Mental Health Challenges Impact Veterans’ Community Care Experiences

Veterans with mental health conditions (MHC) consistently report worse experiences with community care (CC) compared with those without MHC, highlighting the urgent need for improvements in care coordination and clinician communication, according to a study published in JAMA Network Open.

“Research has found that veterans seeking behavioral health care in the community frequently face challenges, such as long wait times to schedule first appointments and a lack of familiarity with military culture among clinicians based outside of the VA,” explained Megan Vanneman, PhD, MPH, Veterans Affairs (VA) Informatics, Decision Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System, Department of Internal Medicine, University of Utah School of Medicine, Department of Population Health Sciences, University of Utah School of Medicine in Salt Lake City, Utah, and coauthors.

Using data from the Veterans Affairs (VA) Survey of Healthcare Experiences of Patients—Community Care Survey (SHEP-CCS) from 2016 to 2021, the researchers aimed to investigate these disparities among veterans who received VA-funded care outside the VA system. They analyzed data from 231 869 veterans, including 62 911 with MHC, who reported their experiences across various aspects of CC, such as clinician communication, care coordination, and eligibility determination.

The researchers weighted survey data and linked administrative data sources to control for differences in demographics, health status, and other factors. Veterans with MHC had an average age of 55.8 years compared to 62.5 years for those without MHC. They were more likely to have substance use disorders (15.1% vs 3.1%) and higher levels of service-connected disability (86.2% vs 63.2%). In unadjusted analyses, veterans with MHC consistently rated their experiences with CC lower across 8 of 9 domains, with persistent differences over time. In fully adjusted models accounting for potential confounders, veterans with MHC still reported significantly lower ratings across all domains, including overall satisfaction with CC (−1.8 points), clinician communication (−2.0 points), and care coordination (−2.4 points).

Additionally, veterans with MHC were more likely to report low ratings of care and less likely to report high ratings compared to those without MHC. For example, they were 2.2 percentage points more likely to give low ratings of overall CC and 2.4 percentage points less likely to give high ratings.

“In this survey study of veterans using VA-funded CC during 2016 to 2021, veterans diagnosed with a MHC were found to have reported worse experiences with CC compared with veterans without a MHC,” concluded the study authors.

Reference

Vanneman ME, Roberts ET, Li Y, et al. Experiences with VA-purchased community care for US veterans with mental health conditions. JAMA Netw Open. 2025;8(5):e2511548. doi:10.1001/jamanetworkopen.2025.11548