A few years ago, President George W. Bush asked the Bush Institute’s team a simple question about its work on helping veterans experiencing mental or brain health challenges: “How do we know if our veterans are getting better?”
It was a fair question. And at the time, we had a fair answer: we trust our clinical partners. Every organization we had brought into the Veteran Wellness Alliance (VWA) through Check-In, a tool to connect veterans and their families to high-quality mental and brain health care, had been rigorously vetted. They use evidence-based treatments. They serve veterans and military families with real commitment and cultural competency. We believed in them.
But belief and proof are different things. And the people we serve deserve both. So, at the President’s behest, we went to work.
In 2023, the VWA launched a Clinical Outcomes Working Group. We gathered clinical leaders from across the Alliance, including Road Home Program, Cohen Veterans Network, Centerstone’s Military Services, UCLA Health Operation Mend, the Emory Healthcare Veterans Program, SHARE Military Initiative, and others.
In over a dozen working sessions spanning two years, we did something that almost never happens in the nonprofit space: organizations that could reasonably view each other as competitors for finite philanthropic funding chose instead to share data.
Each organization agreed to share its outcomes in the same report because they care more about the people they serve than about looking better than each other. That alone is worth recognizing and celebrating.
We agreed on three categories of measurement: clinical outcomes, client satisfaction, and process outcomes (specifically, timely access to care). For clinical outcomes, we aligned on two industry-standard tools used across all participating programs: the PCL-5, which measures PTS symptom severity, and the PHQ-9, which tracks depression. Both are brief, scientifically validated, and widely used in clinical settings. They gave us a common language.
Here’s the good news: The data confirmed that these programs are truly effective.
On the PHQ-9, between 57% and 72% of clients experienced clinically significant improvement in depression symptoms. On the PCL-5, 59% of clients in outpatient programs and 68% of clients in intensive inpatient programs saw clinically significant reductions in PTS symptoms. Across every participating organization, the overwhelming majority of clients said they would recommend the program to a fellow veteran or family member, and satisfaction scores were consistently high.
On the process side, VWA outpatient clinical partners average just under 20 days from intake to a first therapy appointment. That’s an impressive number in a mental health landscape where wait times ordinarily can stretch to months.
None of this surprised us. But it changed the conversation. Because now, when someone asks whether veterans are actually getting better, we don’t have to say “we think so.” We can say yes, and here is how we know.
What these organizations did is uncommon. The philanthropic funding landscape is competitive. Every grant dollar that goes to one organization does not go to another. There is a real incentive to protect your data, your brand, your story. These organizations set that incentive aside because the mission was bigger than the competition.
It is also a signal to anyone in the veteran and military family community who is on the fence about seeking care. The programs accessible through Check-In are not just well-intentioned. They are accountable. They are measuring their results, sharing them honestly, and continuing to raise the bar.
If you are a veteran or military family member who has been hesitant to reach out for mental or brain health support, this data is for you. It is not a marketing pitch. It is what happened when a group of serious clinicians agreed to hold themselves accountable to the same standard and share what they found. The results speak clearly: the care is working, the people receiving it are satisfied, and you will not be waiting long.
You can visit veterancheckin.org to connect with a high-quality clinical partner in your area or even get to know some of the incredible peer networks we partner with to get involved in your community. President Bush asked how we know people are getting better. Now we can show him. And we’d be very happy to show you.
______________________
Blayne Smith is Director of Health and Wellbeing at the George W. Bush Institute’s Veterans and Military Families program and co-founder of Applied Leadership Partners. He is a West Point graduate and former Army Special Forces officer.
