Congress Confronts the VA Over Mental Health Care Failures

Lawmakers pressed VA officials on systemic gaps in suicide prevention, staffing shortages, and care coordination that continue to endanger veterans' lives.

April 30, 2025

⚡NIMITZ NEWS FLASH⚡

“Answering the Call: Examining VA’s Mental Health Policies”

House Veterans Affairs Committee, Oversight and Investigations Subcommittee Hearing

April 30, 2025 (recording here)

HEARING INFORMATION

Witnesses & Written Testimony (linked):

  • Dr. Ilse Wiechers: Deputy Executive Director, Office of Mental Health, U.S. Department of Veterans Affairs, Veterans Health Administration

  • Dr. Anthony Stazzone: Chief Medical Officer, Veterans Integrated Service Network 9, U.S. Department of Veterans Affairs, Veterans Health Administration

  • Dr. Julie Kroviak, MD: Principal Deputy Assistant Inspector General in the Role of Acting Assistant Inspector General for Healthcare Inspections, U.S. Department of Veterans Affairs, Office of the Inspector General

Keywords mentioned:

  • Mental health policies, suicide prevention, telehealth delays, PTSD treatment, veteran suicide rate, mental health care access, workforce reform, staffing shortages, community care coordination, alternative treatments, outreach

IN THEIR WORDS

“One veteran suicide, again, is too many. These men and women volunteered to serve their country in a variety of roles throughout our armed services. They've answered the call to serve. As a veteran and a nurse practitioner, it's alarming that we have allowed the VA to fail to move the needle for this long.”

Chairwoman Jen Kiggans

“Our responsibility is to ensure that when veterans need help, they are connected to the clinicians who can provide the care and the services that they need so that no veteran has to confront these challenges alone.”

Ranking Member Delia Ramirez

Today’s witnesses from the VA and OIG shed light on VA mental health processes and related areas of improvement.

OPENING STATEMENTS FROM THE SUBCOMMITTEE

  • Chairwoman Jen Kiggans discussed the urgent need to examine the VA’s mental health policies and the quality of care provided to veterans. She outlined long appointment delays, inadequate telehealth services, and ongoing failures despite billions spent on posttraumatic stress disorder (PTSD) and suicide prevention. The Chairwoman cited alarming statistics, including 6,407 veteran suicides in 2022 and additional deaths from self-injury, and she shared concerns from her district about careless prescribing practices. She called for oversight of the VA’s bureaucracy, expressing hope that the hearing would yield actionable answers.

  • Ranking Member Delia Ramirez reflected on her experience running a homeless shelter, where she saw veterans struggle with PTSD, depression, and substance abuse in isolation. She stressed the importance of adequate screening, staffing, and working conditions, particularly in the wake of federal mandates that forced clinicians into unsuitable environments for telehealth sessions. Ranking Member Ramirez criticized staffing shortages and workplace conditions, calling out the administration’s return-to-office order and its impact on privacy and quality of care. She also condemned the recent cuts to gender-affirming care and asserted that veterans' mental health is being compromised by political decisions that breed trauma and uncertainty.

SUMMARY OF KEY POINTS

  • Dr. Ilse Wiechers described the VA’s efforts to deliver high-quality, evidence-based, and accessible mental health services to veterans, especially in response to the elevated risk of suicide among those with PTSD, depression, and substance use disorders. She outlined the VA’s continuum of care, including same-day services, crisis lines, and suicide prevention coordinators, and noted that most veterans report positive experiences. She also detailed the implementation of the VA Suicide Risk Identification Strategy (Risk ID) and a 2024 clinical practice guideline developed with the Department of Defense (DOD), along with mandatory suicide prevention training. Dr. Wiechers asserted the VA’s commitment to innovation and accountability and expressed appreciation for the Committee’s oversight in helping veterans receive the care they deserve.

  • Dr. Julie Kroviak talked about the Office of the Inspector General’s (OIG) independent oversight of VA mental health services and outlined key deficiencies in suicide prevention efforts. She reported that only 55% of veterans received required suicide risk screenings in FY23 and cited multiple cases where failures in assessment or inpatient safety protocols resulted in suicide attempts or deaths. Dr. Kroviak underscored that post-discharge planning and timely internal reviews are often delayed, which undermines suicide prevention and family support. She stressed that while no single solution exists, ongoing oversight and comprehensive services are essential to meet veterans’ mental health needs.

  • Chairwoman Kiggans asked Dr. Kroviak to elaborate on the unclear roles of Veterans Integrated Service Network (VISN) chief mental health officers. Dr. Kroviak explained that many VISN leaders lacked the authority to intervene in facility-level issues and were often unaware of problems until they escalated. She called for clearer role definitions and greater enforcement capabilities.

  • Chairwoman Kiggans then asked why there was such variation in the implementation of VA mental health policies across facilities. Dr. Wiechers responded that variation could stem from unclear policies or inconsistent training, and she shared that her office was working to improve both policy clarity and communication with VISN leaders.

  • The Chairwoman expressed frustration over poor care coordination between the VA and community providers, particularly regarding access to mental health records and medication lists. Dr. Wiechers acknowledged the issue and stated that the VA was working with third-party administrators to improve data sharing. When asked who ensures follow-up after a veteran leaves a community care appointment, Dr. Wiechers said that she would follow up with more specific information.

  • Ranking Member Ramirez questioned the use of a one- to two-sentence rubric for VA supervisors to justify whether employees, including mental health providers, should be subject to workforce reductions. Dr. Wiechers said that she could not speak to the rubric without more information but acknowledged that mental health work is complex and difficult to capture in a sentence.

