Congressionally Mandated Report Finds 50% of Veterans Needing Mental Health Care Remain Untreated

Washington, DC, February 1, 2018.

A study released by the National Academies of Science, Engineering and Medicine, despite concluding that the VA provides mental health care of comparable or superior quality to that provided in private and non-VA public sectors, found that fully half of all post-9/11 veterans needing mental health services do not receive any treatment.  Commissioned by the U.S. Department of Veterans Affairs in 2014 in the wake of a national uproar over crushing wait times for basic medical care at VA health care facilities, the study examined veterans’ ability to access mental health services at the VA, as well as the quality of those services.  According to study authors, the massive, unmet need is attributable to factors including lack of information on how to access care, lack of transportation to treatment sites, concerns about missing work time, and fear of stigma.

The consequences of untreated mental health conditions can be tragic.  Suicide risk among Veterans is 22 percent higher compared with U.S. civilian adults, even after adjusting for age and sex.   According to VA data, Veterans comprise 8.5% of the U.S. adult population, but account for 18 percent of all deaths by suicide among U.S. adults.

To ensure that Veterans in need of mental health services receive the care that they need, the report recommends that the VA substantially increase the use of telemedicine to overcome barriers to mental health care.  Telemedicine uses communication and information technology –typically phone, internet and video—to enable medical care between a patient and clinician in different geographic locations.   A typical telemedicine appointment can occur using video functions on a patient’s own mobile device, and in many cases patients are able to self-schedule appointments online using a provider’s dedicated patient portal.   Simplifying scheduling and eliminating transport concerns and associated travel times remove significant barriers to access.  But perhaps most important for patients is the ability to receive mental health care in the privacy of their own homes.

Significantly, evidence from prior research suggests that using technology to deliver care can lead to greater reductions in PTSD and depression symptoms compared to care provided in-person only.   Post-9/11 veterans, mostly millennials, may prefer tele-mental health services over in-person visits.  Clinical tele-mental health is already one of the most commonly used telemedicine services within the VA, serving approximately 133,500 veterans and 427,000 encounters in 2016.  The study authors urged VA to leverage this existing infrastructure and expertise to “substantially expand the scale and quality” of mental health services.

“Tele-mental can eliminate many of the barriers Veterans face in accessing and receiving mental health care,” said Dr. Peter Yellowlees, Professor of Psychiatry at the University of California-Davis and President of the American Telemedicine Association, who contributed to the report.  “93% of post-9/11 veterans are between the ages of 18-54.  These individuals are just entering, or in the midst of, their peak working years, and we must do all we can to provide much-needed care to support their return to civilian life.”

“This important report from the National Academies highlights the critical importance of expanding telehealth and telemedicine infrastructure,” said Dr. Sabrina Smith, Interim CEO of ATA.  The VA is the largest healthcare provider in the nation, with tremendous potential to achieve huge gains through expanding telehealth.  The ATA stands ready to assist VA in these new efforts.”

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