Stop Confusing Medical Instructions From Putting Veterans at Risk

To the Acting Under Secretary,

Please issue a national directive that standardizes plain-language discharge instructions and medication-consent documentation across VA inpatient mental health services. Establish implementation deadlines, audit facility compliance, and publish the results.

The October 2026 inspector general review identified recurring discharge and consent-documentation problems. Your leadership can turn corrective commitments into consistent protections that veterans experience directly.

Require every discharge plan to identify follow-up appointment dates, times, and locations in ordinary language. Include each medication’s name, purpose, directions, and relevant precautions. Explain whom veterans can contact with questions, how they can obtain help after hours, and what to do when an appointment or prescription cannot be secured.

Require staff to review these instructions with the veteran before departure. Use a respectful teach-back process that allows the veteran to explain the plan in their own words. Provide accessible formats, language assistance, and caregiver involvement when the veteran authorizes it.

Standardize documentation of medication-consent discussions. Records must reflect an explanation of benefits, risks, side effects, alternatives, and appropriate discontinuation guidance, along with the veteran’s questions and decision. Address emergencies and impaired decision-making capacity through applicable clinical and legal safeguards. Preserve timely access to necessary treatment.

Build on VA’s announced consent changes for 2027. Give facilities practical templates, training, and clear responsibility for implementation. Allocate staff time for meaningful conversations. A signature or completed checkbox must not substitute for an explanation the patient understands.

Set a public implementation schedule. Audit representative discharge records and incorporate voluntary patient feedback. Publish facility-level compliance rates, methods, corrective actions, and completion deadlines without identifying patients. Assign responsible leaders and require follow-up reviews when deficiencies persist.

Humanity and compassion belong in every transition from hospital care to home. Veterans deserve patience when they ask questions and respect when they make treatment decisions. Clear communication can support that dignity while giving clinicians a consistent process.

Please make these protections a national priority and provide the public with evidence of progress. These actions will ensure a better future for all by strengthening trust, informed choice, and continuity of care for veterans and their families.

Sincerely,