Haley VA Hospital Complaint Points To Psychology Trainees

In the past we had have a number of stories about psychiatrists and psychologists who plainly miss the boat when it comes to patient diagnosis and evaluations. Given that those clueless wonders were licensed professionals, we cannot help but be alarmed at this report. From the Tampa Tribune.

Veterans who go to James A. Haley VA Medical Center for mental health care are unknowingly treated by psychologists who are inexperienced and not fully licensed, according to a complaint filed last week with a state board.

Hiring unlicensed psychologists is legal, but Haley is skirting the state's requirements by not sufficiently supervising them as they treat patients, the complaint alleges. It was filed with the Florida Board of Psychology by Brian Nussbaum, one of Haley's licensed psychologists.

Nussbaum claims there are 12 unlicensed psychologists on a staff of 34. John Pickens, a regional VA spokesman, acknowledged there are unlicensed psychologists at Haley, but said there are only nine and that they are all closely supervised.

Even nine, if that number is accurate, is too many, Nussbaum said Tuesday.

"Being that they're freshly out of school, and when you're working with a population that is so complex and sensitive as combat veterans, this is not a population that you throw in people who don't have the necessary expertise," he said, adding: "I would hope that the VA would hire the most experienced, qualified psychologists to provide this care."

Nussbaum filed the complaint with the state Board of Psychology, part of the Florida Department of Health, in an effort to draw attention to what he says is a patient care issue.

The board ultimately, though, has no power over the VA hospital, said a health department spokeswoman.

Nussbaum also takes issue with the unlicensed psychologists using the title of "psychologist." Patients don't know they're being treated by someone who is essentially a post-doctoral resident in training, he said. It's not illegal, but it's unethical, he said.

Patients "may not want to see a trainee," said Nussbaum, who is the only psychologist with a license on the staff of four who work in Haley's Post Traumatic Stress Disorder Clinic. "If you're getting heart surgery, you want the licensed, expert surgeon."

The hospital says its unlicensed psychologists are on track to get their licenses, by completing the required 2,000 hours of supervised work - including two hours a week that is directly supervised and one hour a week that is face-to-face supervision.

In his complaint, Nussbaum alleges the unlicensed staffers are not getting that supervision, and that some work in clinics in New Port Richey, Brooksville and Zephyrhills and never even come into the Tampa hospital.

"If you have a complex patient, you need to have a mentor, a colleague that you can go to," Nussbaum said.

Pickens disputed the complaint and said psychology residents get even more than the two hours of direct supervision a week. All notes taken by those psychologists after every session are reviewed and signed by the lead psychologist, he said.

The mental health care veterans are receiving is not suffering, Pickens said, and he pointed out that Haley is a prime place for post-doctoral residents to study.

"Where better for graduate psychologists to learn, to work with veterans who have post-traumatic stress disorder?" he said.