Veterans Mental Health Programs: A Case Study on Gaps in Budget Transparency

For the past decade, the federal government has failed to comply with a mandate to create an inventory of federal programs along with their funding levels. One of the roadblocks has been applying a consistent definition of what constitutes a program across federal agencies. One rule of thumb Congress might consider: if there is a website for a service, program, or agency, then taxpayers should be able to access basic budget information for that program. 

Currently, budget information is scattered across dozens of agency and department websites, and there are gaps in the data that is presented. Access to a comprehensive and centralized database would provide great value, enabling taxpayers to easily see how their tax dollars are being spent. It would also help lawmakers to identify waste and duplication across the massive federal bureaucracy. 

Better organization of budget information would also make it easier for researchers to assess the cost of new proposals, like NTUF’s analysis of campaign platforms. In cases where a candidate promises to establish a new program and a cost estimate is not available, NTUF matches it with related legislation or similar existing programs to provide some budget context for the potential impact on spending. This entails digging through the budget appendix published annually by OMB or in the agencies’ and departments’ detailed budget justification documents.

Research into Vice President Joe Biden’s promise to create “a national center of excellence for reducing veteran suicide, similar to the National Center on Homelessness among Veterans” provides a case study in the incompleteness of the federal budget.

If there was a program inventory, his policy people might have known that there is already a similar Center of Excellence (CoE) for Suicide Prevention with a website at mirecc.va.gov/suicideprevention/. The “About” section notes that the Department of Veterans’ Affairs (VA) established the CoE in 2007 “with the overarching mission to reduce morbidity and mortality associated with Veteran suicide and self-directed violence.” There is no budget information provided.

The website is listed as a subdirectory of a VA program, but when you go up to the “MIRECC” page, it does not indicate what that acronym means. There is no “about” page providing information about the program and its mission. A google search identifies it as the Mental Illness Research Education Clinical Center.

Neither the CoE nor the MIRECC are included in VA’s budget appendix. The VA presents its 2021 budget justification across four volumes plus a Budget in Brief document. Volume II includes budget information for “Medical Programs and Information Technology Programs.” The CoE is mentioned in the text but without budget information and there is no mention of the MIRECC. The Volume also mentions an Office of Mental Health and Suicide Prevention but there is no line item budget figure for the office. The budget justification lumps together veteran suicide prevention programs at $237 million in 2020 and includes a second line item for “Suicide Prevention Treatment in Non MH Setting” totaling $348 million.

The VA needs to increase budget transparency by providing basic budget information of its various subprograms instead of listing them altogether in a lump sum. The budget details should easily match up with all the programs and services included in the VA website. It would also be helpful for taxpayers if VA, and other departments, would also provide a single PDF of their annual budget justification in addition to the multiple volumes that are published separately.