The US Department of Veterans Affairs (VA) seems to be reconsidering its proposal to relocate telehealth mental health therapists back to office environments that may not guarantee privacy. This information was disclosed in a memo acquired by NPR. The document highlights the necessity for providers to have private workspaces, conducive to trustworthy and confidential interactions with veterans, as they transition back to office work in the coming weeks.
The memo, dated April 12, was distributed to regional directors shortly after NPR released its recent analysis addressing these issues. The concerns followed earlier reports and objections from lawmakers about the mental health clinicians’ ability to maintain confidentiality during therapy sessions upon returning to VA facilities. Currently, many clinicians are delivering telehealth consultations from their homes. However, a mandated return-to-work policy requires them to report to VA offices, raising concerns about the adequacy of these facilities in offering private settings.
The move comes amidst an announcement by VA officials, including Secretary Doug Collins, to reduce the workforce by 80,000 positions. This reduction follows the allocation of nearly $800 billion under the PACT Act, intended to expand VA services and benefits. Despite this significant funding increase, there is ambiguity about how the VA will meet its legal obligations under the PACT Act while also downsizing its staff to previous levels.
Before the April 12 memo, management in some VA regions distributed a script to therapists, acknowledging the potential lack of complete confidentiality while working in environments similar to call centers. Federal laws guarantee confidentiality to healthcare patients, and the strength of the patient-provider relationship is crucial to successful therapy outcomes. The memo clarifies that spaces for telehealth services should offer the same privacy level and therapeutic setting as in-person visits.
Despite the memo, confusion persists among clinicians. The document does not explicitly confirm if therapists may continue home-based work if private office space is unavailable, raising concerns about meeting privacy requirements amid reports of insufficient space for personnel and essential resources at VA facilities. Another document indicated that mental health clinicians might qualify for exceptions to the return-to-work order, though details remain scarce.
The VA has not clarified how the new memo impacts employees at overcrowded facilities. VA spokesperson Peter Kasperowicz consistently maintains that veterans’ care will remain uninterrupted and that facilities will comply with federal privacy laws. The VA is expected to accommodate employees to ensure sufficient workspace. As per the current directive, some VA staff were required to return to the office on April 14, with others set to follow by May 5, per a department-wide mandate initiated during the Trump administration under Secretary Collins.
The American Psychological Association has raised concerns about VA therapists’ ability to adhere to federal privacy standards, emphasizing the longstanding importance of confidentiality in psychological services. Recognized as a leader in mental health care in the US, the VA’s shift to office work and workforce reduction risks potential attrition among providers and a decline in veteran care quality. According to Lynn Bufka, head of practice at APA, the VA is esteemed for its rigorous training and evidence-based care, serving a population that has significantly contributed to national welfare.
