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VA and NW MIRECC History

VA and NW MIRECC History

National Home for Disabled Volunteer SoldiersThe United States has the most comprehensive system of assistance for Veterans of any nation in the world, with roots that can be traced back to 1636, when the Pilgrims of Plymouth Colony were at war with the Pequot Indians. The Pilgrims passed a law that stated that disabled soldiers would be supported by the colony.

Later, the Continental Congress of 1776 encouraged enlistments during the Revolutionary War, providing pensions to disabled soldiers. In the early days of the Republic, individual states and communities provided direct medical and hospital care to Veterans. In 1811, the federal government authorized the first domiciliary and medical facility for Veterans.

Also, in the 19th century, the nation's Veterans assistance program was expanded to include benefits and pensions not only for Veterans, but for their widows and dependents. On March 3, 1865, a month before the Civil War ended, President Abraham Lincoln authorized the first-ever national soldiers' and sailors' asylum to provide medical and convalescent care for discharged members of the Union Army and Navy volunteer forces. As the first-ever government institution created specifically for honorably discharged volunteer soldiers, it would later be renamed the National Home for Disabled Volunteer Soldiers

With malice toward none, with charity for all, with firmness in the right as God gives us to see the right, let us strive on to finish the work we are in, to bind up the nation’s wounds, to care for him who shall have borne the battle and for his widow, and his orphan, to do all which may achieve and cherish a just and lasting peace among ourselves and with all nations. President Abraham LincolnFrom 1866 to 1930, branches of the National Home for Disabled Volunteer Soldiers opened throughout the country. Following the Civil War, many state Veterans homes were established. Indigent and disabled Veterans of the Civil War, Indian Wars, Spanish-American War, and Mexican Border period, as well as the discharged regular members of the Armed Forces, received care at these homes. Beginning in late 1800's, National and State Homes opened in Idaho, Oregon, and Washington.

The first Soldiers' Home of the Pacific Northwest was located in Orting, Washington. In 1894, the Idaho State Soldiers' Home opened in Boise and the Oregon State Soldiers' Home opened in Roseburg. Later in 1907, the state of Washington passed legislation for the establishment of the Washington Veterans' Home in Retsil. As the U.S. entered World War I in 1917, Congress established a new system of Veterans benefits, including programs for disability compensation, insurance for service personnel and Veterans, and vocational rehabilitation for the disabled.

The Soldiers’ Hospital of Roseburg served the needs of Oregon's volunteer veterans from 1917 to 1933, when the VA completed construction of a new hospital in Roseburg. Within five years of opening, the mission of the Roseburg VA Hospital was re-designated to serve as a neuropsychiatric veterans hospital. The first hospital for Veterans in Portland Oregon was opened in November of 1921. A year later the United States Public Health Service (USPHS), founded as U.S. Marine Hospital Service (USMHS), transferred the Portland hospital to the United States Veterans Bureau. In Washington, there were U.S. Marine Hospitals located in Seattle, Port Townsend/Port Angeles, and Knappton Cove.

The Secretary of the Army authorized, under a revocable license, the Veteran Bureau's use of 377 acres of the 87,000-acre Fort Lewis property. Construction on the 94th Veterans Hospital began in 1923 and in 1924 American Lake VA Medical Center was dedicated. American Lake VA Medical Center was chartered with a single mission - neuro-psychiatric treatment. Oregon deeded Marquam Hill to the Veterans Bureau in 1926 for a hospital. The Portland Oregon VA Medical Center opened in 1928 with dedication in 1929. Also in 1928, admission to the National Homes was extended to women, National Guard, and militia Veterans. 

On July 21, 1930, President Herbert Hoover signed an executive order consolidating three independent bureaus---The Veteran's Bureau, the Bureau of Pensions, and the National Homes for Disabled Volunteer Soldiers creating the Veterans Administration (VA) with the purpose to "consolidate and coordinate Government activities affecting war veterans". The Veteran population vastly increased in the 1940s following World War II – more than 15 million Veterans were demobilized – and 671,817 returned injured. The World War II Servicemen’s Readjustment Act – the "GI Bill of Rights" – signed into law on June 22, 1944, provided new education benefits, unemployment compensation and home loans.

The VA has been serving Veterans in Vancouver since May 1946 when President Truman authorized the transfer of the U.S. Army Barnes General Hospital to the Veterans Administration. From 1950 to the present, the Boise VA Medical Center has occupied the main part of the grounds of the former Fort Boise. The sandstone buildings erected in 1864 are still in use by the Boise VA Medical Center today. The Seattle Division was dedicated on May 15, 1951, on Beacon Hill, with views of downtown Seattle and the Puget Sound to the North and Northwest, Mt. Rainier and the Cascade Range to the South and Southeast.

