Allegation of Underutilization of Mental Health Clinics, and Concern for Delays in Patient Care, at the Hinesville VA Clinic in Georgia

The VA Office of Inspector General (OIG) conducted a healthcare inspection to determine the validity of an allegation that select therapists do not maintain optimal utilization of individual mental health clinics and clinic administrative processes related to the Choose My Therapy (CMT) program, creating barriers to patients receiving care, timely care, or follow-up care at the Hinesville VA Clinic (Clinic).

The OIG substantiated that therapists’ clinic utilization rates were not optimal. Analysis of clinic utilization data revealed that Clinic therapists who provided individual psychotherapy generally had clinic utilization rates ranging from 32–68 percent, which was below the lowest target of 80 percent recommended by the Veterans Health Administration (VHA). The Clinic mental health section chief (section chief) acknowledged awareness of low utilization rates since 2022 but cited competing priorities as barriers to change.

The OIG analyzed data of 285 unique patients who received a diagnostic evaluation and found that patients experienced delayed access to mental health care. Specifically, a median wait time of at least three weeks between three subsequent individual psychotherapy sessions. Delayed initiation of mental health treatment may put patients at risk for negative outcomes, and VHA expects sessions to occur weekly. Further analysis of the data showed a progressive loss of patients engaged in treatment.

The OIG learned that Clinic mental health staff utilized a prohibited waitlist. The section chief confirmed the waitlist was discontinued in April 2023 and reported that patients’ care requests have since been tracked through clinical consults in electronic health records.

The OIG made six recommendations to the Facility Director related to optimizing clinic utilization, accurate use of current procedural terminology codes, consult management and patient scheduling processes, review of patients who experienced individual therapy delays and were on the discontinued waitlist, and evaluation of CMT programs operating in other facility locations.