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yeesh. The social workers at my hospital are into that stuff, but thankfully the psychologists largely aren't. I would have been openly salty about that if forced to listen to it as a trainee.
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VA Mental Health Provider Venting / Problem-solving / Peer Support Thread
Started by Fan_of_Meehl
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Sanman
O.G.
It may address or exacerbate the problem depending on how it is used. Folks are still going to need to be housed while the guardianship process is seen through and courts are often already backed up. Just because VA can initiate the guardianship process now does not mean it is getting approved by a judge any quicker or at all. Then there remains the issue of placement. Our VA CLC and veterans home have a months long wait list already. I imagine this may exacerbate that issue. It may also alienate veterans who need care but are concerned about being 'locked up' in a nursing home.
What about all of the TBI patients who are presenting/malingering to levels that would suggest they need to be in guardianship if taken at face value? I can easily see some ***** doing a problem list study, again, where they fail to appreciate the inherent problems with such methods, and it getting a lot of play, again.
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Could always add that in to the informed consent. "Also, if testing shows you're so impaired that it raises concerns about your ability to make decisions for yourself and independently manage self-care, we have a team in the facility on standby to admit you to a locked long-term care unit for your own safety while we initiate guardianship proceedings. They'll probably also need to confiscate and hold any firearms you own while we sort this out."
I'm sure that'll go over very well. I already have a not-insignificant number of patients who look at me sideways anytime I mention driving.
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Yeah, I usually incorporate something to the effect of "If I were to take these performances at face value, I would have to conclude that you were not safe to operate a motor vehicle, manage your own medications, manage your own finances, and other activities. Does that sound about right to you, should I draft letters to the appropriate state agencies?" Granted, this situation occurs far less often for me outside of the VA now, so I don't need to bring that out often these days.
New ProPublica article:
www.propublica.org
Veterans Who Depend on Mental Health Care Keep Losing Their Therapists Under Trump
Hundreds of mental health professionals have left the Department of Veterans Affairs since President Donald Trump took office, leaving staff “at a breaking point” and some veterans waiting as long as six months for help.
www.propublica.org
I have forwarded this along to several psychologists. We're all feeling it. Out of curiosity, I took a peek at some of the responses. A worrying number of people said it's always been bad, so this is nothing new. Things can always get worse? That's such a weird stance to take.New ProPublica article:
Veterans Who Depend on Mental Health Care Keep Losing Their Therapists Under Trump
Hundreds of mental health professionals have left the Department of Veterans Affairs since President Donald Trump took office, leaving staff “at a breaking point” and some veterans waiting as long as six months for help.
People also shared how much they liked their community providers. Our community providers are swamped too. The reimbursed rate is also terrible. I wouldn't take it in private practice. Wild stuff.
Sanman
O.G.
You can like a provider even if they are incompetent. I know a veteran who I formerly treated said the community provider was very nice. When I looked up the provider, it was a provisionally licensed social worker with education from an online SW program. Some veterans will not understand the difference in provider skill level or competence.
A common trap many fall into, especially early career clinicians…not all patients will agree with you and if you are doing your job correctly, that is to be expected.
Yep, a therapist's job is often to tell people things they don't want to hear.
And at least not tell them things that they don't actually believe to be true just to "keep the peace" or be liked by them.
PsynofTimes
Full Member
I am predicting an impending disaster with Cerner.... I'm actually pretty nervous (at a Cerner site).
There is a big push lately for us to cover all outpatient psychotherapy groups when other providers are out. I'm not a fan of group work in the best of times, and I literally feel like just a warm body when I cover. It's awkward and doesn't feel very productive. It's almost certainly not good therapy. It is hastening my burnout.
Confronting erroneous beliefs? Communicating directly? That's too "sciency". It's more comfortable to stick with our preferred way of communication. If someone calls you out for being indirect, call it some form of aggression. If you want to shoot for the gold, add in some activity that you like, and call it "XYZ therapy".
Would you like to pay 5k to get a weekend seminar and a Level .5 Certificate on my "Separating a Fool/Provider from their money and telling them to lie to their patients" Therapy? If you act now I'll give you 5% off and an automatic invite for the next $10k seminar so you can be level .75 Certified.
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*Starts to pull out money*
Wait a second... This is a total scam. They didn't use buzz words like "trauma-informed" or "neurodivergent." Can't trust anyone these day! /s
"You have a diagnosis. Instead of helping you overcome it, I'll tell you that the diagnosis means you CAN'T do things. Even though I'm saying that you can never be cured, you still have to meet with me once a week for.... reasons. You know, the same way a blind person has to go to the optometrist every week until someone dies."
Sanman
O.G.
Confronting erroneous beliefs leads to lower patient satisfaction and customer service scores. We don't do that anymore because "front-line staff" don't know anything. Instead, we have more surveys and self-report measures.
"Self-awareness" of limitations can be freeing....of your wallet, don't worry about functional outcomes, those are just holding you back from your awareness.
Gunman killed and employee hospitalized after a shooting at a Georgia VA clinic, police say
Police in Georgia say they have responded to a shooting at a Department of Veterans Affairs clinic, where a suspect was shot and killed by police.
apnews.com
The comments are... holy victim blaming
Sanman
O.G.
Gunman killed and employee hospitalized after a shooting at a Georgia VA clinic, police say
Police in Georgia say they have responded to a shooting at a Department of Veterans Affairs clinic, where a suspect was shot and killed by police.
The comments are... holy victim blaming
Veterans are the only victims. We can't be worrying about staff. Surprised the comments are not worse actually.
