Wednesday, May 11, 2011

Court blasts VA for mental health care

TUESDAY, MAY 10, 2011 AT 8:41 P.M.
In an impassioned legal decision that quotes Tennyson and Abraham Lincoln, a federal appeals court in San Francisco said the U.S. Veterans Affairs Department has failed to provide adequate mental health care to battle-traumatized veterans and ordered the agency to overhaul its programs.
The language in the 104-page decision, handed down Tuesday by a three-judge panel of the 9th U.S. Circuit Court of Appeals, could hardly be stronger.
“There comes a time when the political branches have so completely and chronically failed to respect the people’s constitutional rights that the courts must be willing to enforce them. We have reached that unfortunate point with respect to veterans who are suffering from the hidden, or not hidden, wounds of war,” said the decision, written by Judge Stephen Reinhardt.
San Diego is home to the nation’s largest population of recent veterans, estimated at more than 28,000.

Download: VA decision

VA officials wouldn’t respond to the court’s ruling Tuesday afternoon, referring questions to the U.S. Justice Department, whose spokeswoman said the decision was being reviewed.
In the past, VA-San Diego officials have said they learned from the lessons of the Vietnam Warera and have bulked up their psychotherapy staff. Last year, the La Jolla hospital reported it had 12 psychiatrists and 30 other health-care professionals assigned to work with post-traumatic stress disorder patients, either one-on-one or in group sessions.
The lawsuit against the VA was filed by two nonprofit groups, Veterans United for Truth in Santa Barbara and Veterans for Common Sense in Washington, D.C. The court agreed with their argument that veterans were being denied their right to care because of huge wait times and ordered the VA to negotiate with the plaintiffs on fixes.
At least one local Iraq veteran says the VA has improved but it still has a long way to go before it treats PTSD in a realistic way.
Joseph Qualls is a 30-year-old Chula Vista resident who served in Iraq as an Army infantryman in 2004 and 2005.
Qualls said the VA system should be refined so wait times are reduced and experienced people are processing benefit claims. It took him two months to get his first therapist appointment for treatment of PTSD.
“As far as long-term service, if you say I’m not suicidal, I’m not homicidal, it’s going to take anywhere from a month to three for an Iraq or Afghanistan veteran. One guy called me and said, ‘Hey man, it’s been six months.’ ”
He added that it can take longer — six months to a year — for a veteran with PTSD to get financial benefits that would help him exist in civilian life even as he struggles to keep or find a job and relate to his family.
A lawyer for the groups that filed the lawsuit said the backlog of cases keeps growing despite increases to the VA budget and staff.
“A lot of people have been hired by the VA. There’s a tendency to hire social workers at a lower cost, as opposed to psychiatrists. There’s been a major trend away from individual therapy. Instead they use group therapy because it’s cheaper,” said Gordon Erspamer, lead attorney for the veterans groups.
“There’s been a huge decline in the number of inpatient beds at VA hospitals. They deal with people on an outpatient basis. I think that has led to a lot more suicides because they can’t be given the same level of care,” Erspamer said.
The court decision highlighted the prevalence of suicide among veterans, quoting the statistic that 18 military veterans will end their lives on an average day. Of those, roughly one quarter are enrolled with the VA.
“The VA’s unchecked incompetence has gone on long enough; no more veterans should be compelled to agonize or perish while the government fails to perform its obligations,” Reinhardt wrote in the court’s decision.
“Having chosen to honor and provide for our veterans by guaranteeing them the mental health care and other critical benefits to which they are entitled, the government may not deprive them of that support through unchallengeable and interminable delays.”
The VA can appeal Tuesday’s decision to the full 9th Circuit court and, ultimately, to the U.S. Supreme Court.

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