Drawing on our findings, we developed recommendations for improving access to mental healthcare across three timeframes, ranging from immediate fixes to large-scale institutional change.

Quick Wins address urgent, solvable problems that can have fast impact — efforts that could launch within the year.

1. Redesign VA Form 21-0781 and other intake screening forms so they are not burdensome, disrespectful, or re-traumatizing to veterans with PTSD or traumatic brain injuries.
2. Create plain-language one-page intake guides with real-world timelines for the five most common mental health services, to address veterans’ widespread confusion about how — and how long — it takes to access care.
3. Provide veterans visiting a VA facility for the first time with an individual welcome and orientation from a knowledgeable guide, to reduce the dropout that so often follows a confusing or unwelcoming first experience.

Pilot Projects are design concepts for hands-on testing at VA medical centers and benefits offices — not finished solutions, but structured opportunities for collaborative prototyping with veterans, VA employees, and community partners.

1. VA PreCheck, which would pre-approve veterans for mental healthcare based on their service record before they ever contact the VA.
2. Local matching tools to help veterans confidentially identify VA and non-VA providers that fit their individual preferences and timeframes.
3. Third-party supports, enabling voluntary organizations and non-VA providers — including peer networks and family members — to play a more formal role in connecting veterans to care.
4. Space standards to make VA physical environments more welcoming, particularly for female and younger veterans.
5. Service standards to build a veteran-centered customer service culture across mental health delivery.

System Transformations are the largest-scale opportunities — changes that go beyond what any single pilot can accomplish and require the engagement of VA leadership, legislators, and external partners.

1. Redesign pathways to treatment so veterans feel safe and confident regardless of their chosen provider or location.
2. Holistically reimagine the intake and screening process — unifying the parallel tracks of health intake and benefits screening into a single system that emphasizes choice, confidentiality, continuity, and community.
3. Establish VA as a model for best-in-class mental healthcare in the 21st century, including by improving coordination with private providers, reducing out-of-pocket costs for non-VA care, and offering more holistic treatment pathways.

We provided a service map of current mental health access experiences and design opportunities; a set of eight mental health personas — Fast Tracker, In Transition, Forging Ahead, Day-by-Day, Still Serving, Knowledgeable Buddy, Front-Line Provider, and Family Member — to drive veteran-centered decision-making; and visualized journey maps of veterans and their supporters gathered during fieldwork.