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The Problem With VA Mental Health Services

Why is it still so hard for veterans to access mental health services?

By Jackson SherryPublished 2 years ago 8 min read
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It's no secret that the Department of Veterans Affairs has its problems when it comes to access to mental health services. The organization has made leaps and bounds in the right direction since it started recognizing and treating PTSD in 1980, but there is still a long way to go. Veterans like myself are constantly experiencing extremely lengthy wait times and a lack of choice when seeking out any care within the VA system.

In my experience, the VA has been pretty good. When I broke my neck in 2016, I received excellent care at the VA hospital in Palo Alto, CA. Since then, aside from a few minor outliers, my health issues have been addressed in a timely manner by a competent person. 

Essentially, the system works like this: I have a non-emergent health issue, I contact my primary care team either by phone or secure message, they respond to me somewhere between immediately to three days at which point we discuss what's going on, troubleshoot, and figure out our next steps. If I need tests, there is a local VA clinic I can go to. If I need to be referred to a specialist, one is chosen for me based on what the VA nearest to me offers. If the VA cannot provide the services I need within twenty days or within a thirty-minute drive radius, they can refer me to what they call the Community Care Program, which is a pre-picked civilian provider.

Regardless of whether we are receiving care from the VA or the Community Care Program, one thing remains consistent, we have no choice. The VA is not an insurance network that has a list of approved providers to choose from. We get what we get, which may be fine for most services, but mental health is a bit different. 

The person I choose to share the inner workings of my mind with is not a choice I take lightly. It is not a gap I allow to be filled by whoever happens to be there. In order to reach the necessary level of vulnerability, I need to be working with someone who is the right fit for me. For the first few years following my accident, I worked with a fantastic therapist from the VA in Palo Alto. He drove a three-hour round trip to see me each month and the time we spent together was full of growth and progress. He eventually took a new position at the VA and was no longer able to see me, at which point I decided to take a hiatus from therapy altogether. 

After three years my mental health began to decline and I made the choice to pursue therapy once again. This is my experience:

During my annual physical, I spoke to a psychologist and asked about a referral to local VA mental health services (my primary care team is based in Palo Alto, but I live ninety minutes away). I was told that if I called my local VA mental health clinic they would see me within three days, which would be much quicker than her entering a referral into the system. 

I procrastinated, then eventually called my local VA clinic. After listening to the automated options, I pressed the appropriate '0' to reach the operator. I asked to be transferred to the mental health clinic. A few seconds later, someone answers the phone. After inquiring about seeing a therapist I was told that, due to my proximity, they would refer me to community care. I was confused because my local clinic is only a twenty-minute drive on a bad day. I prodded the person on the other end of the phone, soon discovering that I was speaking with the Menlo Park mental health clinic, a ninety-minute drive.

Back to the operator. 

I made sure to clearly specify that I wanted the Monterey clinic. They confirmed and transferred me. This time, the phone was answered by the security desk at the Monterey clinic. Right location, wrong department. I refused to let them transfer me back to the operator and politely, yet firmly, asked them to transfer me to the mental health clinic. They made a few strong attempts, then hung up on me.

I called back, reached the operator, and once again made my request. This operator searched for a few moments, then told me, "There isn't an extension for that clinic, so I'll just transfer you to 49832 (I don't remember the exact number)." The phone rang a few times then went to the voicemail of a community care extension that had nothing to do with mental health. By this point, I had lost all faith in the phone system and decided to give up.

I sent a message to my primary care team in Palo Alto, asking them to input a referral for the mental health clinic, knowing that this would result in them calling me. The ball was in their court. A few days passed, and the scheduler for the mental health clinic called me. My plan worked. 

My options were a video call or a phone call with a social worker who would help me get established at the clinic. I asked for an in-person appointment, but that wasn't an option for the initial visit. So far, so good. I had a video appointment for 8:30 a.m. a few days later.

The day of my appointment rolled in and I was signed in and ready to chat at 8:27 a.m., eager to get this consult out of the way and make my first therapy appointment. 8:30 came around, then 8:35, then 8:39. My phone rang. Caller ID showed that it was the VA. I answered. The social worker I was supposed to meet with asked for Sherry Jackson. I understand that I have a name that could go both ways, but the VA lists everyone the same way: Last name, comma, first name, middle initial. SHERRY, JACKSON S. is pronounced, "Jackson Sherry," just like JONES, MATTHEW M. is pronounced, "Matthew Jones."

Immediately, we are off on the wrong foot. I wasn't too worried, because this was a consultation, not an initial meeting with my therapist. She was having trouble with her audio and asked if we could conduct the interview over the phone. I agreed. She didn't hear me. I agreed louder and more clearly. The next portion of the interview sounded like she was reading from a form. She asked me some standard questions about suicide. I had to repeat myself multiple times due to her audio issues.

We moved on to talk about my reasons for seeking counseling. I gave her a very brief overview of what I've been dealing with. She asked if we could dive a little deeper and talk about some of these issues. This is where I started to get confused. I asked what the purpose of the phone call was, and why I needed to explain every detail to her before doing it all over again to my therapist. She informed me that she was the therapist who would be working with me, provided I wanted 1-on-1 counseling.

We got off on the wrong foot which, for a potential mental health provider, is an immediate disqualifier. She was late for our appointment, got my name wrong, spoke in a mildly abrasive and robotic tone, and needed me to frequently repeat myself and speak louder. There was no way I could move forward and work with this person as my therapist. I just couldn't allow her access to my most vulnerable thoughts. 

I told her that a phone appointment with this poor of a connection wouldn't work. I can't talk openly while sitting in a house that I share with three other people, while constantly needing to speak loudly and repeat myself. In an attempt to get out of the VA system, I asked if she could refer me to Community Care, letting her know that this wasn't working for me. She told me that, since the VA offers the service within my area, my request for Community Care would get kicked back to her.

Searching for a way to take back control of the situation, I let her know that anything other than an in-person meeting wouldn't work for me. According to the scheduler, in-person appointments weren't available, which is how I ended up on this phone call. She told me that wasn't the case. She offered in-person meetings on Tuesdays and Thursdays. That solved one of my problems, the necessity to sit in a private space with no possibility of someone walking in on me or overhearing things that I don't wish to share with them. I was, however, still stuck with this person as my only option for a therapist.

I agreed to let her kick me back into the scheduling process so I could make an in-person appointment. As soon as our phone call ended, I messaged my primary care team once again and asked if, since I'm technically under the care of a VA outside of the driving range, they could refer my case out to the Community Care network.

I'm still waiting on the results of my proposed loophole, but going through this process has me asking the question: Why is it still so difficult for veterans to access mental health services? I'm a relatively patient person and the process so far has outraged me. I can't imagine what someone having a mental health crisis would feel while reaching out for help in this broken system. 

The barriers to entry are not the only issue. The other, more important problem is the lack of choice. When selecting someone to help me take care of my mind in a delicate, vulnerable setting, I need to have a say in who that person is.

veteran
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About the Creator

Jackson Sherry

Like many others, I'm on a journey in search of mental clarity. I've been a lot of things; a US Navy submariner, a rock climber, a filmmaker, and a life coach, to name a few. But, life's a little too complex to settle for just one label.

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