More Than 2 Million Unique Veterans Received Mental Health Care from VA over the 5-Year Period from Fiscal Years 2006 through 2010

Over the 5-year period from fiscal years 2006 through 2010, about   2.1 million unique veterans received mental health care from VA. Each  year the number of veterans receiving care increased—from about  900,000 in fiscal year 2006 to about 1.2 million in fiscal year 2010. VA provided this mental health care to veterans in both specialty  mental health care and other settings, such as primary care clinics staffed  with mental health providers. Although the number of veterans receiving mental health care from VA  increased for both OEF/OIF veterans and veterans of other eras of  service, as shown in figure 1, OEF/OIF veterans accounted for an  increasing proportion of the veterans receiving care. 2.) Stigma, Lack of Understanding of Mental Health, Logistical Challenges, and Concerns about VA May Hinder Veterans from Accessing Care

The key barriers we identified from the literature that may hinder veterans  from accessing mental health care from VA, which were corroborated  through interviews with VA and VSO officials, are stigma, lack of  understanding or awareness of mental health care, logistical challenges  to accessing mental health care, and concerns about VA’s care. Many of these barriers are not necessarily unique to veterans accessing  mental health care from VA, but may affect anyone accessing mental  health care from any provider. For example, veterans may  be affected by barriers differently based on age, gender, Reservist or  National Guard status, or rural location.   Age: OEF/OIF veterans, who are generally younger than other  veterans, may have concerns about VA’s health care system because  they perceive that primarily older veterans, such as those who served  in Vietnam, go to VA for care.   Gender: Female veterans may perceive some barriers to accessing  mental health care differently than male veterans. VA Has Implemented Several Efforts to Increase Veterans’ Access to Mental Health Care

VA has expanded options to increase veterans’ access to mental health  care and implemented education efforts to help connect veterans with  care, according to VA officials. VA Has Implemented Education Efforts to Help Connect Veterans with Mental Health Care

To help connect veterans with mental health care, VA has implemented  various efforts to educate veterans, veterans’ families, health care  providers, and other community stakeholders about mental health  conditions and care. In its response,  which is reprinted in appendix IV, VA provided technical comments, which  we have incorporated as appropriate. GAO staff who made key contributions to this report  are listed in appendix V.

Appendix I: Scope and Methodology

To determine how many veterans received mental health care from the  Department of Veterans Affairs (VA) from fiscal years 2006 through 2010,  we obtained data from VA’s Northeast Program Evaluation Center  (NEPEC). Additionally, the number of veterans represents a unique  count of veterans; veterans were counted only once, even if they received  care multiple times during a fiscal year or across the 5-year period.
Why GAO Did This Study

In fiscal year 2010, the Department of Veterans Affairs (VA) provided health care to about 5.2 million veterans. Recent legislation has increased many Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF) veterans' priority for accessing VA's health care, and concerns have been raised about the extent to which VA is providing mental health care to eligible veterans of all eras. There also are concerns that barriers may hinder some veterans from accessing needed mental health care. GAO was asked to provide information on veterans who receive mental health care from VA. In this report, GAO provides information on (1) how many veterans received mental health care from VA from fiscal years 2006 through 2010, (2) key barriers that may hinder veterans from accessing mental health care from VA, and (3) VA efforts to increase veterans' access to VA mental health care. GAO obtained data from VA's Northeast Program Evaluation Center (NEPEC) on the number of veterans who received mental health care from VA. The number of veterans represents a unique count of veterans; veterans were counted only once, even if they received care multiple times during a fiscal year or across the 5-year period. GAO also reviewed literature published from 2006 to 2011, reviewed VA documents, and interviewed officials from VA and veterans service organizations (VSO).

What GAO Found

Over the 5-year period from fiscal years 2006 through 2010, about 2.1 million unique veterans received mental health care from VA. Each year the number of veterans receiving mental health care increased, from about 900,000 in fiscal year 2006 to about 1.2 million in fiscal year 2010. OEF/OIF veterans accounted for an increasing proportion of veterans receiving care during this period. The key barriers identified from the literature that may hinder veterans from accessing mental health care from VA, which were corroborated through interviews, are stigma, lack of understanding or awareness of mental health care, logistical challenges to accessing mental health care, and concerns about VA's care, such as concerns that VA's services are primarily for older veterans. Many of these barriers are not necessarily unique to veterans accessing mental health care from VA, but may affect anyone accessing mental health care from any provider. Veterans may be affected by barriers differently based on demographic factors, such as age and gender. For example, younger OEF/OIF veterans and female veterans may perceive that VA's services are primarily for someone else, such as older veterans or male veterans. VA has implemented several efforts to increase veterans' access to mental health care, including integrating mental health care into primary care. VA also has implemented efforts to educate veterans, their families, health care providers, and other community stakeholders about mental health conditions and VA's mental health care. According to VA officials, these efforts help get veterans into care by reducing, and in some cases eliminating, the barriers that may hinder them from accessing care. GAO provided a draft of this report to VA for comment. In its response, VA provided technical comments, which were incorporated as appropriate.