Health.com
January 31, 2018

WEDNESDAY, Jan. 31, 2018 (HealthDay News) -- Many U.S. veterans of the Afghanistan and Iraq wars aren't getting needed mental health treatment for conditions such as post-traumatic stress disorder, depression or substance abuse, a national panel of experts says.

Female vets may be at special risk of missing out on services, the report found.

The survey found that about half of all veterans of the Iraq/Afghanistan conflicts who may require mental health care do not use U.S. Department of Veterans Affairs (VA) or non-VA services, according to a new report from the National Academies of Sciences, Engineering, and Medicine.

The congressionally mandated report cites two primary reasons for this gap: The VA does not have sufficient resources, or veterans don't know how to access VA mental health care.

"The VA needs to make high-quality mental health care consistently and predictably available at every facility for all veterans," said report committee chair Alicia Carriquiry in a National Academies news release.

The panel recommended that the VA aim to become "a reliable provider of high-quality mental health care services" within three to five years.

The good news: The VA provides mental health care that's comparable or better than care offered by private and non-VA public providers, according to the report. But it also says there is significant variation in accessibility and quality of services across the VA health system.

That leaves many of the 4 million U.S. service members who've been in Afghanistan or Iraq without required mental health services.

The survey also found that more than half of veterans who screened positive for a mental health problem did not believe they needed mental health treatment.

For those who could use VA mental health care but haven't sought it, the report cites lack of awareness as a key reason: They don't know how to apply for VA mental health care benefits; they are unsure whether they are eligible; or they are unaware that VA offers these benefits.

Compared to men, women veterans are much more likely to believe they are not entitled to VA mental health services, according to the report.

Other barriers include lack of transportation and inconvenience of treatment locations; concerns about taking time off from work; and fears that discrimination could jeopardize contact with or custody of their children, or lead to a loss of medical or disability benefits.

Also, many vets who know that VA mental health services are available said it's difficult to access those services.

On the other hand, many veterans who receive VA mental health care give it high marks.

"As the nation's largest provider of mental health care services, the VA system has a unique and unparalleled opportunity to address the mental health care needs of veterans in a truly integrated and strategic manner," said Carriquiry, a professor of liberal arts and sciences at Iowa State University.

What's needed? A comprehensive plan for improving "timely access" to care, hiring and retaining skilled staff, expanding virtual care technologies, and overcoming barriers such as lack of parking, the report recommended.

Adequate office space and staffing could reduce wait times, lessen clinician burnout, improve the reliability of treatment, and increase adherence to clinical practice guidelines, the report concluded.

The National Academies' mission is to provide independent, objective advice to the nation.

More information

The VA has more on mental health.

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