Veterans groups said the VA must put forth a more serious response and punishment following the discovery that a VA clinic manager in Indianapolis sent out an email mocking veterans' mental health and suicide.
The email sent out by the clinic manager -- who has since apologized for it -- included a toy Christmas elf jokingly pleading for Xanax in one photo and another showing the elf hung by Christmas lights with a note that read "caught in the act of suicidal behavior."
Robin Paul, Roudebush VA Medical Center's manager of its Seamless Transition Integrated Care Clinic, sent out the email and still manages the clinic. Officials from the hospital said Paul received an administrative punishment, but would not release further details.
On Tuesday, lawmakers and leaders of the nation's leading veterans groups demanded more details into the punishment as well as an independent investigation into the matter.
"The American Legion takes health care for veterans very seriously," Legion National Commander Michael D. Helm said on Tuesday. "We expect Secretary [Bob] McDonald to act appropriately in this matter. Veterans suffering from TBI and PTSD should not be held up to ridicule."
John. W. Stroud, national commander for the Veterans of Foreign Wars, said the manager's "senseless attempt at gallows humor has caused her to lose the respect and trust of veterans."
"It is for that reason that the VFW demands she be replaced as program manager," he said.
Paul remains the manager of the hospital's Seamless Transition Integrated Care Clinic, which provides mental health and readjustment services for veterans. She reportedly earns about $80,000 per year.
VA officials have known about the email since January. The issue came to light this week after The Indianapolis Star obtained a copy of the email. In a statement, the Indianapolis VA hospital said it had dealt with the incident.
"While we cannot comment on specifics due to confidentiality, the matter had been administratively addressed," it said.
Julie Webb, a spokeswoman for the center, told Military.com earlier on Tuesday she is not aware of any investigation underway related to the incident.
On Capitol Hill, Sen. Dan Coats, R-Indiana, already has demanded an independent investigation, though there is no indication that the VA intends to conduct one. Asked by Military.com if it planned to review the episode, a VA spokesman did not say, but referred to the Roudebush center's statement.
Separately, VA headquarters apologized to veterans and called Paul's behavior "completely unacceptable."
"We are committed to treating our veterans with respect and compassion and providing them the quality mental health care they have earned and deserve," the statement said.
Rep. Jeff Miller, R-Florida, who chairs the House Veterans Affairs Committee, agreed the behavior was unacceptable.
"But if VA officials truly feel this way, they need to outline the steps they have taken to hold the responsible employee accountable," he said. "Veterans ... need to have confidence VA adequately holds its employees accountable. In this instance, they don't have that assurance."
One photo in the email shows the elf-as-patient with a sticky note on which is written "Out of XANAX -- please help!" A caption with the image says: "Self-medicating for mental health issues when a CNS would not give him his requested script." CNS is a clinical nurse specialist.
Another photo shows the elf hanged by a strand of Christmas lights, with a caption reading, "Caught in the act of suicidal behavior (trying to hang himself from an electrical cord)." the email says.
In another photo, the elf is shown peering between the legs of a female doll, with the caption: "Trying his skills as a primary care provider (doing a pap)."
Paul said in her apology that she accepted "full responsibility for this poor judgment. I have put my heart and soul into my work with veterans for many years. I hold all veterans and military personnel in the highest regard and am deeply remorseful for any hurt this may have caused."
More than 8,000 veterans die by suicide each year, an average of about 22 each day, according to the VA.
"There is nothing amusing about 22 veterans committing suicide every day," Stroud said, "and it is absolutely inexcusable that a VA supervisor would make light of any issue that veterans face."
The embarrassing email was revealed as the VA continues to try and dig out from under a series of public relations and political disasters that have frequently seen it flogged by lawmakers from both parties on Capitol Hill.
For several years, critics hit the department over its huge disability claims backlog, bonuses that went to senior executives for questionable job performance and for conferences that saw employees accepting gifts from contractors.
Nearly a year ago, whistleblowers from the VA Medical Center in Phoenix, Arizona, revealed that dozens of veterans whose names were on a secret appointment wait list died before getting care. Investigations spurred by the report found that data manipulation intended to hide or obscure the seriousness of backlogged wait times was systemic across VA.
The wait-list crisis ultimately forced the resignation of Secretary Eric Shinseki.
-- Bryant Jordan can be reached at firstname.lastname@example.org