Mission Roll Call’s February 2026 survey of more than 2,200 veterans asked respondents to gauge the VA’s change in performance one year after Secretary Collins was appointed. The results point to a Department of Veterans Affairs that is holding steady, with modest signs of improvement over the past year. But stability, particularly in a system serving a growing and evolving veteran population, is not the same as progress.

The key question we asked in this survey was:

Thinking about your experiences with the Department of Veterans Affairs over the past year, please indicate whether each area has gotten better, stayed about the same, or gotten worse.

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Overall VA Performance

Nearly half of respondents say overall VA performance has stayed about the same, while 38% report improvement and 17% report that conditions have worsened. This distribution suggests that while positive movement is occurring, it has not yet translated into a consistent experience for most veterans.

That distinction matters. Seventy-three percent of respondents rely on the VA as their primary source of health care, meaning that incremental gains are often overshadowed by day-to-day realities around access, timeliness, and continuity of care. For these veterans, performance is measured in whether they can get an appointment when they need one, maintain a relationship with a provider, and receive care without unnecessary delay.

The data reflects a system that is trending in the right direction but not yet keeping pace with demand. Improvements in overall performance and quality of care are evident but often constrained by underlying challenges in staffing and access.

Access to Care Remains the Defining Issue

Demand for VA services remains high, and for many veterans, the system is a central part of their health care. Survey responses show widespread use across primary care, specialty care, and community care, reinforcing how heavily veterans rely on the VA to meet both routine and complex medical needs.

Across multiple categories, veterans report a similar pattern: the system works, but not always when they need it. As shown in the graphic, Timeliness of Care mirrors overall performance, with 44% of respondents saying it has stayed the same, 38% reporting improvement, and 17% reporting it has worsened. These numbers suggest that while progress is being made, it has not yet translated into a reliably faster or more responsive experience for most veterans.

This gap between availability and accessibility shows up in practical ways. Veterans often describe delays in scheduling, long wait times for specialty care, and difficulty navigating referrals—particularly when transitioning between VA providers and community care. For those living in rural areas or managing ongoing conditions, these delays turn routine care into a prolonged process.

Community care has expanded options for many veterans, but it has also introduced additional complexity. While some report positive experiences, others point to delays in authorization, lack of coordination between providers, and confusion about eligibility or next steps. The VA system offers more pathways to care, but not always a clearer or faster route to receiving it.

Staffing Shortages Continue to Limit Access

Behind many of the access challenges veterans report is a more fundamental constraint: staffing.

Survey results show that staffing and continuity of care remain among the weakest performing areas. Nearly half of respondents say conditions have stayed the same, while a higher percentage of veterans report worsening conditions, producing one of the lowest scores across all categories.

When staffing levels are insufficient, the effects show up in different ways. Appointment availability declines and wait times increase. Veterans are more likely to see different providers from one visit to the next, making it harder to build continuity and trust.

The takeaway from the data shows that access and timeliness cannot be achieved without addressing staffing capacity. Scheduling systems and referral pathways can be refined, but without enough providers to meet demand, those improvements will have limited impact.

Mental Health Access Remains Inconsistent

Mental health care is one of the most critical services the VA provides, and it is where the system’s strengths and limitations are most clearly felt.

Survey results show that access to mental health care has made incremental improvement, but remains uneven. While some veterans report improvement, a significant portion indicate no change. Taken together, these responses point to a system that is not consistently reaching all veterans who may need support.

Unlike other areas of care, gaps in mental health services can have more immediate and lasting consequences.

Veterans frequently describe difficulty maintaining consistent relationships with providers, particularly when staffing shortages lead to turnover or reassignment. In a field where trust and continuity are essential, disruptions in care can make it harder to sustain progress or seek help during periods of need.

These figures suggest the VA should keep a close eye on the relationship between staffing and mental health care. When mental health professionals are in short supply, appointment availability declines and wait times increase. This can lead to delayed care, reduced session frequency, and greater reliance on already stretched providers.

Stability Is Not Enough

The VA is showing improvement in the first year of Secretary Collins’ tenure, though work remains.

Over the past year, the department has made targeted investments in the right areas. Efforts to improve scheduling and referral systems, strengthen continuity of care, and modernize how care is delivered are beginning to show up in performance data. Veterans are reporting gains in overall performance and quality of care, and the VA has taken steps to improve how it coordinates with community providers and processes payments. These are meaningful moves, and they reflect a system that is focused on the right problems.

Progress leads to performance at scale, and there are notable areas for continued improvement. The most consistent constraint remains staffing. Without enough providers, improvements to scheduling, referrals, and community care cannot deliver the access veterans need. The result is what veterans are reporting: a system that is getting better in places, but still inconsistent when it matters.

As the 2026 midterm election approaches, decisions made in Washington will shape the future of veterans’ healthcare, benefits, and support systems for years to come. Those decisions should be informed by the voices of veterans themselves.

As we do every month, Mission Roll Call is launching a national survey on March 1st to ensure that veterans help define the priorities and expectations that will guide the next Congress and the future direction of the Department of Veterans Affairs.

