VA Health Care: Prevalence Information Needed to Better Understand and Address Harassment Involving Veterans

What GAO Found

The Department of Veterans Affairs (VA) has a policy to end harassment-related behaviors—including harassment of a non-sexual nature, sexual harassment, and sexual assault—at its VA medical centers. The policy gives certain VA medical center staff responsibility for managing reported incidents of these behaviors involving veterans. GAO’s analysis of VA data found there were over 31,000 reported incidents from fiscal years 2020 through 2025. Most involved veterans (or other patients) who engaged in these behaviors against staff.

Number of Reported Incidents of Harassment-Related Behaviors Involving Veterans at VA Medical Centers, Fiscal Years 2020-2025

However, the data on reported incidents likely do not capture all incidents of harassment-related behaviors. According to reports by stakeholders, most individuals who experience such behaviors do not notify the institutions at which the incidents occur. For example, several studies found that just 2 to 7 percent of individuals formally notify someone about experiencing sexual harassment. Individuals’ unwillingness to report is attributed to causes such as fear of retaliation. As a result, stakeholders have indicated the importance of identifying the prevalence of these behaviors, or their occurrence regardless of whether individuals notify someone, to better understand their potential within organizations. This can be done through anonymous or confidential surveys.

VA officials said they collect information on veteran experiences with certain harassment-related behaviors at a subset of VA medical centers to inform policies and practices. However, VA has not implemented any effort to identify the systemwide prevalence of these behaviors. Implementing a means to do so, such as through a survey, would better allow VA to know whether increases in reported incidents reflect greater willingness to notify staff or an actual increase in these behaviors. It also would help VA more effectively direct resources toward prevention and mitigation efforts to reach those most at risk.

Why GAO Did This Study

Harassment-related behaviors within the VA health care system may put veterans at risk and compromise care. For example, researchers have found that veterans who experience these behaviors may avoid needed care. Further, staff who experience such behaviors may rush care in response. In 2022, VA established a policy aimed at ending harassment-related behaviors, but reported incidents of these behaviors have since generally increased.

GAO was asked to review VA processes for responding to harassment-related behaviors. This report describes data on reported incidents of these behaviors involving veterans at VA medical centers and examines VA’s efforts to identify the prevalence of these behaviors.

GAO analyzed available VA data on reported incidents of harassment-related behaviors from fiscal year 2020 through fiscal year 2025; reviewed relevant VA policies; interviewed VA officials responsible for harassment-related matters; reviewed reports by and interviewed stakeholders, including officials from the National Academies of Sciences, Engineering, and Medicine and RAND, on their published work related to identifying the prevalence of these behaviors; and reviewed relevant publications from VA researchers.