Guideto

VA MentAl HeAltH SerViceS

forVeterans & Families
It takes the strength and courage { of a warrior to ask for help. }

South Central Veterans Integrated Service Network (VISN) 16

Mental Illness Research, Education, and Clinical Center (MIRECC) 

Consumer Guide Workgroup

Greer Sullivan, MD, MSPH

Director, South Central MIRECC

Kimberly Arlinghaus, MD

Associate Director for Clinical Care, South Central MIRECC

Carrie Edlund, MS

Research Associate, South Central MIRECC

Michael Kauth, PhD

Co-Director and Associate Director for Education, South Central MIRECC

We Wish to express our thanks to the many Veterans, clinicians, and 

administrators who gave us valuable guidance and feedback on translation of VA 

policy into a simple, direct, and easily understandable document for Veterans and 

their family members. In particular, we thank the South Central Mental Illness 

Research, Education, and Clinical Center (SC MIRECC) Consumer Advocacy Board 

who have collectively kept the SC MIRECC’s researchers, clinicians, and educators 

“on track” for many years. So many individuals have contributed to this document 

that it is not possible to list them all. However, we want to acknowledge that the help 

we received was truly invaluable.

January 2011
579113579Guide to VA Ment Guide to VA MentAl HeAltH SerViceS for Veterans and Families Al HeAltH SerViceS

Some wounds are invisible. 3Guide to VA MentAl HeAltH SerViceS for Veterans and FamiliesSome wounds are invisible.

Guideto

VA MentAl HeAltH SerViceS

forVeterans & Families

n 2008, VA introduced a new mental health 

handbook that provides guidelines for VA 

hospitals and clinics across the US. The new 

handbook specifies exactly what mental health 

s

I

ervices VA hospitals and clinics are required to offer 

to Veterans and their families. The requirements differ 

depending on the size and type of VA hospital or clinic 

but apply across the entire VA system.

This brochure is a shorter, simplified version of the handbook intended for the general 

member of a Veterans Service 

 VA mental health care you can 

our local or regional VA health 

of mental health care. Then, we 

public. If you are a Veteran, Veteran family member, 

Organization, or member of another group interested in

use this handbook to learn what mental health services y

care facility has pledged to provide to Veterans.

In this brochure, we first describe the guiding principles 

explain how to find mental health care and the different treatment settings where VA 

offers mental health care, such as hospitals (inpatient care) or clinics (outpatient care) 

or through telemedicine (where mental health providers in one location can talk with, 

evaluate, and treat Veterans at another location through a closed-circuit television). We 

provide information about the types of treatments available for the most common mental 

health problems of Veterans (such as depression, substance abuse, and posttraumatic 

stress disorder) and describe the special programs offered for particular groups of 

Veterans (such as women Veterans, homeless Veterans or older Veterans).

Finally, Appendix A shows the mental health services VA hospitals and clinics are 

required to provide, and the glossary defines common VA mental health terms. Use 

this information to find out what services your VA hospital or clinic should be able to 

offer you.
4Guide to VA MentAl HeAltH SerViceS for Veterans and Families

It takes the strength and courage of a warrior to ask for help. 

PrinciPleS tHAt Guide VA MentAl HeAltH cAre for VeterAnS

Certain basic principles form the foundation of all VA mental health care. They are:

■ Focus on Recovery – VA is committed to a recovery-oriented approach to 

mental health care. Recovery empowers the Veteran to take charge of his/her 

treatment and live a full and meaningful life. This approach focuses on the 

individual’s strengths and gives respect, honor, and hope to our nation’s heroes 

and their families.

■ Holistic Coordinated Care – VA health care providers coordinate with each 

other to provide safe and effective treatment for the “whole” person—head 

to toe. Many Veterans begin mental health care with their VA primary care 

provider. VA believes Veterans can continue to be treated for many mental 

illnesses in primary care or referred for more intensive treatment to specialty 

mental health care. Also, most VAs have chaplains available to help Veterans 

with their spiritual or religious wellbeing. Having a healthy body, satisfying 

work, and supportive family and friends, along with getting appropriate 

nutrition and exercising regularly are just as important to mental health as to 

physical health.

■ Mental Health Treatment in Primary Care – Like a quarterback, the 

primary care provider directs the Veteran’s overall care by coordinating services 

among a team of providers. If you are experiencing mental health problems, 

talking to your primary care provider is a good place to start. Many times your 

mental health problem can be evaluated and treated by your primary care 

provider, with extra help from a case manager who can stay in close contact 

with you. There are also mental health providers on primary care teams to offer 

guidance to your primary care provider when needed. When more complex 

or intensive care is needed, your primary care provider will refer you to a 

specialized mental health program for further treatment.

