This story discusses suicide. If you or someone you know is having thoughts of suicide, please contact the Suicide & Crisis Lifeline at 988 or 1-800-273-TALK (8255).
FIRST ON FOX: Michael Cohen, a veteran of the U.S. Air Force, has not slept in a week.
At night, the 54-year-old former law enforcement specialist is tortured by "horrendous memories" from his 22 year-long career in the Air Force, serving both on active duty and in the reserves. Cohen estimates he's been deployed to 85 countries in that time, including areas where he was not allowed to wear his uniform "because of the terrorist threat."
"A number of traumatic events happened," Cohen told Fox News Digital in an interview. He described having symptoms that have hurt his relationships, including "nightmares, the attitude, withdrawal."
"The wife is completely freaking out because as I'm getting older, something is going on. I cannot repress, push down all of this to where my triggers are horrendous, and I actually have to do something with my civilian employment, because the people I interact with are triggering me, and I don't even realize that," Cohen said.
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Some years ago, his wife begged him to get help from the local Veterans Affairs medical facility in West Palm Beach, Florida. Cohen said he tried, but after many years and multiple VA therapists who could not see him on a regular basis, he decided to pay out-of-pocket for private care. He would like the VA to pay for his therapy through community care — a program designed for eligible veterans to receive care from a community provider when the VA cannot provide the care needed.
Cohen is one of several veterans who spoke to Fox News Digital about how the West Palm Beach VA Healthcare System is no longer approving their requests for community care, cutting them off from their longtime mental health providers, with potentially devastating results.
Jessica Carillo, a former Air Force staff sergeant, receives primary care through the West Palm Beach VA.
"I got laid off last year in September, and I have not been able to pay for my psychiatrist that I used to pay out of pocket," she told Fox News Digital. She said community care helped pay for her therapy, but the VA cut her off in January.
"I was in the middle of a big, big, big session. We just discovered some major things. And then, they left me in limbo," Carillo said.
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Rep. Brian Mast, R-Fla., a former Army bomb technician who lost both his legs and a finger in Afghanistan, represents the Palm Beach area in Florida's 21st Congressional District. He said his office has been contacted by over 70 veterans, relatives and mental health providers who have complained that the VA will no longer refer patients to community care.
"They are now being told, listen, everybody that you were seeing outside for your mental health care, you can't do that anymore. You now have to come internal to the West Palm Beach VA hospital and get your mental health care there," Mast said.
Community care has existed in a limited form since the early 1920s and was made permanent when President Trump signed the VA Mission Act in 2018.
"Initially, people were always required to get their care inside of the VA. The VA started having really long wait times, or wasn't providing adequate service, or a number of reasons why people decided they wanted to get outside of the VA. And the Trump administration said, great, you want to go get community care, we're going to create a system for you to go outside of the VA," Mast explained.
READ REP. BRIAN MAST'S LETTER TO THE VA BELOW – APP USERS, CLICK HERE:
"Now the Biden administration is saying, we don't want to allow that to happen," he said. Mast sent a letter to VA Secretary Denis McDonough last week demanding an explanation for this apparent "departure from long-standing practices."
Mast warned that interruptions to veterans' care, especially mental health treatments, can have tragic consequences.
"When you talk about some of the issues that are created, when you're switched from doctor to doctor to doctor, there are frustrations that exist, and we all handle frustrations differently. And sometimes those frustrations create serious moments of crisis in your life," Mast said.
"It's really difficult to build a rapport with a provider, a doctor, a therapist, and then to be stripped away of the care that you're used to getting," said Ingrid Hernandez, an Iraq war veteran who runs a PTSD support group in Mast's district. Her community care referral was canceled in March.
The Department of Veterans Affairs denies there's been any change in its policy or budget cuts for community care. The Biden administration's 2025 budget estimates that the Veterans Health Administration will obligate a total of $139.5 billion in 2024. Of this total, community care is expected to comprise $36.5 billion, officials said, a record high.
Veterans who qualify are still eligible to get community care referrals, but what has happened is that fewer veterans can qualify for the program because the VA has expanded facilities and hired more doctors in Florida, according to officials.
"There is no change to VA’s community care program — in Florida or nationally — and VA continues to ensure that Veterans can access world-class care whenever and wherever they need it, whether that’s in the community or in the direct VA care system," VA press secretary Terrence Hayes told Fox News Digital.
Hayes said that in the past six years, the VA has delivered "all-time record numbers of community care appointments" to veterans, including 46 million appointments in 2023. "We are on pace to break that record again this year," he added.
