VA shortens wait for mental health help

• Robin Aube-Warren is new director of Wilmington VA Medical Center
• She is a veteran who participated in the invasion of Panama

Two years ago, veterans seeking mental health care at the Wilmington Veterans Affairs Medical Center near Elsmere were waiting far longer than the agency's two-week standard to be assessed, and as many as two months before beginning therapy.

Those delays have been shortened considerably. New patients – save those considered as emergencies – who ask to be assessed specifically for mental health issues get their first appointment in an average of 6.5 days after enrollment, says Robin Aube-Warren, the center's brand new director. They begin their treatment plans within 10 days after that assessment – five fewer than in 2012.

Overall, the average wait time for newly enrolled veterans to be seen by a primary care provider at Wilmington is 11 days. Primary care referrals are typically the way vets are sent to mental health treatment, she said.

"We have improved in our timeliness," said Aube-Warren, who just completed her fourth week on the job, although she served as interim director for two months last summer.

She said she couldn't comment on Wilmington issues that arose before she arrived. "We exceed most of the performance measures. We have hired additional staff in the mental health arena. ... We've beefed up our staff."

A total of 4,900 veterans receive some sort of mental health treatment at Wilmington.

The staffing increase was part of VA's 2012 initiative to hire 1,600 more mental health clinicians and 300 additional support staffers nationwide in response to complaints of treatment delays. Wilmington is authorized to have 60 mental health providers on staff and currently has 57, with "two more in the pipeline," Aube-Warren said.

Those with pressing needs who say they are veterans and show up asking for help are not turned away, even if they've never been seen.

As they are treated, the VA checks their eligibility. If for some reason that can't be done immediately, she said, they'd still receive treatment.

"We would tell you that while we're not able to verify you as a veteran right now, you clearly need help, and we'll see you [on] a humanitarian basis," she said. Those not eligible – dishonorably discharged veterans, for instance – would be billed for services.

The appointment delays were documented in an April 2012 review by VA's inspector general, who found that about half of all mental health patients were evaluated within two weeks; the rest waited about seven weeks. The previous year, VA had claimed that 95 percent of first-time patients received a full mental health evaluation within 14 days.

Wilmington's veteran population has risen as well, she said.

As it is, Vietnam veterans make up nearly half of the patients seen at Wilmington – 49.44 percent. Aube-Warren wants to see more of them.

"There was a lot of distress and dissatisfaction after the war, with the VA. … And so I think we're still dealing with those stigmas. A lot of people aren't willing to give us a chance. And VA health care has improved dramatically and amazingly."

Significant health care issues at certain VA medical centers over the past several years have made bigger headlines. Preventable patient deaths at the center in Atlanta and a deadly Legionnaires' disease outbreak in Pittsburgh that left five veterans dead, for example, have drawn angry calls for better care, better management and more accountability from, among others, the House Committee on Veterans' Affairs.

Wilmington has managed to stay clear of such problems. Aube-Warren said Wilmington last year was the only hospital in the U.S. to receive zero recommendations for improvements from the Long Term Care Institute, a quality review group out of Madison, Wisc. She also pointed to Wilmington's "top performer" rating on three different quality measures from the nonprofit Joint Commission, awarded two years running.

Aube-Warren brings more than a fresh face to Wilmington leadership. She's also a military veteran, having spent 3½ years on active duty as an airborne military police officer. She deployed three times during that span and took part in the 1989 U.S. invasion of Panama. She retired from the Army Reserve at the rank of major in 2006.

She downplayed any advantage that might give someone charged with overseeing health care for veterans. But she knows it matters to them.

"I think it does bring a kinship, a common language, the ability to relate to a lot of what they have. And it is a brotherhood. I mean, there's a very small percentage of us that have actually served. And I think it means something to the veterans that I've shared that.

"So I think that it perhaps makes things a little easier," she said. "They know that I have their back – that I've been there, and I care about 'em."

Contact William H. McMichael at (302) 324-2812 or bmcmichael@delawareonline.com. On Twitter: @billmcmichael