Mental Health

Mental health conditions and substance use disorders, known collectively as behavioral health conditions, affect millions of people in the United States every year. Treatment for mental health conditions, such as anxiety and depression, can help people manage their symptoms and improve their quality of life.  

However, there are a number of issues concerning access to mental health treatment. For instance, the availability of qualified behavioral health providers in the United States has been a persistent challenge, particularly in rural areas. And certain populations are at higher risk for mental health conditions and suicide, including veterans and military service members.  

Multiple federal programs are working to address these and other issues, but additional federal actions could improve care for the individuals who rely on these programs.  

For example: 

• Crisis services. Suicide rates in the U.S. increased by 31% from 2003 through 2023. To help those at risk, the Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration operates the 988 Suicide & Crisis Lifeline, a network of independent crisis contact centers that answer calls, texts, and chats from people in suicidal crisis or emotional distress. Similarly, the VA operates the Veterans Crisis Line (VCL), a 24/7 national toll-free number, online chat, and text messaging service for veterans—whose suicide rate was over twice that of non-veterans in 2022. But the VA faces challenges related to the VCL. For example, staff handle multiple chat and text interactions at once, which makes it harder for staff to focus and can lead to burnout. Another challenge is routing calls from "complex needs" callers—those who are abusive or call frequently. If these calls go to responders who aren't trained for them, it can cause stress and put callers at risk. 

• Service members’ mental health needs. Military service members may experience mental health conditions as a result of exposure to dangerous and traumatic situations. The Department of Defense (DOD) has reported that suicide rates among service members increased by one-third between 2016 and 2020. Service members assigned to remote installations outside the U.S. may be especially at risk for suicide because of less access to mental health services and increased social isolation. However, DOD has not established oversight mechanisms to ensure that suicide prevention program requirements are implemented in accordance with DOD policies. 

• Children in military families. DOD research has found that military families and children face severe barriers to accessing mental health care, harming family well-being and military readiness. The Department of Defense Education Activity (DODEA), which educates military-connected children in the U.S. and overseas, has implemented several programs that provide mental health services for children who attend DODEA schools. However, DOD has not evaluated these programs to make sure they are working as intended. 

• Transitioning to civilian life. Thousands of service members transition from military to civilian life each year. Some may face challenges during the period, such as the loss of a sense of purpose or symptoms of PTSD. While VA screens transitioning service members for certain mental health conditions, including PTSD, VA has not validated its screening tools to make sure they work as intended. 

• Caregivers for veterans. The Veterans Health Administration’s (VHA) Caregiver Support Program offers mental health support, among other benefits, to eligible caregivers who provide around-the-clock care for veterans with serious injuries. This includes support groups and respite care. In FY 2025, the program served about 98,000 caregivers. VHA established 4 goals to assess whether its outreach efforts are effective at increasing caregivers’ awareness of the program. However, it doesn’t have quantitative targets for all these goals.  

• Human trafficking survivors. HHS’s Office on Trafficking in Persons and the Department of Justice’s Office for Victims of Crime administer survivor assistance grant programs that help provide survivors of human trafficking access to needed services, including behavioral health care. In FY 2025, HHS awarded approximately $7.5 million to two key trafficking survivor services programs and DOJ awarded approximately $45 million for two key programs. The programs assisted approximately 2,600 survivors and 11,300 survivors in that year, respectively. While the Office on Trafficking in Persons followed leading practices to assess the performance of its key programs, the Office for Victims of Crime did not fully do so.