VA to increase mental health staffing

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As one of my supervisors put it: "finally some good news."

http://www.nytimes.com/2012/04/19/us...r=1&ref=health

Before we rejoice...let's see how many are actually psychologists/neuropsychologists. I think some VISNs are far better than others at meeting the needs with appropriate staff, while others are using paraprofessionals to try and get by.

Seeing the effects of this already; good news

Originally Posted by Therapist4Chnge

Before we rejoice...let's see how many are actually psychologists/neuropsychologists. I think some VISNs are far better than others at meeting the needs with appropriate staff, while others are using paraprofessionals to try and get by.

Agreed, although I think it's promising that the article mentions "about 1,400" of the hirees will be direct care providers. I'd imagine just based on logistics that the majority will be master's-level, followed by psychologists, and then psychiatrists. Even if it's only a couple hundred, that'd still be a nice (albeit small) boost.

I was going to say, they're probably going to be all Masters-level hires...

Also, its going to be critical WHERE the hiring takes place. I see job ads for psychologists in the VA all the time, they tend to be in locations that are either undesirable or out-of-the-way CBOCs, so that most people wouldn't want to work/live there. As the article mentioned, its hard to get psychiatrists to move to Montana...

Originally Posted by positivepsych

Also, its going to be critical WHERE the hiring takes place. I see job ads for psychologists in the VA all the time, they tend to be in locations that are either undesirable or out-of-the-way CBOCs, so that most people wouldn't want to work/live there. As the article mentioned, its hard to get psychiatrists to move to Montana...

This is actually one of the reasons why I'm not as worried as I could be about my job prospects; I've generally made a life out of moving to less-than-desirable locales.

Originally Posted by AcronymAllergy

This is actually one of the reasons why I'm not as worried as I could be about my job prospects; I've generally made a life out of moving to less-than-desirable locales.

Ditto.

I was actually thinking this would be more in psychiatrists and psych NPs than Masters-level therapists, though. It's a shame that psychology hasn't done a better job of defining, protecting, and marketing itself as a unique and valuable profession.

I am seeing this. A month ago the service chief at the VA i am gunning for said some stuff was "coming down the pipe" and that I needn't worry too much. Today one popped up. And supposed to be 3 more in the near future at the same facility (or maybe their CBOCs). Also, has anyone seen that the James Haley in Tampa has a announcement with like 14 vacancies. That's nuts! I applied for that just to see if I get a bite. lol

Any neuro positions? I like the rehab & neuro folks down in Tampa.

This was discussed on the PBS Newshour last night, they interviewed a VA senior mental health official regarding the increase. Here's the clip:

http://www.pbs.org/newshour/bb/healt...lth_04-19.html

If you watch the interview, Sonja Batten specifically mentions that the VA will be hiring MFTs and LPCs now. The floodgates have opened...

Originally Posted by positivepsych

If you watch the interview, Sonja Batten specifically mentions that the VA will be hiring MFTs and LPCs now. The floodgates have opened...

Scary.

Originally Posted by positivepsych

If you watch the interview, Sonja Batten specifically mentions that the VA will be hiring MFTs and LPCs now. The floodgates have opened...

I don't know how worried I am at this moment (probably less than I should be), but if nothing else, it just cements the idea that psychologists need to 1) improve our own self-advocacy efforts and scope of practice protections, and 2) market the myriad skills we provide outside of psychotherapy and even clinical assessment.

Originally Posted by positivepsych

If you watch the interview, Sonja Batten specifically mentions that the VA will be hiring MFTs and LPCs now. The floodgates have opened...

Frustrating but I would prefer to work with a mix of LCSW and LPC and MFT than just LCSW.

Originally Posted by positivepsych

If you watch the interview, Sonja Batten specifically mentions that the VA will be hiring MFTs and LPCs now. The floodgates have opened...

I've gotta assume that they are all being hired as title 5 employees, though. Is there any word on how much of that 1600 will be title 38?

Originally Posted by Veit

I've gotta assume that they are all being hired as title 5 employees, though. Is there any word on how much of that 1600 will be title 38?

What is the difference?

Originally Posted by Therapist4Chnge

What is the difference?

Title 38 employees are what are deemed "professional employees," the doctors, nurses and PhD psychologists. Title 5 employees are basically everyone else: the nurses aides, the dosimetrists, and similar. A number of my family members have worked for the VA for years, in various places; I was just talking to my father, and he said that they plan to build small professional teams, led by psychologists and including a psychiatrist to prescribe medication and lower level mental health professionals, although he doesn't know if they would hire LCSWs and similar as Title 5 or Title 38 employees. The psychologists heading up the teams would be Title 38.

Originally Posted by Veit

Title 38 employees are what are deemed "professional employees," the doctors, nurses and PhD psychologists. Title 5 employees are basically everyone else: the nurses aides, the dosimetrists, and similar. A number of my family members have worked for the VA for years, in various places; I was just talking to my father, and he said that they plan to build small professional teams, led by psychologists and including a psychiatrist to prescribe medication and lower level mental health professionals, although he doesn't know if they would hire LCSWs and similar as Title 5 or Title 38 employees. The psychologists heading up the teams would be Title 38.

