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Submission For The Record of The Honorable Eric K. Shinseki, Secretary, U.S. Department of Veterans Affairs

Thank you, Mr. Chairman, Ranking Member Brown, distinguished members of the committee, thank you for this opportunity to speak on behalf both of veterans and their families but also the employees of VA about this important issue of mental health.

Mr. Chairman, I ask the department's prepared written statement that was previously submitted by Dr. Jesse be included in the record.

MILLER:

Yes, without objection.

SHINSEKI:

OK. Thank you.

Well, joining me today as you have introduced them are the leaders and senior clinicians of the Veterans Health Administration who are the appropriate experts to provide clinical staffing and policy information that you had requested in your letter.

I want to be clear, mental health and wellbeing of our brave men and women who have served the nation is the highest priority for me, for this department and for our nation. We are here to care for veterans' mental as well as physical health and wellbeing.

Today's testimony takes me back a few decades, Mr. Chairman, and my own experience coming back out of a combat situation. And I think you'll appreciate that why this has priority for me on remembering some of the transitions I went through.

I'm here today to speak to America's veterans and their families as well and represent the dedicated employees of this department. And especially today to the 20,590 mental health providers that are a part of this discussion.

History shows that VA's requirements will continue to grow for a decade or more after the operational missions as they have in Iraq and next in Afghanistan come to an end. And as veterans depart the military, we must ensure that all of them have access to quality mental health care. I believe we are all united in that pursuit.

I believe the strong actions taken under the president's leadership have illustrated that clearly for the past four budgets. In the last three VA has devoted more people, programs and resources towards mental health services to serve the growing number of veterans seeking mental health care services to serve the growing number of veterans seeking mental health care from VA.

Last year VA provided specialty mental health services, Mr. Chairman, as you pointed, to 1.3 million veterans, with the president's 2013 budget request the VA has increased the mental health care budget by 39 percent since 2009 and if we add to that the 2014 advanced appropriations request that's currently being considered, that increases that factor to 45 percent.

Since 2007 VA has seen a 35 percent increase in the number of veterans receiving mental health services as the ranking member pointed, but at the same 41 percent increase in mental staff to adjust to that.

And I think this describes a little bit of what we're dealing with and that is that in our process here, Mr. Chairman, you resource us to a requirement. And at best those requirements, because of the advanced appropriations request that gives us a two-year budget, those requests are based on a prior year number of folks who walk in the door, we try to extrapolate that into some estimate of the future but we're really covering about four years as we look forward.

And what this really means is we are essentially in a react cycle, that what walks in the door becomes the basis for understanding what the requirements could be in the future years, and so, if the trend-line is smooth and uniform over time there is an opportunity in the system to react because this is primarily a reaction process. Where we have spikes in that requirement then we have these occasional needs to address the staffing issue as we have in this case.

Additionally in 2010 I think we'll all recall that the department simplified its rules for veterans submitting PTSD related disability claims which has greatly simplified access to care and benefits and contributed to growth in the PTSD mental health requirements. So that was done in '10. The claims have been submitted and we are beginning a growth in PTSD mental health requirements and therefore not unexpectedly a requirement to adjust our staffing.

VA's announcement on the 19th of April that we would add approximately 1,600 mental health clinicians to include psychiatrists, psychologists, mental health nurses, social workers, as well as 300 support staff to our existing workforce of 20,590 reflects both our commitment to mental health and the acknowledgment that changes in policy are having an impact.

And our efforts will likely not cease with the announcement of 1,900 additional personnel being added to our workforce. Future adjustments may be likely.

VA has a long history of being on the cutting edge of mental health care whether through the use of vet centers, our National Center for PTSD, our veterans crisis line or integrating mental health into the primary care environment of our health care facilities.

We will continue to review and monitor our facilities and veterans' feedback so that we can make other adjustments that are needed and we will not hesitate to take action again, and I appreciate the support of this committee and the Congress over the past years as you continue to provide us the resources we need and the authorities we need to make this care available to our veterans.

My invitation is let's continue to work together along with our partners in the veterans service organizations focusing on what's important, providing timely access to care and benefits our veterans have earned. And I look forward to working these issues with the committee and look forward as well to your questions.

Thank you, Mr. Chairman.