While some veterans prefer to see outside providers, the VA insists that peer-reviewed studies, hospital ratings and patient satisfaction surveys indicate "veterans who come to the VA have better health outcomes."
"That’s why, across the state of Florida, we have hired mental health professionals and opened clinics for Veterans in Jacksonville, Tampa, Daytona, and Pensacola in the past year alone," Hayes said. "Because of this — along with VA’s recent efforts to increase access to care — some Veterans may find that they are no longer eligible for community care, by law, due to increased access to VA care."
The veterans who spoke to Fox News Digital dispute the VA's view of its quality of care. Cohen described how his previous attempts to see a VA psychiatrist were "counterproductive" and "ridiculous." In a "typical interaction," the VA would tell him, "we're going to have somebody call you. This is the date and time," he said. "Nobody calls."
When he went back to schedule another appointment, the same thing would happen.
"You're telling me I missed the appointment, I said. But nobody called me. I have no number to call. This was the norm. It was always a lot of deflection to where I just say, this is beyond ridiculous," he said.
Others shared similar stories. Mast related that he had to see his primary care doctor, a physical therapist, and a lab technician before VA approved him to receive a new cane — with two-week intervals between each appointment.
"That was the bureaucratic process for getting a guy with no legs a cane," he said.
Officials emphasized that wait times for primary care decreased by 11% in April 2024, and 7% for mental health compared to the same time last year. The improved wait times come as the VA is seeing more patients than ever before — with 401,006 veterans enrolled in the past year, a 30% increase over the previous year.
Even if VA wait times have improved, patients and mental health professionals say the effort to have more veterans receive VA care can be distressing for patients that must switch doctors.
Dr. Sarah Coleman, a private therapist who owns a practice in Stuart, Florida, said it is crucial for veterans who need therapy for post-traumatic stress disorder (PTSD) and other issues to have continuity of care. With over three decades of experience in clinical psychology, Coleman has treated hundreds of veterans, often working all day, six days a week, she says, because she loves her job.
"I want to serve the military, the people who've served in the military. I want to be able to help them," Coleman told Fox News Digital. She said that beginning in December, the VA stopped referring patients to her through community care and would not reauthorize those she had been seeing to continue treatment with her. She is afraid some of her veterans who have had bad experiences with the VA will stop seeking treatment.
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"It's not ethical, it's not professional for therapists to stop treatment until the treatment is done. And it's different for every patient. But these patients in particular need long-term therapy," Coleman said.
People suffering from PTSD can have episodes of intense anger, fear and hypervigilance, she explained. Some may be unable to eat at restaurants, or may have to always sit with their back facing the wall. Many have broken family relationships. Veterans with PTSD can also suffer from insomnia, alcoholism, drug abuse, anxiety, deep depression and, in the worst cases, may commit suicide.
"It affects every area of their life, their family, their work. And if they don't get treatment, they're going to suffer," Coleman said.
The suicide rate for veterans is 1.5 times higher than that of the general population, according to the VA, which has made a major push for veteran suicide prevention in recent years. Coleman expressed concern that veterans who are told by the VA they can no longer see their preferred doctors will stop seeking care and may harm themselves.
"The vets themselves are telling me, 'If they make me go back to the VA, I'm not going to want to live anymore. I don't want to deal with the VA. I want to keep up therapy with you,'" she said. Coleman doesn't understand why her patients have lost eligibility for community care.
"I've had three patients so far come back and tell me that they are only being scheduled every two weeks to see a therapist," she said, stating that this is insufficient.
Hernandez said it is not enough for the VA to replace one doctor with another.
"Just getting a record from a previous doctor, that's not continuity," Hernandez said.
She often thinks about the Vietnam veterans in her support group.
"They're 70, 80 years old having to get to West Palm to have someone try to understand … It's not just, hey, on page 84 of your psychology book it states PTSD, this is what it looks like. It's so much more than that. And when you strip someone from that, it really takes a toll."
Mast said he has asked the House Veterans Affairs Committee to probe the matter. He said Congress has a responsibility to ensure that the VA is "veterans first" and that the government keeps its promise to take care of those who risk their lives for the country.
Cohen thinks that so far, the government has not lived up to that promise. He and the others want the VA to let them get the care they need.
"There are a lot of people out there that need help. You made a promise to them, and you're reneging on your promise. You're leaving them high and dry and not the individual alone, but the individual and the families are suffering," he said. "You're pulling the rug out from under all these people."
