More Veterans Screening Positive for Depression and PTSD

PALO ALTO, CA — More veterans are screening positive for depression and post-traumatic stress disorder (PTSD), even as measures of suicide risk and alcohol-use disorder show modest improvement, according to a large new study of more than 3.6 million veterans receiving care through the VA.

The findings, published in JAMA Network Open, provide one of the most comprehensive recent snapshots of mental health screening trends among veterans and highlight areas where additional attention and resources may be needed.¹

The study, led by researchers at the Stanford University School of Medicine and the VA Palo Alto, CA, Healthcare System, examined trends in four routinely administered mental health screening programs between fiscal years 2021 and 2024. Investigators found that adjusted positive screening rates increased 9% for depression and nearly 30% for PTSD, while decreasing 29% for suicide risk and 7% for alcohol use disorder.

The findings come at a time when mental health conditions continue to represent a significant public health challenge. The researchers noted that the prevalence of mental health conditions is rising and contributes substantially to the global disease burden. They also pointed to the COVID-19 pandemic as a factor that intensified psychological stress through widespread illness, mortality and social disruption.

After adjusting for patient, practitioner, visit and facility characteristics, researchers found that positive screening rates for depression increased from 8.8% in 2021 to 9.6% in 2024. PTSD screening rates rose even more sharply, increasing from 8.1% to 10.5% during the same period.

The increase in PTSD screening rates was particularly notable, representing nearly a 30% increase over the 4-year study period.

“Taken together, these findings emphasize the ongoing need to manage depression and PTSD among veterans and to manage mental health burden broadly among populations historically identified to be at risk,” the researchers wrote.

While depression and PTSD increased, the study found modest but statistically significant reductions in positive screening rates for suicide risk and alcohol-use disorder.

Adjusted rates of positive suicide risk screening decreased from 0.7% to 0.5%, while positive alcohol-use disorder screens declined from 5.8% to 5.4%. Although the absolute declines were relatively small, the percentage decreases were meaningful.

“Although the absolute magnitudes of the declines for suicide risk and AUD were small, these were statistically significant and the percentage decrease was 29% for suicide risk and 7% for AUD,” the researchers wrote.

The reasons for these improvements remain uncertain, but investigators suggested that VA programs might have contributed.

“The VA’s substantial investment in suicide prevention efforts and the VA’s uniqueness in screening, prevention and treatment intervention efforts for AUD may have contributed to the reductions in positive screen rates, but the associations between VA interventions and reduction in positive screens need to be evaluated,” they wrote.

The analysis also identified several factors associated with increased odds of screening positive across all four mental health conditions.

Veterans who were younger, had higher clinical risk scores, lived farther from medical facilities or identified as Hispanic were more likely to screen positive for depression, PTSD, suicide risk or alcohol-use disorder.

The finding regarding access to care was particularly noteworthy because it suggests that geographic barriers might continue to affect mental health outcomes.

The study also highlights the value of systematic mental health screening programs, particularly within large healthcare systems such as the VA.

Although positive screens do not necessarily indicate a formal diagnosis, the researchers noted that annual screening can help identify mental health concerns that might otherwise go undetected.

“Annual screening is helpful for identifying mental health risk that could go undetected,” the researchers wrote. They noted that the VA uses standardized and validated screening instruments that are widely used because of their predictive value and correlation with patient symptoms.

The researchers cautioned that the study was designed to identify trends rather than determine the causes behind them. Additional research will be needed to understand why depression and PTSD rates increased while suicide risk and alcohol-use disorder rates declined.

Still, the findings provide one of the most comprehensive recent snapshots of mental health screening trends among veterans.

In their conclusion, the researchers said the findings “emphasize the need to manage depression and PTSD while signaling slight improvements for suicide risk and alcohol use in the VA population, which should be studied further.”

They added that targeted efforts might be beneficial for populations that remain at elevated risk and suggested that the trends observed within the VA may reflect broader developments occurring throughout the United States.

 

1. Tran LD, Wagner TH, Bahraini N, Gujral K. Positive Mental Health Screens in the Veterans Health Administration, 2021 to 2024. JAMA Netw Open. 2026 May 1;9(5):e2613818. doi: 10.1001/jamanetworkopen.2026.13818. PMID: 42160051; PMCID: PMC13191389.