More veterans speak out about problems with San Diego VA mental health care

More veterans have come forward to share problems about accessing mental health care at the San Diego VA following an inewsource investigation last week that found the agency has recently made it more difficult for vets to go outside the system for care. 

Army veteran Richard Guilfoyle is one of those who has been unsuccessful in seeking the VA’s approval for outside therapy.

“It seems like they don’t really want to help,” Guilfoyle told inewsource. “It seems pretty ridiculous.” 

The 26-year-old said the stress of COVID-19, compounded with his service-related PTSD, made him want to reconnect with his outside psychotherapist, Keynan Hobbs. He said he’s had three appointments with the VA to get approval to see Hobbs but with no luck.

“It seems impossible to be able to get referred to him again, even though I’ve established care with him in the past,” Guilfoyle said.

Hobbs said he is trying to work with the system from the other end: calling the VA, sending emails and faxing over forms. So far, he hasn’t gotten the agency to approve him treating Guilfoyle again, even though the two had sessions last year. 

“I’ve been driving myself crazy trying to figure out what I needed to fix to get veterans back into my practice,” Hobbs, an Army veteran, wrote to inewsource. “This isn’t just my job, these are my brothers and sisters and my purpose — I didn’t stop protecting them when I left combat.” 

He said it hurts in a way he can’t describe that over and over again the VA “gets directly in the way of that.”

Hobbs is among more than 20 veterans and clinicians who this year have shared with inewsource issues in trying to obtain healthcare authorizations, but the San Diego VA won’t acknowledge the problem. 

“No patients are encountering clinically significant delays,” spokesperson Christopher Menzie said in an email on Nov. 13. Asked to reconsider that statement this week in light of the number of people contradicting it, the VA had not responded by Tuesday evening.

Interviews with clinicians and veterans, along with emails obtained by inewsource, show the problem appears to stem from how the San Diego VA is interpreting the 2018 MISSION Act, which Menzie partially acknowledged in his email to inewsource.

The federal law sought to expand veteran access to healthcare. As part of that process, TriWest Healthcare Alliance served as a VA contractor to help veterans and outside therapists coordinate care with the agency.

TriWest sent VA authorizations to providers, scheduled appointments, coordinated care and served as the primary customer service contact for veterans throughout 13 western states under a taxpayer-funded contract valued at up to $26 billion.

But the San Diego VA has recently taken over many of those duties, and TriWest’s presence in San Diego has gone “virtual,” a company spokesperson said. The VA won’t explain why it’s performing work that it contracted with TriWest to do.

“The policy change was rolled out in such a disastrous way that it’s just not workable right now,” said Alexandra Laifer, a therapist in Oceanside having trouble getting the VA to authorize sessions so she can treat her patients who are veterans. 

“The entire San Diego team at TriWest was let go, and the new community care network office at the VA, I believe, is only staffed by four people,” Laifer said. 

“Which, given the scope of this region and the number of people we’re serving, is absolutely ludicrous.”

The San Diego VA provides healthcare to 86,000 veterans in San Diego and Imperial counties but doesn’t have the staff to treat them all. That’s why it contracts with outside providers like Laifer and Hobbs. But the VA must first authorize, or sign off on, those treatments — and that’s what’s causing the delays.

For veterans seeking mental health treatments, COVID-19 is making things worse. Army officials cited a 30% increase in suicides among active-duty soldiers during the first six months of the pandemic.

“It’s my personal and professional opinion that every single one of us is going to come out of this pandemic with at least some level of post-traumatic stress,” said Ty Smith, a retired Navy SEAL and CEO of CommSafe AI, a San Diego technology company.

“We’ve seen a spike in domestic violence, child abuse, cyber sexual harassment, cyber bullying, cyber stalking, homegrown terror, hate crimes,” Smith said. He asked the public to consider how these current events may impact veterans already struggling with mental health issues. 

“If you’re a combat veteran, it’s just exacerbating the problem that you’ve already been dealing with for however long,” Smith said.

One local Navy veteran with PTSD, Jordan Hewelt, said he has found one way to get help: The 31-year-old told inewsource he now calls the White House VA Hotline at (855) 948-2311 because obstacles at the San Diego VA seem insurmountable.

“You don’t wait on hold for 30 minutes,” Hewelt said, comparing the hotline to his typical experience with the VA. “It’s like a beautiful system.”

The service launched in 2017 as part of President Donald Trump’s “commitment to reforming VA,” and is staffed primarily by veterans or veteran family members who assist callers who are having trouble getting the care they need, according to the VA. 

The agency said last year that the hotline surpassed a quarter million calls and had a 94% case resolution rate.