Veterans with PTSD get less treatment

Number of veterans treated grew 4 percent, but the
number of VA appointments rose just 1 percent.

MCCLATCHY NEWSPAPERS

WASHINGTON — The Department of Veterans Affairs, which touts its special programs to treat post-traumatic stress disorder in returning soldiers, spends little on those programs in some parts of the country, and some of its efforts fail to meet some of the VA’s own goals, according to internal reports obtained by McClatchy Newspapers.

In fiscal year 2006, the reports show, some of the VA’s specialized PTSD units spent a fraction of what the average unit did. Five medical centers — in California, Iowa, Louisiana, Tennessee and Wisconsin — spent about $100,000 on their PTSD clinical teams, less than one-fifth the national average.

The documents also show that though the VA’s treatment for PTSD is generally effective, nearly a third of the agency’s inpatient and other intensive PTSD units failed to meet at least one of the quality goals monitored by a VA health-research organization. The VA medical center in Lexington, Ky., failed to meet four of six quality goals, according to the internal reports.

A top VA mental-health official dismissed the reports’ significance, saying veterans receive adequate care, either in specialized PTSD units or from general mental-health providers. In addition, he said, some of the spending differences aren’t as extreme as the documents indicate, and the department is working to increase its resources for mental health treatment.

As the VA prepares for a surge of Iraq and Afghanistan veterans experiencing PTSD, it’s come under fire for staffing and funding shortfalls in its mental health units and for the wide differences in how much it spends on such treatment at its medical centers.

The agency maintains that it delivers consistently high-quality treatment.

The spending and quality numbers are in two reports that a VA mental health-research office produces each year. The reports used to be readily available to the public, but the VA removed them from its Web site in the past year. McClatchy obtained the most recent reports, for fiscal year 2006, under provisions of the Freedom of Information Act.

How bad it is

One of the reports indicates that the number of veterans using the VA’s specialized outpatient PTSD services is growing much faster than the number of medical appointments the VA is providing. The report shows that the number of veterans treated grew more than 4 percent from 2005 to 2006, while the number of appointments the VA provided grew just 1 percent, meaning that the average number of visits each veteran got dropped.

The VA has 153 medical centers, and one of the reports lists 103 centers with the special PTSD clinical units as of the end of fiscal 2006. The VA has added such units rapidly in the past year, and by the end of this year about 120 centers will have them, according to a May statement by the department.

Spending varies widely among the units, however, from more than $2,000 per treated veteran in centers in The Bronx, N.Y., and Boise, Idaho, to about $300 per treated veteran in Augusta, Ga., and about $200 in Palo Alto, Calif., one of the reports says.

Ira Katz, a top VA mental-health official, said different medical centers used different accounting systems but that the VA was working to make its PTSD care more uniform across the country.