On October 25, 1988, President Ronald Reagan elevated VA to a cabinet-level executive department.On October 25, 1988, President Ronald Reagan elevated VA to a cabinet-level executive department. President Ronald Reagan said, "This bill gives those who have borne America’s battles, who have defended the borders of freedom, who have protected our nation’s security in war and in peace—it gives them what they have deserved for so long, a seat at the table in our national affairs. ... I like to think that this bill gives Cabinet rank not just to an agency within the government, but to every single veteran. And so in signing this bill, I’m saying to all our veterans what I say to new Cabinet members, 'Welcome aboard.'" 

The switch to cabinet-level executive department took effect in March 1989 under President George H. W. Bush and the Veterans Administration was renamed as the U.S. Department of Veterans Affairs (USDVA). As part of the cabinet-level elevation, VA’s Department of Medicine and Surgery was re-designated as the Veterans Health Services and Research Administration. In 1991, the Veterans Health Services and Research Administration was re-designated Veterans Health Administration (VHA).

The Anchorage Alaska VA Medical Center was opened in 1992. Also in 1992, the Portland VA Medical Center (PVMC) became physically joined to the Oregon Health and Science University (OHSU) Medical School with the completion of a steel, glass-enclosed, cable-stayed pedestrian sky bridge. Partnered institutions since 1948, the bridge spans a 150-foot-deep ravine separating PVAMC and OHSU. 

In the fall of 1997, Veterans Integrated Services Network (VISN 20) leaders from the VA Puget Sound Health Care System (VAPSHCS) and the VA Portland Health Care System (VAPORHCS) were commissioned by Congress and VA to establish one of the first three Mental Illness Research, Education, and Clinical Center (MIRECCs) in the United States. VISN 20 spans three time zones and includes medical centers in Alaska, Idaho, Oregon, and Washington. The primary research center located in VAPSHCS is affiliated with the University of Washington. VAPSHCS serves Veterans from a five-state area in the Pacific Northwest with two main divisions: American Lake and Seattle. The research center located at VAPORHCS is affiliated with the OHSU. VAPORHCS serves Veterans from Oregon and Southwest Washington with two main divisions: Portland and Vancouver.

From its early days, NW MIRECC has conducted research to understand PTSD, Traumatic Brain Injury, and other mental health challenges facing Veterans. During its first years, the NW MIRECC focused on posttraumatic stress disorder (PTSD), schizophrenia, and Alzheimer’s disease. That emphasis led to genetic discoveries in schizophrenia and to the identification of cerebrospinal fluid biomarkers for disruptive agitation in Alzheimer's disease. These findings were then passed on to clinicians and other VA personnel via MIRECC Presents, an interactive teleconference series that continues to this day but with enhanced web-related features for experiential learning. 

Wounded WarriorThe mission of VA VISN 20 MIRECC is to improve the quality of life and function of Veterans by developing, evaluating, and promoting the implementation of effective treatments for military PTSD and its complex comorbidities. These PTSD comorbidities include the behavioral consequences of mild traumatic brain injury (mTBI), substance use disorders, chronic pain, and dementia. NW MIRECC seeks to improve the mental health and well-being of Veterans through research and dissemination of information to providers both within the VA and the general public. NW MIRECC's diligent search for answers to mental health problems afflicting our Veterans continue today. 

Staff at the NW MIRECC pioneered the use of this medication to treat trauma-related nightmares, one of the most common symptoms of military PTSD. Due in part to our web-based and face-to-face educational outreach efforts, prazosin is now prescribed to over 100,000 Veterans and active-duty Servicemembers, and we continue to investigate its usefulness for other Veteran-related illnesses, including, for example, the post concussive headaches that Veterans report as one of the most disabling symptoms of mTBI. As part of the VISN 20 Northwest MIRECC mission to enhance access to mental health expertise, the NW MIRECC collaborates and consults with other MIRECCs and Centers of Excellence, as well as with other VA, DoD, Federal, State departments of Veterans Affairs, community agencies, and experts. 

VA is the world's leading research and educational center of excellence on Posttraumatic Stress Disorder (PTSD) and traumatic stress. Research studies at NW MIRECC are currently enrolling Military Veterans, First Responders, Health Care workers, and Civilians in Seattle, Washington. The VISN 20 NW MIRECC research studies significantly contribute to advancements in understanding medical problems that lead to health improvements for Veterans and civilians alike. 