The issues facing veterans are daily realities, but they are often lost in the abstract policy debates so often witnessed in Washington. As we know, elections have consequences, and the 2026 mid-term is no different. Elected leaders will continue to debate important issues impacting veterans. Access to timely, high-quality care. Mental health and suicide prevention. Disability compensation and long-term sustainability of the system. The balance between direct VA care and community-based options. These are structural questions that will be shaped by the outcomes of the 2026 election and the leadership that follows.

This survey is designed to do more than measure opinion. It will identify what issues veterans believe should define the national conversation, how much confidence they have in Congress to protect VA funding, and what expectations they have for candidates seeking federal office. It will also examine how veterans view civic engagement itself—whether elected officials are providing adequate attention to veteran issues and whether greater accountability is needed.

Veterans understand service and responsibility. This survey recognizes that civic engagement does not end when military service concludes. It continues in how veterans vote, how they participate, and how they hold institutions accountable.

The results of this survey will be shared directly with congressional offices, VA leadership, policymakers across the country, and of course you – the veteran. They will help shape advocacy efforts and ensure that legislative priorities reflect documented veteran perspectives—not assumptions.

The strength of this effort depends on participation. The more veterans who engage, the clearer and more influential the message becomes.

In 2026, your voice should help shape the path forward.

Traumatic brain injury (TBI) remains one of the most common and complex injuries affecting post-9/11 veterans. While awareness and diagnosis have improved over the past two decades, many veterans continue to face limited treatment options, long wait times, and care models that do not fully address the long-term cognitive, emotional, and social effects of brain injury. New bipartisan legislation introduced in Congress aims to change that.

The BEACON Act, introduced by Jack Bergman (R-MI) and Sarah Elfreth (D-MD), seeks to modernize how the Department of Veterans Affairs delivers care to veterans with mild to moderate TBI. The bill focuses on expanding access to evidence-based, non-pharmacological therapies and strengthening partnerships between the VA and leading civilian, academic, and nonprofit institutions.

For many veterans, TBI does not exist in isolation. It often intersects with post-traumatic stress, sleep disorders, depression, chronic pain, and difficulties reintegrating into civilian life. Current treatment pathways can be fragmented or overly reliant on medication, leaving veterans and families searching for alternatives that better address the full scope of their needs. The BEACON Act is designed to help close these gaps by supporting innovation and accelerating the integration of proven therapies into VA care.

The legislation would establish two new VA grant programs. One would support clinical research, provider training, veteran and family outreach, and partnerships focused on effective non-pharmacological treatments. The second would advance independent research and implementation of validated therapies, with oversight modeled after the VA’s National Center for PTSD. Together, these programs aim to move promising treatments from research settings into consistent, real-world clinical use.

The bill’s emphasis on outcomes is particularly significant. By prioritizing cognitive function, mental health, and quality of life, the BEACON Act recognizes that successful TBI care must extend beyond symptom management. Improving access to comprehensive, evidence-based treatment can play a meaningful role in reducing long-term disability, improving employment and family stability, and lowering suicide risk among affected veterans.

Support for the BEACON Act reflects broad agreement across the veteran community that current systems need to evolve. National organizations such as American Legion (https://www.legion.org) and Avalon Action Alliance (https://www.avalonactionalliance.org) have endorsed the legislation, underscoring shared recognition that innovative, whole-person approaches to brain health are long overdue.

Mission Roll Call supports bipartisan efforts to improve care and outcomes for veterans living with traumatic brain injury. The BEACON Act represents an important step toward a more modern, flexible, and veteran-centered approach—one that reflects what veterans consistently report they need most: access to effective care that works in practice, not just in theory.

As Congress considers this legislation, Mission Roll Call will continue engaging with policymakers to ensure veteran voices remain central to the discussion and that reform efforts translate into meaningful, measurable improvements in care.

 

Mission Roll Call launched 2026 with a bipartisan kickoff reception on Capitol Hill, bringing together senior federal leaders, policymakers, veteran advocates, and partners from across the veteran and military community. The event underscored Mission Roll Call’s commitment to elevating veteran voices and advancing practical, veteran-driven policy solutions.

The reception featured remarks from Secretary of Veterans Affairs Doug Collins, House Committee on Veterans’ Affairs (HVAC) Chairman Mike Bost (IL), and House Appropriations Committee Ranking Member Debbie Wasserman Schultz (FL). Also in attendance was HVAC Subcommittee on Health Chairwoman Mariannette Miller-Meeks (IA), HVAC Member General Jack Bergman (MI), and HVAC Member Tom Barrett (MI). Their participation highlighted the continued bipartisan focus on veterans’ health care, benefits, and long-term well-being at a critical moment for federal veterans’ policy.

Mission Roll Call CEO Jim Whaley hosted the evening, welcoming attendees and emphasizing the organization’s mission to ensure veterans’ experiences inform decision-making in Washington. Strategic Director of Government Affairs and Advocacy Mike Desmond served as emcee, guiding the program and reinforcing the importance of collaboration between Congress, the Department of Veterans Affairs, and the broader veteran community.