■ Principal Mental Health Provider (PMHP) – Every Veteran who sees a 

mental health specialist is getting “specialty mental health care.” The mental 

health specialist might be a psychiatrist, psychologist, social worker or 

counselor. Veterans who receive specialty mental health care have a Primary 

Mental Health Provider (PMHP). The PMHP is the Veteran’s main contact for 

all specialty mental health services. The PMHP’s job is to coordinate a mental 

health treatment plan for the Veteran. The plan combines Veterans’ (and their 

families’) goals with mental health specialists’ recommendations.

■ Around-the-Clock Service – Emergency mental health care is available 24 

hours per day, 7 days per week at VA medical centers. If your VA does not 

have a 24-hour emergency room, it must provide these services through a 

local, non-VA hospital. Telephone evaluations at VA medical centers and the 

national suicide hotline are also available 24/7.

■ Care That is Sensitive to Gender and Cultural Issues – VA health care 

providers receive training about military culture, gender differences, and 

ethnic issues in order to better understand each Veteran. In situations where a 

Veteran might feel more comfortable with a same-sex provider (or an opposite 

sex provider), VA will make every effort to arrange gender-specific care. 
579113579Guide to VA Ment Guide to VA MentAl HeAltH SerViceS for Veterans and Families Al HeAltH SerViceS

Some wounds are invisible.

17

18

19

20

23

21

22

20 12

11

10

15

9

16

6

2

1

4

5 3

7

8

21

8 includes:

Puerto Rico

U.S. Virgin Islands

21 includes:

Guam

American Samoa

Philippines
6Guide to VA Men HeAltH Ser tAl cVi eS for Veterans and Families

It takes the strength and courage of a warrior to ask for help. 

How You cAn find tHe MentAl HeAltH cAre You need

If you have a mental health emergency (like wanting to hurt yourself or 

someone else), go to the nearest hospital emergency room or call 911. If it is not a VA 

hospital, you may be able to move to a VA facility depending on your circumstances. 

If you are feeling suicidal, you can also call the National Suicide Prevention Lifeline 

1-800-273-TALK (8255) and press 1 for the Veterans Suicide Prevention Hotline, or 

visit http://www.suicidepreventionlifeline.org/ and click on Veterans Chat Live with 

a Counselor. Mental health professionals are available to talk with you 24 hours 

per day. 

If you have a mental health problem and have never been seen in a VA hospital or 

clinic, call VA general information hotline at 1-800-827-1000 or visit VA’s website 

at www.va.gov. You will be able to find the address and phone number of a VA 

hospital or clinic near you. Some Veterans begin the process of finding mental 

health care through a Veterans Center. Homeless Veterans can get help finding 

mental health care at a Veterans drop-in center. 

If you are already using VA medical services, ask your primary care provider to arrange 

for you to see a VA mental health provider.

How You know if You HAVe A MentAl HeAltH ProbleM

Sometimes it can be hard to tell. Since the brain and body affect one another, mental 

problems can cause physical problems along with changes in thinking, feeling, and 

behavior. In addition to commonly recognized emotional problems, like feeling 

very sad or nervous, symptoms and signs of mental health problems can include: 

■ changes in sleep, appetite, weight, or sex life

■ headaches or other physical pain

■ muscle tension and weakness

■ decreased energy, motivation, or interests

■ problems with attention, concentration, or memory

■ irritability, anger, or “short temper”

■ feelings of guilt, worthlessness, helplessness, or hopelessness

■ unhealthy behaviors (misusing drugs, alcohol, food, sex, or other behaviors 

like gambling or spending too much money to cope with stress or emotions) 

■ problems functioning at home, work, or school

The most important thing to remember is to talk with your primary care or mental 

health provider when you notice new symptoms or problems. Your health care 

team can help you figure out what’s going on and what to do about it.
579113579Guide to VA Ment Guide to VA MentAl HeAltH SerViceS for Veterans and Families Al HeAltH SerViceS

Some wounds are invisible.

A

l He

a

lt

h Ser

vice

s for Veterans and Families

Some wounds are invisible.
8Guide to VA MentAl HeAltH SerViceS for Veterans and Families

It takes the strength and courage of a warrior to ask for help. 

■ residential care for Veterans with a wide range of mental health problems and/

or rehabilitative care needs (such as homelessness, job training, and education) 

who would benefit from living in a structured environment for a period of time 

(see Appendix B).

