The Guide to VA Mental Health Services for Veterans and Families is intended for Veterans, Veteran family members, members of Veterans Services Organizations, or members of other groups interested in VA mental health care. You can use this handbook to learn what mental health services your local or regional VA health care facility has pledged to provide to Veterans.
The following information has been pulled from the guide, and is intended to serve as a brief overview. Please see the Guide for more detailed information.
Focus on Recovery - Recovery empowers the Veteran to take charge of his/her treatment and live a full and meaningful life. This approach focuses on the individual’s strengths and gives respect, honor, and hope to our nation’s heroes and their families.
Coordinated Care for the Whole Person - VA health care providers coordinate with each other to provide safe and effective treatment for the whole person—head to toe. Having a healthy body, satisfying work, and supportive family and friends, along with getting appropriate nutrition and exercising regularly, are just as important to mental health as to physical health.
Mental Health Treatment in Primary Care - Primary Care clinics use Patient Aligned Care Teams (PACTs) to provide the Veteran’s healthcare. A PACT is a medical team that includes mental health experts.
Mental Health Treatment Coordinator - Veterans who receive specialty mental health care have a Mental Health Treatment Coordinator (MHTC). The MHTC’s job is to understand the overall mental health goals of the Veteran.
Around-the-Clock Service - Emergency mental health care is available 24 hours per day, 7 days per week at VA medical centers. If your VA does not have a 24-hour emergency room, it must provide these services through a local, non-VA hospital. Telephone evaluations at VA medical centers and the national crisis hotline are also available 24/7.
Care that is Sensitive to Gender & Cultural Issues - VA health care providers receive training about military culture, gender differences, and ethnic issues in order to better understand each Veteran.
Care Close to Home - VA is moving closer to where Veterans live by adding more rural and mobile clinics and working with other health care providers in the community.
Evidence-Based Treatment - Evidence-based treatments are treatments that research has proven are effective for particular problems. Mental health providers receive training on a wide variety of proven treatments. Mental health providers must offer evidence-based treatments to Veterans.
Family & Couple Services - Sometimes, as part of a Veteran’s treatment, some members of the Veteran’s immediate family or the Veteran’s legal guardian may be included and receive services, such as family therapy, marriage counseling, grief counseling, etc.
Finding Care
If you have a mental health emergency (like wanting to hurt yourself or someone else), go to the nearest hospital emergency room or call 911. If it is not a VA hospital, you may be able to move to a VA facility depending on your circumstances. If you are feeling suicidal, you can also call, text, or chat online with the Veterans Crisis Line. The Veterans Crisis Line connects Veterans in crisis and their families and friends with qualified, caring Department of Veterans Affairs responders through a confidential toll-free hotline, online chat, or text. To speak with a responder by phone, call 1-800-273-8255 and Press 1. To chat online go to www.veteranscrisisline.net. To text with a responder, send a text message to 838255. These confidential support options are available 24 hours a day, 7 days a week, 365 days a year.
If you have a mental health problem and have never been seen in a VA hospital or clinic, you can:
Call VA general information hotline at 1-800-827-1000 or visit VA’s website at www.va.gov. You will be able to find the address and phone number of a VA hospital or clinic near you.
Veterans who are homeless can get help finding mental health care at a Veterans drop-in center, or by contacting the National Call Center for Homeless Veterans at 1-877-424-3838, or by visiting the VA’s Homeless Veterans Website at www.va.gov/homeless.
If you are already using VA medical services, ask your primary care provider to arrange for you to see a VA mental health provider.
Please see the Guide for information on How You Know If You Have A Mental Health Problem (page 9) and What Will Happen When You Request Mental Health Services (page 10).
Treatment Settings & Services
VA offers a range of treatments and services to improve the mental health of Veterans.
VA offers treatments in a variety of settings, including:
Short-term, inpatient care;
Outpatient care in a psychosocial rehabilitation and recovery centers (PRRC);
Regular outpatient care, which may include telemedicine services;
Examples of common mental health treatments for Veterans include:
Treatments for Depression and Anxiety
Antidepressant medications, anti-anxiety medications, and medications to
improve sleep and other problems
Talk therapies (also called psychotherapies), such as:
Cognitive behavioral therapy (CBT) to help individuals understand
the relationship between thoughts, emotions, and behaviors, learn new
patterns of thinking, and practice new positive behaviors (relaxation
techniques, using calming tapes to improve sleep, exercising, or socializing
with friends)
Acceptance and commitment therapy (ACT) to help people overcome
their struggles with emotional pain and worries. It helps them recognize,
commit to, and achieve what’s important to them
Interpersonal therapy (IPT) to help people promote positive relationships
and resolve relationship problems.