Ah, my father looked into it, and has more information. Psychology professionals at both the masters level and the doctorate level are 5-38 hybrids, which has ups and downs, but more ups. It has the job security of a Title 5 employee, so they're harder to fire, but like Title 38 employees, they are paid at the market rate, rather than at a lower capped rate based on the GS pay-scale; on the other hand, they don't have a say in hospital governance. It's still not clear how many of the positions are going to become masters-level, but it seems to depend on what each hospital needs to build their teams. There really shouldn't be concern about doctors being replaced, in this situation, because all of the teams still call for a hierarchy that requires a PhD or PsyD at the top.

Ah okay...I vaguely remember that from my VA orientation. I know as a hybrid we are not allowed to be in a union, but there are better protections because of the 38-status.

I know the VA is the #1 agency for hiring psychologists (at least I heard this awhile back, not sure if it's still true), but I wonder how much the APA is doing advocacy work in maintaining presence (and importance) of psychologists in the VA healthcare system?

This article was striking because in IMHO it seems there is going to be a fierce debate among mental health professionals (masters-level vs. doctoral) when it comes to hiring and standards of care. Any thoughts? Particularly by those in the VA now- have you noticed any push in one direction or the other??

http://www.armytimes.com/news/2012/0...hiring-050312/

Originally Posted by psychology24

I know the VA is the #1 agency for hiring psychologists (at least I heard this awhile back, not sure if it's still true), but I wonder how much the APA is doing advocacy work in maintaining presence (and importance) of psychologists in the VA healthcare system?

This article was striking because in IMHO it seems there is going to be a fierce debate among mental health professionals (masters-level vs. doctoral) when it comes to hiring and standards of care. Any thoughts? Particularly by those in the VA now- have you noticed any push in one direction or the other??

http://www.armytimes.com/news/2012/0...hiring-050312/

I was mildly heartened by the article. LCSWs, psychiatrists, and psychologists in the VA = good. MFTs and LPCs, bleach. Yes, I'm prejudiced.

http://www.armytimes.com/news/2012/0...hiring-050312/

"But with a nationwide shortage of trained mental health workers,"

Whats the cite for this statement and how would one go about even making that claim? Whats the proper amount anyway? And who establishes that? There's difference between being unable to see a clinician for your PTSD for six months vs. the ridiculous pie-in-the sky notion that there should be a counselor in every social service agency on every corner....

Moreover, I have NEVER heard of a service line chief complain that they cant fill psychologist positions. Usually there competition is fierce (70 apps for our facility's god forsaken C&P position for goodness sake!). Sure its hard to get people in some of the remote CBOCs, but they do fill.

Originally Posted by erg923

http://www.armytimes.com/news/2012/0...hiring-050312/

"But with a nationwide shortage of trained mental health workers,"

Whats the cite for this statement and how would one go about even making that claim? Whats the proper amount anyway? And who establishes that? There's difference between being unable to see a clinician for your PTSD for six months vs. the ridiculous pie-in-the sky notion that there should be a counselor in every social service agency on every corner....

Moreover, I have NEVER heard of a service line chief complain that they cant fill psychologist positions. Usually there competition is fierce (70 apps for our facility's god forsaken C&P position for goodness sake!). Sure its hard to get people in some of the remote CBOCs, but they do fill.

This was my thought exactly. You can tell that it is from the LPC perspective (the quote is from the president of the ACA). I am wondering if anyone has noticed psychologists being pushed out by masters-level clinicians?

Originally Posted by psychology24

This was my thought exactly. You can tell that it is from the LPC perspective (the quote is from the president of the ACA). I am wondering if anyone has noticed psychologists being pushed out by masters-level clinicians?

That ship has already sailed. Psychologists are too costly to have only do therapy work. You still see positions being offered in Primary Care and also for assessment-heavy roles, but the more generic out-pt therapy spots appear to be filled by mostly mid-level providers.

LCSWs, psychiatrists, and psychologists in the VA = good. MFTs and LPCs, bleach. Yes, I'm prejudiced

Now that is just ignorant. I would expect a Psychologist to base conclusions on empirical data rather than personal prejudices.

The bottom line is to improve mental health services to veterans and letting professional politics interfere with that is unethical.

Originally Posted by DrPablo

Now that is just ignorant. I would expect a Psychologist to base conclusions on empirical data rather than personal prejudices.

The bottom line is to improve mental health services to veterans and letting professional politics interfere with that is unethical.

First, you would be "ignorant" to think you can get rid of personal prejudiced with data. What a ridiculous statement, especially from a psychologist. The data does NOT demonstrate that nurse aesthetics are more likely to kill me during surgery, but I'm still biased in preferring an anesthesiologist when i go under the knife...

Second, I would expect psychologists to protect their scope of practice and to be skeptical of other professionals hired to perform their same job duties but have less than half the training. So, yes, I would expect that we are biased in the direction that we can bring something to the table and to the patient that the other guy cant. I guess that a business mentality. But then again, keeping myself (and my profession) in business is pretty high on my priority list.

Originally Posted by DrPablo

Now that is just ignorant. I would expect a Psychologist to base conclusions on empirical data rather than personal prejudices.

No, not ignorant. Prejudiced. Little bit of a difference there.

Originally Posted by DrPablo

The bottom line is to improve mental health services to veterans and letting professional politics interfere with that is unethical.

If we really want VA psychologists to be replaced by masters-level therapists to perform therapy-heavy services I think social work could probably handle it, and they have the benefit of being (empirically speaking) a known quantity at the VA besides. I don't trust the average training quality in the MFT or LPC, and that's informed by some personal and professional experience. If that makes me "unethical" or "ignorant," oh well.