■ Supported work settings to help Veterans join the work force and live well in 

the community (see Appendix C for more details) 

Different treatment settings are appropriate for different problems at 

different times. For example, a severely ill or suicidal Veteran might 

need inpatient treatment in a hospital for several days. When the 

illness becomes less severe, he or she may return home and receive 

treatment as an outpatient in a VA clinic. 

For Veterans who receive inpatient mental health treatment, VA will 

check on the Veteran’s progress within one week after she/he leaves the 

hospital. This evaluation might be by telephone or, possibly, in person, 

just to make sure the Veteran is doing well. VA will also ask the Veteran 

to come back for a follow-up appointment no later than two weeks 

after discharge from the hospital. 

In addition, Veterans who live a long distance from a VA medical center can still 

receive treatment through telemedicine. In many parts of the country, especially 

in rural areas, there may not be very many providers experienced in treating 

mental health problems. To remedy this situation VA offers treatment through 

telemedicine. That is, mental health providers located at larger VA medical centers 

can talk with, evaluate, and provide treatment for Veterans at smaller communitybased VA clinics through a special closed-circuit television. Telemedicine services, 

like face-to-face mental health services, are confidential. More and more VA clinics 

are using telemedicine technology to connect patients with specialists who are not 

on-site. For example, if you are a Veteran living in a rural area and need specialized 

care for PTSD that is not available at your local VA clinic, you may receive this 

treatment from a PTSD specialist at another VA location using telemedicine 

technology. 

treAtMentS for SPecific MentAl illneSSeS 

VA offers treatment for a wide range of mental health problems. These problems 

include, but are not limited to, depression, anxiety, posttraumatic stress disorder 

(PTSD), substance abuse, bipolar disorder, and schizophrenia. Treatments such as 

medications, psychotherapies (talk therapies), and psychosocial rehabilitation and 

recovery services help the Veteran along the road to recovery. VA uses treatments 

that have been proven to be effective for specific mental health disorders. These 

proven treatments are called evidence-based treatments.

Examples of common mental health treatments for Veterans include: 

Treatments for Depression and Anxiety. Depression and Anxiety are common 

among the general public and among Veterans. Treatments include:

■ Antidepressant medications, anti-anxiety medications, and medications to 

ease sleep and other problems
579113579Guide to VA Ment Guide to VA MentAl HeAltH SerViceS for Veterans and Families Al HeAltH SerViceS

Some wounds are invisible. Some wounds are invisible.

■ Talk therapies, such as: 

◆ Cognitive behavioral therapy (CBT) to help individuals understand the

relationship between thoughts, emotions, and behaviors, learn new patterns

of thinking, and practice new positive behaviors (relaxation techniques,

using calming tapes to improve sleep, exercising, or socializing with friends)

◆ Acceptance and commitment therapy (ACT) to help people overcome

their struggles with emotional pain and worries. It helps them recognize,

commit to, and achieve what’s important to them

◆ Interpersonal therapy (IPT) to help people promote positive relationships

and resolve relationship problems

treAtMentS for SubStAnce AbuSe

Substance abuse problems are common in the general public and among Veterans. 

When Veterans have trouble readjusting to civilian life, some turn to substances 

to help them cope. Persons can abuse or become addicted to alcohol, tobacco, and 

illegal drugs and misuse prescription medications. Treatments for substance abuse 

include:

■ Medications, such as Acamprosate or Naltrexone, to decrease cravings for alcohol 

and medications to ease withdrawal (“detox”) from alcohol and drugs. Medications 

like buprenorphine and methadone can also be used as therapeutic substitutes 

for illegal drugs (heroin) or addictive prescription pain medications.

■ Talk therapies, such as:

◆ Motivational enhancement therapy to help the individual strengthen 

his/her commitment to getting clean and sober 

◆ Cognitive behavioral therapy to help the individual identify the needs 

that alcohol/drugs meet and learn new ways of meeting those needs. 

In this way, the individual develops new coping skills to avoid relapse. 

■ Opioid Treatment Programs (OTPs) that include illegal substances, such as heroin 

and some prescription pain medications. Opioid Treatment Programs offer talk 

therapies and provide medications like methadone and buprenorphine to help 

Veterans stop abusing opioids. These medications work as carefully-monitored 

substitutes for the drugs of abuse. Methadone can only be obtained in methadone 

maintenance programs located at some VA hospitals. But buprenorphine, a newer 

medication similar to methadone, can be prescribed by any physician who has 

received training, even a primary care physician. This means that Veterans who 

live far from VA OTPs can receive buprenorphine from a primary care provider or 

psychiatrist at their local community based outpatient clinic.

