Testimony presented before the Senate Appropriations Committee, Subcommittee on Military Construction, Veterans Affairs, and Related Agencies on April 27, 2017.
Special Feature: The Cost and Quality of VA Mental Health Services
U.S. veterans have higher rates of serious mental health and substance use disorders than civilians. Prolonged and repeated deployments to Afghanistan and Iraq have magnified these problems. RAND assessed the cost, quality, and capacity of VA care for these disorders.
How much health care is used by veterans with mental health and substance use disorders, and how much does it cost?Click to Enlarge
Veterans with mental illness and substance use disorders represent a large and growing population with severe and complex disorders. Despite representing only 15 percent of the U.S. Department of Veterans Affairs' (VA's) patient population in 2007, veterans with these problems accounted for one-third of all VA medical costs.
What is the VA's capacity to deliver mental health and substance use care to veterans?Click to Enlarge
Basic and specialized mental health services were reported to be widely available, and services have been expanding. The study found that therapies which are linked to improved outcomes have increased substantially, as have suicide prevention services.
What is the quality of mental health care received by veterans, and how does the quality compare with that delivered in the private sector?Click to Enlarge
It is generally as good as or better than care delivered by private plans. The team found that the VA had higher levels of performance than private providers for seven out of nine indicators. However, care is given at less than existing capacity, and less than a third of those targeted for specialized therapy receive it.
How does quality given by the VA vary?Click to Enlarge
Quality of care varies across regions and populations. Overall, no regional network is above or below the average, but treatment rates varied as much as 20% across networks. Veterans over age 65, veterans under age 35, and veterans who resided in rural areas were less likely to receive appropriate services.
Are veterans satisfied with the care they receive?Click to Enlarge
Overall, veterans' perceptions of VA mental health services were quite favorable: on a 10 point scale, 42% of veterans rated VA mental health care at 9 or 10, and 74% reported being helped by counseling or treatment received in the prior 12 months. Still, only 32 percent perceived improvement in their problems or symptoms.
More Research on Veterans' Mental Health
Supporting Those Who Served in Massachusetts: Needs, Well-Being, and Available Resources for Veterans2017
Massachusetts veterans have unmet needs for education, employment, health care, housing, financial, and legal services. A better understanding of these needs can inform investments in services and guide efforts to remedy barriers to access.
Supporting Veterans in Massachusetts: An Assessment of Needs, Well-Being, and Available Resources2017
There are numerous resources available to Massachusetts veterans and service members, but there are still pockets of unmet need in the areas of education, employment, health care, housing, financial, and legal services — particularly for newer veterans and National Guard/reserve members. A better understanding of these needs can inform investments in initiatives that target these populations and guide efforts to remedy barriers to access.
There are numerous resources available to Massachusetts veterans and service members, but there are still unmet needs in the areas of education, employment, health care, housing, financial, and legal services. This interactive tool features data from a study of the needs of Massachusetts veterans and available services, and it can help inform investments in services and guide efforts to remedy barriers to access.
Association Between Quality Measures and Mortality in Individuals with Co-Occurring Mental Health and Substance Use Disorders2016
This study suggests that the association between process-based measures of care quality and mortality in veterans with co-occurring mental and substance use disorders could be used to improve performance and reduce mortality in this population.