Can I keep seeing an outside therapist while also getting VA mental health care, or do I have to choose one?

There is no VA regulation that flatly prohibits a veteran from seeing an outside, privately-arranged therapist while also being enrolled in VA mental health care. The 'unethical' concern some clinicians raise usually refers to two licensed therapists independently treating the same diagnosis without coordinating care, which can create conflicting treatment plans, not a legal bar to concurrent care. It is a clinical judgment call, and individual providers or facilities can set their own policies about how they will structure your treatment, but they cannot deny you access to VA care outright simply because you are also seeing someone outside the system, nor can they refuse to log or process a required intake form as a form of leverage.

Separately, Community Care referrals (governed by 38 CFR 17.4010 and 17.4020, under the VA MISSION Act) are based on specific eligibility criteria: unacceptable wait times, distance standards, lack of an appropriate specialist, or a determination that it is in the best medical interest of the veteran. A long wait for an initial mental health appointment can support a Community Care request, but the decision is discretionary and made by VA clinical staff, not guaranteed by asking for it. If your facility currently has in-house capacity (such as a newly onboarded therapist with openings), VA can lawfully choose to offer that instead of an outside referral, even if the wait was long.

If you believe a provider mishandled your case, refused to document your intake, or denied care unprofessionally, the appropriate paths are: filing a formal patient complaint through the Veterans Health Administration Office of Integrated Veteran Care or the facility's Quality Management office (separate from the informal patient advocate conversation), requesting a new provider assignment within the same VA mental health clinic, and documenting every interaction with dates and names. You can also request that your intake paperwork be entered into your VA electronic health record regardless of which therapist you ultimately see, since VA is required to maintain accurate treatment records.

If ongoing mental health treatment is tied to a pending or future disability claim, keep copies of all private therapy records yourself, since VA is not obligated to retrieve outside records automatically, and you may need to submit them directly with a claim or supplemental claim under 38 CFR 3.159.

As a next step, file a formal written complaint through your VA facility's Patient Advocate office in addition to the informal conversation you already had, explicitly requesting a different VA mental health provider and stating that VA is refusing to log a required intake form.