■ Residential treatment programs for substance abuse allow Veterans to live 

at a treatment facility, usually for 30-90 days, while undergoing intensive 

treatment. This treatment environment provides support and structure to help 

the Veteran achieve long-term recovery. See Appendix B for more information 

about residential treatment options.

■ Work therapies are commonly prescribed for Veterans to promote and support 

recovery as Veterans learn to live clean and sober lives (see Appendix C).
treAtMentS for PoSttrAuMAtic StreSS diSorder (PtSd)

Posttraumatic stress disorder can occur after a person has a very 

serious or life threatening traumatic experience. For Veterans, this life 

threatening event often occurs during combat. However, other noncombat related events – such a natural disasters, motor vehicle accidents, 

or sexual trauma – can also threaten life and can result in PTSD. VA has 

been a national leader in the development of talk therapies for PTSD. 

Treatments for PTSD include:

■ Antidepressant medications, anti-anxiety medications, mood stabilizing 

medications, and other medications to ease nightmares, irritability, 

sleeplessness, depression, and anxiety

■ Talk therapies:

◆ Cognitive behavioral therapy (CBT) to help individuals understand 

the relationship between thoughts, emotions, and behaviors, learn new 

patterns of thinking, and practice new positive behaviors

◆ Cognitive processing therapy (CPT), a form of CBT that involves writing 

about one’s traumatic experience and correcting negative thought patterns 

so that memories of trauma don’t interfere with daily life

◆ Prolonged Exposure Therapy (PE) to help people reduce fear and anxiety 

triggered by reminders of the trauma. This is done by confronting (or being 

exposed to) trauma reminders in a safe treatment environment until they 

are less troubling. In this way, individuals can stop avoiding and reacting to 

trauma reminders and live their lives more fully in the present with greater 

freedom from the past. 

■ Residential care for longer-term, intensive treatment within a structured 

setting (see Appendix B) 

10Guide to VA MentAl HeAltH SerViceS for Veterans and Families

It takes the strength and courage of a warrior to ask for help. 
579113579Guide to VA Ment Guide to VA MentAl HeAltH SerViceS for Veterans and Families Al HeAltH SerViceS

Some wounds are invisible.

■ Psychosocial Rehabilitation and Recovery Services to optimize functioning 

(see Appendix D).

■ Work therapies to promote and support recovery (see Appendix C).

■ Residential care for longer-term, intensive treatment within a structured 

setting (see Appendix B).

■ Mental Health Intensive Case Management (MHICM). A team of mental 

health doctors, nurses, and social workers that treat Veterans in their homes 

and community. MHICM helps Veterans experiencing severe mental illness 

have less need for hospitalization and live more successfully at home and in 

the community. 

SPeciAl ProGrAMS for VeterAn PoPulAtionS witH 

SPeciAl needS

VA recognizes that some groups of Veterans have special mental health needs. 

In response to these needs, VA has developed special programs tailored for 

these groups. VA special programs include: 

■ Services for Women Veterans

 Several women’s inpatient units, residential treatment programs, or 

special treatment tracks for women exist. In addition, mixed gender 

inpatient units or residential treatment centers must ensure safe and 

secure sleeping and bathroom arrangements, including, but not limited 

to, door locks and proximity to staff. Each regional VA network (called 

a VISN) must have residential care programs able to meet the needs of 

women Veterans. However, the needs for some types of sub-specialty 

care (e.g., women with PTSD) may be limited, and women Veterans who 

need these services may be referred to regional or national resources.

■ Suicide Prevention Services

◆ Suicide prevention coordinators work with mental health care teams to 

monitor and support Veterans at high risk for suicide

◆ National Suicide Prevention Lifeline: 

1-800-273-TALK (8255) (press 1 for Veterans Suicide Hotline) or go to 

http://www.suicidepreventionlifeline.org/

◆ A personal safety plan that helps the Veteran recognize signs that 

often precede his/her suicidal ideas and lists strategies that help the 

Veteran manage those thoughts and feelings. The plan also identifies 

people that the Veteran can turn to for help. Safety plans are created 

with the mental health provider and the Veteran (including family 

members, if desired). This way, a plan is designed specifically for the 

Veteran and his/her problem areas.
12Guide to VA MentAl HeAltH SerViceS for Veterans and Families

It takes the strength and courage of a warrior to ask for help. 

