The Veterans Health Administration wants to hire more than a few good psychiatrists and is willing to pay more than a few dollars extra to get them.

Psychiatrists say they’d like to work (or continue working) for the VHA but existing salary levels were proving an obstacle, said a statement from the Department of Veterans Affairs.

At least one very practical obstacle stands in the way of luring more psychiatrists. “Starting salaries for VA psychiatrists… are far below the starting salaries offered by private health care, state mental health programs, and even Department of Defense programs,” said James H. Scully Jr., M.D., CEO and medical director of APA, in an April letter to the Senate Committee on Veterans’ Affairs.

In some cases, the Department of Defense has offered at least a $50,000 boost in annual salary to VHA psychiatrists to jump ship, according to a May memorandum from Michael Culpepper, acting chief officer of the Department of Veterans Affairs’ Workforce Management and Consultant Office.

The current salary range at the VA for Tier 1 psychiatrists is $97,987 to $195,000. Existing pay flexibility apparently has not led to recruiting and retaining enough psychiatrists. The top of the new range will rise to $250,000 and become the new permanent standard, according to a VA spokesperson.

The VHA currently has about 2,500 psychiatrists on its staff and had about 400 openings in mid-July, not counting the positions to be filled under the most recent authorization. Those new positions began being posted on May 16.

The VA said it will especially target recruitment for rural areas and will develop more psychiatric residency and loan-forgiveness programs. The department has expanded its mental health professions trainee program at the VA ’s rural health facilities since 2007 with a 42 percent increase in psychiatry resident positions, a 61 percent increase in psychology trainee positions, and a 26 percent increase in social worker trainee positions.

To manage existing vacancies, VA facilities are now allowed to use existing staff, contract staff, locum tenens, or consultant psychiatrists or psychologists. Other prescribers, like nurse practitioners or physician assistants, may also be used to provide psychiatric coverage. Telemental health services from sites with extra capacity may be used to cover sites with limited capacity.