Provider Shortage, Readiness Risk: The Behavioral Health Access Gap

Four in ten active-duty families reported waiting more than two months for a family member to get specialty care, according to the 2023 Military Family Lifestyle Survey. A GAO report examining one specialty in particular, behavioral health, shows why that number holds up under scrutiny rather than reading as an outlier.

What GAO found

GAO’s review of DHA’s TRICARE behavioral health referrals found that service members referred out to civilian providers for urgent behavioral health needs waited an average of two to three weeks for a first appointment, depending on region, even though Military Treatment Facilities are instructed to see urgent referrals within 24 hours. The gap traces to provider vacancy rates: as of January 2023, the most recent figure GAO has published, MTF civil service behavioral health vacancy rates exceeded 40%, the primary reason GAO’s site visits were identified for inconsistent appointment availability. 

GAO also flagged a structural blind spot. DHA has no established timeframe specifically for urgent civilian referrals, so it monitors urgent and routine referrals together rather than separately, which means the agency cannot currently see how many service members with urgent behavioral health needs are experiencing the longest delays, or diagnose why.

Why this matters beyond behavioral health

The pattern GAO documented in one specialty mirrors what military families report across specialty care broadly. An NPR analysis found that half of all U.S. military bases sit in federally designated health professional shortage areas. That mismatch between demand and staffing is what drives the appointment wait times. 

Every day a service member waits for care, medical deployability declines, training time is lost, and clearance gets delayed. Provider vacancy is a staffing problem no single technology solves. But the referral, scheduling, and visibility layer sitting on top of that staffing gap is exactly where the access bottleneck can be addressed today, without waiting for a hiring pipeline to catch up.

Where digital care fits

This is the specific gap eVisit’s platform is built around for the Military Health System: a Digital Front Door that gives service members an integrated point of access into available care rather than a black box referral process, virtual visit capability that connects behavioral health providers to service members regardless of where either one is physically stationed, and reporting that gives DHA and MTF leadership the kind of near real-time visibility into referral status that GAO’s report shows is currently missing.

None of that fixes the underlying provider vacancy rate. What it does is make existing capacity go further, and arm leadership with the data GAO says they currently lack, the kind needed to manage the problem rather than simply document it after the fact.

Sources: U.S. GAO, “Defense Health Care: DOD Should Monitor Urgent Referrals to Civilian Behavioral Health Providers to Ensure Timely Care,” GAO-24-106267; 2023 Military Family Lifestyle Survey (Blue Star Families); NPR analysis of military base health professional shortage areas.