VA Montana poised to open inpatient psychiatric wing

Billings Gazette

by Cindy Uken

More than a year after a $7 million, 24,000-square-foot facility opened at Fort Harrison, the eight-bed unit designed for veterans needing inpatient psychiatric care is nearly ready to open.

The target date for admitting patients is Oct. 2.

VA Montana has long failed to recruit three psychiatrists to staff the unit to ensure around-the-clock coverage and avoid staff burn out. It was, however, successful in recruiting one psychiatrist, which opened the door to creative staffing options.

Steve Young, interim director of VA Montana, said the plan is to open the unit using a combination of the new psychiatrist, Dr. Robert “Walt” Lovell, who began work at VA Montana on July 30; the hospital’s outpatient psychiatrist; two psychiatric nurse practitioners; and on-call psychiatrists at the Salt Lake City VA Medical Center.

Nurse practitioners can perform clinical duties and can prescribe medications. They will have access to the on-call psychiatrist in Salt Lake City as a backup for complex patient issues.

In addition, a newly hired staff psychologist will oversee all mental health programs at VA Montana.

“This is so exciting,” Young said. “I am confident we can be successful. Sharing between facilities like this really highlights the benefit of a nationwide health care system like VA.”

Opening the unit means that some of the most troubled veterans – on average, about six at a time – will be able to stay closer to home for treatment. They are currently being sent out of the state for treatment.

The failure to open the unit has captured the attention of the U.S. Secretary of Veterans Affairs, the regional VA office in Denver and U.S. Sen. Jon Tester, D-Mont., the state’s only member of the Senate Veterans Affairs Committee. Tester has been insistent on making the unit accessible to Montana veterans.

Tester turned up the heat on July 10 when he met with VA Undersecretary for Health Dr. Robert Petzel to discuss the facility. Tester implored Petzel to help get the facility open. On Aug. 1, two days after the new psychiatrist began his duties, Tester again called Petzel to tell him that one psychiatrist was insufficient.

Tester’s relentless pursuit has not gone unnoticed at Fort Harrison.

“He has maintained an intense interest while also understanding that we could – and should – only open this unit when we could ensure safe patient care,” Young said of Tester.

The inability to open the wing has been a source of embarrassment for VA leaders, especially at a time when the VA is bolstering mental health services in VA hospitals and clinics across the country.

VA Secretary Eric Shinseki announced in April that the department would add approximately 1,600 mental health clinicians as well as nearly 300 support staff. VA Montana, which employs 81 mental health clinicians and support staff, received five mental health clinicians and two support personnel.

The problem is compounded by the number of veterans returning home from Iraq and Afghanistan with physical and mental wounds. It is estimated the medical and disability costs for Iraq and Afghanistan veterans could reach $930 billion nationwide over the next 40 years.

“Mental health challenges are the signature injury of the wars in Iraq and Afghanistan and our veterans deserve to have the best available treatment as close to home as possible,” Tester said. “Opening this much-needed facility is good news for Montana veterans.”

The government continues to advertise two psychiatrist vacancies at Fort Harrison with a salary range of $97,987 to $250,000 per year.

The inpatient psychiatric unit is one of three located in the facility. The eight-bed substance abuse wing opened earlier this year. The eight-bed unit for those suffering from less severe cases of post-traumatic stress disorder also is open to patients.