Today, I listened to the House Committee of Veterans Affairs hearing to address the scandalous situation stemming from e-mails provided in discovery at the recent trial in San Francisco.  I will try to give you my honest impressions of the hearing.

First, the Secretary of the Veterans Affairs came across as out of touch, inept, and unable to deal with the fact that thousands of veterans suffer from mental health issues such at PTSD/TBI which leads to substance abuse, domestic violence, depression, and suicide. 

The Secretary, from high aloft his pedestal which may be called the DVA/VHA bureacracy doesn’t get it.  Dr. Michael Kussman and Dr. Ira Katz obviously don’t get it.  Gordon Mansfield doesn’t get it.  I was not certain but it appears Gerald Cross, Principal Deputy Under Secretary for Health, Veterans Health Administration may get it.

I have written previously that Congress should not make Dr. Katz a scapegoat.  Let me be the first to admit I was wrong.  Not only was I not impressed with the doctor personally, he comes across as a sniveling, inept administrator, but also I was not impressed with his grasp of the situation and his ability to deal with the problem.

Unfortunately, all the Secretary could do was to say his concern for veterans was paramount, make nonsensical excuses, and point to two year old data.  It was obvious that the Department had no meaningful data for suicides or real method of collecting it, not that that matters. 

The Secretary’s answer was another Blue Ribbon Peer Review Committee to look at what and how the Department is addressing the problem and confirm things were “under control”.  Congressman Filner had a fit!  It was very clear he was not swayed by the Secretary’s recommendation.

Expert witnesses, particularly Professor Emeritus Ronald William Maris, Ph.D., University of South Carolina and M. David Rudd, Ph.D., Texas Tech University provided a clear view of the failings of the Department, both fundamentally and clinically.  It was pointed out that a veteran, suffering from PTSD, deep in the troughs of depression, is faced with a 23 page application, a C& P exam, and then months or years to receive “permission” to be treated.  Is it not amazing even more veterans don’t suicide?

The Ranking Member could do nothing but attempt to undermine the hearing, and of course the trial, by disparaging questions and comments about the motives of CBS News and whether the data they provided was verifiable. 

In point of fact, Professor Maris pointed out that the mental health assessment questionnaire is of no actual use, is less than cursory, and would provide no meaningful data from which to focus efforts showing that the Department has not taken the problem of suicides seriously.  The DVA’s assessment is two questions meant not to address fifteen potential risk factors, but to permit the Department to say it is doing something.  The mental health plan, well into its third year of implementation is useless.  It will never be implemented. 

Suicide prevention coordinators surround the ivory towers, most often at the huge medical centers, but not one at a CBOC.  Family counseling is non-existent, and the Outreach Program is non-persuasive.  It consists of pamphlets ignominiously vouching for the “professional” care provided. 

The DVA program does not seek to implement vet-to-vet assistance or provide outreach training to community clergy so families of effected servicepersons who might mention a potential situation may be referred.  It does not provide trained staff in and around the communities serviced by service centers and outpatient clinics.

It is so obviously clear that the DVA/VHA have ceased to be relevant in servicing veterans.  It is time to dismantle the federal bureaucracy and replace it with aggressive community-based outreach, streamlined processing, and adherence to more than minimal standards of care. 

Rather than relying on “doctors” replete with fine educations, discussing issues of public health and epidemiologies, and the implementation of standard processes, we need leaders with flexibility, who can think outside-the-box, can act decisively, and communicate effectively to change the culture of the Department. 

The Chairman requested an action plan from the Secretary within 15 days.  I am one vet that will not hold his/her breath. 

Congress should demand the resignations of the Secretary and the Under Secretary of Veterans Affairs, the Under Secretary for Health, and the Chief, Mental Health Branch to start then move to the fortress of the Veterans Benefits Administration.  The inability to insure transition and treatment is grounded in a quagmire of forms, applications, processes, and denial rather than getting a vet help.