NW MIRECC has adapted its mission to more readily address the most critical needs of Veterans in the region: PTSD and its associated conditions; mTBI, SUD, chronic pain, and dementia. The following three factors compelled us to make this shift:

  1. The return home of Veterans from Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) has substantially increased the already large number of Veterans who struggle with the distress and functional impairments of PTSD and its associated conditions.
  2. The close geographic proximity (40 miles) of Department of Defense (DoD) Joint Base Lewis-McChord/Madigan Army Medical Center to VA Puget Sound has provided an exciting opportunity to develop innovative and productive research, education, and clinical care collaborations with DoD personnel that address military PTSD and its associated conditions in their early stages in active-duty Servicemembers.
  3. It has become clear to NW MIRECC clinicians that PTSD is usually complicated by at least one--and often multiple--associated conditions. The typical OEF, OIF, and OND combat Veteran with PTSD -- as well as Veterans from the Vietnam War and other conflicts--also experiences persistent post concussive symptoms (such as chronic headache) from one or multiple mTBIs; struggles with chronic musculoskeletal pain; is excessively using alcohol to relieve symptoms; and is increasingly concerned that his or her subjective cognitive symptoms will develop into dementia. These other conditions associated with PTSD demand the concentrated focus of multidisciplinary centers like the NW MIRECC.

The VA Advanced Psychology Postdoctoral Fellowship in Mental Illness Research and Treatment (MIRT) is a two-year postdoctoral training program at VAPORHCS. The primary goal of the NW MIRECC Advanced Psychology Postdoctoral Fellowship program is to train and equip physicians, psychologists, and other allied health professionals with the knowledge and expertise to lead clinical research efforts that make lasting contributions in the lives of Veterans experiencing mental health challenges. Postdoctoral fellows have the opportunity to provide individual and group psychotherapy, supervise doctoral-level trainees, and actively participate in weekly team meetings and PTSD consultation as junior colleagues.

Social WorkerIn collaboration with their mentors, the Advanced Psychology Postdoctoral Fellows develops and implements research projects, publishes, presents findings, writes grants, and utilizes the latest technology for educational activities and clinical service delivery. Psychology Postdoctoral Fellows devote 75% of their time to research and education activities and 25% to clinical training. Over the course of the two-year program, NW MIRECC fellows are trained in clinical and health systems research, advanced clinical care service delivery, and program administration in an interdisciplinary setting.

Vet Centers in the VISN 20 Health Care Network are community-based counseling centers that provide confidential counseling, outreach, and referral services, including professional readjustment counseling to eligible Veterans, active-duty Army, Navy, Marine Corps, Coast Guard, Air Force, and Space Force service members, including National Guard and Reserve components, and their families. Vet Centers are located at more than 300 locations, including more than 80 Mobile Vet Centers. The staff is comprised of combat Veterans from several eras as well as family members of combat Veterans. This benefit is prepaid through the Veteran’s military service. 1-877-WAR-VETS is an around the clock confidential call center where combat Veterans and their families can call to talk about their military experience or any other issue they are facing in their readjustment to civilian life.

Today's VHA - the largest of the three administrations that comprise VA - continues to meet Veterans' changing medical, surgical, and quality-of-life needs. The VA health care system has grown from 45 hospitals in 1930 to 1,298 health care facilities today, including 171 VA Medical Centers and 1,113 outpatient sites of care of varying complexity. Veterans may be eligible to receive care from a community provider when VA cannot provide the care needed. VA provides health care for Veterans from providers in your local community outside of VA. VA has opened outpatient clinics and established telemedicine and other services to accommodate a diverse Veteran population, and continues to cultivate ongoing medical research and innovation to improve the lives of America’s patriots. 

U.S. Armed Forces VeteransNew programs provide treatment for TBI, PTSD, suicide prevention, women Veterans, homeless Veterans and more. On March 15, 2019, VA Puget Sound Health Care System opened a new 220,000-square-foot Mental Health & Research Building on the Seattle campus. The VA MISSION Act went into effect on June 6, 2019. In July of 2022, the United States launched a three-digit mental health crisis phone number -- 988. For calls, pressing “1” after dialing 988 connect directly to the Veterans Crisis Lifeline which serves our nation’s Veterans, service members, National Guard and Reserve members, and those who support them. Beginning on January 17, 2023, Veterans in acute mental health crisis were approved to go to any VA or non-VA health care facility for emergency health care at no cost – including inpatient or crisis residential care for up to 30 days and outpatient care for up to 90 days. This care is provided on behalf of and paid for by VA. 

