The VA is also expanding its efforts. When he appeared before the Senate Veterans Affairs Committee last February, R. James Nicholson, secretary of the VA, said, “The department will continue to place particular emphasis on providing care to those suffering, as a result of their service in Operation Enduring Freedom and Operation Iraqi Freedom, from a spectrum of combat stress reactions, ranging from readjustment issues to . . . PTSD.”
Ira Katz, MD, PhD, deputy chief patient care services officer for mental health at the VA, said in an interview that the VA is working hard to expand mental health services for both veterans with PTSD and those with other psychiatric diagnoses. Reflective of that effort is a request for proposals recently issued by the VA. The 21 Veterans Integrated Service Networks (VISNs), which are regional arms of the VA, were asked to submit proposals for better integrating mental health care into primary care settings. Laurie Tranter, a VA spokeswoman, said there is no dedicated funding stream attached to this initiative. The first set of winning proposals will be funded in fiscal year 2006 and will have their funding continued in fiscal year 2007, when additional VISNs may be added to this new program.
Katz explained that of the 555,500 veterans who have returned home since the Iraq and Afghanistan war fronts opened, 168,500 as of February 2006 have elected to seek care from VA health centers for a psychiatric diagnosis (the second most common diagnosis after musculoskeletal conditions) and 15% of the latter group sought treatment for PTSD.
In addition, the VA is slowly setting up 3 new centers of excellence for mental health that were mandated by Congress. Legislation for these centers was established by Congress in 2005 and sponsored by Sen Kay Bailey Hutchison (R-Tex). Nicholson designated the 3 centers on December 5, 2005, to the VA hospitals in Waco, Texas; San Diego; and Canandaigua, NY.
VA officials in the 3 cities are currently searching for directors for those centers. They could be psychiatrists, psychologists, doctoral social workers, or doctoral nurses. “We are very pleased the centers will give us opportunity to focus on PTSD and other mental health conditions, including the stress and resiliency veterans experience throughout their life span, from the point they leave the military and as they age,” Katz stated.
Meanwhile, Congress is likely to increase VA mental health funding for those centers and for support of initiatives such as better mental health care at primary care clinics. The appropriations bill for the VA, passed by the House a few days after the GAO report on PTSD came out, contains $2.8 billion for specialty mental health care for fiscal year 2007, which starts on October 1, 2006. That would be an increase over the $2.2 billion budgeted for fiscal year 2006, according to Tim Peterson, a staffer on the House Appropriations Subcommittee on Military Quality of Life and Veteran’s Affairs. Treatment for PTSD and funding for the 3 centers of excellence is included within the $2.8 billion. The Senate has not acted yet.
Dan Gage, spokesman for Rep James Walsh (R-NY), chairman of the House appropriations subcommittee in charge of VA and DOD mental health funding, said it is not surprising that the VA is taking its time setting up those 3 centers. “It is a new step for the VA and we don’t want to rush to do it just to say we did it,” explained Gage.
