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Outrage Among Therapists And Veterans Over San Diego VA Mental Health Care

 November 18, 2020 at 11:17 AM PST

Speaker 1: 00:00 The San Diego VA is making access to mental health care harder for local veterans during the COVID-19 pandemic therapists say the agency's actions are dangerous and irresponsible investigative reporter Brad Racino with KPBS partner. I new source has the details. Speaker 2: 00:23 That's the humming of Wendy Belding. She's a San Diego therapist who specializes in helping PTSD and sexual abuse survivors. That's because the San Diego VA doesn't have the resources to treat all the vets. It cares for. The arrangement has been around for years and building is one of many providers in the County, but recently the LA Jolla therapist has had a hard time getting the VA to continue authorizing mental health treatments for her patients. Belding has heard the agencies on hold music so often she can hum it from memory. Speaker 3: 01:01 Now it's like a 45 minute wait on hold saying how much they care about veterans and how much, you know, their concern is about veteran suicide. And you're waiting and waiting. Speaker 2: 01:13 Five clinicians told, I knew source that without much warning or explanation, the VA has started making it more difficult for veterans to get the okay to go outside the system for mental health care. And with the coronavirus pandemic growing worse building says now is not the time for the system to falter. I'm Speaker 3: 01:32 Concerned that this is like the perfect storm Speaker 2: 01:34 Suicide rates among military personnel reached an all time high last year. But recent reports suggest COVID 19 may be making things worse. Army officials reported a 30% increase in suicides among active duty soldiers during the first six months of the pandemic. Speaker 3: 01:52 It's frankly frightening. What's going to happen to veterans. Speaker 2: 01:57 Those interviewed for this story told, I knew source. At least three veterans have taken their lives over the VA's actions. One was a patient of San Diego psychotherapist, Devin price. Speaker 1: 02:08 She was told, no, you can't have any more sessions. Speaker 2: 02:11 Price says the VA denied the woman further treatments in December in April, the veteran took her life. Speaker 1: 02:18 I sent in a report, the after action report and no one contacted me nothing. So she's just gone. She doesn't live anymore. And that's it. No, they never checked in with me about anything. Nobody Speaker 2: 02:27 In some cases, treatment stopped before eventually getting VA approval in others, veterans and therapists that they've been waiting weeks or months for authorizations. Several therapists are continuing to treat patients with no guarantee of payment by the VA because they can't bring themselves to stop helping the vets building is one of them. Okay. Speaker 3: 02:46 If one of my clients commit suicide and I made the choice to not take care of, um, I'm not willing to live with that. Speaker 2: 02:57 We sent the San Diego VA list of questions about the mental health care cuts. A spokesperson wouldn't answer any of them. Instead. He asked for the names of the veterans and therapists interviewed for this investigation. One of those events is April Cobelli. She's a 37 year old Navy veteran with a history of PTSD, depression and sexual trauma. She says it's always been tough, getting good mental health care from the VA, but recently it's gotten worse. Speaker 4: 03:25 It's such a looming institution. It has so much red tape and different things that you don't understand Speaker 2: 03:32 After years of being bounced from one psychiatrist to another, within the VA system Cobra, Lee says she finally found stability with an outside provider, but now she's been waiting weeks to hear from the VA, whether she'll be able to continue those sessions. Speaker 4: 03:47 I think it gives you kind of like this like hopeless feeling, kind of where it's like, I keep having to push to get what they promised and it's exhausting. It's it's I know why a lot of people give up Speaker 1: 04:05 Joining me is I knew source reporter, Brad Racino and Brad, welcome to the show. Thanks for having me. Now you say the practice of the VA contracting with outside mental health providers has been going on for years, but how long has this recent problem with access been going on? Speaker 2: 04:22 It appears to have started sometime in mid to late 2019. I first heard about the problem earlier this year, when I naively thought that it was related to just one clinic in LA Jolla, where veterans were being treated with ketamine. And at the time the doctor there told me he first started having issues with VA authorizations around the summer of 2019. Then when I started interviewing people for this story, I found out the problem was much more widespread and it appeared to have started for them a little bit later around December or so of last year. Speaker 1: 04:54 Now the San Diego VA did not answer any of the questions you put to them about this issue. What were the questions you asked them? Speaker 2: 05:03 Well, I sent them a list of nine questions. Some were very specific. Um, others were, were pretty general and actually linked to the questions in our stories. So readers can see them, but I basically just wanted to know what is going on here. Why are there problems with vets getting mental health care? Um, you know, what measures has the VA taken to prevent any kind of catastrophic outcomes or increased veteran suicide? And I asked them a couple more specifics about