The Plymouth colony first cared for veterans beginning in 1636. Three hundred and eighty-seven years later, the United States continues to provide the best possible care for our greatest assets. NW MIRECC reaffirms its commitment that there is no higher priority than caring for the wounded, ill, and injured service members who have sacrificed so much. NW MIRECC continues to be at the tip of the sword in response to Warrior Care and continues to strive to improve the health and well-being of our Veterans. There is no greater calling than to care for those who ensured our freedom; Warrior Care is America's duty.

VA VISN 20 consists of four states across three time zones; Alaska, Idaho, Oregon, and Washington. The primary research center located at VA Puget Sound Health Care System (VAPSHCS) is affiliated with University of Washington. VAPSHCS serves Veterans from a five-state area in the Pacific Northwest with two main divisions: American Lake and Seattle. Veterans in Washington are also served by VA Medical Centers in Spokane, Vancouver, and Walla Walla. In Washington, there are VA Community Based Outpatient Clinics (CBOC's) located in Bellevue, Bremerton, Chehalis, Edmunds, Everett, Federal Way, Mount Vernon, Olympia, Port Angeles, Puyallup, Richland, Renton, Silverdale, Seattle, Wenatchee, and Yakima. The research center located at VA Portland Heath Care System (VAPORHCS) is affiliated with Oregon Health and Science University. VAPORHCS serves Veterans from Oregon and Southwest Washington with two main divisions: Portland and Vancouver. Veterans in Oregon are also served by VA Medical Centers in Roseburg and White City. In Oregon, there are CBOC's located in Bend, Boardman, Brookings, Enterprise, Eugene, Fairview, Grants Pass, Hines, Hillsboro, Klamath Falls, LaGrande, Lincoln City, Newport, Portland, Salem, The Dalles, Warrenton, and West Linn. VA provides health care for Veterans from providers in your local community outside of VA. Veterans may be eligible to receive care from a community provider when VA cannot provide the care needed.

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VA Vet Center Logo Vet Centers in the VISN 20 Health Care Network are community-based counseling centers that provide a wide range of social and psychological services, including professional readjustment counseling to eligible Veterans, active-duty Army, Navy, Marine Corps, Coast Guard, Air Force, and Space Force service members, including National Guard and Reserve components, and their families. 1-877-927-8387 is a free, around the clock confidential call center where Veterans, service members and their families can talk about their military experience or any other issue they are facing in transitioning after military service or trauma and get connected to their nearest Vet Center.

Veterans Crisis Hotline 988 - If you are having a medical or mental health emergency, dial 911. If you are having thoughts of suicide, dial 988, then press 1 at the prompt to reach the Veterans Crisis Line

Veterans Crisis "988" - The Military Crisis Line is a free, confidential resource for all service members, including members of the National Guard and Reserve, and Veterans, even if they’re not enrolled in VA benefits or health care. Call 988 then Press 1 If you are a Veteran, service member, or any person concerned about one who is hard of hearing, you can connect with professional, caring VA responders through online chat and text message (838255). 

In Europe
Call 00800 1273 8255 or DSN 118

In Korea
Call 080-855-5118 or DSN 118

In Afghanistan
Call 00 1 800 273 8255 or DSN 111

In the Philippines
Call #MYVA or 02-8550-3888 and press 7

A Veteran overseas may contact the Veterans Crisis Line via the chat modality at If the Veteran prefers a phone call, they can request this within the chat venue. For TTY users: Use your preferred relay service or dial 711 then 1-800-273-8255. Are you looking for clinical care or counseling? Assistance with benefits? No matter what you’re experiencing, we’re here to connect you with resources and support systems to help. The Veterans Crisis Line is free and confidential. When you call, chat, or text, a qualified responder will listen and help. You decide how much information to share. Support doesn't end with your conversation. Our responders can connect you with the resources you need.


VA has a variety of mental health resources, information, treatment options, and more — all accessible to Veterans, Veterans’ supporters, and the general public. Explore the pages below to learn more about a specific mental health topic. Each of these pages includes resources, information on treatment options, and more.

Stories of Support

Telehealth Therapy

For Daniel, Don, and Jennifer, convenient video counseling made it easier to put their health first. Adjusting from military service to civilian life can be both exciting and challenging. Make the Connection

Dial 988 then press 1

Connect with the Veterans Crisis Line to reach caring, qualified responders with the Department of Veterans Affairs. The Veterans Crisis Line is free and confidential. Support doesn't end with your conversation. Our responders can connect you with the resources you need.

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