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Publication Briefs

Gulf-War Era Veterans with Depression and/or PTSD were More Likely to Receive Mental Healthcare if They were Enrolled in VA

Depression and PTSD are two of the most common mental health conditions experienced by Veterans, but it is unclear what individual and system level factors are associated with receiving mental health treatment. Though most Veterans are eligible for VA healthcare, it is also unclear which Veterans are most likely to access VA services. The aim of this study was to explore factors associated with treatment utilization for depression and PTSD among Gulf War Era Veterans who served in active duty on or after August 2, 1990, and who represent roughly half of all living Veterans. Using a national sample of these Veterans who endorsed lifetime diagnoses of either depression or PTSD (N = 425; 26% female; 41% identified as a racial minority; 78% reporting current VHA enrollment), analyses were used to predict past-year treatment utilization. [This sample included Veterans recruited for a larger project and national survey of Gulf War Era Veterans’ healthcare needs, use patterns, and associated costs.] Predictor variables were those indicated in the Behavioral Model of Healthcare Utilization (BMHU), including predisposing demographic variables (e.g., age, race), enabling variables (e.g., service connection, enrollment in VA), and need-based variables (e.g., current symptom severity). Of the Veterans in this study, 362 (85%) reported having ever been diagnosed with depression, and 197 (46%) reported being treated for depression in the past year, while 281 (66%) reported having been diagnosed with PTSD, and 153 (36%) were treated for PTSD in the past year.


  • Veterans who used VA healthcare were significantly more likely to receive mental health treatment than those who did not. VA enrollment was associated with three- and five-times higher odds of being treated for depression or PTSD, respectively.
  • VA enrollment was the strongest predictor of receiving mental health treatment, after controlling for all other variables.
  • Higher reported income was associated with a higher likelihood of receiving treatment for both PTSD and depression.


  • Increased enrollment in VA healthcare may result in more Veterans receiving mental health treatment for diagnoses that often go untreated, such as depression and PTSD. Expanding eligibility and retaining enrolled Veterans may aid in increasing Veterans’ contact with the VA healthcare system.


  • This study relied on patient self-report as opposed to an objective measurement of diagnoses and healthcare use, such as a review of medical records.

This study was funded by HSR&D, and Dr. Pugh is supported by an HSR&D Research Career Scientist Award. Drs. Calhoun and Kimbrel are with HSR&D’s Center of Innovation to Accelerate Discovery and Practice Transformation

Peter S, Halverson T, Blakey S, Pugh MJ, Beckham J, Calhoun P, and Kimbrel N. The Veterans Health Administration’s Integrated Model of Care Increases Accessibility and Delivery of Mental Health Services. Psychological Services. July 4, 2022; online ahead of print.

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What are HSR Publication Briefs?

HSR requires notification by HSR-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR published articles. Visit the HSR citations database for a complete listing of HSR articles and presentations.

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