MICHEL MARTIN, HOST:
Federal employees at the U.S. Department of Veterans Affairs are facing a deadline Monday. They have to report to work in person. Some, especially mental health clinicians, are objecting. They say VA offices won't give them the privacy they need to do their jobs. NPR's Katia Riddle reports.
KATIA RIDDLE, BYLINE: Every day for the last few months, D. has been reporting in-person to work. His office is about 15 by 15 feet. D. is a middle initial. He didn't want to use his name or location for fear of reprisals from the VA.
D: So there are three of us that work together in the office. There's a physician assistant, a psychologist and myself.
RIDDLE: D. works in HR. He regularly discusses sensitive information on the phone. The clinicians are doing telehealth. He can't hear the patients on the other end of the calls, but he can't help but hear his colleagues who are sitting in the same room.
D: I do hear the psychologists mirroring back or summarizing what they say, and none of us in the room like that we can hear all of that. And I, myself, am a veteran, and I wouldn't like any of that repeated back knowing there was somebody else in the room. And it's just - it's not good.
RIDDLE: Not good and possibly not legal. Federal privacy laws guarantee patient confidentiality. Lynn Bufka is with the American Psychological Association. She says patient privacy is tantamount to quality care.
LYNN BUFKA: That's just such a fundamental way that psychological services, psychotherapy has been conducted that I think most people feel sort of like, why would we even need to say that so explicitly?
RIDDLE: The quality of the bond between a patient and provider is one of the key indicators of effective therapy. Bufka says without it, patients are compromised.
BUFKA: They may be less likely to disclose some of the things that are of most importance, or they may not even return for continued treatment.
RIDDLE: NPR interviewed more than a dozen VA mental health care providers about this topic. Most of them didn't want to speak on the record. Many voiced a widespread concern that VA facilities just don't have the space for all mental health staff to work in-person and have privacy. A therapist, who asked to be identified only by her middle name, Lynn (ph), for fear of retribution from the VA, says she's been thinking about her own red lines. She's decided she will not hold therapy sessions if she can't guarantee confidentiality.
LYNN: I will not violate the law, as well as the professional ethics.
RIDDLE: Some mental health clinicians have been granted last-minute or temporary exemptions from the return-to-work order. But Lynn and others say the VA has not given them a long-term guarantee of necessary patient privacy.
LYNN: It's not safe for anyone, particularly in mental health, where the things they're sharing with us are very sensitive and personal and intimate and scary for them.
RIDDLE: In an email response to a request for comment on this story, VA spokesperson Peter Kasperowicz wrote, quote, "VA will extend current telework and remote work arrangements beyond the May 5 deadline when appropriate space is not available," unquote. Lynn says she is not reassured. The inconsistency and intermittent communication about her future is stressing her out.
LYNN: It keeps your cortisol levels up so high. It's unhealthy.
RIDDLE: And she says it's interfering with her ability to be a good therapist to veterans.
Katia Riddle, NPR News. Transcript provided by NPR, Copyright NPR.
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.