One new psychotherapist began work at the Veterans Affairs Salt Lake City Health Care System this week and four more employees are being recruited, part of a nationwide surge to better treat veterans with mental health problems.
Nationally, the VA is hiring 1,600 mental health clinicians and 300 support staff to keep up with the demands of veterans returning from Iraq and Afghanistan with post traumatic stress, depression, substance abuse and other challenges.
The surge was announced this spring just before a blistering Inspector General's report riled members of the Senate Committee on Veterans Affairs.
That report concluded that the VA is much slower about getting veterans in for diagnosis and treatment than it claims. Sen. Patty Murray, D-Wash., committee chairwoman, said the report showed the VA engaging in "rampant gaming of the system" with the way it tracks data.
The new hires come amid the VA's ongoing review of its mental health operations.
The Salt Lake City VA system's five new positions are its share of the national expansion, said Scott F. Hill, chief of mental health for the VA, which serves all but two counties in Utah, as well as areas of southeast Idaho and northeast Nevada.
"This was a nice start. I hope that more are coming," said Hill, who has a request in for four more psychotherapists.
Besides the psychotherapist who began work this week, the VA is hiring a clinician to evaluate veterans for compensation and pension eligibility, an administrative support staffer and two registered nurse-case managers.
Psychologists or psychotherapists are most needed because there is an upswing in the number of veterans who "just need to talk to somebody," Hill said.
"As complicated as Vietnam vets are to treat and they have been complicated these veterans are even more so," he said. "They come with more issues."
Often, there is traumatic brain injury or dependence on pain medication.
"This generation is much more impulsive," he said, and that complicates treatment. They change their minds often and can make rash decisions.
Like Vietnam veterans, today's veterans come home and want to be left alone.
"We don't see them until there's substance abuse or marital problems or legal issues," he said. By then, their lives are like tangled balls of yarn, he said.
The number of veterans receiving mental health care through the Salt Lake VA system, including a number of community clinics, has risen 37 percent since 2008, and now totals 12,000 patients, he said. That's nearly a fourth of all VA patients.
Some are receiving care at clinics in smaller cities throughout the region, and others are treated at tele-health clinics, where they talk with their therapists via cameras on computers.
The VA's goal is to get new patients in for their first complete, diagnostic appointment within 14 days of their initial contact.
Hill said the Salt Lake system does that 95 to 96 percent of the time. "We've not gamed that system," he said.
However, getting veterans into the right treatment can take longer, he said.
"We can reduce their distress, we can get them on medication," he said. "Where we are shortest is in the psychotherapy."
The VA also is building more space for veterans who need to be hospitalized for mental health issues.
The number of beds in a secure unit will increase by 11 to a total of 32 by next spring. The hospital also will add 14 intermediate-care beds.
Further, it is doubling the number of beds available in residential substance abuse treatment facilities to 30, Hill said.