Ten Years of Outcomes in a National Mental Health Network for Veterans, Service Members, and Military Families.

Abstract

Military-affiliated adults including veterans, active-duty service members, and their families experience elevated rates of mental health conditions such as PTSD, depression, and anxiety. Addressing these needs requires accessible, high-quality, and evidence-based care delivered at scale. Cohen Veterans Network (CVN), a national network of community-based military family clinics, was established in 2015 to provide rapid access to mental healthcare, emphasizing evidence-based psychotherapies, measurement-based care, and standardized clinical and operational practices. This retrospective study examined ten years of outpatient mental health care (2016-2025) across CVN clinics (N = 45,947 clients). Analyses focused on symptom change, clinically significant improvement, and trends over time, with stratification by client type and gender. Results indicate that across more than a decade of care, clients demonstrated consistent, meaningful symptom reductions. Among clients who screened positive at intake, mean PHQ-9 improvements ranged from 6.05 to 7.10 points, GAD-7 improvements from 5.67 to 6.24 points, and PCL-5 improvements from 16.50 to 18.37 points, with 55-68% of clients achieving clinically significant change. Outcomes remained stable despite network expansion, shifts in client composition, and external stressors such as the COVID-19 pandemic. Outcomes are also described by client type and gender, with all subgroups demonstrating symptom reductions. These findings demonstrate that using a social franchise model combining centralized infrastructure, local clinic management, standardized training requirements, and rigorous quality control can sustainably deliver high-quality, effective psychotherapy at scale. The CVN experience provides a replicable framework for addressing mental health disparities among military-affiliated populations and other underserved groups.