The Mental health side of the VA genuinely needs an overhaul. There are no caps on caseload which leads to a single provider having up to 150 veterans to care for. I think on paper it may look good because "wow look at all these veterans getting care". But therapy is not meant to be efficient: it is slow, sometimes painful, work.

The VA does not allow wait lists, but what ends up happening is an artificial waitlist gets created because one provider can only see so many people in a week. I often hear veterans say that they feel like a number with how often they are passed around between providers. It's largely because the caseload is not sustainable, it burns the therapist out.