Along with enhanced partnerships between the VA and community providers, the executive order addresses suicide prevention and substance-abuse treatment, mental healthcare staffing, research and development, and the creation of an interagency task force that will develop new strategies to treat veterans. It requires the VA and HHS within 180 days to establish at least 15 pilot projects in which the VA will contract with community-based providers to ensure timely care for veterans.
“VA will work closely with our federal partners to implement the executive order immediately, and continue to expand access to the high-quality mental healthcare services our veterans have earned and deserve,” said VA Secretary Eric Shinseki in a statement.
The VA has traditionally been reluctant to pursue contracts with community-based providers, said Charles Ingoglia, vice president of public policy for the National Council for Community Behavioral Healthcare. Only one state—Montana—has contracted with the VA for clinical services on a statewide level for several years, he added, with most VA contracting limited to nonclinical services such as housing.
“It's impossible for the VA to have sufficient capacity to meet the needs” of veterans, Ingoglia said.
Ron Honberg, national director of policy and legal affairs at the National Alliance on Mental Illness, said the mandate to establish partnerships between community-based providers and the VA is important for several reasons. It will provide veterans and service members living in rural areas with increased access, and it will also offer access to veterans who choose not to seek mental healthcare services at a VA facility. “The VA doesn't have the capacity to reach everybody who needs it at this point,” Honberg said.
More than 2 million service members have been deployed to Iraq or Afghanistan since Sept. 11, 2001. A Government Accountability Office report published in October 2011 found that the number of veterans of those wars who have received mental healthcare services from the VA rose more than 300% to about 139,000 in 2010 from about 35,000 in 2006.
In April of this year, the VA's inspector general's office reported that first-time patients at the VA did not receive timely mental-health evaluations, and current patients often had to wait two weeks past their desired date for an appointment.