Public-Private Partnerships for Providing Behavioral Health Care to Veterans and Their Families

American veterans and their family members often struggle with behavioral health problems, such as posttraumatic stress disorder, depressive disorders, and family conflict, yet few engage in behavioral health treatment to address these problems. Barriers to care include trouble accessing treatment and limited communication between civilian and military health care systems, which treat veterans and their family members separately. Even though the Department of Veterans Affairs (VA) is making efforts to address barriers to care among veterans, more work is needed to effectively serve veterans and their families. Federal entities—notably, the President of the United States, the Department of Defense (DoD), and the VA—have discussed public-private partnerships as a potential solution to overcome barriers to care in this population. Such partnerships could include collaborations between a public agency, such as the VA, and a private organization, such as a veteran service organization, private industry, or private hospital. Despite the call for such partnerships, not much is known about what a public-private partnership would entail for addressing behavioral health concerns for veterans and their families. The health care literature is sparse in this area, and published examples and recommendations are limited. Thus, we designed this study to inform the creation of public-private partnerships to better serve veterans and their families.

Key Findings

• Public-private partnerships offer a potential opportunity to improve the standard of current care for veterans and their families.
• A champion is needed. Typically, key people within the public agency take the lead on creating the partnership.
• Stakeholder support is critical. Support from the nonpublic communities involved in the partnership is necessary at the regional and local levels.
• Successful public-private partnerships develop a clear description of the plan for addressing the established need and consider the risks in addition to the benefits likely to emerge from the partnership.
• The structure of the public-private partnership is typically established at the beginning of the relationship, with a dedicated support structure and staff that monitor the process from inception to the evaluation of outcomes.
• Successful public-private partnerships draw on the strengths of the public and the private entities so that both can work together toward a common goal.
• Most partnerships are time limited by way of contracts and agreements, but there should be consideration of financial capacity for the long-term sustainability of efforts.
• Sustainability is important to ensure that the partnership is making an impact on the targeted systems or populations.
• Flexibility is key. Partners need to be flexible in adapting to technological innovations, information technology, needs of the target population, funding environments, and changes to strategic objectives over time.

Conclusion

An increasing number of veterans and their families are struggling with behavioral health problems; addressing these concerns is a national priority. The creation and expansion of public-private partnerships have been suggested as methods to help overcome barriers to care and meet the needs of this population. Much can be learned from successful public-private partnerships, both within and outside the veteran behavioral health area. The intent of this study was to inform how the field considers public-private partnerships by reviewing their current evidence base and then offering nine key components that characterize effective partnerships. We recommend additional study of the key components, as well as the evaluation of established and developing public-private partnerships to assess key outcomes. We call for the broad dissemination of key findings to fill current evidence gaps. We also encourage policymakers in the federal government (including the VA and DoD) and in private entities to work together to develop evidence-informed public-private partnership models, and then evaluate them to effectively expand behavioral health services for veterans and their families.

The research described in this article was conducted within RAND Health.