VA Spent $2.6 Billion on Veterans' Family Caregivers in 2025. Only 9% Got Mental Health Care Through the Program.

Forty-three percent of caregivers of servicemembers or veterans aged 60 or younger meet clinical criteria for depression, according to a 2024 RAND Corporation study cited in an April 2026 GAO report on the Department of Veterans Affairs' Caregiver Support Program.▸ Caregivers of younger veterans report stress at nearly double the rate of those caring for a veteran 60 or over — 75% versus 44%, per the literature GAO reviewed — and roughly one in three caregivers who needed mental health care never sought it, most commonly because they said they didn't have the time.

Into that population VA has poured a rapidly growing budget.▸ The Caregiver Support Program, which pays a monthly stipend and covers benefits for relatives who provide around-the-clock care to disabled veterans, obligated $2.6 billion in fiscal 2025 — up from $874.5 million in fiscal 2021 and $437.9 million in fiscal 2019, before the VA MISSION Act of 2018 expanded who could qualify. The money bought scale: about 98,000 caregivers participated last year, nearly double fiscal 2021. It did not buy, GAO found, a way to know whether the sliver of that budget meant to protect caregivers' own mental health is working.

VHA established the Caregiver Support Program in 2011 to support the health and wellbeing of family caregivers, and it now runs through 173 VA medical centers.▸ It has two tiers. Any caregiver of a veteran enrolled in VA health care can join the general component — peer support, respite care, skills training. The comprehensive component pays: a monthly stipend, travel benefits, CHAMPVA health coverage, and access to mental health treatment, but only to caregivers of veterans with at least a 70% service-connected disability rating who need in-person personal care for six continuous months or more.

That comprehensive tier is where the growth is.▸ Of the 98,000 caregivers VHA served in fiscal 2025, about 70,000 were in the comprehensive component and about 28,800 in the general component, GAO found — a mix that has shifted steadily toward the paid tier since the MISSION Act widened eligibility for it in October 2020. Most caregivers are women: 89% in the comprehensive component, 93% in the general component. Most are the veteran's spouse or partner. About 7,300 of the 98,000, just over 7%, are themselves veterans.

VA has asked for more every year since: $3.3 billion for fiscal 2026 and $3.6 billion for fiscal 2027, both still to support "further anticipated increases in enrollment," per the report.▸ This isn't the program's first run of underestimating its own growth — a 2014 GAO review found VA had so badly underestimated comprehensive-component demand that VA medical centers were understaffed to run it; VA implemented that report's tracking-system recommendations in 2015, 2019, and 2020.

"The majority of program spending is for stipends and benefits VA pays to caregivers in the comprehensive component for their caregiving duties," GAO's report states.▸ Specifically: of the $2.6 billion obligated in fiscal 2025, about $1.8 billion — 72% — was monthly stipends, travel benefits, and CHAMPVA coverage. The remaining 28%, roughly $800 million, covered everything else the program does across both components: respite care, mental health treatment, coaching, self-care education, legal and financial planning, and running the program at 173 medical centers.

That split is by design — the stipend is the program's headline benefit — but it means the $800 million funding mental health treatment, respite, coaching, and everything else is spread across roughly 98,000 caregivers at facilities nationwide.▸ One veterans service organization official told GAO the stipends themselves are "often insufficient to cover costs, such as their veterans' medical expenses," compounding rather than relieving caregivers' financial stress.

The comprehensive component isn't open enrollment.▸ In fiscal 2025 the program received about 66,000 applications and approved roughly 30% of them, denying the remaining 70% "due to clinical reasons, such as the veteran not needing personal care services for at least 6 continuous months," per GAO's account of VA data. Caregivers who are turned away, or who are waiting for a decision, can enroll in the unpaid general component in the meantime — but general-component caregivers cannot receive mental health treatment through the program at all, unless it's incidental to the veteran's own VA care.

Staff at three of the four VA medical centers GAO visited said they saw the gap firsthand and were "disappointed that caregivers in the general component cannot access" mental health treatment, and caregivers interviewed agreed it should be available to them too.▸ In September 2025 the Caregiver Support Program Office estimated that extending mental health treatment to the general component would draw up to 1,622 additional caregivers into care. As of January 2026, VA officials were still reviewing whether they even have the legal authority to make that change.

Mental health treatment — individual, group, couples, or family therapy, in person or through the Virtual Psychotherapy Program for Caregivers VHA phased in starting fiscal 2023 — is available only to the 70,000 caregivers in the comprehensive component.▸ From fiscal 2021 through 2025, the number of those caregivers who had a mental health encounter within VHA tripled, and the share who did rose from 6% to 9%.

That's the number VA can point to, because it's the only one it set a target for.▸ Applying its own performance-management framework, GAO found the Caregiver Support Program Office had set four goals for spreading awareness of the program — enrollment, inquiries, email subscribers, service use — but attached a quantitative target and timeframe (15% enrollment growth a year) to exactly one of them. It did the same on mental health: it set one measurable goal, a 10% annual increase in Virtual Psychotherapy Program encounters, met it by growing those encounters more than 50% from fiscal 2024 to 2025 — and set no goal at all for mental health treatment delivered any other way, or for whether respite care, coaching, or support groups are doing anything for caregivers' wellbeing. About a third of caregivers who got mental health treatment in fiscal 2025 got it in person at a VA medical center, outside the one metric VA tracks.

GAO's review was required by the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, signed into law January 2, 2025, which directed GAO to examine mental health support for veteran caregivers specifically.▸ It made two recommendations: set quantitative targets and timeframes for all four outreach goals, and do the same for all the mental health support the program offers — not just the one telehealth program it already measures. VA concurred with both and told GAO it expects to finish implementing them by February 2027.

Figures are drawn from GAO's April 2026 review of VA data spanning fiscal years 2019 through 2027 (2026 and 2027 are budget requests, not appropriations) and are cited to their original reporting period; VA's review of its own legal authority to expand mental health eligibility was ongoing as of January 2026, GAO's cutoff for this report.