Psychiatrick (Substack)

Veteran clinician’s Substack · Rick Leach, MSN, APRN, PMHNP-BC — combat veteran, now a psychiatric nurse practitioner

A combat veteran turned psychiatric nurse practitioner writes about VA mental-health care from inside the clinic: what the wait-time numbers actually mean for a veteran in crisis, and how power, policy, and trauma collide. Independent, free to read, and blunt about the gap between the department’s promises and its appointment book.

Why we carry them. He does the math on VA’s own wait-time data and says plainly what it means at the kitchen table — the closest voice in the sweep to this site’s premise.

Start here — their essential work

• The VA Is Recruiting Veterans Into a Waiting Room (2026-10-17) — VA’s own posted data showed most facilities past the 20-day first-appointment standard in July 2026 — while the department kept recruiting more veterans into the same queue.
• It Doesn’t Filter Up. It Rolls Downhill. — The follow-on: even on VA’s friendlier numbers, a veteran in crisis waits weeks — and the consequences of decisions made far away land on families, not decision-makers.
• The Public Execution Is Back. You Are the Target. (2026-10-09) — A clinician’s reading of the planned livestreamed military execution: what public killing has historically taught the crowd watching it.
• They’re Going to Steal November. — His pre-midterm warning, argued from the public record: election interference that was rewarded the first time repeats.
• I Need to Ask You Something (2026-10-07) — A straight subscription ask that doubles as his method statement: every article free, paid readers keep it independent, no sponsors.

Summaries are ours. The work is theirs — we link to it, we don’t lift it. Visit Psychiatrick (Substack) →