Speakers addressed the evolving needs of veterans following two decades of sustained conflict, including access to timely and effective health care, mental health and brain injury treatment, accountability within federal systems, and the challenges veterans and military families face during transition to civilian life. Throughout the program, speakers emphasized that durable solutions require both strong oversight and consistent engagement with veterans themselves.

The event drew participation from across the veteran community, including representatives from veteran service organizations, military family advocates, health care innovators, congressional staff, and nonprofit leaders. Conversations throughout the evening reflected shared priorities for the year ahead and reinforced the value of cross-sector coordination in driving meaningful progress for veterans and their families.

Mission Roll Call’s 2026 Kickoff Reception highlighted the organization’s role as a bridge between veterans and policymakers. Through national polling, veteran outreach, and direct engagement with policymakers, Mission Roll Call continues to translate veteran perspectives into actionable policy recommendations. The reception demonstrated that work in action, creating space for dialogue, relationship-building, and alignment across ideological and institutional lines.

Photos from the event and links to the speakers’ remarks are included below. Mission Roll Call thanks all who joined the reception and contributed to a strong start to 2026. The organization remains focused on advancing bipartisan, results-oriented policies that reflect the real priorities of veterans and military families nationwide.

On January 13, 2026, Mission Roll Call’s Chief Executive Officer, Jim Whaley, testified before the House Committee on Veterans’ Affairs Subcommittee on Health in Washington, D.C., to present the veteran community’s data-driven priorities on a broad slate of legislation addressing critical areas of veteran health care. The hearing focused on policies related to suicide prevention, traumatic brain injury, access to care, mental health, addiction treatment, and innovations in care delivery.

Jim opened his remarks by reiterating Mission Roll Call’s mission: to bring unfiltered veteran perspectives directly into policymaking through systematic polling and engagement. He emphasized that the bills under consideration — from the RECOVER Act to the BEACON Act, as well as proposals on access, TBI care, and pain management — reflect problems veterans have consistently identified in MISSION ROLL CALL’s national surveys.

Bringing the Veteran Voice to Suicide Prevention

Jim highlighted data from Mission Roll Call’s National Suicide Prevention Survey (July 2025) showing that veterans see suicide prevention not as a single program issue but as a system problem requiring multiple tools. A large majority of respondents emphasized that suicide prevention requires both clinical treatment and community-based support working together, and that community providers must be included in prevention efforts. Veterans also stressed the importance of training, coordination, and accountability in suicide prevention strategies.

In his testimony, Jim noted that the RECOVER Act (H.R. 2283) aligns with these priorities by expanding community-based mental health capacity, supporting provider training on veteran risk factors, and requiring transparent outcome reporting so policymakers and health systems can evaluate what works in practice.

Addressing Gaps in Traumatic Brain Injury Care

Jim also discussed the significant access challenges veterans face in obtaining appropriate care for traumatic brain injury (TBI). Drawing on MISSION ROLL CALL’s TBI Priorities Survey (August 2026), he noted that an overwhelming majority of veterans believe access to specialized TBI care is extremely important, yet many who seek care find it difficult to obtain.

He highlighted the BEACON Act as responding directly to that need by establishing a structured, evidence-based framework for evaluating innovative neurorehabilitation approaches — including rigorous independent outcome measurement and clear criteria for expanding access based on real results.

Modernizing Care and Accountability

In addition to TBI and mental health, Jim voiced support for measures that modernize how the VA delivers care. He testified in favor of the NOPAIN for Veterans Act and Veterans Mental Health and Addiction Therapy Quality of Care Act (H.R. 2426), describing how MISSION ROLL CALL’s broader polling shows veterans are concerned about overly narrow treatment approaches, want evidence-based options, and value care that can be evaluated and improved over time.

These bills — when considered together — reflect priorities veterans have repeatedly expressed: the need for expanded, measurable options that reduce risk and improve outcomes across the health care system.

Improving Access in Rural and Remote Communities

Another theme of Jim’s testimony was the persistent access gaps in rural, remote, and overseas communities. Citing data from Mission Roll Call’sACCESS Act Survey, he underscored veteran support for expanding community care options, streamlining access processes, and ensuring care is available when and where it is needed.

Jim expressed support for the Veterans Health Desert Reform Act and the U.S. Vets of the Freely Associated States Act as vehicles to leverage community providers, telehealth, and pharmacy services to break down geographic barriers to care.

A Data-Driven Path Forward

Throughout his testimony, Jim stressed that good policy starts with listening and that veterans consistently want transparent rules, reliable access, and accountability for outcomes. He concluded by urging Congress to continue grounding veteran health policy in the perspectives and experiences of those who have served.

A full video of the hearing and Jim Whaley’s complete testimony are available here and through the House Veterans’ Affairs Committee repository.

Inadequate family inclusion and support

Families and loved ones are often the first to recognize when a veteran begins to struggle physically, mentally, or emotionally, and their early awareness can make a world of difference for a veteran. Long before a challenge becomes a crisis, it is the spouse who notices the sudden withdrawal, the parent who hears something different in a phone call, or the sibling who sees a shift in routine. Yet during one of the most important periods in a veteran’s life, the transition out of the military, these same loved ones are often left on the sidelines. Because the separation process is fast paced, stressful, and packed with dense information, many veterans walk away without fully understanding the benefits they have earned or how to access them.

