Mental Health Problems and Treatment Utilization of Iraq and Afghanistan Veterans Enrolled in Department of Veterans Affairs Health Care

Since the conflicts began in 2001, military service-related mental health problems, particularly posttraumatic stress disorder (PTSD), have steadily increased among Iraq and Afghanistan Veterans, the majority of whom receives care from the Department of Veterans Affairs (VA) healthcare system. Because of patient and system barriers to VA specialty mental health care, many Iraq and Afghanistan Veterans fail to access and receive an adequate course of mental health treatment, which puts this new generation of Veterans at risk for chronic mental health problems. Notably, combat Veterans with mental health disorders utilize primary care medical services in greater numbers than their counterparts without mental health problems. VA has seized this opportunity and has integrated mental health services into primary care in an attempt to engage returning veterans in mental health treatment. Nevertheless, several potentially modifiable barriers to mental health care still exist. This chapter charts the mental health epidemic and utilization patterns among returning Veterans in the VA healthcare system, delineates residual barriers to care, and proposes innovations to overcome these barriers to improve the health and functioning of returning combat Veterans.