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Originally published Sunday, July 20, 2014 at 5:12 PM

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Guest: How to get veterans psychiatric care they need

Ensure that the significant mental health needs of our veterans are not overlooked, writes guest columnist Peter Roy-Byrne.

Special to The Times


THE national controversy that has engulfed the U.S. Department of Veterans Affairs (VA) strikes close to home. Washington is home to more than 602,000 veterans, men and women who have sacrificed for our country and deserve timely access to care rather than the reported months-long waits for appointments. It’s time for urgent action to right these wrongs.

In Congress, legislation is moving through both chambers that would make sorely needed reforms in the VA’s delivery of health-care services. The bills that the U.S. House and Senate are working on are to be applauded, for they are good efforts that have garnered bipartisan support.

But the legislation should go further. Our leaders in Washington, D.C., including U.S. Sen. Patty Murray, D-Wash., have an opportunity to ensure that the significant mental-health needs of our veterans are not overlooked. Seize this moment for comprehensive reform.

No matter their branch of service, their age or their background, it’s well-documented that veterans face significant challenges, including depression, anxiety, post-traumatic stress disorder (PTSD) and substance-use disorders.

These mental-health issues are real, serious and sadly too often undiagnosed or untreated. They can also be deadly: We know that, across the country, about 8,000 vets take their own lives annually — 22 on average each day — and some of those preventable deaths happen in Washington state, though they may not make headlines.

These interminably long wait times should not be tolerated. But it’s not the full picture. In fact, many veterans may not receive adequate treatment for mental illness or substance-use disorders for another reason: a persistent shortfall of psychiatric physicians in the VA system to meet the need.

The Office of the Inspector General for the VA wrote, in 2013, that the department’s “greatest challenge has been to hire and retain psychiatrists.” But there’s hope if the U.S. levels the playing field and equips the VA with recruitment tools that other top employers have.

The VA, because of how current law is written, isn’t able to compete with other federal departments and private-sector employers in attracting talent. Employment incentives such as medical education loan repayment are a potent recruitment tool for new hires, including psychiatrists. In Washington state, only four psychiatric vacancies statewide are currently eligible for loan forgiveness. What’s the solution?

The Ensuring Veterans’ Resiliency Act (H.R. 4234/S. 2425) is bipartisan and was introduced by U.S. Reps. Larry Bucshon, R-Ind., David Scott, D-Ga., and Sen. Mark Begich, D-Alaska. It deserves support.

While the legislation is in many ways modest, it provides exactly the tool that the VA now needs — implementation of a pilot project where the VA recruits a limited number of psychiatrists into long-term employment with competitive medical school loan forgiveness incentives.

The burden of debt from medical school often leads young doctors to seek out the highest-paying work opportunities, rather than to begin their professional career working where they may be most needed. This bill complements the VA reforms that Congress is now considering, so when leaders from both chambers work to reconcile their bills into one, we urge that the resiliency act is part of the agreement.

Every one of Washington’s veterans pledged to defend our country, and now Congress has a chance to defend them by passing comprehensive reforms in the VA health-care system. Their mental-health needs cannot and should not be overlooked, and a proper workforce is a part of delivering on that promise. The resiliency act does just that.

Dr. Peter Roy-Byrne is president of the Washington State Psychiatric Society.

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