{"id":804,"date":"2025-03-22T14:12:10","date_gmt":"2025-03-22T14:12:10","guid":{"rendered":"https:\/\/wpinitiate.com\/echo-test\/demo973e36f5\/2025\/03\/22\/inside-the-turmoil-at-the-v-a-mental-health-system-under-trump-the-new-york-times\/"},"modified":"2025-03-22T14:12:10","modified_gmt":"2025-03-22T14:12:10","slug":"inside-the-turmoil-at-the-v-a-mental-health-system-under-trump-the-new-york-times","status":"publish","type":"post","link":"https:\/\/wpinitiate.com\/echo-test\/demo973e36f5\/2025\/03\/22\/inside-the-turmoil-at-the-v-a-mental-health-system-under-trump-the-new-york-times\/","title":{"rendered":"Inside the Turmoil at the V.A. Mental Health System Under Trump &#8211; The New York Times"},"content":{"rendered":"<div id=\"site-content\">\n<article id=\"story\">\n<div id=\"fullBleedHeaderContent\">\n<header>\n<div data-testid=\"imageblock-wrapper\">\n<figure aria-label=\"media\" role=\"group\">\n<div data-testid=\"imageContainer-children-Image\"><picture><source media=\"(max-width: 599px) and (min-device-pixel-ratio: 3),(max-width: 599px) and (min-resolution: 3dppx),(max-width: 599px) and (min-resolution: 288dpi)\" ><source media=\"(max-width: 599px) and (min-device-pixel-ratio: 2),(max-width: 599px) and (min-resolution: 2dppx),(max-width: 599px) and (min-resolution: 192dpi)\" ><source media=\"(max-width: 599px) and (min-device-pixel-ratio: 1),(max-width: 599px) and (min-resolution: 1dppx),(max-width: 599px) and (min-resolution: 96dpi)\" ><img loading=\"lazy\" alt=\"Sandra Fenelon, wearing a gold blazer, leans against a tree in a park.\" src=\"https:\/\/static01.nyt.com\/images\/2025\/03\/22\/multimedia\/22dc-veterans-01-gmjh\/22dc-veterans-01-gmjh-articleLarge.jpg?quality=75&#038;auto=webp&#038;disable=upscale\"   decoding=\"async\" width=\"600\" height=\"900\"><\/picture><\/div><figcaption data-testid=\"photoviewer-children-ImageCaption\"><span>\u201cI just constantly felt like I am at war,\u201d said Sandra Fenelon, a Navy veteran who had a rocky transition back to civilian life.<\/span><span><span>Credit&#8230;<\/span><span><span aria-hidden=\"false\">Sarah Blesener for The New York Times<\/span><\/span><\/span><\/figcaption><\/figure>\n<\/div>\n<div>\n<p><h2 id=\"link-2c2aaeb3\" data-testid=\"headline\">Trump and DOGE Propel V.A. Mental Health System into Turmoil<\/h2>\n<\/p>\n<p>A chaotic restructuring ordered threatens to degrade services for veterans of wars in Vietnam, Iraq and Afghanistan.<\/p>\n<\/div>\n<\/header>\n<p aria-hidden=\"true\"><span>\u201cI just constantly felt like I am at war,\u201d said Sandra Fenelon, a Navy veteran who had a rocky transition back to civilian life.<\/span><span><span>Credit&#8230;<\/span><span><span>Sarah Blesener for The New York Times<\/span><\/span><\/span><\/p>\n<div>\n<ul>\n<li><time datetime=\"2025-03-22T08:05:35-04:00\"><span>March 22, 2025<\/span><span>Updated <span>8:05 a.m. ET<\/span><\/span><\/time><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<section name=\"articleBody\">\n<div data-testid=\"companionColumn-0\">\n<p>Late in February, as the Trump administration ramped up its quest to transform the federal government, a psychiatrist who treats veterans was directed to her new workstation \u2014 and was incredulous.<\/p>\n<p>She was required, under a new return-to-office policy, to conduct virtual psychotherapy with her patients from one of 13 cubicles in a large open office space, the kind of setup used for call centers. Other staff might overhear the sessions, or appear on the patient\u2019s screen as they passed on their way to the bathroom and break room.<\/p>\n<p>The psychiatrist was stunned. Her patients suffered from disorders like schizophrenia and bipolar disorder. Treating them from her home office, it had taken many months to earn their trust. This new arrangement, she said, violated a core ethical tenet of mental health care: the guarantee of privacy.<\/p>\n<p>When the doctor asked how she was expected to safeguard patient privacy, a supervisor suggested she purchase privacy screens and a white noise machine. \u201cI\u2019m ready to walk away if it comes to it,\u201d she wrote to her manager, in a text message shared with The New York Times. \u201cI get it,\u201d the manager replied. \u201cMany of us are ready to walk away.