Majority of VA mental health visits are timely, but referrals lag: Watchdog

Roughly 80% of mental health appointments made in the Veterans Affairs’ Community Care Program are scheduled within the department’s 30-day wait-time standard, but VA schedulers still struggle to meet the seven-day requirement for making these appointments, the VA Office of Inspector General has found.

The VA’s watchdog evaluated mental health referrals for community care at 133 VA medical systems and found that just five met the seven-day metric for scheduling the appointments.

But the inspectors also found that despite those delays, 80% of the referrals received appointments within 30 days.

Of those that didn’t meet the requirement, the average wait time for an appointment was 56 days.

In the report released Monday, OIG inspectors said the scheduling issues contributed to the delays in care, with staff often relying on telephone calls and postal mail to communicate with veterans.

Other roadblocks to timely referrals included providers not being available for the types of appointments veterans wanted and issues reaching providers, according to the report.

Delays in mental health consults are a problem because veterans who need the care may pose a risk to themselves and others without treatment, said Larry Reinkemeyer, assistant inspector general for audits and evaluation.

“Process improvements are needed to enable VA to meet its scheduling and appointment timeliness standards for mental health consults. Veterans who receive community care services for mental health consults represent a vulnerable group,” Reinkemeyer wrote in the report.

For the analysis, the OIG reviewed community care consults for mental health services from Oct. 1, 2024, through Sept. 30, 2025. More than 825,000 veterans received mental health treatment during that period, either directly from the VA — with more than 1 million consults to VA facilities — or 198,000 referrals for community care.

The analysts found that when an appointment did not meet the 30-day metric, scheduling delays consumed much of that window.

Community care is the VA’s program for veterans to receive medical services in the private sector with the cost covered by the VA.

By law, the VA must refer veterans to community care if the wait time for a primary or mental health care appointment at a VA facility is more than 20 days or the drive time is longer than 30 minutes.

Also by law, appointments must occur within 30 days to ensure patients have access to care.

The VA is in the process of reorganizing the management and structure of its medical arm, the Veterans Health Administration, to include reducing the number of regional offices and streamlining the leadership framework.

The reforms also will create a “Community Care Hub” designed to improve services to veterans by improving access to care, tracking payments and standardizing the referral/consult process.

The VA OIG made recommendations to improve the scheduling process, including: adjusting contracts for the companies that manage community care to ensure they can deliver timely care; evaluate its referral system to ensure that it follows best practices; improve its system for identifying available providers to ensure they can provide the care veterans want; and determine whether community care contractors can meet demand for in-person and tele health appointments.

In their response, VA officials said they have addressed several of the recommendations already and expect its new Community Care Network contracts to improve performance.

VA officials also said they were engaging with providers, its contractors and others to identify gaps and address them. They also noted that they are reviewing best practices for reaching patients and working with facilities to ensure that their schedulers are able to communicate with veterans and providers.

“The [Veterans Health Administration] greatly values the OIG’s assistance in ensuring that all stakeholders are unified in supporting VHA’s vision of providing all Veterans with access to the highest quality care,” wrote John Bartrum, the department’s former Under Secretary for Health.