  • Ranking Member Ramirez criticized the administrative burden placed on clinicians, some of whom had to fill out rubrics for over 300 employees, and asked if this was a good use of a clinician’s time. Dr. Wiechers replied that prioritizing veterans’ care is paramount but did not directly answer the question.

  • The Ranking Member then asked whether the VA would provide gender-affirming care if it would save a veteran from suicide. Dr. Wiechers stated that mental health and preventive services remain available for all eligible veterans, and those already receiving hormone therapy could continue. When asked about top staffing shortages, Dr. Kroviak named nurses, physicians, psychologists, and psychiatrists.

  • Ranking Member Ramirez also asked if the VA was barring field staff from conducting veteran outreach. Dr. Wiechers said that she was unaware but asked for specific examples and committed to looking into a previously submitted letter about the issue.

  • Chairwoman Kiggans returned with a question about improvements in care coordination for transitioning service members since the new administration took office. Dr. Wiechers explained that the VA continues to work closely with the DOD to ensure seamless transitions, particularly for veterans already receiving treatment.

  • Chairwoman Kiggans also asked about staffing concerns and the use of advanced practice nurses. Dr. Kroviak confirmed that staffing shortages remain a concern and said that while the OIG had not specifically reviewed nurse practitioner utilization, they are a vital resource and likely underused.

  • On the topic of alternative treatments, the Chairwoman asked for updates on the VA’s efforts. Dr. Wiechers shared that the VA has expanded the use of treatments such as electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and ketamine, and is actively investing in research on psychedelics and other emerging therapies. Dr. Anthony Stazzone added that VISN 9 is working to ensure that all three somatic treatments are available at every site and reiterated the VA’s focus on evidence-based care. Dr. Kroviak praised the VA as a pioneer in mental health and expressed appreciation for its continued research and innovation.

  • Ranking Member Ramirez pivoted to the topic of overdose prevention, asking whether Narcan saves lives and if cuts to Narcan funding could increase veteran deaths. Dr. Wiechers affirmed that Narcan is lifesaving and that the VA’s naloxone distribution program has been nationally recognized.

  • Ranking Member Ramirez then asked about the VA’s partnership with SAMHSA and the potential impacts of funding cuts. Dr. Wiechers highlighted strong interagency collaboration, particularly in developing psychedelic treatment strategies, but declined to speculate on the effects of hypothetical funding cuts.

  • Rep. Tim Kennedy raised concerns about the forced return-to-office order for VA employees, asking whether space and privacy had been adequately considered. Dr. Wiechers assured him that each facility reviews space availability before issuing return orders and has processes to address privacy concerns.

  • Rep. Kennedy also asked about the VA’s plans to maintain mental health services amid proposed job cuts. Dr. Wiechers stated that 30,000 frontline positions, including mental health providers, are exempt from the freeze and that hiring continues. Dr. Stazzone confirmed that VISN 9 is actively onboarding staff and agreed to provide data on hiring since January.

  • Ranking Member Ramirez requested unanimous consent to enter several news articles and six veteran testimonials into the hearing record, all related to mental health and workforce cuts at the VA. She stressed that honoring veterans’ service requires protecting their access to mental health care, which begins with ensuring there are enough providers available to meet demand. The Ranking Member reiterated her commitment to continuing oversight and follow-up based on the testimony provided.

  • Chairwoman Kiggans appreciated the clarification that frontline mental health providers are exempt from workforce cuts and affirmed that both she and VA Secretary Doug Collins had personally worked to ensure these providers are protected. The Chairwoman advocated for continued reforms to improve VA policy and services, restating that veterans should not be burdened by bureaucracy when seeking help and that mental health care must remain a bipartisan priority.

SPECIAL TOPICS

 🖤 Mental health and suicide:

  • Chairwoman Kiggans stated that mental health access delays, poor prescribing practices, and the stagnation of suicide prevention progress are urgent concerns. She noted that despite rising budgets, veteran suicide rates have remained largely unchanged.

  • Ranking Member Ramirez underscored the intersection between employment instability and mental health risks, criticized facility staffing cuts, and spotlighted the need to address workplace conditions impacting care delivery.

  • Dr. Wiechers detailed the VA’s suicide prevention strategy, including the Risk ID screening program, access to care through various platforms (e.g., crisis lines, outpatient clinics), and integration of updated clinical guidelines. She described a whole-of-society approach and accountability across systems.

  • The OIG reported serious gaps in suicide screening, acute risk management, and post-incident review processes. Dr. Kroviak described tragic examples of veterans dying by suicide due to systemic failures and stressed the need for stronger oversight and discharge planning.

  • Chairwoman Kiggans and Ranking Member Ramirez raised concerns about the administrative burden on mental health providers, inadequate continuity of care, medication mismanagement, and limited authority of VISN leaders.

  • Dr. Wiechers and Dr. Stazzone confirmed the active hiring of mental health staff and discussed the expansion of evidence-based treatments like ECT, TMS, ketamine, and psychedelic research.

  • Ranking Member Ramirez asked if the VA would continue to provide gender-affirming care if it helped prevent suicide. Dr. Wiechers confirmed that mental health and preventive services remain available.

  • Both Ranking Member Ramirez and Rep. Kennedy criticized staff reductions and return-to-office orders that may harm mental health care delivery.

  • Chairwoman Kiggans echoed the importance of coordination between VA and community care providers for veterans’ mental health continuity.

JOIN THE NIMITZ NETWORK!

Enjoying our updates? Don’t keep it to yourself — forward this email to friends or colleagues who’d love to stay informed. They can subscribe here to become part of our growing community.