The Department of Veterans Affairs, sharply criticized in recent weeks for delays in getting help for veterans with mental-health problems, promised an aggressive timetable Monday to hire hundreds of psychologists, counselors and social workers this year.
The VA said it has put together a team of experts and established a recruiting and retention program to meet VA Secretary Eric Shinseki's goal of hiring 1,600 more mental-health clinicians. VA officials said they hope to fill most of the positions within six months, except for hard-to-fill jobs such as psychiatry, which they hope to fill by spring 2013.
The VA, responding to a crush of Iraq and Afghanistan veterans needing services for post-traumatic stress, depression and traumatic brain injuries, has increased its mental-health staffing by 41 percent since 2007 to more than 20,000 employees nationwide. But the VA still has 1,500 vacancies, including many psychiatrists. The problem is particularly acute in rural areas and cities with a high cost of living.
Mary Schohn, a clinical psychologist and director of Mental Health Operations for the VA, said she hopes that as more personnel are added "follow-up times will be sooner, veterans will be satisfied with the care they're receiving and there will be more consistent staffing across the country."
Some members of Congress and watchdogs in the veterans community have wondered why the VA would announce plans to hire additional personnel when it hasn't filled existing positions. The leadership of the largest group of licensed professionals in the U.S., the American Counseling Association in Alexandria, Va., has also been highly critical of the VA for not hiring its members when veterans are going without timely services.
"There are 120,000 licensed professional counselors in the U.S., many of whom have served in the military," said David Kaplan, chief professional officer for the organization. "But the VA is simply not hiring us."
For many years, the VA did not hire licensed professional counselors because there was no job description, preferring to hire psychologists and social workers. Congress stepped in six years ago to create a job category for mental-health counselors, but the details were four years in the making. Even after the details were worked out, Kaplan said, the VA has been dragging its heels.
"Over the last four-month period, we have seen 18 positions posted across the country for licensed professional mental-health counselors versus 503 positions for social workers," he said.
Schohn and Bradley Karlin, a clinical psychologist and the national mental health director for psychotherapy and psychogeriatrics in the VA, said the lag in hiring licensed counselors results from "a lot of misinformation" within local VAs over whether the counselors could be hired yet. The confusion arose because the national VA had not completed professional standards for the new positions, they said.
Mental-health staffing became an issue last month when an inspector general's report said the VA had been boosting its data on the timeliness of services provided to veterans. The VA told Congress that 95 percent of veterans received a full mental-health evaluation within two weeks. But the report said that it was really half that number and that many veterans were waiting months for an evaluation.
Kaplan called the VA's delays in hiring counselors "unconscionable" because of the consequences to veterans.
Licensed mental-health counselors who have master's or doctoral degrees would be of significant help, Kaplan said. They are trained to treat anxiety, stress, family issues and post-traumatic stress as well as help with the transition from military to civilian life, he said.
Kaplan said his organization has met with senior VA leaders multiple times in the past six months, and "their consistent response is to tell us 'it's not our job to tell local VAs who to hire,'" he said. "The solution is for central VA to provide leadership and take an active role in directing the local VAs to hire mental-health counselors."
Schohn and Karlin said the central VA is providing "national guidance" and has implemented a plan for tracking the hiring of psychiatrists, psychologists, mental health nurses, licensed counselors and marriage and family therapists.