VA mental health therapists’ script: ‘I cannot guarantee complete confidentiality’ : Shots

Panic, fear, uncertainty, anger.

They describe as mental health clinicians working for the U.S. Veterans Affairs Office and preparing for the VA’s mandatory return order. Some were immediately summoned to the office on Monday, April 14th. Virginia representatives say they plan to complete the back-to-office efforts by May 5th.

For this story, NPR interviewed 10 clinicians at Virginia locations nationwide. A few days before the office deadline on April 14th, many still had no idea about expectations for return dates. Some people had received last-minute changes or delays to report to the office.

In a memo obtained by NPR, community leadership at one VA facility provided scripts for therapists to read to patients. “Before I start a session, I would like to inform you that I am currently in a shared office space,” reads the script. “I will do my best to maintain your privacy, but I cannot guarantee full confidentiality.”

These directives come after the VA showed that it would cut around 80,000 staff in a massive restructuring effort. Wide distribution Leaked notesprovides an overview of the efforts that was first obtained by the Associated Press. in video Working on the cut, VA secretary Doug Collins suggested that the agency would eliminate waste, suggesting that “the era of kicking cans is over.” He assured that the VA benefits would not be affected and that the VA would “remorse those who lost their job.”

Telehealth is hired

Many VA therapists have been hired Telehealth Standards And I’ll point out that there simply isn’t a space for them to work in the VA facility. They anticipate confusion and crowds regarding issues such as parking, bathroom use and proper kitchen equipment, and are reheating lunches.

However, the main concern for therapists is whether they can provide quality care to patients in the environment without confidentiality.

During emails and meetings, the VA manager explained the VA Mental Health staff “POD” work environment. Here, clinicians use headphones in a call center-like configuration to provide telehealth. In one recording obtained by NPR, the teleconference manager admitted that he had heard it was an inevitable treatment session and encouraged people not to share sensitive information.

Supervisors working in “Shower”

“We cannot provide private sessions,” says a licensed clinical social worker who was asked to be identified by the middle initials L., for fear of retaliation. Guaranteed privacy between patients and physicians is the fundamental doctrine of quality mental health care protected by federal law.

A group of 20 House Democrats I signed the letter Voice up your anger over the issue to VA Secretary Doug Collins. They describe one scenario where a social worker supervisor was ordered to return to work “sharing a 100-foot shower with another supervisor” to provide case management and clinical supervision. “We are sure you can agree,” they write.

VA response

Representatives from the VA have repeatedly argued that federal privacy laws are supported. In response to an email to questions about these issues, VA spokesman Peter Casperowitz repeatedly accused employees of alarming being motivated by their desire to “make a call.”

People will step into the headquarters of the Veterans Affairs Department from the White House on March 6th. President Trump and Elon Musk’s Doge efforts target approximately 80,000 jobs from the VA.

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Kasperowicz wrote that these ongoing concerns are “fearing fear from the media,” and that “a few employees desperate to avoid returning to the office will do more to drive away more staff and patients than the VA’s common sense return policy.”

VA care continues uninterrupted, and “VAs will ensure that employees have a workspace that is right for their work,” he said.

But therapists say they don’t logistically see how this is possible.

L. Disclaimer Be aware that it is encouraged to be used at the start of a session.

“The therapist will cancel the session itself,” L. “And the risk of being blamed, or the patient will cancel.”

L. points out that the resulting wait times for veterans seeking care are longer, and veterans are at a more disproportionate risk of suicide than those who are not serving. The wait time is already bad. Often, he says his clients have “waited months and months, many of them have serious mental health issues, including suicidal ideation.”

It will be changed at the last minute

VA is one of the largest providers of mental health care across the United States.

An email shared with NPR told me that some clinicians would return to their offices on May 5th, some were granted exemptions and some were told to report to work on April 14th, but these dates may also change. One document retrieved by NPR provides an overview of the manager’s steps.

“This memo provides a framework for notifying us of a standardized approach to terminating remote and telehealth agreements.”

Many clinicians He expressed confusion as to why certain workers were on the mandatory returns list. Others were evaluating the possibility of working in the car or finding spaces at bathroom stalls to carry out treatment sessions.

Some workers were asked to participate in furniture repositioning to accommodate group seating arrangements. Tasks such as “rolling tables into rooms as temporary desks” and “rolling extra furniture” were on NPR’s to-do list.

“Full pain”

Published by the American Psychological Association statement It criticizes policy and raises concerns about compliance with federal privacy laws.

“Providers face difficult choices between violating ethical standards regarding patient confidentiality or facing disciplinary action to violate and violate duties to the office,” the statement reads. Additionally, the policy warns that “it could undermine access to key care and confidentiality standards for effective mental health treatment.”

under President Biden, Agreement Act It allocated nearly $800 billion to expand VA care and benefits for toxin-exposed veterans. The current initiative aims to reduce the number of personnel to the level that the VA had before this legislation. It is not clear how the VA will reduce staff to 2019 levels and meet legal requirements under the PACT Act.

Many clinicians described recent experiences as a kind of emotional war, noting the irony of undermining their own mental health while trying to provide mental health care to others.

“I expect a lot of pain across the board,” says L.

If you or your loved one is in danger, call, text, or chat 988 Lifeline of Suicide and Crisis.