The Department of Veterans Affairs (VA) operates 205 community-based facilities known as Vet Centers to help veterans make a successful transition from military to civilian life. Vet Center counselors reported visiting with about 138,000 veterans during fiscal year 1995, 84,000 of whom were new to Vet Centers. Most veterans do not establish long-term relationships with Vet Center counselors; however, those who do represent a core group who use services over extended periods for serious psychological problems, such as post-traumatic stress disorder. Other veterans usually visit Vet Center counselors only once or twice for social concerns, such as employment or benefit needs.

Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.

Pursuant to a congressional request, GAO reviewed the Department of Veterans Affairs' (VA) Vet Center program, focusing on: (1) the individuals served and the services provided; and (2) VA methodology for determining whether Vet Center services are appropriate and effective. GAO found that: (1) vet centers help certain veterans make a successful transition from military to civilian life; (2) vet center services range from assistance with basic needs and benefits to drug and alcohol abuse and post-traumatic stress disorder (PTSD) counseling; (3) veterans who have more serious psychological problems, such as PTSD, visit vet centers more often than veterans with employment or benefit concerns; (4) about 283,000 new clients used vet centers during fiscal years 1993 through 1995; (5) many veterans have social concerns that can be addressed by other VA and non-VA programs, thus limiting the number of center visits needed; (6) client visits are generally recorded accurately in the workload reporting system, but program managers and supervisors lack the information needed to oversee the program and monitor staff activities and resources; and (7) VA has established standards for determining whether treatment plans are appropriate, but it has not developed a systematic approach for demonstrating that vet center services are effective in meeting veterans' psychological needs.