After 13 years of war, a new survey of veterans today found many suffering from post-traumatic stress syndrome are not satisfied with the care they're receiving from the Veterans Administration.
Kevin O'Brien, a veteran of the war in Afghanistan, says his PTSD therapy at the VA can be excellent one day but horrible the next.
One of his counselors, he says, is caring and helpful, while the other is cold and bureaucratic.
O'Brien is on four different medications for anxiety and depression, but says the drugs don't work.
"I still have, like I said, my terrible days so in that sense no, my PTSD is not getting any better and the fact that they just throw medication at it doesn't do anything," he said. "It just prolongs it."
Two recent studies confirm widespread concern with VA mental health care.
In an American Legion survey of VA patients, 59 per cent of veterans report that their PTSD symptoms are not improving or are getting worse. That figure comes when the VA budget for mental health has risen 61 per cent in six years, to $7.2 billion.
Jeffrey Greenberg conducted the survey.
"The numbers were a bit shocking," Greenberg said. "The challenge of it is is that when you talk about people with very complex problems, PTSD disorder, substance abuse problems, head injuries, etc., treatment is very challenging."
One challenge is that both the Pentagon and the VA have attacked the PTSD problem without measuring what kind of therapy works. The Institute of Medicine in a report said "without tracking outcomes, neither department knows whether it is providing effective, appropriate, or adequate care for PTSD."
VA officials point out that 49 per cent of PTSD patients did report getting better, and officials said they would use the survey to help them learn what works. But here is one more area where veterans are raising red flags about inconsistent or low quality health care.