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The Department of Veterans Affairs has already cut several thousand jobs and intends to cut 80,000 more. It's also affected by President Trump's executive orders on gender and diversity. Among other things, the VA is one of the biggest providers of mental health care in the country, and some patients say they're already feeling the impact of these changes to their mental health. NPR's Katia Riddle reports.
KATIA RIDDLE, BYLINE: A point of pride for mental health care providers at the VA - it's integrated into regular health care. Rashi Romanoff works with a nonprofit, the National Association of Veterans' Research and Education Foundations, or NAVREF. They do advocacy around medical research at the VA.
RASHI ROMANOFF: They really invested a lot to have this feel like one experience that the patient is having.
RIDDLE: Patients see therapists as part of their regular visits to the doctor. Romanoff says even though the VA has promised not to cut clinicians, any kind of change to this delicate medical ecosystem is disruptive.
ROMANOFF: So when you have this loss of personnel, you feel it in really, really, you know, significant and concerning ways when it comes to patient care.
RIDDLE: One such patient, a woman who has to be identified only with her initials, DM - she's fearful of retribution for speaking out.
DM: While I served, I was a victim military sexual trauma or sexual assault from a fellow service member.
RIDDLE: DM served nearly 26 years on active duty as a nurse. She worked through the trauma from the assault, but she took this lesson away from it. Anytime she's asked to meet with a man, never be in a room alone with him.
DM: You don't go in there alone. Even if you have to grab the office secretary, you make sure you are not one-on-one with that male. And that's to protect you and to protect him.
RIDDLE: She says for female veterans like herself who have been sexually assaulted, seeing a male health care provider is threatening.
DM: If that person taking your vital signs is a male and you've been traumatized by a male, and that person's going to touch you, and it's a stranger. Right there, that is gone by having that person you know is female when you're in the women's health clinic.
RIDDLE: The women's health clinic through the VA - that's where she goes now to receive both mental and physical health care. But with the new executive orders around DEI and gender, she fears spaces like this will be eliminated from veteran and Army life.
DM: We're going to get rid of anything that involves, you know, women, transgender, all that stuff. Well, right there - women, women's health clinics.
RIDDLE: To be clear, the VA has not announced any plans to eliminate women's clinics. The executive order DM is referring to states that it is an effort to protect women. In an email statement to NPR, a spokesperson said, quote, "the VA will always provide veterans, families, caregivers and survivors the health care and benefits they have earned," end quote. DM is not reassured. Therapists say these kinds of perceived threats are destabilizing to their patients.
LYNN: It's already hurting people's mental health.
RIDDLE: This woman is a VA mental health practitioner. She asked only to be identified by her middle name, Lynn. She fears she will lose her job for speaking out.
LYNN: We've had patients going to the medical records and asking for their charts to be altered and have, like, diagnoses rescinded and making changes to them to remove references to their gender identity or their sexual orientation because, again, they're fearing that they might be put on a list or that they might be discriminated against.
RIDDLE: Another thing that's stressing people out, the fear that they'll lose their therapist. The VA's reassurances that they would not cut these positions have not been convincing, they say. DM has been working with one therapist for 2 1/2 years.
DM: You know, you know them. They know you.
RIDDLE: She says she and other veterans are fearful of the women's health clinic being shut down altogether.
DM: We walk in, and we're like, is this going to be here next week? And what do we do if the door's closed? Like, we don't know what to do.
RIDDLE: Before making changes to veterans' health care, says DM, she suggests officials talk to veterans, ask them what they want. Katia Riddle, NPR News. Transcript provided by NPR, Copyright NPR.
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