manager and licensed social worker  at a Veteran Affairs Medical Center in Indianapolis apparently sent an e-mail that pokes fun at the mental health problems by showing a combat veteran as a Christmas elf ready to hang himself with holiday lights and another begging for a hit of Xanax.

The Dec. 18 e-mail, was obtained by the Indianapolis Star. It shows pictures of a toy Christmas elf posing as a patient in what appears to be the hospital’s transitional clinic for former troops.

The paper reports that the woman who sent the e-mail is Robin Paul, who manages the hospital’s Seamless Transition Integrated Care Clinic. The clinic provides returning veterans with transition assistance.

When initially asked about the e-mail, Paul responded, “Oh my goodness.” She then referred a reporter to the hospital’s public affairs department, which e-mailed the Star a statement for her:

“I would like to sincerely apologize for the email message and I take full responsibility for this poor judgment,” Paul said. “I have put my heart and soul into my work with Veterans for many years. I hold all Veterans and military personnel in the highest regard and am deeply remorseful for any hurt this may have caused.”

The e-mail was sent to the “IND STICC Team” with the subject, “Naught [sic] Elf in the STICC clinic.”

One photo depicts the elf looking between the legs of a female doll. “Trying his skills as a primary care provider (doing a pap),” the e-mail says.

Another shows the elf and a note with the words, “Out of XANAX — please help!” A caption says, “Self-medicating for mental health issues when a CNS would not give him his requested script.”

A third photograph of the suicidal vet has a caption that says, “Caught in the act of suicidal behavior (trying to hang himself from an electrical cord).”

Julie Webb, a Roudebush spokeswoman, said administrators were made aware of the e-mail “a couple of months ago.”

“The e-mail is totally inappropriate and does not convey our commitment to veterans,” she said. “We apologize to our veterans and take suicide and mental health treatment seriously, striving to provide the highest quality.”

Webb said the issue was “administratively addressed.”

“This type of behavior is completely unacceptable and we apologize to all our Veterans and their families,” said a statement from the VA released Monday. “This one incident is not reflective of the quality care and services that hundreds of thousands of Veterans receive every day from VA employees across the country. We are committed to treating our Veterans with respect and compassion and providing them the quality mental health care they have earned and deserve.”

Paul remains employed at the hospital. She earns an annual salary of $79,916. She received a $2,000 performance bonus in 2013, the Indianapolis Star reported.

Webb said she didn’t know how many employees were involved in the incident.

The e-mail comes at a time when the VA’s Secretary Bob McDonald has pushed for more funding through the passage of the Clay Hunt Suicide Prevention for American Veterans Act, designed to help veterans deal with an epidemic of veteran suicides. An estimated 22 veterans commit suicide in the United States every day, according to the VA.

The measure will help the VA study would fund new programs for prevention and give student loan incentives to help psychiatrists work with veterans.

Rep. Jackie Walorski (R-Ind.), a member of the House Veterans’ Affairs Committee, released a statement Monday on the issue: “In what is becoming all too common, the VA continues to turn a blind eye to negligence and inexcusable behavior by  their employees.  Ms. Paul should be ashamed of her actions and embarrassed for the veterans and the families she shamelessly mocked. What’s more concerning is she apparently is still employed by the VA. I don’t understand how keeping this individual on VA’s payroll will bring accountability to a department mired in scandal and negligence.  Her continued employment only lowers Americans’ confidence in the ability of the VA to provide medical care to service members, both past and present.  I hope that leadership within Roudebush grasps the fact that supporting veterans and their families must be their top priority, not saving a disgraced employee.”

Ken Hylton, commander of the Indiana Department of the American Legion, called for an investigation and told the Indianapolis Star that he wanted “immediate dismissal of this government employee and all of those who received this correspondence and said nothing.”

“It is a slap in the face to our recent and past veterans suffering from mental health issues every single day,” he said. “These men and women went to war and do not deserve this type of ridicule. This is a disgusting display of mockery. This is supposedly someone who is caring for our veterans, and we in the Indiana American Legion are disgusted.”

This is not the first time VA employees have made fun of veterans seeking care.

Last summer, a Department of Veterans Affairs office drew fire for likening disgruntled veterans to Oscar the Grouch in a training guide for employees who were preparing for a town hall meeting, according to the Philadelphia Inquirer.

It  obtained an 18-page slide show in which the agency’s Philadelphia benefits office used an image of the Sesame Street character to depict former troops who might come off as demanding.