■ Services for Veterans Just Returning From Deployment

VA operates 232 community based counseling Vet Centers. Many providers 

at Vet Centers are Veterans themselves. Vet Centers provide readjustment 

counseling and outreach services to all Veterans who served in any combat 

zone. Military Sexual Trauma counseling and bereavement counseling are also 

provided. Services are available for family members for military related issues, 

and bereavement counseling is offered for parents, spouses, and children of 

Armed Forces, National Guard, and Reserves personnel who died in the service 

of their country. Veterans have earned these benefits through their service, and 

all are provided at no cost to the Veteran or family. 

■ Military Sexual Trauma Services

Veterans who experienced military sexual trauma (MST) may develop PTSD 

and/or other mental illnesses. Any Veteran who was sexually traumatized 

while serving in the military, can receive counseling. This is true for both 

male and female Veterans who served in any era. Special inpatient, outpatient, 

and residential treatment programs are available to male and female Veterans 

who experienced MST, using proven medications, talk therapies, and social 

supports. Veterans receiving MST-related counseling or treatment are not 

billed for inpatient, outpatient, or medication copayments. 

■ Services for Homeless Veterans

◆ 1-877-4AID VET (877-424-3838) or 

http://www1.va.gov/HOMELESS/NationalCallCenter.asp

◆ Outreach to Veterans living on the streets and in shelters who otherwise 

would not seek help 

◆ Drop in centers where homeless Veterans can shower, get a meal, and get 

help with a job or getting back into society

◆ Medical treatment for physical and mental disorders, including substance 

abuse

◆ Emergency shelter referral (temporary housing must be arranged within 

three days of shelter placement)

◆ Transitional housing in community-based programs

◆ Referral to permanent housing through the use of rental assistance 

vouchers with case management

◆ Long-term assistance, case management, and rehabilitation

◆ Employment assistance 

◆ Residential treatment (see Appendix B).
■ Services for Veterans Involved with the Criminal Justice System 

(Justice-Involved Veterans)

◆ Mental health assessments for Veterans charged with offenses (usually 

non-violent crimes) that allow for community-based alternatives to 

jail or prison

◆ Assistance for Veterans to connect them with VA care and services 

when they are released from state or federal prisons

579113579Guide to VA Ment Guide to VA MentAl HeAltH SerViceS for Veterans and Families Al HeAltH SerViceS

Some wounds are invisible.

■ Services for Older Veterans

◆ VA Community Living Centers (CLCs) for Veterans needing 

temporary assisted care until they can return home or find placement 

in a nursing home 

◆ Home-based Primary Care that includes a mental health professional 

as part of the team providing care to Veterans in their homes

◆ Screening for dementia like Alzheimer’s disease and/or other 

problems that interfere with memory 

◆ Assessments that help decide whether the Veteran can safely live at 

home and make informed medical decisions 

VeterAnS MentAl HeAltH councilS

These important groups provide a way for people (Veterans, their families, and 

community groups) who “consume” VA services to offer input to VA leaders about 

the structure and operations of mental health services. Each facility is strongly 

encouraged to implement and maintain a local Veterans Mental Health Council. 

Each Council has a VA mental health staff member as a liaison. Councils may 

include several different kinds of members: 

■ Veteran consumers and family members of consumers

■ Veteran consumer advocates, such as: 

◆ Veteran Service Organizations (VSOs) 

◆ Representatives from the National Alliance on Mental Illness 

e (DBSA), 

entatives

(NAMI), Depression and Bipolar Support Allianc

and other mental health advocacy groups 

◆ Local community employment and housing repres

If you’re concerned about getting the care you need,

talk to your provider about other treatment options.
14Guide to VA MentAl HeAltH SerViceS for Veterans and Families

It takes the strength and courage of a warrior to ask for help. 

Hours of Care Medical Center Very Large 

CBoC

(more than 

10,000 Veterans 

per year)

Large CBoC

(5,000-10,000 

Veterans per year)

Mid-sized CBoC

(1,500-5,000 

Veterans per year)

Small CBoC

(fewer than 1,500 

Veterans per year)

Additional 

evening, early 

morning, or 

weekend hours 

(check location 

for more info)

Must provide as 

needed to meet 

needs of patient 

population

Must provide as 

needed to meet 

needs of patient 

population

Strongly 

encouraged to 

provide

Strongly 

encouraged to 

provide

Strongly 

encouraged to 

provide

Emergency care Immediate onsite 24/7 (in larger 

medical centers 

a mental health 

provider is available 

in the emergency 

department from 

7 am to 11 pm)

Immediate onsite during hours 

of operation 

and/or local 

community 

emergency 

department 24/7

Direct patients to 

nearby emergency 

department ➢

Direct patients to 

nearby emergency 

department ➢

Direct patients to 

nearby emergency 

department ➢

The RANGE program might be available in some rural areas for Veterans with SMI.

