Concerns with Access and Delays in Outpatient Mental Health Care at the New Mexico VA Health Care System, Albuquerque, New Mexico

The VA Office of Inspector General (OIG) conducted a healthcare inspection to address concerns with patients’ access to care and delays in outpatient mental health care. The OIG identified patients’ limited access to outpatient mental health care as evidenced by the staff’s insufficient use of the electronic wait list, high appointment clinic cancellation rates, and long wait times for new patient appointments. In addition, there were delays in providing outpatient mental health care for new patients’ consults and for patients receiving ongoing mental health care. Contributing factors included underutilizing telemental health and community care services, staffing shortages, delays in hiring staff, hiring practice issues, disproportionate care provider productivities, and a lack of training and supervision for scheduling staff. The OIG determined that the facility policy for no-show patients did not reflect Veterans Health Administration requirements and scheduling staff did not consistently follow up with no-show patients. During the inspection, OIG staff identified issues involving an incomplete administrative investigative board review and action plan, and although some patients had consults marked complete, documentation did not reflect that they were evaluated and/or seen by a mental health provider as requested by the consult. The OIG made 12 recommendations related to electronic wait lists, outpatient mental health appointments, non-VA and telemental health care, scheduling delays for patients’ consults and return-to-clinic appointments, provider and scheduling staff shortages, hiring practices, consult and no-show policy compliance, administrative investigation board review processes, and the consult completion process.