In our recent survey, 87 percent of respondents said they did not receive any follow-up from the VA or DoD after their separation. A percentage this high, combined with the veteran frustration outlined above, makes clear that a family member or trusted loved one should be involved in the discharge process. Families usually notice subtle changes in a veteran’s well-being long before a crisis occurs. If trusted family members also understand the benefits, enrollment steps, and programs available, they can help ensure nothing is missed.

Strategies Moving Forward

Recommendation #1: Automatic enrollment in VA at time of separation, with an option to opt out.

We asked veterans and their family members how they would prefer to be enrolled in the VA, and one answer stood out: automatic enrollment at the time of transition*, with the option to opt out. One way to ensure that all eligible servicemembers have access to the care provided by the VA is to automatically enroll them at the time of first eligibility, which is the moment they are separated from active duty with any discharge other than dishonorable.

*Some VA-related programs can be used before separation, such as the VA Home Loan Certificate of Eligibility, the Transition Assistance Program, and Pre-Discharge Disability Claims.

This option will guarantee that veterans have coverage and will make the transition easier. If a veteran does not want to take advantage of VA benefits, they will be able to easily opt out of coverage if they choose to do so.

Recommendation #2: Involve immediate family members or caregivers at critical moments during transition

Ensuring a family member or trusted advocate is present during VA enrollment and TAP instruction helps solidify understanding, spreads the burden of information retention, reduces the mental overload on the veteran, recruits the veteran’s own support network, and increases follow-through. A recent Mission Roll Call survey indicated that 69 percent of 595 family members/caregivers felt they were excluded in servicemember’s transition planning or enrollment discussion. Providing clearer, streamlined information that is delivered to servicemembers and their families can reduce confusion that occurs during an already stressful time.

Sharing information about VA programs, caregiver resources, and support services helps families prepare and advocate effectively. When families understand VA services before they are needed, veterans are more likely to connect with care early and maintain long-term engagement, reducing the burden on the veteran and their families.

This lack of clarity is compounded by the fact that many veterans were unsure whether they were ever clearly offered the opportunity to enroll in VA health care or benefits during transition.

This gap in communication and understanding leaves veterans, and especially younger veterans, navigating complex systems such as health care, education benefits, and disability compensation without the guidance or confidence needed to access what they have earned.

Moving Forward

Despite the programs and resources designed to support transitioning service members, many veterans leave the military feeling unprepared for civilian life. They encounter complex and confusing VA enrollment processes, often struggle to understand official guidance, and experience limited support from their families due to gaps in inclusion and communication. These challenges are particularly acute for younger veterans, who may enter service with little civilian experience, no professional networks, and few of the life skills necessary to navigate employment, healthcare, and financial responsibilities. Without targeted support, these veterans are at greater risk of underemployment, financial strain, housing instability, and mental health challenges, including depression and suicidal ideation.

Addressing these gaps requires a multi-pronged approach. Targeted transition support and mentorship can help veterans translate military skills into civilian credentials and career pathways. Clear, consistent communication from the Department of Defense and the VA, coupled with streamlined enrollment processes, can reduce confusion and delays in accessing benefits. Actively involving families in transition planning ensures that veterans have a support network that understands available resources and can intervene early when challenges arise. By implementing these measures, we can not only ensure veterans access the benefits they have earned, but also help them build stable, healthy, and fulfilling post-service lives, strengthening both individual outcomes and the broader community that relies on their contributions.

Every year, more than 200,000 men and women transition from military service to civilian life. Although policymakers frequently emphasize the goal of a “seamless transition,” the lived experience of veterans suggests that this goal remains unmet. Their families and loved ones often absorb the resulting challenges, providing support where existing systems fall short.

In October 2025, Mission Roll Call conducted a nationwide survey examining the transition process. More than 1,500 veterans and family members participated, offering frank assessments of current programs and support structures. Their responses reveal consistent themes: veterans do not feel thoroughly prepared for civilian life; they lack clear guidance on navigating VA benefits, and the broader system does not sufficiently address the needs of their families.

Our survey identifies four key areas in which the transition process falls short, leaving veterans and their families insufficiently prepared for life after service:

• Limited preparedness for civilian life: Half of veterans’ report feeling unprepared for the challenges of civilian life.
• Complex and unclear VA enrollment: The process of enrolling in VA benefits is often opaque, inconsistent, and more complicated than other aspects of transition.
• Low trust in DOD and VA guidance: Veterans frequently place low trust in official sources, instead relying on peers for guidance on transition-related tasks.
• Inadequate family inclusion and support: Families are often under-informed and excluded from the transition process.

Veterans often feel unprepared for life after service, face confusing and inconsistent VA enrollment, lack confidence in official guidance, and experience limited support for their families. We must address these gaps to ensure veterans and their loved ones receive the guidance and support they need for a successful transition.

Preparation for Civilian Life

We asked veterans how well their military service prepared them for civilian employment, education, and community life. The responses show that half of all veterans felt insufficiently prepared for life after service.

