May 9, 2025

As the current administration continues to implement harmful policies affecting both our practices and our patients, you may have not have heard about the changes being made to how LCSWs are providing mental health services in the Veterans Administration. There is an excellent article in the New York Times about the way this has impacted confidentiality and privacy about this problem, which we hope you will all read. 

In short, most of the 100,000 LCSWs and other VA mental health staff have been required to return to working in offices without having private spaces in which to work. As the article notes:

“In a Boston V.A. hospital, six social workers are conducting phone and telehealth visits with veterans from a single, crowded room, clinicians say. In Kansas City, providers are planning patient care while facing each other across narrow, cafeteria-style tables in a large, open space, according to staff members.

And in South Florida, psychiatric nurses have been treating veterans with mental health conditions in a hallway near a bathroom, sitting down with them in a makeshift medical bay jury-rigged out of filing cabinets and a translucent screen.”

This new policy violates basic social work ethics and HIPAA rules. As stated in the Clinical Social Work Association (CSWA) Code of Ethics (2024):

“Clinical social workers have a primary obligation to maintain the privacy of both current and former clients, whether living or deceased, and to maintain the confidentiality of material that has been transmitted to them in any of their professional roles. Exceptions to this responsibility will occur only when there are overriding legal or professional reasons and, whenever possible, with the written informed consent of the client(s).”

The conditions under which LCSWs are being forced to work violates this fundamental clinical premise. This puts LCSWs in a difficult position of choosing between ethics, their livelihoods, and continuing to serve their patients. The CSWA calls on the VA to ensure all mental health professionals in their organization have private spaces in which to work.

CSWA would like to know if any members who work for the VA or have other connections to VA patients have been affected by these changes. Please let CSWA Director of Policy and Practice, Laura Groshong, LICSW, know if this is your experience by emailing her at lwgroshong@clinicalsocialworkassociation.org.