\u201d<\/p>\n<\/div>\n<div data-testid=\"companionColumn-1\">\n<p>Scenes like this have been unfolding in Veterans Affairs facilities across the country in recent weeks, as therapy and other mental health services have been thrown into turmoil amid the dramatic changes ordered by President Trump and pushed by Elon Musk\u2019s Department of Government Efficiency.<\/p>\n<p>Among the most consequential orders is the requirement that thousands of mental health providers, including many who were hired for fully remote positions, now work full time from federal office<strong> <\/strong>space. This is a jarring policy reversal for the V.A., which pioneered the practice of virtual health care two decades ago as a way to reach isolated veterans, long before the pandemic made telehealth the preferred mode of treatment for many Americans.<\/p>\n<p>As the first wave of providers reports to offices where there is simply not enough room to accommodate them, many found no way to ensure patient privacy, health workers said. Some have filed complaints, warning that the arrangement violates ethics regulations and medical privacy laws. At the same time, layoffs of at least 1,900 probationary employees are thinning out already stressed services that assist veterans who are homeless or suicidal.<\/p>\n<\/div>\n<div data-testid=\"ImageBlock-3\">\n<figure aria-label=\"media\" role=\"group\">\n<div data-testid=\"photoviewer-children-figure\">\n<p><span>Image<\/span><\/p>\n<picture><source media=\"(max-width: 599px) and (min-device-pixel-ratio: 3),(max-width: 599px) and (min-resolution: 3dppx),(max-width: 599px) and (min-resolution: 288dpi)\" ><source media=\"(max-width: 599px) and (min-device-pixel-ratio: 2),(max-width: 599px) and (min-resolution: 2dppx),(max-width: 599px) and (min-resolution: 192dpi)\" ><source media=\"(max-width: 599px) and (min-device-pixel-ratio: 1),(max-width: 599px) and (min-resolution: 1dppx),(max-width: 599px) and (min-resolution: 96dpi)\" ><img loading=\"lazy\" alt=\"A man holding a sign that reads \u201cwe want to work\u201d takes part in a demonstration.\" src=\"https:\/\/static01.nyt.com\/images\/2025\/03\/22\/multimedia\/22dc-veterans-03-gmjh\/22dc-veterans-03-gmjh-articleLarge.jpg?quality=75&#038;auto=webp&#038;disable=upscale\"   uri=\"nyt:\/\/image\/e7b7f740-f512-511e-8dbd-aded6b9e65ea\" decoding=\"async\" width=\"600\" height=\"400\"><\/picture><\/div><figcaption data-testid=\"photoviewer-children-caption\"><span>A demonstration outside a V.A. medical center in Detroit last month.<\/span><span><span>Credit&#8230;<\/span><span><span aria-hidden=\"false\">Paul Sancya\/Associated Press<\/span><\/span><\/span><\/figcaption><\/figure>\n<\/div>\n<div data-testid=\"companionColumn-2\">\n<p>In more than three dozen interviews, current and recently terminated mental health workers at the V.A. described a period of rapid, chaotic behind-the-scenes change. Many agreed to speak on the condition of anonymity because they want to continue to serve veterans, and feared retribution from the Trump administration.<\/p>\n<\/div>\n<div data-testid=\"companionColumn-3\">\n<p>Clinicians warn that the changes will degrade mental health treatment at the V.A., which already has severe staffing shortages. Some expect to see a mass exodus of sought-after specialists, like psychiatrists and psychologists. They expect wait times to increase, and veterans to eventually seek treatment outside the agency.<\/p>\n<p>\u201cPsychotherapy is a very private endeavor,\u201d said Ira Kedson, a psychologist at the Coatesville V.A. Medical Center in Pennsylvania and president of AFGE local 310. \u201cIt\u2019s supposed to be a safe place, where people can talk about their deepest, darkest fears and issues.\u201d Veterans, he said, trust that what they tell therapists is confidential.<\/p>\n<p>\u201cIf they can\u2019t trust us to do that, I think that a sizable number of them will withdraw from treatment,\u201d he said.<\/p>\n<p>A Veterans Affairs spokesman, Peter Kasperowicz, dismissed the contention that a crowded working environment would compromise patient privacy as \u201cnonsensical,\u201d saying that the V.A. \u201cwill make accommodations as needed so employees have enough space to work and comply with industry standards for privacy.