One veteran wrote in our survey, “I was trained to do my job, not to navigate civilian life.” Another said, “I did not know how to translate my skills into something employers understood.”

These comments align with the data. Veterans arrive in civilian life with strong, marketable skills developed through military service but receive too little guidance on how to translate those skills into civilian credentials, language, and career pathways. The impact is not abstract. When veterans cannot clearly articulate their experience to employers, they are more likely to be underemployed or unemployed, even when jobs are available. That underemployment often leads to financial strain, loss of identity and purpose, and growing frustration with systems that promised a seamless transition but did not deliver.

Over time, these pressures compound. Difficulty securing stable, meaningful work is a well-documented risk factor for housing instability and homelessness, particularly for younger veterans and those leaving the service without a strong civilian network. Prolonged economic stress and a sense of failure or invisibility can also deepen mental health challenges, increasing the risk of depression, substance use, and suicide. In this way, inadequate skills translation is not just a workforce issue; it is a public health and public safety issue.

Because many of the most at-risk veterans entered service so young, many had little experience managing personal finances, navigating healthcare, or making major life decisions before joining. The military’s structured environment provides housing, healthcare, and a clear professional pathway. Once separated, veterans are suddenly responsible for decisions previously handled by their chain of command.

This pressure shows clearly in the job market. When asked which statement best describes their first civilian job, many respondents said they took the first job they could get. Perhaps more concerning, 67 percent of respondents did not choose a job based on fit, interest, or long-term career goals. They simply needed work or lacked guidance to make a more informed decision.

Unlike many older veterans who transition with more life experience, younger veterans often leave the military without strong community ties outside the service. The loss of camaraderie, routine, and purpose can create feelings of isolation or disorientation. These young service members often stepped into uniform at a time when their civilian peers were developing foundational life skills, pursuing education, and gaining early work experience.

As a result, many separate from the military without a college degree, without a professional network, and without the civilian work history employers expect. For some, the transition is not just a career shift but the end of the only adult life they have ever known. In the most serious cases, these pressures intersect with mental health challenges and increase risk for crisis or suicide.

These findings point to multiple areas of concern deserving of more focused solutions. Younger veterans require targeted and intensive support to successfully navigate the transition from military to civilian life. This includes:

• stronger communication about benefits
• more accessible and effective transition education
• financial guidance
• mentorship and career coaching
• community building and focused programs alongside veterans that replicates the cohesion they lose after separation
• By understanding where the gaps exist, we can ensure veterans enter civilian life with clarity, confidence, and connection instead of uncertainty and risk.

Complex and unclear VA enrollment

The process of enrolling in Department of Veterans Affairs benefits is often opaque, inconsistent, and more complicated than other aspects of the transition to civilian life. Compounding this challenge, our survey found that the Transition Assistance Program is frequently viewed as unhelpful or, in some cases, counterproductive. Even among veterans who did participate in TAP, only a small share reported that it meaningfully prepared them for what came next.

Veterans’ comments consistently point to problems with timing, delivery, and relevance. Many cited the speed at which information was presented, the lack of follow up, and content that felt disconnected from their immediate needs. One veteran described TAP as “information, not preparation.” Another noted that it “came at the end, when my attention was split between out processing tasks.”

Together, these responses reveal two critical gaps. First, a significant number of servicemembers never meaningfully engage with TAP at all. Second, for those who do, the program is often experienced as brief, generic, and easy to forget rather than as a sustained bridge to civilian life. These gaps leave veterans navigating complex benefit systems on their own at precisely the moment when clear guidance and continuity matter most.

Others described how the process competed with immediate financial and family pressures. “I was trying to find a job, move my family, and figure out health care all at once,” one veteran wrote. “VA enrollment just became another full-time job.”

For some veterans, the complexity and opacity of the VA enrollment process are so discouraging that they disengage entirely, particularly when faced with lengthy, repetitive, and confusing paperwork. Even minor errors can trigger significant delays, with forms often requiring repeated submissions across offices that do not communicate with one another. Veterans describe this experience as overwhelming, and as a result, some forego benefits entirely, delaying or losing access to healthcare, education programs, and financial support.

Low trust in DOD and VA guidance

Veterans consistently describe required forms as lengthy and difficult to understand, with unclear instructions and little support for completing them correctly. Many report being caught in cycles of submission and correction that erode confidence and momentum. One veteran stated, “After being sent in circles so many times, I just stopped trying.” Another explained, “I filled out the paperwork the best I could, only to be told months later that something was missing or wrong.”

Even small errors can trigger significant delays. As one respondent shared, “One mistake on a form meant everything was kicked back, and no one could tell me how to fix it.” Others described having to provide the same information repeatedly across different offices that do not communicate with one another. “I felt like I was doing the same paperwork over and over,” one veteran wrote, “but every time it was for a different system.”

These administrative barriers have real consequences. Delays in completing or correcting paperwork can postpone access to health care, education benefits, and income support for months or longer. Rather than serving as a stabilizing force during transition, unclear and burdensome paperwork often becomes an added source of stress and discouragement. For veterans already balancing employment, family responsibilities, and the emotional challenges of leaving military service, paperwork difficulties can be the tipping point that leads them to disengage entirely, leaving critical benefits unused.

