Improving Behavioral Health Care Access and Treatment Options for Veterans with Co-Occurring Behavioral Health Problems

by Sierra Smucker, Eric R. Pedersen, Terri Tanielian

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Veterans are at greater risk of behavioral health problems than the civilian population, with posttraumatic stress disorder (PTSD), depression, and substance use disorders (SUDs) among the most common. Co-occurrence of SUDs with other behavioral health disorders is also high among veterans.

Veterans continue to face barriers to accessing high-quality behavioral health care. In addition to logistical barriers and stigma, the co-occurrence of disorders can prevent veterans from getting the care they need. Specifically, traditional treatment models for those with co-occurring behavioral health problems have required patients to seek treatment for substance use before they qualify for targeted, empirically based treatments for PTSD and depression, because heavy substance use can hinder the progress and completion of such treatments. However, veterans may be using substances to manage symptoms of PTSD and depression.

Treating substance use problems concurrently with PTSD or depression as part of an integrated approach to care is one promising route to ensuring that veterans receive the care they need without delay. This brief working paper reviews the research on co-occurring behavioral health problems and treatments among veterans and outlines several recommendations for improving veterans' access and expanding their treatment options.

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The research described in this report was conducted by the Social and Behavioral Policy Program within RAND Social and Economic Well-Being.

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