A new Pentagon report says thousands of troops and family members may not have access to mental health care through their military or civilian health care providers. The Defense Department Inspector General found patients seeking outpatient mental health treatment often experienced delays or never obtained care at all due to inconsistencies in standards, staffing and other shortcomings in the military’s health system.

In 2017, almost 14% of troops, or just over 200,000, were diagnosed with mental health disorders. The report said delays in getting service members care could affect readiness. Auditors examined appointment booking and referral data at 13 military treatment facilities from December 2018 to June 2019. The inspector general’s office said an average of 53% of service members and their families served by Tricare in the United States did not receive mental health care after getting referrals. Health officials in charge of tracking their care could not say why, the IG said.

The Defense Health Agency agreed to develop a single systemwide staffing approach that estimates the number of appointments and personnel required to meet the demand for mental health. The agency will also establish a standard process for mental health assessments tailored to patients’ needs, officials said in their response.