At the same time, many veterans report low trust in official sources of transition information and instead rely on peers for guidance. Official briefings, websites, and help lines are frequently described as confusing, inconsistent, or disconnected from lived experience. One veteran explained, “I trusted other veterans more than anything I was told in a briefing.” Another shared, “The official information sounded good, but it did not match what actually happened once I got out.”

Peer networks are viewed as more credible because they offer practical, experience-based advice. Veterans commonly turn to friends who have already separated, informal online groups, or fellow servicemembers slightly ahead of them in the process. “I learned more from talking to other veterans than I did from any official program,” one respondent noted. Another added, “Other vets told me what paperwork actually mattered and what mistakes to avoid. That was never clear from the VA or TAP.”

This reliance on informal networks reflects a deeper breakdown in institutional trust. Veterans described receiving different answers depending on who they contacted, leading many to stop seeking official guidance altogether. As one veteran put it, “Every office gave me a different answer, so I just listened to people who had already been through it.” As a result, veterans often navigate one of the most complex transitions of their lives through word of mouth rather than through clear, reliable, and accountable support systems.

When veterans talk about traumatic brain injury, they do not speak in abstracts. They talk about headaches that will not quit, memory slips that cost them at work, mood swings that wear on a marriage. Caregivers talk about sleepless nights and learning how to manage symptoms at home. This is life for many families in our community.

Mission Roll Call surveyed 2,408 veterans, family members, and caregivers nationwide. 337 told us they have a TBI diagnosis in their household. That is fourteen percent of everyone who responded. The message that comes through is simple. Too many veterans with TBI are not getting the help they need, and families are carrying the load.

Access to Care Is Still Too Hard

Among the 337 who reported living with TBI, too many said their care needs had not been met. Some had received treatment, but many had not. The challenges aren’t new: distance to VA facilities, long wait times, and bureaucracy that makes it harder to stay in the fight for care.

When you’re living with a brain injury, the last thing you should have to do is navigate a maze. Yet that’s exactly what too many veterans described.

Care That Feels Disconnected

Those who did get treatment often described it as a patchwork. Some went to the VA, some to private providers, and many to both. What was missing was continuity. Veterans were left to coordinate between systems that don’t always talk to each other.

One veteran told us he felt like he had to be his own case manager — scheduling, tracking, and explaining his injury over and over. For an injury that affects memory, concentration, and emotional stability, that’s not just frustrating, it’s dangerous.

Mental Health Is on the Line

We asked directly whether TBI had been tied to mental health struggles like depression, anxiety, or suicidal thoughts. A meaningful number said yes.

This is where the system is failing veterans. TBI isn’t just about bumps to the head in combat or training. It’s about how those injuries ripple through a veteran’s entire life. It’s about families watching their loved one change, often without the support they need.

Families and Caregivers Feel It Too

The survey also reached caregivers. 346 respondents said they currently or previously served as a caregiver for a veteran. Their answers paint a tough picture: many don’t feel they have the training or support needed to manage symptoms at home. And they described the personal toll caregiving takes — exhaustion, stress, and declining health of their own.

TBI doesn’t just affect the person who lived through it. It reshapes households. When caregivers aren’t supported, veterans suffer too.

Veterans Want Options

Across all 2,400 respondents, one message came through loud and clear: veterans want options. They believe it’s important to have access to specialized care, even if that means working with non-VA providers.

This isn’t about rejecting the VA. It’s about recognizing that no single system can meet every need. Veterans are telling us they want the freedom to get the right care, in the right place, at the right time.

Veterans Are Asking for Help

Perhaps the most telling part of the survey wasn’t in the multiple-choice boxes. Nearly 800 people left their email addresses asking for follow-up. That’s not just data collection. That’s veterans and families raising their hands and saying, “I need help.”

We owe them more than another report that sits on a shelf. We owe them action.

A Call for Leadership

Veterans with TBI have already carried the weight of their injury. They shouldn’t have to carry the burden of fixing a broken system too.

The call from this survey is simple: listen to veterans, clear the barriers, support the families, and expand access to the care they say they need. Veterans have done their part. Now it’s time for Congress and the VA to do theirs.

The Bottom Line

This survey makes the message clear. Many veterans are living with TBI, yet too few have had their needs met. The barriers are familiar—distance to care, long delays, and layers of bureaucracy that make it harder to get help. Even when treatment is available, it often feels fragmented, leaving veterans to manage their own recovery. Families and caregivers are carrying much of the burden, often without the support or training they need.

Veterans are also telling us they want more options, including access to specialized care outside the VA when the system cannot meet their needs. And perhaps most importantly, hundreds of respondents are actively asking for follow-up and help right now.

Earlier this year, Mission Roll Call asked veterans which treatments and services they believe the VA should offer. The answers weren’t ambiguous. Veterans expressed broad support not just for traditional services, but for a range of emerging and at times controversial options—from medical marijuana and psychedelics to hyperbaric oxygen therapy (HBOT), and abortion under certain conditions.