Treatments for Substance Use Disorders (SUD)
Medications to decrease cravings for alcohol and medications to ease withdrawal
(“detox”) from alcohol and drugs. Medications like buprenorphine and
methadone can also be used as therapeutic substitutes for illegal drugs (heroin)
or addictive prescription pain medications.
Talk therapies (also called psychotherapies), such as:
Motivational enhancement therapy to help the individual strengthen his/
her commitment to recovery
Cognitive behavioral therapy to help the individual identify the risks for
relapse and learn new coping skills to avoid relapse.
Opioid Treatment Programs (OTPs) help Veterans who misuse Opioids.
Opioids include illegal substances, such as heroin, and legally prescribed
medications such as some prescription pain medications.
Residential treatment programs for substance use disorders allow Veterans to
receive intensive treatment in a supervised residential setting.
Work therapies.
Treatments for Posttraumatic Stress Disorder (PTSD)
Antidepressant medications, anti-anxiety medications, mood stabilizing
medications, and other medications to ease nightmares, irritability,
sleeplessness, depression, and anxiety
Talk therapies (also called psychotherapies):
Cognitive behavioral therapy (CBT) to help individuals understand
the relationship between thoughts, emotions, and behaviors, learn new
patterns of thinking, and practice new positive behaviors
Cognitive processing therapy (CPT), a form of CBT that involves correcting
negative thought patterns so that memories of trauma don’t interfere with
daily life. It may also include writing about one’s traumatic experience.
Clinical guidelines strongly recommend CPT for PTSD treatment.
Prolonged Exposure Therapy (PE) to help people reduce fear and anxiety
triggered by reminders of the trauma. This is done by confronting (or being
exposed to) trauma reminders in a safe treatment environment until they
are less troubling. In this way, individuals can stop avoiding and reacting to
trauma reminders and live their lives more fully in the present with greater
freedom from the past. Clinical guidelines strongly recommend PE for
PTSD treatment.
Residential Rehabilitation Treatment Programs provide intensive, specialized
treatment for posttraumatic stress disorder within a structured, 24/7 care
setting.
Treatments for Serious Mental Illnesses, Like Schizophrenia, Schizoaffective Disorder, and Bipolar Disorder
Antidepressant medications, mood stabilizing medications, antipsychotic
medications and other medications to stabilize mood, organize thoughts,
reduce hallucinations, and ease related symptoms. If a Veteran with severe
schizophrenia or schizoaffective disorder does not improve after trying
two antipsychotic medications (and giving them enough time to work), the
antipsychotic medication clozapine should be considered. Clozapine is a very
effective medication.
Psychosocial Rehabilitation and Recovery Services to optimize functioning.
Work therapies to promote and support recovery.
Social skills training.
Residential Rehabilitation Treatment Programs allow for intensive treatment
for Veterans with severe mental illness within a structured, supervised setting.
Mental Health Intensive Case Management (MHICM). A team of mental health
physicians, nurses, psychologists, and social workers that treat Veterans in their
homes and community. MHICM helps Veterans experiencing symptoms of
severe mental illness cope with symptoms and live more successfully at home
and in the community.
Special Programs
VA recognizes that some groups of Veterans have special mental health needs.
In response to these needs, VA has developed special programs tailored for these
groups. VA special programs include:
Services for Women Veterans
VA offers a full range of mental health
services for women Veterans, including outpatient, residential and inpatient
services. Available outpatient services include assessment and evaluation,
medication management, and individual and group psychotherapy. Specialty
services are available to target problems such as PTSD, substance abuse,
depression, conditions related to military sexual trauma (MST), and
homelessness. In addition to the mixed gender residential and inpatient
resources, VA has regional or national resources that provide treatment to
women only or that have separate tracks for women. All VAs maintain treatment
environments that can accommodate and support women with safety, privacy,
dignity and respect.
VA has almost a dozen residential or inpatient programs that provide treatment
to women only or that have separate tracks for men and women. Mixed gender
inpatient units or residential treatment centers must ensure safe and secure
sleeping and bathroom arrangements, including, but not limited to, door locks
and proximity to staff. Each regional VA network (called a VISN) must have
residential care programs able to meet the needs of women Veterans. However,
the needs for some types of sub-specialty care (for example, women with
PTSD) may be limited, and women Veterans who need these services may be
referred to regional or national resources.
Family Services
VA offers family services for Veterans and their family
members. These include family education, brief problem-focused consultation,
family psychoeducation, and marriage and family counseling. Family education
provides families with the information they need to partner with the treatment
team and support the Veterans’ recovery. For brief family consultation the family
meets with a mental health provider as needed to resolve specific issues related
to the Veteran’s treatment and recovery. Family psychoeducation is a part of
recovery services for Veterans with serious mental illness. It focuses mainly on
supporting the Veteran’s well-being and functioning. The overarching goal of
marriage and family counseling is to reduce relational distress and strengthen
couple and family relationships.
Coaching Into Care Resources: VA works with Veterans’ family members and
friends who notice Veterans having difficulties. VA supports their efforts to help
the Veteran. Coaching Into Care is a free and confidential telephone coaching
service. It helps callers discover new ways to talk with a Veteran about their
concerns and about treatment options. Callers can reach the service at (888)
823-7458. More information can be found at www.mirecc.va.gov/coaching.
Readjustment Counseling Services (Vet Centers)
VA operates 300 community-based counseling Vet Centers. Many providers at Vet Centers are
Veterans of combat themselves. Vet Centers provide readjustment counseling
and outreach services to all Veterans who served in any combat zone. Military
sexual trauma counseling and bereavement counseling are also provided.
Services are available for family members for military related issues, and
bereavement counseling is offered for parents, spouses, and children of Armed
Forces, National Guard, and Reserves personnel who died in the service of
their country. Veterans have earned these benefits through their service, and
all are provided at no cost to the Veteran or family.
Military Sexual Trauma Services
Both women and men can experience
military sexual trauma (MST), and for some, the experiences can affect their
health even many years later. Because MST is an experience, not a diagnosis,
Veterans who experienced MST can benefit from the range of treatment
options VA has available to treat conditions commonly associated with MST,
including posttraumatic stress disorder (PTSD), depression, substance abuse,
and others. VA also has MST-specific outpatient, inpatient, and residential
services available to assist Veterans in their recovery. It’s important to know
that VA provides all treatment for MST-related mental and physical health
conditions free of charge. A service-connected disability rating is not required,
and Veterans may be able to receive MST-related care even if not eligible for
other VA services. Veterans do not need to have reported the incident or have
other documentation that it occurred.
Services for Veterans Who are Homeless
VA offers special programs and
initiatives to help homeless veterans live as self-sufficiently and independently
as possible. VA is the only Federal agency that provides substantial hands-on
assistance directly to homeless persons including:
Outreach to Veterans living on the streets and in shelters who otherwise
would not seek help
Drop in centers where Veterans who are homeless can shower, get a
meal, and get help with a job or getting back into society
Medical treatment for physical and mental disorders, including
substance abuse
Emergency housing referral
Transitional housing in community-based programs
Referral to permanent housing through the use of rental assistance
vouchers with case management
Long-term assistance, case management, and rehabilitation
Employment assistance
Residential treatment
Services for Veterans Involved with the Criminal Justics System (Justice-Involved Veterans)
An eligible Veteran who is not currently
incarcerated can access VA health care regardless of any criminal history,
including incarceration. Only when an otherwise eligible Veteran is currently
incarcerated, or in fugitive felon status, is he or she not able to access VA health
care. VA has two programs serving Veterans across the criminal justice system.
Their shared goal is to provide the earliest possible intervention to link Veterans
to the full array of VA services that will promote treatment while preventing
homelessness and further contact with the criminal justice system.
Veterans Justice Outreach (VJO) program: outreach and linkage to
VA medical, mental health, and homeless services for justice-involved
Veterans. Every VA medical center has at least one VJO Specialist, who
serves as a liaison between VA and the local criminal justice system.
Health Care for Reentry Veterans (HCRV) program: outreach and reentry
planning assistance for Veterans incarcerated in state and federal prisons.
Services for Older Veterans
VA Community Living Centers (CLCs) for Veterans needing temporary
assisted care until they can return home or find placement in a nursing
home
Home-Based Primary Care that includes a mental health professional as
part of the team providing care to Veterans in their homes
Screening for dementia like Alzheimer’s disease and/or other problems
that interfere with memory
Assessments that help decide
whether the Veteran can safely
live at home and make informed
medical decisions
Other
Veterans Health Administration Mental Health Program Evaluation: Capstone Report - This is the first public report of the conclusions of a comprehensive program evaluation of mental health services in VHA conducted under a contract awarded by VA’s Office of Policy and Planning (OPP-008). The study began in 2006 and was concluded in November 2010. It concludes that as of 2008, most quality indicators showed good care that was comparable to or better than the care for comparable privately insured patients, but that there was room for improvement, especially to reduce variability across the system and to ensure delivery of evidence-based treatments. The evaluation is considered the largest and most comprehensive systematic assessment of a mental health system ever undertaken.
Mental Health Liaison Roster - Provides a listing of the Mental Health Liaisons at each VISN. When emailing the liaisons, please do not include any personal health information or SSNs.
Contact Us
For more information on VA Mental Health Services visit our Contact the VA site.
Our mailing address is:
Mental Health Services (10P4M)
810 Vermont Ave., NW
Washington, DC 20420
For Public Affairs inquiries, please contact the VA Public and Intergovernmental Affairs Office at (202) 461-7600 or email va.media.relations@va.gov.
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