Bill Seeks to Boost Number of Psychiatrists in VA

Legislation was introduced in Congress last month to address a severe shortage of psychiatrists in the Veterans Administration (VA) to serve members of the military returning from Afghanistan and Iraq.

The Ensuring Veterans Resiliency Act, introduced by Rep. Larry Bucshon (R-Ind.) and Rep. David Scott (D-Ga.), would establish a three-year demonstration program under the VA modeled on the Department of Defense Health Professions Loan Repayment Program, which offers physicians up to $60,000 in medical school loan repayment for each year of service. The bill also authorizes the VA to recruit at least 10 psychiatrists into the loan-repayment program each year; the VA would hire these physicians permanently to fill full-time positions, and participants would be required to demonstrate a long-term commitment to the VA.

Additionally, the legislation requires a report to Congress on the program’s impact on psychiatric vacancies and recruitment and authorizes a government study on pay disparities between psychiatric physicians at the VA.

In a letter of support for the bill sent to Bucshon and Scott, APA CEO and Medical Director Saul Levin, M.D., M.P.A., noted that veterans face significant mental health challenges and pointed out that several studies place the rate of posttraumatic stress disorder (PTSD) in veterans of wars in Iraq and Afghanistan at approximately 40 percent. And each year, approximately 6,000 veterans complete suicide.

“Staff vacancies likely contribute to the Veterans Health Administration’s (VHA) inability to deliver mental health services in a timely fashion,” Levin wrote. “Current policy makes it extremely difficult for the VHA to compete with other public and private entities in offering employment incentives, such as medical school loan repayment. According to USAjobs.gov, on September 17, 2013, there were 142 federal job vacancies for psychiatrists. Of those, 138 were for the VA, and 128 were for permanent hires. Of those permanent positions, only 33 were eligible for medical school loan repayment.

“The demonstrated shortage of psychiatrists is a contributing factor to the inability of the VHA to deliver mental health services in a timely fashion,” Levin wrote. “Given that the acute mental health needs of our veterans will persist for years to come, APA strongly supports the demonstration project established by the Ensuring Veterans Resiliency Act. This project . . . promises to identify a critical strategy for the VHA to maintain a robust and stable psychiatric workforce.” Levin noted as well that APA supports the bill’s requirement for a government report to examine pay disparities among psychiatrists at the VHA. “This report is critical for determining how pay disparities negatively affect the stability of VHA’s psychiatric workforce,” Levin wrote.

In a “Dear Colleague” letter written by Bucshon and Scott to fellow representatives, they urged support for the legislation, saying that a new way of encouraging more psychiatrists to choose a career with the VHA is needed. “We believe this modest legislation promises to identify a critical strategy for the VHA to maintain a robust and stable psychiatric workforce that can serve the acute mental health needs of our nation’s veterans,” they wrote. ■