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The Department of Veterans Affairs says it plans to cut 80,000 more jobs out of a workforce of several hundred thousand. That's one of many administration moves against the workforce that was hired to look after veterans. In speeches before the election, President Trump's budget director said his goal was to put federal employees, quote, "in trauma." NPR's Katia Riddle reports on the new rules, small and large, that affect one VA employee as she tries to provide mental health care.
KATIA RIDDLE, BYLINE: Since the Trump White House issued an executive order to eliminate diversity, equity and inclusion programs, therapists at the VA can no longer have pride flags in their offices.
LYNN: We're kind of skirting around that. Some people have put up art in their office that says, like, love is love, and it'll be a rainbow.
RIDDLE: This woman is a mental health practitioner at a VA facility. She asked us not to disclose exactly where she works and to identify her only as Lynn (ph), her middle name. She fears she could be fired for speaking out. She and some of her colleagues have started wearing rainbow jewelry and clothing, sending a message to her queer patients, you are safe here.
LYNN: So we're all kind of, like, being subversive.
RIDDLE: Her defiance comes with a cost.
LYNN: Feeling like if I wear this stuff, am I then going to become a target from either my patients but also maybe my peers, because there's this culture of you need to rat on people?
RIDDLE: She's received emails encouraging people to report colleagues who are violating the new ban on DEI. All this stress and anxiety, she says, demands a lot of mental energy, energy that gets robbed from her patients.
LYNN: I've been really struggling with my concentration and my ability to focus when I'm at work because, again, I feel like I have this axe over my head all the time.
RIDDLE: She says the news around federal cuts is destabilizing to her patients as well. For those that have post-traumatic stress disorder, it's especially difficult.
LYNN: That sense of insecurity and lack of control is really triggering for PTSD. And then there's a sense of the betrayal from the government.
RIDDLE: The VA is one of the biggest providers of mental health care in the country. The positions that have already been cut have not primarily been clinicians, like doctors and nurses, but some warn the disruption to care will get worse regardless. Rashi Romanoff is the CEO of a nonprofit known as NAVREF, which stands for the National Association of Veterans' Research and Education Foundations. The organization helps facilitate research projects at the VA.
RASHI ROMANOFF: The challenge is that, you know, health care and the delivery of health care really requires these broad, diverse teams of individuals.
RIDDLE: Romanoff says the VA has been a leader in not just providing mental health care but also innovating in it.
ROMANOFF: We're really focused on the ability to conduct high-quality research, because having high-quality research is a part of high-quality care.
RIDDLE: In addition to the firings, the VA indicated it would not renew research positions and then reversed course and took a 90-day pause to review the research contracts. NAVREF warns that if these positions are lost, clinical trials studying opioid dependency or suicide prevention could end. They estimate $35 million of research is in jeopardy.
ROMANOFF: Between 350 and 400 clinical trials, which would have to be stopped or interrupted or halted or canceled because of this staffing shortage.
RIDDLE: In an email response to NPR, the VA underscored that no contract positions will be terminated in the next 90 days, quote, "while the department conducts a comprehensive assessment of ongoing research," unquote. Nurse practitioner Lynn says going to work every day feels like she's working on the Titanic.
LYNN: And half the people on the boat are still in the ballroom partying, and 25% of them are actively telling me I'm hysterical.
RIDDLE: Every day of providing mental health care requires its own mental battle.
LYNN: And another portion of them are actively putting more holes in the boat at the same time.
RIDDLE: She plans to stay aboard until she has no choice but to save herself.
Katia Riddle, NPR News.
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