More than half of veterans surveyed said they supported the VA providing access to medical marijuana. Nearly the same number supported the use of psychedelic therapies like MDMA and psilocybin. Even abortion, a politically fraught subject, drew support when presented in the context of VA care. These results demonstrate that veterans are open to and seeking innovative care solutions and asking for a system willing to do the same.

That survey helped reframe the conversation in Congress and in the VA. It challenged assumptions that the veteran population would reflexively oppose novel or nontraditional treatments. It showed that today’s veterans are practical, open-minded, and focused on results. They want veterans taken care of in a way that meets the veteran’s needs and they want a VA that is equipped and authorized to deliver it.

This brings us to HBOT.

Veterans Want Better Options, Delivered Faster

Hyperbaric Oxygen Therapy (HBOT) is a promising new therapy treatment that a growing number of veterans are using to help treat Post Traumatic Stress and Traumatic Brain Injury.

We asked veterans whether they would support the Department of Veterans Affairs piloting HBOT to evaluate its effectiveness for treating traumatic brain injury and post-traumatic stress. Eighty-five percent said yes. Among those, over seventy percent said they strongly support a pilot program.

Veterans are not a group resistant to progress. In fact, even among those who said they had never heard of HBOT prior to the survey—nearly 42 percent of respondents—support for trying something new remained high. When asked if they would personally consider HBOT if it were available through the VA, more than seventy percent said either yes or that they might, given more information.

That level of support, despite limited familiarity, reflects a wider truth: veterans are not clinging to old models. They are open to innovation. What they are not interested in is delay.

The Current Model Isn’t Moving Fast Enough to Keep Up, and It Isn’t Enough

Of course, many veterans continue to rely on traditional mental health care models. Some of those experiences are positive. But for a meaningful portion of the population, the current system is not meeting the mark.

Only 12.6 percent of survey respondents said they are very satisfied with their available treatment options for mental health or brain injury. Over 17 percent reported some level of dissatisfaction. Another 28 percent said the options offered do not apply to their needs at all.

Those numbers do not indict the system, but they do clarify its limits. There are good clinicians inside the VA and given the sheer size of the veteran population receiving care from the VA, the VA does an admirable job of meeting a great deal of their needs. There are programs that work. But there are also gaps—and those gaps are not theoretical.

Veterans are not asking for the impossible. They are asking for a care model that accounts for the complexity of their experience. That model must include both the conventional and the emerging, with an emphasis on treating the whole person rather than just managing a condition.

Leadership Requires More Than Management

The VA has an opportunity here. So does Congress. For that matter, so do the VSO’s looking out for veterans. The opening is not to defend past choices or to slow-walk reform through years of committee review. It is to lead.

If the VA can take the initiative in deploying limited, well-structured pilot programs for HBOT or similar therapies, it can set the standard for how large systems adapt to the evolving science of trauma and recovery. Congress, for its part, can provide the legislative and fiscal support needed to make that transition possible. This is not about policy experimentation for the sake of headlines. It is about evaluating options that veterans are already asking for with rigor, transparency, and urgency.

There are precedents. HBOT is not new. It is used in hospitals across the country to treat diabetic wounds, carbon monoxide poisoning, and other physical injuries. It has also shown promise in helping patients with neurological symptoms related to traumatic brain injury. A 2017 study published in the National Institutes of Health database found cognitive and quality-of-life improvements among TBI patients who completed HBOT treatment (source). Similarly, research on MDMA-assisted therapy for PTSD has advanced to the final stage of FDA trials, with one major study finding that 67 percent of patients no longer met the criteria for PTSD after completing treatment (source).

What has been missing is not evidence of promise but willingness at the system level to formally test these tools in the veteran population and track outcomes in a way that can inform policy and practice.

What Veterans Are Telling Us Is A Simple Call to Action

Veterans are asking for options. They are not asking the VA to abandon its mission. They are asking it to modernize its model and to speed up the adoption process for novel care options.

Nor are they asking Congress to reinvent the wheel. They are asking it to provide the authority and support necessary for forward motion.

That bias for action we all learned as service-members? That’s what veterans are asking for from leadership.

By Mike Desmond | Strategic Director of Government Affairs and Advocacy, Mission Roll Call

Despite Decades of Increased Spending, the Veteran Suicide Rate Continues to Rise

Veteran suicide remains a national crisis. Despite decades of effort and billions of dollars spent, the numbers haven’t meaningfully improved. In some areas, they’ve actually gotten worse.

To help shape a more informed strategy going forward, Mission Roll Call recently conducted a national survey addressing the subject of suicide prevention. Over 2,100 veterans, family members, and caregivers from all 50 states responded. Their responses were as clear as they are sobering. But they also pointed toward solutions grounded in lived experience and capable of producing real impact.

Before we dive into our survey results, it’s important to understand the worsening trend within the staggering numbers of veteran suicides every year. As shown in the chart below from the Department of Veteran Affairs’ 2024 National Veteran Suicide Prevention Annual Report, not only do annual suicide deaths among veterans’ approach or exceed 6,000 per year, but the raw numbers are worsening year over year.

