3 VA mental health counselors kept their jobs after starting relationships with patients, watchdog says

Three mental health counselors were allowed to continue practicing at a veterans medical center in Danville, Ill., after officials knew they had formed inappropriate relationships with patients, the lead investigator found. the VA.

One counselor had a baby with a former patient and another continued to live with a former patient while working at the VA facility for years after complaints were filed by a whistleblower.

Although executives ‘took initial steps’ to address what is seen as a breach of business ethics, an investigation was only opened after the whistleblower filed complaints in 2018 against the first two providers and in 2019 after the patient of the third provider died of an overdose.

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From 2013 to 2020, two licensed clinical social workers and a certified addiction counselor from the VA Illiana Health Care System each developed personal relationships with patients.

In its investigation, the VA Inspector General’s Office found that the addictions counselor was still on staff providing addictions counseling and living with his former patient as of early 2020.

One of the licensed clinical social workers was reassigned to a lower position at the facility and had a baby with his patient in early 2020. The other licensed clinical social worker resigned abruptly after his patient’s death from an overdose in 2019.

According to the report, released May 3, the therapist who resigned continued to have “a full and unlimited license to practice social work” in the state of Illinois as of early 2020.

Principals took some steps to address inappropriate relationships after complaints were filed, Dr. John Daigh, VA assistant inspector general for health care, said in the report, but “several factors affected the effectiveness of these actions”.

Daigh said that while executives have new plans in place to prevent future ethical misconduct, they have not taken the important step of reporting employees to licensing and certification boards.

“Given the egregious nature of provider behaviors, facility leaders failed to report Providers B and C to their state licensing boards in a timely manner and failed to report Provider A to the appropriate professional certification board,” Daigh wrote.

In some states, sexual or romantic relationships between a provider and their patient are criminal offences.

In Illinois, such relationships are not illegal, but they are deeply unethical: A therapist can lose their license or have it suspended if they engage in a sexual or romantic relationship with a client or engages in sexual activity with former clients up to five years after they end their professional relationship.

Daigh said the behavior should have triggered a report to the state licensing board within five days of the employees being removed from clinical duties while an investigation was ongoing.

A claimant was only removed 314 days after a factual review was launched; the other resigned before disciplinary action could be taken. VA Iliana management completed the reporting process 97 days later.

The addictions counselor was never removed, and the VA reported the ethics violation to the employee’s professional certification board several years later, and only after discovering that the board had a process for filing complaint.

“Sexual contact between providers and patients is considered ‘unethical, exploitative, and harmful with the potential for harm such as mental health disorders, sexual dysfunction, and increased risk of suicide,'” according to the report.

This was the case for the patient having a romantic relationship with one of the licensed clinical social workers. During the hospital’s fact-finding investigation, interviewees said the patient had relapsed, was homeless, and had expressed suicidal thoughts, and they believed the relationship contributed to this instability.

Investigators recommended intervention, and there was a record of an attempt to reach the patient. But the link was never established and the patient died of an overdose nine days later.

The Illiana VA report follows a lawsuit filed last December by three veterans against the federal government and a former Palo Alto VA Medical Center psychiatrist, alleging medical malpractice and sexual abuse.

According to court documents from the Northern District of California, former VA psychiatrist Dr. Ferda Sakman had sex with at least one patient and pressured another to have sex. A patient reported that Sakman used astrology as part of her therapy and incorporated hallucinogenic drugs into her practice while taking them herself.

Sakman worked for the VA from 2014 to 2016 and from 2018 to 2020.

She relinquished her medical license in July 2020 after the New York State Board for Professional Medical Conduct found her negligent on “more than one occasion”, for her “care and contact with a patient of male gender that were contrary to accepted standards of medicine and for not respecting professional boundaries.”

In Danville, the VA OIG recommended that the regional director of the Veterans Integrated Service Network 12 assess the processes that led to the facility’s inability to identify and respond to inappropriate staff relationships.

The OIG also made recommendations to the Institutional Head to improve the timing of reporting to state licensing or certification bodies.

In the response, VA officials agreed with the recommendations, saying they plan to implement them this spring.

“We deeply regret the circumstances that have impacted the care of these veterans. As healthcare professionals, we are committed to providing quality care, maintaining patient well-being, and working together to achieve positive patient outcomes,” wrote Staci Williams, VA Executive Director. Illiana Health System.

A spokesperson for the VA headquarters in Washington, DC, said on Tuesday that the recommendations should be completed this month.

According to VA press secretary Terrence Hayes, the hospital took “quick action to address inappropriate relationships,” including revising policies, conducting “professional boundary training,” and making changes to its system. reporting.

“VA continues to focus on providing safe, quality care to our patients,” Hayes wrote in an email.

— Patricia Kime can be contacted at [email protected]. Follow her on Twitter @patriciakime.

Related: Inspector General Finds Disabled VA Vets Overburdened on Home Loans

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