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Federal appeals court orders overhaul of VA mental health care

Friday, May 13, 2011 | 5:13 p.m. CDT; updated 10:45 a.m. CDT, Sunday, May 22, 2011

COLUMBIA — A federal appeals court has ordered a major overhaul of mental health care provided by the Department of Veterans Affairs, but the impact of the ruling at Harry S. Truman Memorial Veterans Hospital in Columbia was not immediately clear.

Delayed treatment, a lack of reductions in suicide numbers among veterans and poor handling of post-traumatic stress disorder were some of the issues raised by the Ninth Circuit Court of Appeals.

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“No more veterans should be compelled to agonize or perish while the government fails to perform it obligations,” Judge Stephen Reinhardt wrote in the ruling released on Tuesday.

Stephen Gaither, the public affairs officer at Columbia's veterans hospital, would not comment on the potential impact of the ruling on the local veterans hospital.

Veterans who walk into the hospital for mental health issues are "triaged" as soon as possible and seen by a health care provider within 14 days “we are mandated to,” Scott Sandstedt, a psychologist at the veterans hospital, said.

The local veterans hospital receives six to eight walk-in patients and about 10 referrals daily, Sandstedt said. Patients can choose to continue treatment at the hospital or any of its seven community-based outpatient clinics.

Last year, the number of veterans receiving health care increased from 32,035 to 33,756, according to the hospital’s 2010 annual report. Of these patients, Gaither said, 25 percent to 33 percent received mental health treatment.

Post-traumatic stress disorder is the primary diagnosis among veteran patients at the veterans hospital along with depression, traumatic brain injury and addiction, Sandstedt said.

The hospital has 65 to 75 staff providing mental health care including psychiatrists, psychologists and social workers.

In their 2-1 ruling, the three judges noted that an average of 18 veterans commit suicide each day. Of these, at least a quarter are enrolled in the VA system with an additional 1,000 suicide attempts reported each month, the ruling said.

Sandstedt said the policy at Truman requires that all veterans be screened for suicide at every visit, especially the first, and suicidal patients are identified frequently.

“It is not uncommon that veterans who are suicidal to contact us, and we have specific staff who work with these veterans,” Sandstedt said.

The judges said in their ruling that the VA is obliged to provide a mental health assessment within 30 days for any veteran requesting help but added that many applications languish for months or years and tens of thousands of those deemed in need of care are relegated to waiting lists because of chronic shortages.

The plaintiffs in the case are the Washington, D.C., based Veterans for Common Sense and Veterans United for Truth, in California.

The court took nearly two years to issue its decision. The case now goes back to U.S. District Judge Samuel Conti with instructions to write a court order to the government to provide the care and compensation promised to veterans by law.

On Wednesday, White House press secretary Jay Carney said that the Veterans Administration and the Justice Department would take a look at the ruling and work to address the issues raised by the court.

"The VA has seen one of the largest increases in its budget in the past 30 years," Carney said in remarks posted on the White House website. "So this is an issue we take very seriously, and that's why the administration will look at this ruling and consider it closely."


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