Title: Mental Health Screenings for Military Service Members Transitioning to Civilian Life Description: This transition from military to civilian life can be difficult for many. Suicide rates among veterans are about 2.5 times higher during that first year of separation than for active-duty military. Both the Departments of Defense and Veterans Affairs require mental health screenings for service members as part of this transition. But how effective are these efforts? We find out more from GAO's Alyssa Hundrup. Related work: GAO-25-107205, Military to Civilian Transition: Actions Needed to Ensure Mental Health Screening at Separation Released: June 2025 [ START ] [ Alyssa Hundrup: ] It is especially important for DOD and VA to get these mental health screens right given the heightened risks of suicide and other challenges that service members face. { Music } [ Holly Hobbs: ] Hi, and welcome to GAO's Watchdog Report, your source for fact-based, nonpartisan news and information from the U.S. Government Accountability Office. I'm your host, Holly Hobbs. Each year, thousands of service members transition from military to civilian life. This transition can be difficult for many. Suicide rates among veterans are about 2.5 times higher during that first year of separation than for active-duty military. Both the Departments of Defense and Veterans Affairs require mental health screenings for service members as part of this transition. But how effective are these efforts? We'll find out more from GAO's Alyssa Hundrup, who led work for a new report on this issue. Thanks for joining us. [ Alyssa Hundrup: ] Thanks for having me, Holly. [ Holly Hobbs: ] So, Alyssa maybe we could start with--as they're leaving the military, service members are supposed to get a mental health screening. What all are they screening for? What are they looking for? [ Alyssa Hundrup: ] Yeah. So, as you noted, the transition from military to civilian life is a particularly vulnerable time for service members. So, to ensure access to mental health care or to suicide prevention services, VA and DOD are supposed to conduct mental health screenings prior to their separation. Now they've decided to do this through the use of a joint Separation Health Assessment. And within that, there are five mental health screens. So there's a screen for depression, for suicide risk, for alcohol use, PTSD, and then violence risk. And those screenings are really supposed to be a way to identify individuals potentially at high risk or in need of care. They're not really meant to be diagnostic, but rather serve as a bridge to further evaluation or treatment as may be needed. [ Holly Hobbs: ] So are service members getting these Separation Health Assessments, or SHAs, from both the VA and the DOD? [ Alyssa Hundrup: ] So right now it's really only through the VA that has implemented the SHA. DOD hasn't yet implemented it. It's in the process of conducting a pilot to do so. Right now, for separation exams that are going through the DOD, the service members are not getting those mental health screens. Now, if a service member is applying for disability claims, meaning that they have an illness or an injury and they're going through the disability process, they would go through the VA. And in that case, they would get the five mental health screens because VA has implemented the SHA. It first did that in April of 2023. And since then, VA has done 59,000 of those exams out of about 210,000 service members separating. So that means that about a quarter of the service members are getting mental health screens, as called for upon separation. [ Holly Hobbs: ] We looked at, these SHAs, did we find out anything about how reliable they are or how effective they are? [ Alyssa Hundrup: ] Yeah, we did. So we looked at the five mental health screens within the SHA. And we looked to see whether or not they're validated. And validated means that they've been tested. So they've been determined to be effective at identifying individuals at risk for a specific condition and then really reliable at yielding consistent results if they were administrated administered to the same person more than once. Research really shows that without that, it can question the effectiveness or the reliability of using that tool. So across the five screens, we found that two of the tools--they were using validated tools. And that was for depression and for suicide risk. For two of the other tools for alcohol and PTSD, the departments are using validated tools, but then they modified those tools in the screens. So, for example, for PTSD, they removed a preliminary question about responding to traumatic events. And then lastly for the violence screen, we found that was not a validated tool. The departments explained that they had that screen and other health forms, so they included it in the SHA for consistency reasons. [ Holly Hobbs: ] We actually talked to some behavioral health experts about the SHA. What did they tell us? [ Alyssa Hundrup: ] Yeah. That's right. We talked to multiple experts identified from, for example, the American Psychiatric Association or the American Medical Association. And the experts generally agree that in their validated form, the mental health screens are the standard of care for those with behavioral health concerns. And they're widely used. For the violence risk screen, however, the experts were not aware of a validated tool, and they did express concerns about the effectiveness of the departments using that screen. { MUSIC } [ Holly Hobbs: ] So Alyssa just told us that while these Separation Health Assessments can be helpful in identifying service members at risk of mental health conditions, the tools being used are not all validated. So Alyssa, what more do we think the DOD and the VA should be doing to improve their efforts? [ Alyssa Hundrup: ] So in order to ensure the most effective identification of service members at risk, the departments really need to be using validated tools. So along those lines, we recommended that the departments use validated screens. So that could be as simple as switching to an already validated screen or taking steps to validate what they're using. And we feel this is a particularly important because when we looked at data that VA had on its use of the screens, we found that over half of service members were screening positive for PTSD. So the departments really need to ensure they're getting it right. And what that means is not missing people, who would have actually screened positive, or for, you know, giving false positives, which might tell somebody that they have a condition or a concern when that's not actually the case. [ Holly Hobbs: ] And last question, what's the bottom line of this report? [ Alyssa Hundrup: ] The bottom line is that it is especially important for DOD and VA to get these mental health screens right given the heightened risks of suicide and other challenges that service members face. By implementing our recommendations to use validated mental health screens across the five areas, they can better ensure the effectiveness of the tool, which really means getting service members the appropriate level of care. [ Holly Hobbs: ] That was Alyssa Hundrup talking about our new report on mental health screenings. Thanks for your time, Alyssa. [ Alyssa Hundrup: ] Thank you. [ Holly Hobbs: ] And thank you for listening to the Watchdog Report. To hear more podcasts, subscribe to us on Apple Podcasts, Spotify, or wherever you listen. And make sure to leave a rating and review to let others know about the work we're doing. For more from the congressional watchdog, the U.S. Government Accountability Office, visit us at GAO.gov. [ END ]