A Pentagon program designed to cover a “vulnerable” mental health period for military members failed to reach 70% of those enrolled, a federal watchdog found. The program, named inTransition, is charged with connecting service members with mental health services as who are in periods of “transition” like leaving the military or returning home from a deployment.
But the program often waits 2 or 3 months to initiate contact with members, and made contact with less than 1-in-3, the Government Accountability Office report found this week.
“The Department concurs with the GAO recommendations. The DoD, along with our partners at VA, are committed to improving access to mental health, especially during the critical military to civilian transition period,” a Defense Department spokesperson told Task & Purpose.
The GAO found that the program didn’t connect with more than 70% of automatically enrolled service members in 2022 (roughly 65,500 out of 91,000) because of its limited outreach strategy using telephone calls. Program officials called cold calls “an outdated form of communication” but said that they are required to use telephone calls as a primary contact method and that email or text required a policy change.
The GAO also said that the program could benefit from expanding to email, text or location services to reach more enrollees. But as of January 2024, the contractor did not have plans to incorporate texting into its outreach strategy.
Many programs but little awareness
The Defense Department and Department of Veterans Affairs have instituted a slew of programs aimed at connecting service members coming home from a deployment or leaving the military with mental health services. The DOD’s inTransition program is aimed at military members whose duties and careers are in transition, either after deployment, a PCS or separating. Though open to all, troops are automatically enrolled in the program if they received mental health or traumatic brain injury care in the year prior to their separation.
Part of the problem, the GAO found may be that the joint Defense Department and Department of Veterans Affairs committee in charge of overseeing all transition activities, does not assess “the effectiveness of these efforts overall.” This means there’s no concept of how successful or effective service member and veteran transition programs are. The GAO recommended that the committee start a tracking system for better service member outcomes.
The VA agreed with the GAO’s recommendation to track these services and said joint DOD-VA subcommittees would establish plans of action, milestones, and metrics “to identify gaps or duplicative efforts.”
According to the contractor that runs inTransition, its workers call service members up to three times to ask if they want to remain enrolled or use the program’s services. When they fail to connect with the servicemember, they mark the case as “unresponsive” and disenroll them from the program. A GAO analysis of 2022 data showed that 66% or nearly 60,000 service members were unenrolled this way.
The GAO also found that in some cases, the contractor was unable to make the three phone calls because the DOD did not have accurate contact information. In 2022, more than 5,700 people who were automatically enrolled could not be contacted.
When the GAO analyzed 2022 acceptance rates for service members who were contacted and not already using mental health services, they found that about 30% opted to remain enrolled – this means that successful engagement would mean higher acceptance rates for the program, the report said.
“Setting performance goals and tracking the program’s progress against them could give decision-makers baseline information and longitudinal data to determine whether changes to the program’s outreach approach are needed. This, in turn, could result in more enrollees participating in the program and more transitioning service members obtaining needed assistance,” the report said.
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The GAO also said that inTransition did not reach out to more than 91,000 service members, or 85% of those automatically enrolled in 2022 until two or three months after they left the military. The contractor that runs inTransition attributed this to delays of separation data reported to DOD’s Defense Manpower Data Center.
“The delayed timing for automatically enrolling eligible members may leave a gap in assistance to obtain mental health services at a time that coincides with the vulnerable post-separation period,” the GAO said.
To overcome this, the federal watchdog suggested that the DOD expand its criteria for automatic enrollment to include troops who participate in the Transition Assistance Program, Military Service Wounded Warrior programs, Integrated Disability Evaluation System, or by tracking responses to mental health questions during separation exams.
The GAO also found that the inTransition program did not have defined performance goals, making it harder for officials to know what needs improvement. Despite findings by the GAO like the contractor’s inability to regularly connect with enrolled service members, “program officials said they have no changes planned to improve the program, and that the program is working as intended.”
DOD-VA mental health efforts
In its report, the GAO also looked at mental health related transition programs overall. For the DOD, that includes inTransition, Transition Assistance Program Defense Health Agency Recovery Coordination Program and Military OneSource. For the VA, those programs are VA Liaison Program, Veterans Health Administration Post-9/11 Military2VA Case Management Program, and VA Federal Recovery Consultant.
The report also included findings from the DOD-VA committee, including a potential healthcare gap for some service members who take separation leave when relocating to a new base. During this time, the service member can’t access medical treatment facilities at their former location and they are not yet eligible for VA health care because they have not formally separated.
The committee officials also found a potential post-separation delay in obtaining VA health care benefits like mental health care because of DOD Form 214 delays. A problem with the Army’s new personnel processing IT system, for example, delayed production of Form 214s from between December 2022 and January 2023, leading to separation benefit delays for 5,000 service members. DOD officials told GAO that those issues were resolved.
The GAO ultimately said that the committee is “uniquely positioned” to assess “how well” DOD and VA programs facilitate access to mental health services during transitions.
“An assessment would help the departments better ensure that transitioning service members and veterans have access to the mental health support they may need when they need it,” GAO said.
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