St. Louis Less than a week after leaving the Army in June 2004, Ted Dalton went to the St. Louis VA Medical Center to report that he was irritable, short-tempered and having trouble sleeping. It would be three years before the Richmond Heights, Mo., resident received what he considered proper treatment for his post-traumatic stress.
"I would say overall, it's been a nightmare," said Dalton, 32, who served in Iraq and Afghanistan.
A report last month on problems at Walter Reed Army Medical Center focused national attention on the medical care the nation's 5.8 million veterans receive.
The poor treatment and run-down conditions at Walter Reed, considered the Army's pre-eminent medical facility, led to firings, appointment of a presidential commission and an order to review conditions at the Department of Veterans Affairs' 1,400 hospitals and clinics.
That includes St. Louis-area facilities, where officials say they are working to solve problems similar to those at Walter Reed.
Veterans, their families and organizations that represent them cite long emergency room waits, poor nursing care, difficulty scheduling appointments and delays in getting needed services. They complain of outdated buildings, indifferent employees and paperwork nightmares.
"They're understaffed, underbudgeted and there are systemic problems throughout," said Pat Kerr of the Missouri Veterans Commission, a state agency that assists veterans with disability claims and other issues.
Kerr said the VA failed to prepare for the Iraq and Afghanistan veterans who are overwhelming an already overtaxed system.
She said she often hears from veterans who have difficulty getting medical evaluations needed for a disability rating. St. Louis VA Medical Center officials acknowledge many of the shortcomings.
"We really, truly are focusing on and have focused on the perceptions of our patients and their concerns about courtesy, care (and) waits and have a number of initiatives going on to try to make sure that we're meeting their expectations," said Michele Brown, associate director of Patient/Nursing Services.
VA officials say the quality of care offered is excellent.
Last year, the VA Medical Center in St. Louis treated about 50,000 veterans from Missouri and Illinois.
In 2006, 280 formal complaints were filed directly with the medical center.
Dalton complained about his treatment to the medical center and to the Department of Veterans Affairs.
He said he was first prescribed an anti-depressant. He took the medicine for about a month with little effect. Six months later, he made an appointment with the center's mental health division. Dalton said he met with the psychologist about eight times during the next two years. She prescribed an anti-depressant and an anti-anxiety drug. Again, Dalton said he did not improve.
"She would ask how I was doing, wouldn't take notes, would offer to refill my prescription and then say, 'I don't need to see you for another 90 days,'" Dalton said.
A few months ago, he said the psychologist finally referred him to the center's Post Traumatic Stress Disorder Clinic at Jefferson Barracks. He lauded the care he's received there.
Four administrators said Friday that recent improvements are aimed at addressing many of their patients' concerns. They include a bigger budget, expanded work force, millions of dollars in planned and completed renovations, and customer service training.
"This place was stagnant for a lot of years," said Kevin Inkley, the medical center's facility planner, "and I think we're getting a lot more focus."