their independent contractor tri West and what was going on there just very, you know, very specific things that should not have been a problem to answer. Speaker 1: 05:35 Did the VA say anything about the delays? These vets and therapists are encountering? Speaker 2: 05:40 Yeah, they said there was no delay that everything was, was fine. Um, they said that, uh, no patients are encountering clinically significant delays and then they added that they are aware of issues moving from a prior contract provider to a new one, but that they service as quickly as possible. Um, and again, that there's not an issue. Speaker 1: 06:01 Tell us about that change that prior contract provider, tri West, there seems to be from your story, something about that change that perhaps precipitated this. Speaker 2: 06:13 Yeah. Tri West has been around for years. There are major healthcare company throughout the country and they manage, um, BA kind of contracts with these outside providers. They do it in California. They do it in a bunch of other States. They were actually awarded a $26 billion contract to do this last year for 13 different States. And they're supposed to be kind of like that middleman between the VA and these outside providers. They're also supposed to be a customer service contact point of contact for veterans having issues. And the therapist I interviewed told me that they actually enjoyed working with tri West in the past, but all of a sudden, you know, earlier this year, they just found out through the entire tri West staff in San Diego was let go with no explanation. They couldn't find these people. They couldn't talk to them again. And the VA ended up bringing what tri West was doing back in-house at the VA. So now they're handling what it appears that they had paid another company already to do. And there's a whole bunch of confusion as to why is this going on? Why is this happening? Speaker 1: 07:08 So there's no indication why the VA chose to remove tri West? Speaker 2: 07:13 No, the only thing I've heard are rumors. I mean, the therapist I've talked to have some friends inside the VA and they have heard through the grapevine that it may have to do with budget cuts, that the VA may not have enough money to, um, be handling some of these things. So they're trying to take it in-house but that that's just rumors. I have not been able to figure out what is going on here. Because as I said before, the VA won't answer these questions. Speaker 1: 07:36 No, the therapist you spoke with whose patient committed suicide said there was no follow-up response from the VA after she submitted her after action report, what kind of follow-up should the VA have done? Speaker 2: 07:50 Well, you would think in a case like this, that the agency would want to know what went wrong here. Um, if a veteran dies and takes her own life in San Diego and they were under VA care, the VA should, should better understand what led to that. Why did this happen? What can we learn from it? What can we do better in the future to prevent this? And instead they did no such thing. And as we also reported in the story, this isn't the first time that a veteran has taken their life and the VA has made no effort at all to learn from the doctors, you know, providing for this veteran, what happened. So this isn't unique. Speaker 1: 08:25 Brad could this problem within the VA, which is apparently jeopardizing vets who need mental health support, especially during COVID, could it be caused by COVID? And by that, I mean, has the VA experienced perhaps an impact on staff and administration? Like many other hospital systems, Speaker 2: 08:44 The VA has been impacted by COVID. Um, but the VA has been understaffed for a very long time and it actually in February the agency, some data showing that it was short 44,000 healthcare professionals. So this isn't the San Diego VA, this is all BS around the country. Um, so they're definitely short staff, but as I mentioned earlier, these problems with authorizations started long before COVID ever came on the scene. So I, I don't believe that this is related to COVID really Speaker 1: 09:16 Are any local members of Congress aware of this problem of accessing mental health care at the San Diego VA. And if so, are they doing anything about it? Speaker 2: 09:26 I reached out to a representative Scott Peter's office last week and spoke to some of their staff. They said that they had not heard anything about this. They hadn't heard any complaints from any of their constituents about this. Um, they took some, some guesses as to what might be going on, but said they're, you know, they're Manning mending the desk waiting to hear if, if there are any issues with this, but so far, no, no one has done anything about this. Speaker 1: 09:51 And you mentioned a little earlier about, uh, people who are hearing this can read more about it. Where can they read your full report bread? Speaker 2: 09:58 They can read that I knew Um, and they can also watch it tonight on KPBS TV. Speaker 1: 10:04 All right. I've been speaking with investigative reporter, Brad Racino with KPBS partner. I news source, Brad, thank you so much. Thanks for having me, Maureen, if you, or someone you know, is considering suicide call the national suicide prevention hotline at +1 800-273-8255.

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Amid a worsening pandemic, the San Diego VA is making access to mental health care harder for local veterans, outraging therapists who say the agency’s actions are dangerous and irresponsible.
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