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Getting into the system, and into a routine with a therapist and receiving consistent care takes time is the hardest part, especially for reservists in rural areas or veterans who move around, Mr. Hansman said.

“If you’re waiting over two to three weeks for care that’s been promised, then there’s some sort of breakdown in the system,” he said. “There’s still this gap between what the VA provides and what is actually needed.”

The VA operates 153 hospitals, 956 outpatient facilities and 232 smaller clinics nationwide.

Kristina Kaufmann, executive director of Code of Support, a military advocacy group, worries that the Navy Yard shooting will make it even harder for veterans to come forward and seek mental health care.

“These things can impede and serve as a barrier to service members who are dealing with mental health issues — just in trying to convince them to go get help and that they are nothing like this guy and they are not crazy,” Ms. Kaufmann said.

“The narrative of this country is starting to fly back to what it was after Vietnam, which is ‘crazy veteran,’” she said. “This guy seems to have deep psychological problems that were pre-existing. — 99.9 percent of veterans are not going around shooting people.”