1 CBT= cognitive behavioral therapy 4

 ACT= acceptance commitment therapy 2

 MHICM= mental health intensive case management 5 PRRC= psychosocial rehabilitation and recovery centers 3

 IPT= interpersonal therapy 6 IOP= intensive outpatient program
579113579Guide to VA Ment Guide to VA MentAl HeAltH SerViceS for Veterans and Families Al HeAltH SerViceS

Some wounds are invisible.

Mental Illness/

Problem

Medical Center Very Large CBoC

(more than 10,000 

Veterans per year)

Large CBoC

(5,000-10,000 

Veterans per year)

Mid-sized CBoC

(1,500-5,000 

Veterans per year)

Small CBoC

(fewer than 1,500 

Veterans per year)

Posttraumatic Stress 

Disorder (PTSD)

Specialized 

outpatient 

programs; 

evidence-based 

talk therapies 

(cognitive 

processing 

therapy, 

prolonged 

exposure therapy) 

on-site 

Specialized 

outpatient 

programs; 

evidence-based talk 

therapies (cognitive 

processing therapy, 

prolonged exposure 

therapy) on-site ■

Evidence-based talk 

therapies (cognitive 

processing therapy, 

prolonged exposure 

therapy) on-site ■

or through 

telemedicine ◆

Evidence-based talk 

therapies (cognitive 

processing therapy, 

prolonged exposure 

therapy) on-site ■

or through 

telemedicine ◆

General and 

specialty services 

on-site ■ or via 

telemedicine ◆,

[referral to 

residential 

treatment 

program, VA 

medical center, 

or community 

■ services ➢]

Schizophrenia,

Schizoaffective 

Disorder, Bipolar 

Disorder, Depression

Anxiety

General and 

specialty services; 

MHICM2

; PRRC5; 

family services; 

skills training; 

peer support; 

evidence-based 

therapies (CBT1, 

ACT4, IPT3) 

for depression/

anxiety on-site ■

General and 

specialty services; 

family services; 

skills training; peer 

support; evidencebased therapies for 

depression/anxiety 

[MHICM2

, PRRC5]

on-site ■

Majority of general 

and specialty 

services on-site ■

or via telemedicine 

◆; evidence-based 

therapies for 

depression/anxiety 

on-site ■ or through 

telemedicine ◆; 

[referrals to VA 

medical center 

or community 

services ➢] 

General and 

specialty services 

on-site ■ or via 

telemedicine ◆, 

referral to residential 

treatment program, 

VA medical center, 

or community 

services ➢ evidencebased therapies for 

depression/anxiety 

on-site ■ or through 

telemedicine ◆

General and 

specialty services 

on-site ■ or via 

telemedicine ◆, 

referral to 

residential 

treatment 

program, VA 

medical center, 

or community 

services ➢

Substance Use 

Disorders

(alcohol, drugs, 

prescription 

medications, 

tobacco)

General and 

evidence-based

specialty services;

inpatient or

outpatient

detoxification;

opioid treatment

programs

providing

methadone at

some medical

centers

[IOP6]; specialized 

outpatient 

treatment programs 

with evidencebased therapies 

and medication 

management 

on-site ■

Specialized 

outpatient programs; 

evidence-based 

therapies on-site ■

or through 

telemedicine ◆

Specialized 

outpatient programs; 

evidence-based 

therapies on-site ■

or through 

telemedicine ◆

General and 

specialty services 

on-site ■ or via 

telemedicine ◆, 

referral to 

residential 

treatment 

program, VA 

medical center, 

or community 

services ➢

Homelessness Shelter and 

emergency services, 

homelessness 

outreach specialist 

and community 

links

Shelter and 

emergency services, 

homelessness 

outreach specialist 

and community 

links

Referrals to 

community 

providers for shelter, 

temporary housing, 

or basic emergency 

services ➢

Referrals to 

community 

providers for shelter, 

temporary housing, 

or basic emergency 

services ➢

Referrals to 

community 

providers for 

shelter, temporary 

housing, or 

basic emergency 

services ➢

■ On-site ◆ Telemedicine ➢ Referral to VA facilities or community providers
16Guide to VA MentAl HeAltH SerViceS for Veterans and Families

It takes the strength and courage of a warrior to ask for help. 

Domiciliary Residential Rehabilitation Treatment Programs (DRRTP) - A DRRTP provides residential 

care for Veterans, treating medical and psychiatric problems, substance use disorders, PTSD, and homelessness. 