Mouth breathers gonna mouth breathe...
The employee died. VA Social Worker. Horrible.
That hurts my heart. I was hoping they would survive.
Sanman
O.G.
Background of the employee
Looks like it was a walk-in/same day access MH appt gone wrong. Everyone stay safe out there.
Looks like it was a walk-in/same day access MH appt gone wrong. Everyone stay safe out there.
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Unfortunately, the population that receives, in general, better healthcare that the vast majority of Americans, is the most violent towards providers of that healthcare. Still have never seen the level of anger and casual violence in a patient population higher than the VA. Keep coddling and letting that behavior go and the more we see this. Entitlement gone horribly awry.
Sanman
O.G.
This combined with some local situations that I am privy to recently and, unfortunately, veteran behavior seems to be getting worse with recent stressors. The anger is, of course, directed at the wrong people.
Maybe it is time to burn it down and privatize it. Create some actual accountability with the patient population. I don't see that happening in the current system, unfortunately.
He shouldn't have had a gun. Why did no one check this? Granted, they don't at our CBOC either... but the CBOC I used to work at had a metal detector and security at the entrance.
Also, i wonder how many DBSRs should have been filed on this patient but weren't.
Also, i wonder how many DBSRs should have been filed on this patient but weren't.
Sanman
O.G.
Privatize what? We are getting calls from patients about some of the private hospitals no longer being able accept community care patients due to rate disputes with United Healthcare and can the VA see them.
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I don't know if much has changed here in almost a decade, but when I was at the VA here and we visited various CBOCs weekly to do neuropsych evals, I don't recall a single one of them having a metal detector.
Then they can raise rates/eliminate the burden of interacting with the system to entice more of us who refuse to join the program, to jump on. Or, Vets can see what healthcare is truly like for most of America and how they continually vote against their own self-interest.
I am actually amazed that there aren't more incidents like this. And I wouldn't be surprised if the precipitant was the attempted enforcement of some behavioral boundary of some sort.
PsynofTimes
Full Member
So, I'm a Cerner site as I mentioned before. They're taking our whole state down at the same time, because that's the way you do these things apparently. Veterans are going to go weeks and weeks without care. I can't help but think this is a similarly dangerous situation.
Wait, so are you guys not seeing patients at all? What are you doing all day?
PsynofTimes
Full Member
We'll have like one a day. I think we'll be trying to figure out the medical record all day and handling walk ins. It's going to be a mess. Truly.
What do you mean?
Thinking that might be related to the GA VA social worker getting murdered
Sanman
O.G.
I don't want to provide specific details. But a general uptick in sexual harassment and verbal threats from older male veterans towards mostly younger female staff providing care from them this week.
Overt aggression/misogyny increases seem to be a larger societal trend in the current climate, as it's normalized at the highest levels of society, is this VA specific, or just an increase that goes along with that societal increase? Of course, the VA has always skewed highly on that issue to begin with, especially in the South.
In my first month of internship we had an intoxicated and agitated veteran show up to the ED with a gun; he was a known flag and thankfully we were able to talk him down. The vast majority of cars in the parking lot had gun racks and/or hunting stuff, and there wasn't a metal detector in any of the buildings. Arming more people isn't the answer, neither are metal detectors. We have a culture of guns and violence, so gun violence is common and expected.
I am using so much more leave lately. I know more efficiency wasn't really the goal for National, but it should be for my local leadership. We could have some flexibility with RTO, but they've been pushing hard to get us in the office too. I am so resentful and tired, I don't give anything extra. I keep looking for closer and remote work options.
Unfortunately, this is becoming a larger societal concern. I work in peds and it's getting worse over here too. Pop Science article to further elaborate:
31% of Gen Z men say wife should 'obey her husband.' Yikes. | Opinion
The results confirm a lot of what Generation Z women already know, regardless of where we live in the world: Our male peers do not see us as equals.
www.usatoday.com
Unfortunately, this is becoming a larger societal concern. I work in peds and it's getting worse over here too. Pop Science article to further elaborate:
31% of Gen Z men say wife should 'obey her husband.' Yikes. | Opinion
The results confirm a lot of what Generation Z women already know, regardless of where we live in the world: Our male peers do not see us as equals.www.usatoday.com
One way to fight back against this? Make these CHUDS bachelors for life.
I've heard of looksmaxxing, and obviously have heard of Tate and his ilk, but didn't know there'd been that much of a swing in overt misogyny in younger men.Unfortunately, this is becoming a larger societal concern. I work in peds and it's getting worse over here too. Pop Science article to further elaborate:
31% of Gen Z men say wife should 'obey her husband.' Yikes. | Opinion
The results confirm a lot of what Generation Z women already know, regardless of where we live in the world: Our male peers do not see us as equals.www.usatoday.com
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We've been hearing a lot more overtly Nazi-like comments from patients, too.
You are in a little bit of the "South of the North" area. My experience in the VAs over there was closer to my experience in the southern VAs moreso than other regions.
Sanman
O.G.
Nice way if saying "Republican stronghold"
Sanman
O.G.
They may be bachelor's for life or not. I am surprised by the number more so than the trend. These are your young Trump fans. As it gets harder for younger folks to be economically successful, there seems to be much of this trend of blaming each other rather than larger trends or causes. Because life is apparently a competition. I imagine the use of AI to displace jobs may exacerbate these trends.
From what I've read, the majority of Gen-Z and Gen-Alpha are left-left, not just left-leaning, but there are a minority of young males who gravitate towards the Manosphere. Some are black-pillers and others claim they want Trad Wives, but women won't give them the time of day.
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