Last Monday, a memorial service was held in Yountville for three mental health professionals taken hostage and killed by an Afghan war veteran. They took risks that thousands of Veterans Health Administration employees take every day caring for their patients.
Sadly, the Trump administration and congressional leaders spend more time bashing VHA professionals than supporting and protecting them, or allaying the job-related fears and frustration of serving on the front lines of caring for 9 million veterans.
A third of the 300,000 VHA staff members are veterans, themselves, but Trump and his allies on Capitol Hill claim that the agency is saddled with too many civil service protections and that veterans would be better served in private hospitals and clinics. In his inaugural address, the president boasted about removing 1,500 federal employees for poor job performance and replacing them with "talented people who love our vets as much as we do," implying that many current VHA employees don't.
As always, Trump was stretching the truth. They work with the some of the most difficult patients in this country and are paid far less than they could earn in the private sector.
Moreover, the Trump administration has tried to cut funding for mental health programs for veterans and has not filled an estimated 35,000 VHA staff vacancies with anyone. With rising patient caseloads and the acute mental health problems of vets who served in Afghanistan and Iraq, VHA facilities are understaffed, with high burnout and turnover rates.
VHA mental health professionals say this adds to the risk of their already demanding and high-stress jobs. While violent veterans are the exception, a 2011 survey found many instances in which patients verbally assaulted their providers, threatened them and reacted angrily when denied opiates for their own good. In January 2015, a VA psychologist in El Paso was shot to death by a patient upset by a VA disability benefit determination. Less than a year later, a 77-year-old veteran held a Denver nurse practitioner hostage, hoping to commit "suicide by cop."
While caregivers are being subjected to increased levels of physical and verbal abuse by patients, private-sector providers can and often do "fire" these patients. They also are free to stop treating patients who don't pay their bills, or follow treatment recommendations. This option is unavailable at VHA, though its patients have more mental illness and substance abuse problems.
While the department has tried to prevent and manage disruptive behavior, these programs go only so far, and their effectiveness is undermined by the lack of funding, staffing and support from the president and VA and congressional leaders.
The tragic events at Yountville present the nation and its leaders with an opportunity to finally thank VHA caregivers for their service.