is having problems getting psychologist and mental health professionals to work there because of their hiring practices. Because of the American Psychiatric Association (APA) lobby in congress the VA has limited their pool of doctorate level psychologist to just over 28% of licensed and licensed eligible Psychologist. The VA requires all psychologist to attend an APA school and have an APA internship. Even if you were an Active Duty, National Guard, or Reserve psychologist you could not work for the VA if you did not attend an APA college with an APA internship. Under the VA requirements 72% of all licensed and licensed eligible psychologist do not meet the VA requirements. These jobs could be filled if the VA would hire qualified licensed psychologist and stop bowing to the APA lobby.
In 2014 less than 2,500 positions were available for APA internships in the US and Canada. These internships are one year in length and are located throughout the United States. The APA estimates there are 8,700 doctorate level psychologist who graduate each year. For these 8,700 psychologist there were only 2,474 APA internships leaving 6,226 psychologist annually without APA internships disqualifying them from working at the VA. According to the APA the expectation of increasing APA internships is not promising. It cost and enormous sum of money and red tape for those that apply to become an APA internship so many internship sights don’t even try. The same can be said for the Social workers. Like psychologist the social workers lobby have used their political capital the same way the APA has.
For a Social worker to be hired must have attended a college that are accredited by the Council on Social Work Education (CSWE), this accreditation is limited to 231 LCSW Schools nationwide. Just like psychologist, if you were an active duty social worker but did not attend a CSWE school you are ineligible to work at the VA. Again the VA is limiting their resources to a select few. Both the APA and CSWE use their influence to ensure that those that pay to be a part of their organizations can work for the VA. The VA is having trouble filling the open mental health positions while our veterans are waiting weeks or months in many cases to receive help because of the APA and CSWE influenced lobby on congress and the VA.
With an average of 20 veterans committing suicide each day many find it unethical that the VA is not employing those that are qualified and licensed. Many licensed clinicians who are veterans can’t work at the VA, this is a real concern. I am aware of 2 veteran psychologist and multiple veteran Licensed Marriage and Family Therapist (LMFT) that the VA will not hire. Instead they hire peer counselors with little or no training in psychology, their requirement is they have had to be in the VA system as a patient. This is a good first step for veterans having someone who can help navigate the VA system but it is not the answer to the problem with veteran’s PTSD. The VA will hire minimally trained peer support specialist but not licensed mental health professionals, this makes no sense.
The income differential between the public sector and the government sector is also a problem. In California the starting salary for psychologist who works for non-profits pay more than the VA in most areas. Why should the 28% of licensed psychologist work for the VA for less pay? For veterans that are waiting for services, qualified licensed people are available if the VA would hire them. The only way we can make a change is contact our local politicians, and national veterans groups and voice your opinion. The VA needs to hire the people who are qualified and available. Until this change is happens I will have to keep getting pissed off about the 20 veterans a day that commit suicide and thousands waiting in line for help. It is unethical to maintain the status quo when there are qualified therapist available.
For questions or comments, I can be reached at bo@afterdutyvets.com or visit our website at afterdutyvets.com.