A top official from the Government Accountability Office told a House committee Wednesday that the Department of Veterans Affairs is failing to follow its own guidelines for treating veterans with mental illness who may be at risk of suicide.
Randall Williamson, director of healthcare issues for GAO, told the House Veterans’ Affairs Committee that the VA set out a clinical practice guideline, or CPG, describing how veterans with major depressive disorder (MDD) should be treated. Among other things, those guidelines say that after antidepressants have been prescribed, a followup assessment should occur within four to six weeks.
But Williamson said that out of a select group of 30 veterans that GAO studied, the VA failed to follow up with 26 of these patients.
“Our recent work, based on the three CPG recommendations we selected, has found almost all of the 30 veterans with MDD in our review who had been prescribed antidepressants received care that deviated from the MDD CPG recommendations,” he said.
There were other failures as well. The VA’s recommendations say veterans need to be educated about how and when to use antidepressants, and what side effects may follow. But six of the 30 veterans didn’t get this information.
And while some veterans were reassessed after taking the drugs, 18 of 30 weren’t assessed with a standardized tool as required.
Williamson said that while deviating from the VA’s guidelines may be acceptable for certain reasons, the VA doesn’t seem to have a grip on why these deviations happened.
“[W]ithout a system-wide process in place to identify and fully assess whether the care provided is consistent with the CPG, VA does not know the extent to which veterans with MDD who have been prescribed antidepressants are receiving care as recommended,” he said.
Williamson’s testimony is the latest in a seemingly endless stream of problems at the VA that have come to light. His remarks indicate the VA is still struggling to cope with veterans who are at risk of suicide, amid its larger problems getting all variations of healthcare to veterans.
