NCPA - National Center for Policy Analysis


February 12, 2007

The Department of Veterans Affairs (VA) is facing a wave of returning soldiers who are struggling with memories of a war where it's hard to distinguish innocent civilians from enemy fighters and where the threat of suicide attacks and roadside bombs haunts the most routine mission.  Since 2001, 1.4 million Americans have served in Iraq, Afghanistan or other locations in the global war on terrorism.

An investigation by McClatchy Newspapers has found that even by its own measures, the VA isn't prepared to give these returning soldiers the care that could best help them overcome destructive, and sometimes fatal, mental health ailments.  Among the findings:

  • Despite a decade-long effort to treat veterans at all VA locations, nearly 100 local VA clinics provided virtually no mental health care in 2005; the average veteran with psychiatric troubles gets almost one-third fewer visits with specialists than he would have received a decade ago.
  • Mental health care is wildly inconsistent from state to state; in some places, veterans get individual psychotherapy sessions while in others, they meet mostly for group therapy.
  • In some of its medical centers, the VA spends as much as $2,000 for outpatient psychiatric treatment for each veteran; in others, the outlay is only $500.


  • The lack of adequate psychiatric care strikes hard in the western and rural states that have supplied a disproportionate share of the soldiers in the wars in Iraq and Afghanistan -- often because of their large contingents of National Guard and Army Reserves.
  • More often than not, mental health services in those states rank near the bottom in a key VA measure of access; Montana, for example, ranks fourth in sending troops to war, but last in the percentage of VA visits for mental health care in 2005.

The uneven mental health treatment of veterans across the country can be traced to the VA's health system reorganization, which gave a lot of leeway to local managers.

Source: Chris Adams, "War In Iraq," Miami Herald, February 11, 2007.


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