Better Understanding Needed to Enhance Services to Veterans Readjusting to Civilian Life
GAO-14-676: Published: Sep 10, 2014. Publicly Released: Sep 10, 2014.
What GAO Found
While many veterans who served in the military after September 11, 2001, have successfully readjusted to civilian life with minimal difficulties in the first few years after they were discharged, others have experienced difficulties, according to veterans GAO heard from in discussion groups and studies GAO reviewed. These readjustment difficulties include financial and employment, relationships, legal, homelessness, and substance abuse. According to VA's strategic plan, one of its strategic objectives is to improve veteran wellness and economic security, and it states that the ultimate measure of VA's success is the veteran's success after leaving military service. However, there is limited and incomplete data to assess the extent to which veterans experience readjustment difficulties. Therefore, it is not known to what extent veterans are facing one or a combination of problems when they readjust to civilian life. There is relatively more information available on the number of veterans who had a physical or mental condition within a few years of leaving the military. For example, one 2010 study shows that 32 percent of recently-separated veterans were diagnosed by either the Department of Defense (DOD) or the Department of Veterans Affairs (VA) with a disease or injury of the musculoskeletal system. In this and other studies reviewed by GAO, estimates for Post-Traumatic Stress Disorder (PTSD) varied from 10 to 12 percent. According to these studies, some groups of veterans--those who had served in combat and younger veterans--were more likely than others to experience readjustment difficulties or be diagnosed with a mental health condition.
While an array of VA benefits and services are available during a veteran's first few years out of the military, GAO has identified long-standing challenges with VA's delivery and management of this support. Specifically, VA provides a wide range of services and benefits through several programs, such as education, health care, counseling, employment, home loans, and insurance. VA informs veterans of these benefits and services before they leave military service through outreach and education. However, GAO's prior work over the last decade has shown that VA has struggled for years to, among other issues, (1) provide timely access to medical appointments, (2) make timely disability compensation decisions, and (3) coordinate the transfer of medical records from DOD. GAO has made numerous prior recommendations to address these issues, and VA has taken some actions to implement them; however, some recommendations remain unaddressed, and GAO continues to monitor VA's progress. Agency officials and veterans GAO spoke with during this review suggested additional actions that VA can implement to improve its assistance for transitioning veterans. For example, a few VA staff suggested that VA conduct additional research to identify veterans who are predisposed to PTSD and better understand why some veterans do not use VA services. Veterans at all of the sites GAO visited suggested that it would be beneficial for separating servicemembers to have additional time to adjust to the idea of being a civilian and relearning what civilian life is like. Without comprehensive information on the difficulties experienced by recently-separated veterans, VA cannot assess risks to achieving its objectives and may be missing opportunities to enhance assistance to veterans by not providing needed services early in the veteran's readjustment process. GAO recommends that VA take steps to better understand the difficulties faced by readjusting veterans and use this information to determine how best to enhance its benefits and services for these veterans. VA concurred with GAO's recommendation and described its recent efforts and plans for improvement.
Why GAO Did This Study
Over the next 6 years, over 1 million servicemembers are expected to leave the military. As was the case with past generations of veterans, the transition from military to civilian life can be challenging for post-9/11 veterans as well. Over the last several years, veterans' struggles to successfully readjust to civilian life have been the subject of numerous Congressional hearings.
Providing support and services for transitioning veterans is a key issue facing the nation. This report examines what is known about (1) the extent to which veterans experience difficulties during their readjustment to civilian life; and (2) how VA assists veterans in their readjustment, as well as what challenges and opportunities exist. GAO conducted a literature search, interviewed VA and DOD officials, and held eight nongeneralizable discussion groups with a total of 45 veterans and family members. GAO also conducted interviews with relevant officials at VA facilities in four states. GAO selected these sites based on diversity of military service branches in a local area, geography, a high concentration of veterans, and proximity to VA resources.
What GAO Recommends
GAO recommends that VA take steps to better understand the difficulties faced by readjusting veterans and use this information to determine how best to enhance its benefits and services for these veterans. VA concurred with GAO’s recommendation and described its recent efforts and plans for improvement.
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Recommendation for Executive Action
Comments: VA has begun taking steps to better understand the difficulties faced by readjusting veterans but has not yet completed them. Since November 2014, VA reported that it has been working with DOD to develop the joint process for conducting Care Coordination Process Reviews (formerly known as Qualitative Case Reviews), which will focus on reviewing care coordination processes and effectiveness. VA's Interagency Care Coordination Committee (IC3) Policy and Oversight Work Group is revising the policies and procedures for these reviews and has begun a national roll out of the Lead Coordinator initiative, which, according to VA, will improve the level of complex care coordination within and between DOD and VA. After completing a tabletop exercise of case review presentations on October 3, 2016, VA identified areas which needed fine tuning, so it developed open forums for lead coordinators to discuss process and resources. In an effort to enhance its briefings under the Transition Assistance Program, now known as the Transition Goals, Plans, Success program, VA used participant satisfaction data and is developing a long-term survey instrument that will assist VA in identifying and tracking recommended process improvements. In January 2015, VA produced a report on veteran economic competitiveness that recommended that VA develop targeted strategies for vulnerable populations, such as veterans who separate from the military without a GED or high school diploma and veterans who are separating after their rehabilitation. The report also recommended that VA continue to research the educational and economic status of veterans and coordinate with other federal agencies to identify and address gaps in current programs and policies that may result in barriers to economic success among vulnerable segments of the veteran population. GAO will consider this recommendation closed when VA has completed the joint Care Coordination Process Reviews, developed the long-term survey instrument for the Transition Goals, Plans, and Success program, and used the results from these reviews and survey to determine how best to enhance its benefits and services to veterans.
Recommendation: The Secretary of Veterans Affairs should take steps to better understand both the difficulties faced by readjusting veterans and the characteristics of those who may be more likely to face such difficulties, and use the results to determine how best to enhance its benefits and services to these veterans.
Agency Affected: Department of Veterans Affairs