DRRTPs provide a 24 hours per day, 7 days per week, structured and supportive residential environment as a 

part of rehabilitative treatment. DRRTPs are larger residential programs with multiple units serving various 

patient populations. 

Domiciliary Care for Homeless Veterans (DCHV) - DCHVs provide a 24/7 structured and supportive 

residential environment as a part of the rehabilitative treatment. 

Health Maintenance Domiciliary - Health Maintenance Domiciliary beds provide residential care for Veterans, 

treating medical and psychiatric problems, substance use disorders, PTSD, and homelessness. Health Maintenance 

Domiciliary beds provide a structured and supportive residential environment 24/7 as a part of rehabilitative 

treatment. Health Maintenance Domiciliary beds focus on symptom reduction and stabilization as part of the 

rehabilitative approach to facilitating community integration. 

General Domiciliary (General Dom) or Psychosocial Residential Rehabilitation Treatment Programs 

(PRRTP) - These programs provide residential care for the general Veteran population, treating medical and 

psychiatric problems, substance use disorders, PTSD, and homelessness. General Doms and PRRTPs provide a 24/7 

structured and supportive residential environment as a part of rehabilitative treatment. 

Domiciliary PTSD (Dom PTSD) or Posttraumatic Stress Disorder Residential Rehabilitation 

Treatment Program (PTSD-RRTP)- These programs provide residential care for Veterans with PTSD including 

Military Sexual Trauma (MST). Both Dom PTSD and PTSD-RRTPs provide a 24/7 structured and supportive 

residential environment as a part of PTSD rehabilitative treatment.

Domiciliary SA (Dom SA) or Substance Abuse Residential Rehabilitation Treatment Program 

(SARRTP) - These programs provide residential care to Veterans with substance use disorders. Dom SA and 

SARRTP provide a 24/7 structured and supportive residential environment as a part of substance use disorder 

rehabilitative treatment. 
579113579Guide to VA Ment Guide to VA MentAl HeAltH SerViceS for Veterans and Families Al HeAltH SerViceS

Some wounds are invisible.

Compensated Work Therapy-Transitional Residence (CWT-TR) - A general CWT-TR is not targeted 

exclusively for any particular mental health population and provides TR services. General CWT-TR offers 

therapeutic work-based residential rehabilitation services designed to help Veterans return to their communities. 

For more information, see http://www1.va.gov/HOMELESS/docs/DCHV_Definitions_of_MHRRTPs.pdf 
18Guide to VA MentAl HeAltH SerViceS for Veterans and Families

It takes the strength and courage of a warrior to ask for help. 

Glossary and links to More inforMation

■ ACT—Acceptance and Commitment Therapy. A proven talk therapy for depression, anxiety, and PTSD. ACT helps 

people overcome their struggles with emotional pain and worries. It helps them learn to recognize, commit to, 

and achieve what’s important to them.

■ CBT—Cognitive Behavioral Therapy. A proven talk therapy for depression, anxiety, and PTSD. CBT helps people 

learn new patterns of thinking and practice new positive behaviors.

■ CLC—Community Living Center. A short-term home for Veterans who need temporary assisted care until they 

can return home or find placement in a nursing home. Also a long-term home for Veterans who cannot stay in a 

community nursing home or who need end-of-life care. For more information, visit: 

http://www1.va.gov/GeriatricsSHG/page.cfm?pg=52 

■ CPT—Cognitive Processing Therapy. A proven talk therapy for depression, anxiety, and PTSD. CPT helps people 

learn new patterns of thinking so their memories of trauma do not interfere with their daily lives. CPT uses some 

exposure therapy (see definition of “PE–Prolonged Exposure Therapy” below).

■ CWT—Compensated Work Therapy. CWT is a recovery-oriented vocational program that is part of VA’s services 

to help Veterans return to work. For more information, visit: http://www.cwt.va.gov/ 

■ Dementia—Loss of memory and intellectual capacity that is severe enough to limit a person’s ability to function. 

Alzheimer’s disease is one common cause of dementia.

■ Domiciliary—A safe, home-like facility where Veterans live for a short time while they “get back on their feet.” 

They receive services that help them get a job, return to school, improve social skills, and address physical and 

mental health problems. 

■ DRRTP—Domiciliary Residential Rehabilitation and Treatment Program. The coordinated treatment programs VA 

provides to Veterans living in domiciliaries. For more information, see Appendix C or: http://www1.va.gov/

HOMELESS/DCHV.asp 

■ Evidence-based Therapy—Evidence-based therapies (or “proven” therapies) have been developed and studied 

scientifically. They are proven to be safe and very effective. 

