Senate Passes Mental Health Bill; Panel to Investigate Perceived Neglect

3 Jun 2008 // The Senate passed by voice vote Tuesday a package of veterans' mental health legislation amid rising congressional scrutiny over perceived neglect by the Veterans Affairs Department.

The Veterans' Mental Health and Other Care Improvements Act of 2008 (S 2162), sponsored by Senate Veterans' Affairs Committee Chairman Daniel K. Akaka, D-Hawaii, is a composite of smaller bills that seek to address mounting cases of post-traumatic stress disorder and a rising tide of suicides among soldiers returning from Iraq and Afghanistan.

The committee also will continue an investigation Wednesday into whether the VA has made a cost-cutting policy of deliberately diagnosing veterans as suffering from ailments less severe than PTSD. The probe follows two high-profile incidents in which e-mails sent by VA officials appeared to minimize cases of PTSD among Iraq War veterans returning home and to downplay their suicide attempts.

The bill passed Tuesday would greatly expand the research and care facilities for veterans suffering from PTSD, substance abuse and chronic pain. The legislation would extend veterans' mental health resources to family members, provide assistance for low-income and rural veterans, and force the VA to conduct a full review of its mental health infrastructure.

"For too many veterans, returning home from battle will not bring an end to conflict," Akaka said during the bill's committee markup. "Invisible wounds are complicated and wide ranging, and our solutions must rise to the challenge."
Testimony Scheduled About Diagnoses

The committee has scheduled a hearing for Wednesday on the VA's alleged efforts to minimize PTSD diagnoses as well as public awareness of veterans' mental health issues.

The hearing will feature the testimony of Dr. Norma J. Perez, former PTSD program coordinator for the Temple, Texas, VA Medical Center, who faces criticism for a March 20 e-mail she sent to social workers that encouraged them not to diagnose returning soldiers with PTSD.

"Given that we are having more and more compensation-seeking veterans, I'd like to suggest you refrain from giving a diagnosis of PTSD straight out," Perez wrote in the e-mail obtained by the watchdog group Citizens for Responsibility and Ethics in Washington (CREW).

In a written statement prepared for Wednesday's hearing, Perez defended her e-mail, claiming that PTSD diagnosis was not an exact science.

"In retrospect, I realize I did not adequately convey my message appropriately, but my intent was unequivocally to improve the quality of care our veterans received," she wrote. VA Secretary James Peake called Perez's e-mail "inappropriate."

Outside experts maintain that the VA is involved in broadly steering diagnoses away from PTSD to ailments that are less costly to treat.

"This is a systemic problem," said Anne Weismann, chief counsel for CREW, citing various other reports from veterans and other VA employees. "The VA's position so far has been to deny that there's even a problem."

The committee and the VA inspector general's office are each investigating whether the e-mail represents a broader policy problem.
Hearing Also Addresses Suicide Attempts

Also testifying at the hearing will be retired Army Brig. Gen. Michael J. Kussman, undersecretary for health for the Veterans' Health Administration. His aide, Dr. Ira Katz, was at the center of a controversy similar to the Texas incident when it was revealed that an e-mail he wrote sought to obscure the number of suicide attempts by soldiers returning from Iraq.

Katz will be present at the hearing, but he will not offer direct testimony, according to a Democratic aide.

"As an oversight body, we must know whether the actions of these VA employees point to a systemic indifference to invisible wounds," Akaka will say in his opening statement, a copy of which Congressional Quarterly obtained.

Following Wednesday's hearing, Akaka plans to hold a news conference with Sens. Patty Murray, D-Wash., and Bernard Sanders, I-Vt., as well as leaders of various veterans' and watchdog groups to push for more public awareness of veterans' mental health issues.

The House has a companion measure (HR 4053), introduced by Rep. Shelley Berkley, D-Nev., which was referred to the House Veterans' Affairs Committee in November.

Last year, Akaka was successful in extending the availability of free mental health screenings for combat veterans from two to five years as part of the wounded warrior amendment to the fiscal 2008 defense authorization bill (PL 110-181).

In that same bill, the VA was required to give mandatory mental health screenings to veterans within 30 days of their return, a result of efforts by Sen. Barack Obama, D-Ill.

Akaka's bill is dedicated to Justin Bailey, a soldier who died in a VA facility while receiving care for PTSD and a substance abuse disorder after returning from service in Iraq.