Delays concern veterans who have mental health issues

Published 12:00 am Saturday, May 19, 2012

By Karissa Minn
SALISBURY — Donald Shawver had to wait more than four months to see a psychiatrist at the Salisbury veterans’ hospital, and a recent federal report says he’s not alone.
The Gulf War veteran was seeking continued treatment for flashbacks and depression related to Post-Traumatic Stress Disorder (PTSD). He applied for assistance in Salisbury after moving from Texas about four years ago.
Shawver said few rotating professionals gave him emergency care at the hospital, but it took 41/2 months to get his first appointment with an assigned psychiatrist.
“Once I got in the VA system, they’ve done me pretty fair, but we need some changes,” Shawver said. “It’s a struggle to get good treatment. I believe they’re just overrun.”
According to an inspector general’s report released last month, many other veterans have waited months for an appointment.
At the W.G. “Bill” Hefner VA Medical Center in Salisbury, federal investigators found patients had to wait an average of 86 days to see a psychiatrist.
Hospital leaders said Friday that those patients had access to other forms of care, and they’re doing everything they can to make sure veterans get the help they need.
During the time of the investigation, staff members said the hospital was trying to replace three psychiatrists who had left within the past year.
“We had multiple providers that were retiring at once,” said Dr. German Molina, interim associate chief of staff. “Luckily, we are in a position to receive candidates and to be able to fill those positions again.”
Carol Waters, public information officer for the Salisbury center, said the federal Department of Veterans Affairs is looking to hire about 1,600 mental health clinicians and nearly 300 support staff.
The local hospital has already started the process.
“Since January, we have selected three new psychiatrists, two new mid-level nurses and six new psychologists,” said Dr. Cheri Anthony, supervisory psychologist.
Anthony said patients receive a full evaluation within the 14-day goal about 96 percent of the time.
But the inspector general’s report said the Veteran’s Health Administration overstated that percentage. For example, the report said, the Salisbury hospital counts 21-minute telephone intake interviews as full evaluations.
Anthony and Molina both said that while there may be long waits to see a psychiatrist, other mental health professionals are available on staff.
“Not everyone needs a psychiatrist,” Molina said.
Psychologists and social workers also can help veterans with their mental health. Mid-level nurses and other staff can prescribe and manage medication for those who need it.
“But treatment is not just medication,” Anthony said. “Especially for PTSD, there are a whole bunch of treatments that can be effective.”
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Shawver served for 14 months in Iraq, where his best friend of seven years was killed. He said he suffers from flashbacks “from time to time,” which at their worst have made him suicidal.
He said he’s worried about the younger Iraq and Afghanistan veterans who are coming home today.
“When you start shooting and killing people, it affects you,” Shawver said. “I shot a few people, and I started getting sick — seeing memories of their faces.”
Waters said the Salisbury hospital is using a number of creative methods to help veterans cope and recover.
That includes Salisbury’s new PTSD hub, which focuses on structured, evidence-based therapies that have been proven to show results. Psychologists can work with patients through video conference — no matter where they are.
“That keeps them from having to drive here or to another major medical center,” said Dr. Christopher Watson, acting coordinator of the specialized inpatient PTSD unit and the PTSD clinical team.
The inpatient unit enrolls veterans in a six-week group program, which they progress through together in cohorts, Watson said.
To help veterans get treatment sooner, the VA Mid-Atlantic Health Care Network has started a pilot walk-in program. For the past couple of weeks, some patients who see primary care physicians have been immediately referred to a mental health professional – without needing to make a separate appointment.
In addition, the network is continuing its co-location program, which allows mental health professionals and primary care physicians to work out of the same office.
Hospital staff members also are trained to help patients deal with other common mental conditions like depression and anxiety.
Construction has started on a new building that will coordinate inpatient medical and surgical services with local health care facilities, making the hospital a VA-designated Center of Excellence for Mental Health and Long-Term Care.
Anthony, Molina and Watson all encouraged veterans and their families to keep an open mind when seeking help.
“Just tell us what your issues are and what you need,” Anthony said. “Then let us help you find what’s going to work best for you.”
Contact reporter Karissa Minn at 704-797-4222.
Facebook: Karissa.SalisburyPost