\u201d<\/p>\n<p>\u201cVeterans are now at the center of everything V.A. does,\u201d Mr. Kasperowicz added. \u201cUnder President Trump, V.A. is no longer a place where the status quo for employees is to simply phone it in from home.\u201d Anna Kelly, a White House spokeswoman, said the president\u2019s return-to-office order was \u201censuring that all Americans benefit from more efficient services, especially our veterans.\u201d<\/p>\n<\/div>\n<div data-testid=\"companionColumn-4\">\n<p>The DOGE cuts have already sparked chaos and confusion within the sprawling agency, which provides care to more than nine million veterans. The Trump administration has said it <a href=\"https:\/\/www.nytimes.com\/2025\/03\/09\/us\/politics\/veterans-affairs-doge-cuts.html\" title>plans to eliminate 80,000 V.A. jobs<\/a>, and a first round of terminations has halted some research studies and slashed support staff.<\/p>\n<\/div>\n<div data-testid=\"ImageBlock-9\">\n<figure aria-label=\"media\" role=\"group\">\n<div data-testid=\"photoviewer-children-figure\">\n<p><span>Image<\/span><\/p>\n<\/div><figcaption data-testid=\"photoviewer-children-caption\"><span>Therapy and other mental health services at Veterans Affairs facilities have been thrown into turmoil amid the dramatic changes ordered by President Trump and pushed by Elon Musk\u2019s Department of Government Efficiency.<\/span><span><span>Credit&#8230;<\/span><span><span aria-hidden=\"false\">Jamie Kelter Davis for The New York Times<\/span><\/span><\/span><\/figcaption><\/figure>\n<\/div>\n<div data-testid=\"companionColumn-5\">\n<p>The cuts drive at a sensitive constituency for Mr. Trump, who has campaigned on improving services at the V.A. In Mr. Trump\u2019s first term, the agency expanded remote work as a way to reach veterans who are socially isolated and living in rural areas, who are at an elevated risk for suicide. Now those services are likely to be sharply reduced.<\/p>\n<p>\u201cThe end of remote work is essentially the same as cutting mental health services,\u201d said a clinician at a mental health center hub in Kansas, who spoke on the condition of anonymity. \u201cThese remote docs aren\u2019t moving and they have other options if they are forced to drive to some office however many miles away every day to see their patient virtually from there.\u201d<\/p>\n<p>Veterans, too, are expressing anxiety. Sandra Fenelon, 33, said she had a rocky transition back to civilian life after leaving the Navy in 2022. \u201cI just constantly felt like I am at war,\u201d said Ms. Fenelon, who lives in New York and is training to become a pharmacist.<\/p>\n<\/div>\n<div data-testid=\"companionColumn-6\">\n<p>It took a year, working with a V.A. psychologist, until she felt safe enough to begin sharing the troubling things she had seen on deployment, things that, she said, \u201cpeople on the outside would never understand.\u201d<\/p>\n<p>Now, Ms. Fenelon is worried that the tumult at the V.A. will prompt her therapist to leave before she is better. In her session this past week, she burst into tears. \u201cI feel like I\u2019m now forced to be put in a position where I have to start over with someone else,\u201d she said in an interview. \u201cHow can I relate to a therapist who never worked with veterans?\u201d<\/p>\n<h2 id=\"link-1c951a78\">\u2018You Deserve Better\u2019<\/h2>\n<p>For a suicide prevention coordinator in California, mornings start with referrals from a crisis hotline. On a typical day, she said, she is given a list of 10 callers, but sometimes as many as 20 or 30. The work is so intense that, most days, there is no time for a lunch break or bathroom breaks.<\/p>\n<p>\u201cMy job is to build rapport, to figure out what I need to do to keep them alive. I let them know: \u2018I\u2019m worried about you, I\u2019m going to send someone out to check on you,\u2019\u201d the coordinator said. \u201cI tell them, \u2018You served this country. You deserve better.\u2019\u201d<\/p>\n<p>The team, which is responsible for covering some 800,000 veterans, was supposed to get three more social workers, but the new positions were canceled as a result of the administration\u2019s hiring freeze, the coordinator said.<\/p>\n<\/div>\n<div data-testid=\"companionColumn-7\">\n<p>She said the stress around the staff reductions is intense, and fears it will cause her to miss something critical. \u201cI\u2019m so scared I\u2019ll make a mistake,\u201d she said. \u201cI\u2019m not sleeping well, and it\u2019s hard to stay focused.