Mental Health Services Questioned

As more veterans from Iraq and Afghanistan seek mental health treatment from the Department of Veterans Affairs, lawmakers, advocates and even some VA experts have raised questions about whether returning troops will get what they need.

So far, 63,767 of those veterans have gone to VA offices with possible mental health problems, and 29,041 have received a preliminary diagnosis of post-traumatic stress disorder.

VA officials say there are enough staff members and resources to treat them, but critics say the VA is straining to keep up. A report that the VA gave to Congress in February noted a drop of nearly 20 percent in the number of visits with PTSD specialists per veteran from 1995 to 2005.

"We are concerned that this . . . reflects a decrease in capacity at a time when VA needs to reach out" to veterans of Iraq and Afghanistan, the VA report said.

Antonette Zeiss, the department's deputy chief of mental health services, said the February report is being updated to reflect improvements. "We have resources to provide very good care to veterans across the country," she said.

The total number of veterans from all eras treated by the VA for post-traumatic stress disorder jumped 30 percent from 2003 to 2005, according to VA figures. Zeiss noted that the new veterans represent a small portion of the VA's health-care caseload.

The VA has expanded its outreach with a program that aims to help returning veterans with stress disorders, officials said.

In addition, the VA recently completed the largest clinical trial ever of individual psychotherapy for post-traumatic stress disorder in female veterans.

But veterans advocates in some areas say they hear complaints of staff shortages and long waits to get care. Rep. Michael Michaud (D-Maine), a member of the House Veterans' Affairs Committee, cited the case of an Iraq veteran who gets 30 minutes of treatment a month for PTSD. "That's not enough," Michaud said.

"By and large, what we're hearing is that the services aren't there like they should be," said Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America.

There is no single course of treatment for PTSD because cases can be very different, said Ira Katz, a mental health official for the VA; services include one-on-one counseling, group therapy and medication.

In West Haven, Conn., Laurie Harkness said the community-based VA mental health clinic she directs has no wait. "We get people in right away," she said.

But in Portland, Ore., Larry Scott, editor of http://vawatchdog.org , said mental health clinics there "have just been decimated," with fewer staff members to treat a growing number of veterans.

Shad Meshad, president of the National Veterans Foundation, said the newest returning troops face a more complex trauma. They are "just young bombs like we were 30 or 35 years ago," he said, but now "you have PTSD layered by multiple tours of duty."

-- Donna St. George