The U.S. Department of Veterans Affairs (VA) is planning mass layoffs in the coming months, aiming to slash upwards of 80,000 jobs.
Providers that work with the department and the advocates of veterans fear the massive cuts will jeopardize health care services for millions of veterans who receive care through the VA. Behavioral health services delivered and supported by the VA may be especially at risk.
“In response to Trump’s Department of Government Efficiency Workforce Optimization Initiative, VA is conducting a department-wide review of its organization, operations and structure,” VA Secretary Doug Collins wrote in an op-ed published by The Hill. “Central to these efforts is a pragmatic and disciplined approach to eliminating waste and bureaucracy, increasing efficiency and improving health care, benefits and services to veterans.”
The VA provides a range of behavioral health services, including mental health treatment, substance use disorder (SUD) care and suicide-prevention programs. These services are available via VA medical centers, community-based outpatient clinics and telehealth options.
Additionally, the VA collaborates with behavioral health providers through partnerships with local organizations, private companies and its Community Care Network (CCN).
In an interview with NPR, one therapist working for the VA said the conversations around cuts have already been “destabilizing” to patients. Uncertainty and a sense of insecurity can be particularly difficult for individuals with post-traumatic stress disorder (PTSD), she noted.
“And then there’s a sense of betrayal from the government,” the therapist continued.
So far, the talk around job cuts hasn’t been focused on patient-facing clinical roles. That’s something Secretary Collins emphasized in his recently published op-ed.
“Our goal is to reduce VA employment levels to 2019 numbers of roughly 398,000 employees from our current level of approximately 470,000 employees – a nearly 15% decrease,” Collins wrote. “We will accomplish this without making cuts to health care or benefits to veterans and VA beneficiaries.”
Even so, the delivery of behavioral health services requires broad teams, with non-clinicians and back-office roles being critical to that mission. Cuts to such positions could realistically impact access and quality, or the breadth of behavioral health services furnished through the VA.
What’s more, behavioral health services linked to the VA could also be impacted by the Trump administration’s focus on slashing federal funding. Not only is the VA one of the largest coordinators of mental health services in the nation, but it’s also among the biggest innovation hubs and research funders.
In Fiscal Year 2024, the VA funded more than 7,200 research projects. Its total research budget checked in at $2.4 billion.
Behavioral health providers will likely feel the turmoil at the VA very differently.
The proportion of revenue that behavioral health providers receive from the VA varies greatly based on a number of factors, including a provider’s location, the demographics of the population it serves and the extent of its engagement with VA programs.
Some behavioral health providers may have substantial contracts with the VA, making it a significant revenue source, while others may have minimal or no interaction with VA funding.