\u201d<\/p>\n<p>Veterans are at <a href=\"https:\/\/www.mentalhealth.va.gov\/docs\/data-sheets\/2024\/2024-Annual-Report-Part-2-of-2_508.pdf\" title rel=\"noopener noreferrer\" target=\"_blank\">sharply higher risk for suicide<\/a> than the general population; in 2022, the suicide rate was 34.7 per 100,000, compared to 14.2 per 100,000 for the general population. A major factor in this is the availability of firearms, which were used in 73.5 percent of suicide deaths, according to the V.A.<\/p>\n<\/div>\n<div data-testid=\"ImageBlock-15\">\n<figure aria-label=\"media\" role=\"group\">\n<div data-testid=\"photoviewer-children-figure\">\n<p><span>Image<\/span><\/p>\n<\/div><figcaption data-testid=\"photoviewer-children-caption\"><span>Bilal Torrens had a job helping homeless veterans settle into life indoors.<\/span><span><span>Credit&#8230;<\/span><span><span aria-hidden=\"false\">Rachel Woolf for The New York Times<\/span><\/span><\/span><\/figcaption><\/figure>\n<\/div>\n<div data-testid=\"companionColumn-8\">\n<p>In Denver, Bilal Torrens was just finishing a shift when he was notified by email that he was being terminated.<\/p>\n<p>His job, he said, was helping homeless veterans settle into life indoors after years of living on the street. During those early months, Mr. Torrens said, the men are often overwhelmed by the task of collecting benefits, managing medications, even shopping for groceries; he would sit with his clients while they filled out forms and paid bills.<\/p>\n<\/div>\n<div data-testid=\"companionColumn-9\">\n<p>The layoffs reduced the support staff at the homeless service center by a third. The burden will now shift onto social workers, who are already staggering under caseloads of dozens of veterans, he said.<\/p>\n<p>\u201cThey\u2019re not going to have enough time to serve any of the veterans properly, the way that they should be served and cared for,\u201d Mr. Torrens said.<\/p>\n<h2 id=\"link-5b6dbbaf\">Alarms Over Privacy<\/h2>\n<p>In Coatesville, Penn., mental health providers have been told they will conduct therapy with veterans from several large office spaces, sitting with their laptops at tables, said Dr. Kedson. The spaces are familiar, he said \u2014 but they have never before been used for patient care.<\/p>\n<p>\u201cThat would sound like you\u2019re seeing them from a call center, because you\u2019d be in a room with a bunch of people who are all talking at the same time,\u201d Dr. Kedson said. \u201cThe veterans who are going to be in that position, I suspect they will feel very much like their privacy is being violated.\u201d<\/p>\n<\/div>\n<div data-testid=\"companionColumn-10\">\n<p>So far, only supervisory clinicians have been affected by the return-to-office policy; unionized workers will be expected to report to the office in the coming weeks.<\/p>\n<\/div>\n<div data-testid=\"ImageBlock-21\">\n<figure aria-label=\"media\" role=\"group\">\n<div data-testid=\"photoviewer-children-figure\">\n<p><span>Image<\/span><\/p>\n<\/div><figcaption data-testid=\"photoviewer-children-caption\"><span>A memorial for veterans who died by suicide in Washington.<\/span><span><span>Credit&#8230;<\/span><span><span aria-hidden=\"false\">Stephen Crowley\/The New York Times<\/span><\/span><\/span><\/figcaption><\/figure>\n<\/div>\n<div data-testid=\"companionColumn-11\">\n<p>Dr. Kedson said clinicians have warned that the orders compromise patient privacy, but he has seen little response from the agency\u2019s leadership. \u201cThey\u2019re doing it because these are the marching orders coming out of the current administration,\u201d he said. \u201cPeople are trying to make something that is really untenable work.\u201d<\/p>\n<p>Dr. Lynn F. Bufka, head of practice at the American Psychological Association, said the \u201clongstanding presumed practice for the delivery of psychotherapy\u201d requires a private location, like a room with a door and soundproofing outside the room.<\/p>\n<p>She said HIPAA, the health privacy law, allows for \u201cincidental disclosures\u201d of patient information if they cannot be reasonably prevented \u2014 a threshold that she said the V.A. risks not meeting. In this case, she said, the privacy risk could be prevented \u201cby simply not requiring psychologists to return to the office until private spaces are available.