Streamline mental health services for Veterans

Prevention, Early Intervention, & Youth
Parity, Coverage, & Equitable Access
social determinants of health
Active Military
Asian American, Native Hawaiian, and Pacific Islander (AANHPI)
Coverage & Standards
No items found.
Federal department
Veterans Affairs
house committees
House Veterans' Affairs Committee
senate committees
Senate Veterans' Affairs Committee


Congress should ensure that all Veterans of the U.S. military, regardless of where they live, can access critical health care services, including for mental health and substance use disorders (MH/SUDs). Congress should also continue to streamline the complicated and burdensome application process for disability benefits.


Every Veteran of the U.S. military, especially those with visible and invisible wounds of war, should have access to high-quality services and supports, including for MH/SUDs. Congress should work to close gaps in services, including for Veterans who live in U.S. Territories (Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa) and U.S.-affiliated Pacific Islands that are freely-associated states (the Marshall Islands, Micronesia, and Palau). Individuals from U.S. territories are U.S. citizens, while individuals from freely-associated states are eligible to come to the U.S. as nonimmigrants to work and live indefinitely.[1] The U.S. is currently investing billions of dollars in military installations on these Pacific Islands as part of the U.S. geostrategic pivot to Asia.[2]

Nearly 3 percent of all U.S. Veterans live in U.S. territories, and Veterans make up nearly 8 percent of Guam’s population and more than 5 percent in American Samoa, the Northern Mariana Islands, and the U.S. Virgin Islands. Puerto Rico has more than 80,000 Veterans.[3] Given the high proportion of Veterans, Congress must do more to ensure the availability of services across U.S. territories. Currently, the nearest Veterans Affairs Medical Center to Guam is 4,000 miles away in Hawaii.[2]

While Veterans in freely-associated states are entitled to care, Congress should pass the Care for Compact of Free Association (COFA) Veterans Act to allow the Department of Veterans Affairs (VA) to provide services in the Marshall Islands, Micronesia, and Palau and to compensate Veterans for the cost of travel to receive needed health care services.[4] In June 2023, the U.S. Secretary of State Anthony J. Blinken and Interior Secretary Deb Haaland requested that Congress make these essential changes to help these U.S. Veterans access services.[5]

More broadly, Congress should work with the VA to streamline the process of applying for VA benefits, which is notoriously complex and frequently requires help to navigate.[6] One issue is that the Veterans Health Administration (VHA) has a wide variety of different, complicated authorities that limit which Veterans are eligible to receive different benefits. Congress should work with the VHA to streamline these authorities and simplify eligibility requirements to help reduce the bureaucracy, thereby improving the efficiency of service delivery and increasing Veterans’ access to MH/SUD services and supports.


1. U.S. Department of Justice, Civil Rights Division. Citizens of the Federated States of Micronesia (FSM), the Republic of the Marshall Islands (RMI), and the Republic of Palau Have the Right to Work Without Facing Discrimination: What Employers Should Know. Last Updated January 2017.

2. The New York Times. The America That Americans Forgot. Last Updated July 7, 2023.

3. Center for New American Security. Veterans Benefits in U.S. Territories. Last Updated February 25, 2020.

4. The New York Times. U.S. Government Moves to Expand Health Care to Pacific Veterans. Last Updated June 24, 2023.

5. Care for COFA Veterans Act. S. 1913 (Schatz-Murkowski) and H.R. 3948 (Case-Radewagen), 118th Congress (2023-2024). Last Accessed July 21, 2023.

6. Wounded Warrior Project. Benefits Services. Last Accessed July 18, 2023.