■ Incentive Therapy—A pre-vocational program for Veterans to perform work at VA Medical Centers.

■ IOP—Intensive Outpatient Program. At least nine hours per week of outpatient treatment.

■ IPT—Interpersonal therapy. A proven treatment for depression, anxiety, and PTSD. Interpersonal therapy focuses 

on a person’s relationships with other people. The therapy helps people promote positive relationships and resolve 

relationship problems.

■ MHICM-RANGE—Mental Health Intensive Case Management Rural Access Network Growth Enhancement Program.

In MHICM, a team of mental health doctors, nurses, and social workers treats patients in their homes in the 

community. MHICM helps Veterans experiencing severe mental illness have less need of hospitalization and live 

better at home in the community. In some cases, MHICM teams can serve rural areas as well.

■ MST—Military Sexual Trauma. MST is sexual assault during military service. It includes uninvited sexual 

advances or contact or forced sex while in the military and happens to men and women. MST can cause mental 

and physical problems. Every VA facility has a designated MST Coordinator who serves as a contact person for 

MST-related issues. For more information, visit: http://www.publichealth.va.gov/womenshealth/trauma.asp 
579113579Guide to VA Ment Guide to VA MentAl HeAltH SerViceS for Veterans and Families Al HeAltH SerViceS

Some wounds are invisible.

GloSSArY

■ Peer Support—Veterans who have experienced mental illness themselves provide support to fellow Veterans 

struggling with similar issues.

■ Primary Care Provider—The provider (doctor, nurse, or counselor) who manages the Veteran’s basic physical 

and mental health problems and coordinates all of the Veteran’s medical care. When a Veteran needs to see a 

specialist, the primary care provider makes a referral to the specialist.

■ Principal Mental Health Provider—The mental health provider (doctor, nurse, or counselor) who manages 

the Veteran’s mental health problems and coordinates the Veteran’s mental health care.

■ PE—Prolonged Exposure Therapy. A proven treatment for PTSD. Prolonged exposure therapy helps people relive 

traumatic memories in a safe environment. Veterans first remember the trauma by retelling it. Then they slowly 

become more comfortable with sights, sounds, and smells that remind them of the trauma. The memories become 

less troubling and interfere less with the person’s daily life. 

■ PRRC—Psychosocial Rehabilitation and Recovery Centers. PRRCs are outpatient programs that help the Veteran 

learn to more fully participate in his or her community. They use a recovery approach to help Veterans 

function better in their communities. PRRCs treat Veterans with severe mental illnesses, like major depression, 

schizophrenia, bipolar disorder, and schizoaffective disorder. 

■ PTSD—Posttraumatic Stress Disorder. An anxiety disorder that may sometimes result when a person experiences 

a traumatic event. PTSD symptoms can disrupt daily life. They include re-experiencing the trauma and emotional 

distancing from other people or feeling emotionally numb. Other symptoms include being irritable or quick to 

anger, trouble sleeping, fearfulness, substance abuse, and feelings of panic. For more information: http://www.

ptsd.va.gov/public/pages/what-is-ptsd.asp

■ RRTPs—Residential Rehabilitation Treatment Programs. RRTPs offer a comprehensive, therapeutic temporary 

residence for Veterans undergoing intensive treatment. This treatment environment provides support and 

structure to help the Veteran make a long-term recovery and achieve his or her highest level of community 

integration.

■ Specialty Mental Health—Mental health services are provided by a mental health specialist (psychiatrist, 

psychologist, social worker, or counselor). Specialty mental health treatments are usually offered for Veterans with 

serious mental illnesses like schizophrenia, depression or bipolar disorder, PTSD, and substance use disorders.

■ Supported Employment—An evidence-based program that helps Veterans with serious mental illness or a 

combination of physical impairments and mental illness be successful in the workplace. 

■ Telemedicine, or Telemental Health—A cutting edge technology that allows a clinical provider to care for 

a patient from a remote location, using a camera and special TV that allows the patient and provider to see 

and hear one another. Telemental health can be used to perform assessments and conduct individual or group 

psychotherapy and medication management. 

■ Transitional Work Experience—TWE offers work assignments in VA Medical Centers or community 

businesses. TWE helps Veterans gain work experience while getting therapeutic rehabilitation and preparation 

for community employment.
South central (ViSn 16) Mental illness research, 

education, and clinical center (Mirecc)

South Central

MIRECC

Additional copies available at

www.mirecc.va.gov/ViSn16

or contact Michael.kauth@va.gov