\u201d<\/p>\n<p>Several V.A. mental health clinicians told The Times they were interviewing for new jobs or had submitted their resignations. Their departures risk exacerbating already severe staffing shortages at the V.A., outlined in <a href=\"https:\/\/www.vaoig.gov\/sites\/default\/files\/reports\/2024-08\/vaoig-24-00803-222.pdf\" title rel=\"noopener noreferrer\" target=\"_blank\">a report last year from its inspector general\u2019s office<\/a>.<\/p>\n<\/div>\n<div data-testid=\"ImageBlock-24\">\n<figure aria-label=\"media\" role=\"group\">\n<div data-testid=\"photoviewer-children-figure\">\n<p><span>Image<\/span><\/p>\n<\/div><figcaption data-testid=\"photoviewer-children-caption\"><span>Matthew Hunnicutt, a social worker with nearly 15 years of experience at the V.A., retired last month.<\/span><span><span>Credit&#8230;<\/span><span><span aria-hidden=\"false\">Jamie Kelter Davis for The New York Times<\/span><\/span><\/span><\/figcaption><\/figure>\n<\/div>\n<div data-testid=\"companionColumn-12\">\n<p>\u201cEverybody is afraid, from the top down,\u201d said Matthew Hunnicutt, 62, a social worker who retired in late February after nearly 15 years, much of it in supervisory positions, at the Jesse Brown V.A. Medical Center in Chicago.<\/p>\n<p>When staff were ordered to shut down diversity initiatives, Mr. Hunnicutt decided to speed up his retirement, feeling that \u201ceverything I had done was just wiped away.\u201d He said care at the V.A. had been improved during his time there, with better community outreach, shorter wait times and same-day mental health appointments.<\/p>\n<p>\u201cJust to have it be destroyed like this is extreme,\u201d he said.<\/p>\n<p>Alain Delaqu\u00e9ri\u00e8re and Kirsten Noyes contributed research.<\/p>\n<\/div>\n<\/section>\n<div>\n<div>\n<p>Nicholas Nehamas is a Washington correspondent for The Times, focusing on the Trump administration and its efforts to transform the federal government.<span> <a href=\"https:\/\/www.nytimes.com\/by\/nicholas-nehamas\">More about Nicholas Nehamas<\/a><\/span><\/p>\n<\/div>\n<div>\n<p>Roni Caryn Rabin is a Times health reporter focused on maternal and child health, racial and economic disparities in health care, and the influence of money on medicine.<span> <a href=\"https:\/\/www.nytimes.com\/by\/roni-caryn-rabin\">More about Roni Caryn Rabin<\/a><\/span><\/p>\n<\/div>\n<\/div>\n<div id=\"bottom-wrapper\">\n<p>Advertisement<\/p>\n<p><a href=\"http:\/\/www.nytimes.com\/#after-bottom\">SKIP ADVERTISEMENT<\/a><\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>\u201cI just constantly felt like I am at war,\u201d said Sandra Fenelon, a Navy veteran who had a rocky transition back to civilian life.Credit&#8230;Sarah Blesener for The New York Times Trump and DOGE Propel V.A. Mental Health System into Turmoil A chaotic restructuring ordered threatens to degrade services for veterans of wars in Vietnam, Iraq [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":805,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-804","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/wpinitiate.com\/echo-test\/demo973e36f5\/wp-json\/wp\/v2\/posts\/804","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wpinitiate.com\/echo-test\/demo973e36f5\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wpinitiate.com\/echo-test\/demo973e36f5\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wpinitiate.com\/echo-test\/demo973e36f5\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wpinitiate.com\/echo-test\/demo973e36f5\/wp-json\/wp\/v2\/comments?post=804"}],"version-history":[{"count":0,"href":"https:\/\/wpinitiate.com\/echo-test\/demo973e36f5\/wp-json\/wp\/v2\/posts\/804\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/wpinitiate.com\/echo-test\/demo973e36f5\/wp-json\/wp\/v2\/media\/805"}],"wp:attachment":[{"href":"https:\/\/wpinitiate.com\/echo-test\/demo973e36f5\/wp-json\/wp\/v2\/media?parent=804"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wpinitiate.com\/echo-test\/demo973e36f5\/wp-json\/wp\/v2\/categories?post=804"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wpinitiate.com\/echo-test\/demo973e36f5\/wp-json\/wp\/v2\/tags?post=804"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}