A higher percentage of veterans are dying by suicide

While the number of veteran suicides is increasing, the number of veterans is declining. According to the VA, today there are roughly 18 million veterans, down from over 26 million in 2001. This means a higher percentage of veterans are dying by suicide. And as startling as these facts are, the situation may be even more dire. Owing to various challenges in identifying suicide among veterans, the actual number of veterans dying by suicide is unclear and certainly higher than these figures. As just a few examples, county coroners often struggle to identify the deceased as a veteran and there is no mandatory reporting system for county coroners to report to a central database when they do manage to identify the deceased as a veteran. Also, identifying an overdose death as a suicide remains a challenge unless a note or other demonstration of intent is left behind.

Given this, it makes sense that the VA’s budget allocated to mental health and suicide prevention continues to increase dramatically with each annual budget allocation. That said, these figures, especially when accounting for unknown suicide numbers, demonstrate that current suicide prevention efforts are costing more money and showing worse results.

With that as background, let’s turn to our survey.

A full two-thirds of veterans struggle with suicidal thoughts

Among only the veteran respondents, a full 67% have either struggled with suicidal thoughts or mental health challenges themselves or know someone personally who has. This figure, extrapolated out over the entirety of the estimated 18 million veterans in the US, means that just shy of 13 million veterans have or might be struggling with mental health challenges or suicidal thoughts.

While the total pool of veterans who might benefit from suicide prevention approaches 13 million, at the same time most veterans express little confidence in the federal government’s current approach to preventing suicide.

Almost one third of veterans described access to mental health care through the VA or other providers as difficult or very difficult. This aligns with what we’ve heard repeatedly from veterans: the system is often too slow, too bureaucratic, and too disconnected from the day-to-day realities veterans face.

 

When asked what they see as the biggest barrier to preventing suicide, respondents didn’t point to a lack of funding. They pointed to deeper structural issues—things like stigma around mental health, social isolation, and the struggle to transition into civilian life with a renewed sense of purpose. These are not problems that can be solved by clinical care alone, but through approaches that emphasize connection as a critical form of intervention.

 

That’s why it’s so important to note what veterans said when we asked them how suicide prevention efforts should be prioritized. A clear majority believe we need both clinical treatment and community-based support, working side by side. This is a strong plea for “all of the above” style solutions and for adhering to the principle of meeting and treating veterans in the manner most meaningful to them.

This shouldn’t surprise us. Programs like Team Red, White, and Blue, and The Mission Continues, and other veteran-led initiatives have demonstrated for years that peer connection, physical wellness, and community engagement save lives. And yet, these programs remain underutilized and underfunded.

The good news is that veterans overwhelmingly support expanding these types of efforts. They also support creative solutions to pay for them. When we asked about redirecting underused federal funds to support veteran suicide prevention efforts that show proven results, the response was overwhelmingly positive.

We then asked if veterans would support a federal match for private donations to veteran mental health programs, the answer was again a resounding yes.

These are pragmatic proposals that align with the will of the veteran community and fit within today’s tight fiscal environment. The Fox Grant Program is one example—designed to channel resources into local, community-based solutions. But its implementation has been rocky. Many worthy organizations have struggled to navigate the bureaucracy needed to receive funding. The message we are hearing from veterans is simple: simplify it, expand it, and pair it with a federal match to increase impact.

Another area of near-universal agreement? Training. When asked how important suicide risk identification training is for veterans and their families, the overwhelming majority said it was essential. This is low-cost, high-impact work that can be deployed nationwide with the right partnerships in place.

Giving family members and caregivers the tools to recognize early signs of distress can make all the difference. Veterans are far more likely to confide in a spouse, sibling, or close friend than in a clinician or crisis line. Equipping those closest to them with practical training could lead to earlier intervention, stronger support at home, and a greater chance of recovery before crisis strikes.

Veterans don’t want to rely solely on crisis lines. They want the people around them to be prepared and empowered.

The most personal responses we received weren’t multiple-choice. They were answers to two simple questions: Do you know a veteran who has taken their own life? And as we opened with above, Have you or someone you know struggled with suicidal thoughts or mental health challenges after military service?

The volume of yes answers to both was staggering. These are not distant, abstract issues for most of the veteran community. They are immediate and they are personal. And they are, in many cases, ongoing.

This country has shown that when it decides something matters, we can move fast and think big. We did it with the PACT Act. We’ve done it with housing. We need that same urgency now when it comes to suicide prevention.

Veterans are not asking for more slogans or awareness campaigns. They’re asking for access, purpose, and connection. They want to see the system reoriented toward prevention and away from just managing crisis. They want to be seen not as patients, but as leaders and contributors in building the solution.

We’ve been at this for more than two decades. We’ve spent billions. The numbers haven’t moved. Improving suicide prevention isn’t a funding issue. It’s a strategy, vision, and implementation issue.

It’s time to re-center this fight around what veterans are telling us they need—and what the data increasingly supports. We have models that work. What we need now is focus and follow-through.

Veterans are speaking clearly. The model for addressing veteran suicide isn’t working as it should be. It’s time for Washington to listen.