At the request of the Department of Veterans Affairs, the RAND Corporation – an independent, nonprofit group which seeks to use research and analysis to improve policy and decision-making – undertook the most comprehensive evaluation of a mental health care system ever conducted.
The study was conducted between August 2006 and November 2010. It focused on the quality of care provided to Veterans by the Veterans Health Administration (VHA) with one or more of the following diagnoses: schizophrenia, bipolar disorder, post-traumatic stress disorder, major depressive disorder and substance abuse disorder.
The resulting 200-plus page report reached a number of interesting conclusions. A few of these findings are:
- While the population of Veterans with one of these mental health diagnoses represented only 15 percent of VHA’s patients, it accounted for a disproportionate amount of costs – nearly 1/3 of overall costs. Yet, most of the health care these Veterans received was not for their mental health conditions.
- VHA mental health care performed better on 7 out of 9 indicators than comparable private providers. VA led the private sector by particularly large margins in the areas of treatment with medication and laboratory testing. VHA fell behind the private sector in initiation and treatment engagement for substance abuse disorders.
- Despite generally outperforming the private sector, VHA did not meet its own performance guidelines in many instances. Only a minority of Veterans were receiving their targeted type of therapy, such as relapse-prevention treatment for those with substance abuse disorders and social skills training for those with schizophrenia. Overall, only about 1/3 of veterans with one of the studied mental health diagnoses were in continuous treatment with medication.
- While 42 percent of Veterans reported being very satisfied with their VA care (assigning a 9 or 10 on a scale of 1 to 10), only 32 percent perceived that their condition or symptoms had improved.