Skip to main content

Veterans Affairs and Department of Defense Integrated Systems of Mental Health Care

  • Chapter
  • First Online:
Military and Veteran Mental Health

Abstract

The Global War on Terror (GWOT) and associated campaigns (Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn) resulted in an immediate need for veteran medical and mental health services. Since fiscal year 2002, nearly two million veterans became eligible for Department of Veterans Affairs (VA) care. Of that total, 1,185,160 (61%) were former active duty, while 754,799 (39%) were either National Guard or Reserve component. Of this cohort, 685,540 (57.6%) carry a mental health diagnosis with 378,993 diagnosed with post-traumatic stress disorder (PTSD), making this diagnosis the most common mental health disorder evaluated at VA facilities for this population. The National Center for Veterans Analysis and Statistics anticipates the number of VA-eligible post-9/11 veterans to expand to nearly 3.4 million by 2018. To meet the needs of the expanding, dynamic composition of the eligible veteran population with mental health treatment needs, the Department of Defense and Department of Veterans Affairs developed an integrated model of mental health services. The continuum of mental health services begins with service-specific mental health resources consisting of established military treatment facilities, programs, and partnerships and continues through programs developed to assist transition of in-need service members to the VA behavioral health system of care. Integration of community outreach, primary care, specialty behavioral health, inpatient, residential, and rehabilitative services provides service members and veterans with a continuum of mental health services unavailable prior to GWOT.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Notes

  1. 1.

    To this point, the medical section associated with the treatment of mental health illness has been referred to as “behavioral health” services. This nomenclature is military specific and, for all intents and purposes of this chapter, is interchangeable with “mental health” services, the VA’s preferred nomenclature.

References

  • Assistant Secretary of Defense for Health Affairs (2010) ASD(HA) memo: the Department of Defense in Transition Program

    Google Scholar 

  • Assistant Secretary of Defense for Health Affairs (2013) ASD(HA) memo: transitioning to the fifth edition of the diagnostic and statistical manual of mental disorders

    Google Scholar 

  • Cigrang J, Rauch S, Mintz J, Brundige A, Avila L, Bryan C et al (2015) Treatment of active duty military with PTSD in primary care: a follow-up report. J Anxiety Disord 36:110–114

    Article  PubMed  Google Scholar 

  • Commission on Care (2016) Final report on the commission on care. Commission on Care, Washington, DC

    Google Scholar 

  • Department of Defense (2013a) DoDI 6490.04: mental health evaluations of members of the military services

    Google Scholar 

  • Department of Defense (2013b) DoDI 6490.12: mental health assessments for service members deployed in connection with a contingency operation

    Google Scholar 

  • Department of Defense (2013c) DoDI 6490.15: integration of Behavioral Health Personnel (BHP) services into Patient-Centered Medical Home (PCMH) primary care and other primary care service settings

    Google Scholar 

  • Department of Defense (2014a) DoDI 1332.18: Disability Evaluation System (DES)

    Google Scholar 

  • Department of Defense (2014b) DoDI 6490.10: transferring Family Advocacy Program (FAP) and behavioral healthcare during Permanent Change of Station (PCS) and Expiration of Time in Service (ETS)

    Google Scholar 

  • Department of Defense (2015a) DoDI 1304.26: qualification standards for enlistment, appointment, and induction

    Google Scholar 

  • Department of Defense (2015b) DoD/VA Report to the Congress in Response to Senate Report 113–44, pg. 133, Accompanying S. 1197, the National Defense Authorization Act for Fiscal Year 2014: mental health counselors for service members, Veterans, and their families. Under Secretary of the Army for Personnel and Readiness

    Google Scholar 

  • Department of Defense (2016) DoDI 6200.06: periodic health evaluations

    Google Scholar 

  • Department of Defense Deployment Health Clinical Center (2016a) Mental health care utilization among active duty service members. http://www.pdhealth.mil/clinical/psychological-health-numbers/mental-health-care-utilization-among-active-duty-service/outpatient-visits-2689. Accessed 4 Oct 2016

  • Department of Defense Deployment Health Clinical Center (2016b). Mental health disorder prevalence among active duty service members. http://www.pdhealth.mil/clinical/psychological-health-numbers/mental-health-disorder-prevalence-among-active-duty-service. Accessed 4 Oct 2016

  • Department of the Army (2012) HQDA EXORD 236–12: army implementation of Behavioral Health System of Care (BHSOC) Embedded Behavioral Health (EBH). Pentagon Telecommunications Center, Washington, DC

    Google Scholar 

  • Department of Veterans Affairs (2011) Veteran Population Projection Model – VetPop2011. Washington, DC

    Google Scholar 

  • Department of Veterans Affairs (2012) Guide to VA mental health services. Veterans Health Administration, Office of Patient Care Services, Mental Health Services, Washington, DC

    Google Scholar 

  • Department of Veterans Affairs (2014) Veteran population projection model – VetPop2014. Department of Veterans Affairs, Washington, DC

    Google Scholar 

  • Department of Veterans Affairs (2015a) Office of Public Health Highlights report. Department of Veterans Affairs, Washington, DC

    Google Scholar 

  • Department of Veterans Affairs (2015b) Veterans health administration locations. http://www.va.gov/directory/guide/division.asp?dnum=1. Accessed 4 Oct 2016

  • Department of Veterans Affairs (2016) VA pocket card, 4th Quarter FY16. http://www.va.gov/vetdata/docs/pocketcards/fy2016q4.pdf. Accessed 4 Oct 2016

  • Department of Veterans Affairs and Department of Defense (2012) Department of Veterans Affairs and Department of Defense Joint Executive Committee Joint Strategic Plan Fiscal Years 2013–2015

    Google Scholar 

  • Headquarters, US Army Medical Command (2010) Operations order 10–70: USAMEDCOM comprehensive behavioral health system of care campaign plan. Office of the Surgeon General US Army Medical Command, Ft. Sam Houston

    Google Scholar 

  • Headquarters, US Army Medical Command (2014) MEDCOM/OTSG policy 14–058: absent and sick accountability and management of soldiers receiving inpatient care outside of military treatment facilities. Office of the Surgeon General, US Army Medical Command, Washington DC

    Google Scholar 

  • Mental Health Advisory Team (2007) Mental health advisory team IV: operation Iraqi Freedom. Office of the Surgeon General, US Army Medical Command, Washington, DC

    Google Scholar 

  • Office of the US Army Surgeon General, Behavioral Health Division (2017) Behavioral Health Service Line Home page. https://bhsl.army.mil . Accessed 27 February 2017

  • Ritchie E (ed) (2014) Forensic and ethical issues in military behavioral health. Borden Institute, Office of the Surgeon General & AMEDD Center and School, Fort Sam Houston

    Google Scholar 

  • United States Army Medical Command (2013) MEDCOM policy 13–059: behavioral health service line policy (BHSL), consolidated behavioral health (BH). Office of the Surgeon General, US Army Medical Command, Fort Sam Houston

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Samuel L. Preston .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Science+Business Media, LLC

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Preston, S.L. (2018). Veterans Affairs and Department of Defense Integrated Systems of Mental Health Care. In: Roberts, L., Warner, C. (eds) Military and Veteran Mental Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-7438-2_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-7438-2_7

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-7436-8

  • Online ISBN: 978-1-4939-7438-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics