Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.

Introduction -- The Veterans Health Administration -- The Veterans Health Administration's Mental Health Services -- Clinical management of mental health conditions at the Veterans Health Administration -- Methodology -- Department of Veteran's Affairs mental health services: need, usage, and access and barriers to care -- Dimensions of quality in mental health care -- Mental health workforce and facilities infrastructure -- Timely access to mental health care -- Patient-centered care and the veteran experience -- Effective mental health care -- Efficient mental health care -- Equitable mental health care -- Health technology for mental health care -- Quality management -- Findings, conclusions, and recommendations -- Appendices. Supporting the documentation for the survey -- Supporting documentation for the site visits: questionnaires and NVivo codes.

This history of psychological care through the VA tells how VA psychologists pioneered research in such areas as pyschopharmacology, care of elderly people, and psychological care aspects in treatment of tuberculosis, and how they helped establish a number of trends for such mental health services as group therapy, compensated work therapy, and other rehabilitation programs.