VA shake-up disrupts mental health services for some US veterans

By Robin Respaut

SAN FRANCISCO (Reuters) - Joey Cortez, who served 24 years in the U.S. Air Force, had been waiting since August to see a mental health specialist from the Department of Veterans' Affairs, when he experienced a fresh jolt of anxiety.

Cortez was fired last month from his human resources job at the agency - one of about 2,400 employees who lost their jobs at Veterans' Affairs (VA) in the first wave of President Donald Trump's efforts to shrink the federal workforce.

"Once the firings happened and I was terminated, I started having panic attacks to the point where I black out," Cortez, who suffers from post-traumatic stress disorder, told Reuters. The layoff is also making it harder to maintain his sobriety, as a recovering alcoholic.  

"Not a day has gone by since I was fired that I haven’t thought about picking up a bottle," said Cortez.

After losing his job, Cortez asked the VA to expedite his wait for a therapist and was told there was no record of his request, he said. After a month of calls to the agency, he got an appointment for this August, one year after he started the process. Then the VA offered him an appointment next week because another patient had canceled.

The VA provides health care to 9.31 million U.S. veterans at hundreds of medical centers, clinics and nursing homes across the country.

It also faces complex problems. 

"The VA has bloat. There are redundancies. There are places where we have questioned the administration of care and asked, does it need to be the way it is?" Pat Murray, the legislative director for the Veterans of Foreign Wars, which represents Americans who have fought overseas, said in an interview.

The Trump administration plans additional cuts to the VA of more than 80,000 personnel, according to an internal memo obtained by Reuters. The agency has also announced it is phasing out telework.

Reuters spoke to nine current and former VA employees in California, Oregon, Texas and the Washington D.C. area who said the changes were further disrupting some mental health services and fueling anxieties among those who provide and rely on them.

The VA employees - who include six mental health professionals and three people in leadership positions - described cancellations of some in-person and telehealth appointments; confusion over staffing of a crisis hot-line; and professionals conducting telehealth visits in makeshift meeting rooms inside VA buildings. 

They spoke on the condition of anonymity, because they were not authorized to speak with the media.

STAFFING SHORTAGES

A former employee at the VA's Office of Inspector General, who is also a veteran, said any future large-scale staffing cuts would likely worsen shortages and impact the quality of care.

"There's no way to take a scalpel and do it appropriately that quickly," he said.

VA spokesperson Peter Kasperowicz told Reuters mental health professionals, such as psychologists and social workers, were not included in February's staffing cuts, and the agency is working to recruit mental health providers and improve wait times.

He did not specify how many support staff for these providers had been affected. 

Last week, two federal judges ordered the VA and other federal agencies to reinstate thousands of fired probationary workers. Cortez's pay was reinstated but he was told not to return to work.

The Veterans Health Administration, the branch of the VA that provides healthcare, has experienced severe staffing shortages since 2015, especially among mental health professionals, according to an OIG report last year. 

Veterans often benefit from specialized services to treat anxiety, trauma, depression and substance abuse. The proportion of veterans receiving mental health services rose to 31% in 2022 from 20% in 2007, according to the VA. Suicide among veterans is twice the rate of Americans overall.

The VFW's Murray said his organization supports a thorough review of the VA's mental health services, but it needs to be done carefully, "not with a chainsaw."

'THE MOOD IS SO LOW'

In recent years, the agency had encouraged remote work to help expand access to telehealth services and reduce wait times, especially in rural areas where recruiting providers is difficult.  

The VA's Kasperowicz said that, while providers will need to return to VA facilities, veterans will be able to access telehealth appointments.

He did not directly address questions about why mental health providers needed to return to the office.

"The VA will make accommodations as needed to ensure employees have enough space to work and will always ensure that Veterans' access to benefits and services remains uninterrupted as employees return to in-person work," Kasperowicz said.

In the last few weeks, demand for services among veterans who are VA employees has also risen, one of the mental health professionals, a social worker, told Reuters. A quarter of VA employees are veterans. 

The social worker said he is meeting with two to three VA employees a week who are seeking access to mental health care, citing stress and the fear that they will lose their jobs. 

"People are calling out sick. People are ill with stress and worry. The mood is so low."

A mental health supervisor in California described scrambling to cover the caseload of a remote worker who had to cancel appointments with more than a dozen veterans, because she could not access a VA facility. 

VA employees in the Washington area and in Oregon said mental health professionals were unsure if they were allowed to answer calls from the VA's crisis hot-line if they were not physically in an office, because they had been instructed not to conduct work outside of a facility.  

"People are nervous to be on-call," said a supervisor of mental health providers in the Washington area. "The system is under a lot of duress."

The VA told Reuters that crisis line workers are exempt from the return-to-office policy, and that staff continue to respond quickly to nearly 3,000 calls daily.

Therapists returning to the office are struggling to find private meeting rooms at some VA facilities, according to four of the mental health professionals interviewed by Reuters.  

They described medical and mental health professionals converting closets and conference rooms into offices to comply with the mandate to conduct telehealth visits from VA facilities. They expressed concerns that the crowded rooms could violate patient privacy rights. 

"We are scrambling to find space," said a provider in California. "Veterans are going without until we can find spaces for these providers.”

Reuters was unable to independently verify the accounts of overcrowding. Kasperowicz said the agency's "policy is to bring as many employees back to the office as space permits."

(Reporting by Robin Respaut in San Francisco; additional reporting by Julia Harte in New York and Gabriella Borter in D.C.; Editing by Michele Gershberg and Suzanne Goldenberg)