The Veterans Administration (VA) in its current format was created in 1930 during Herbert Hoover's presidency with the following commitment: ‘To fulfill President Lincoln's promise “To care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America's veterans.’ Now under the auspices of the US Department of Veterans Affairs, the VA website explains that the ‘VA carries out four specific missions to make good on that commitment’: Veterans Health Care, Veterans Benefits, National Cemeteries and a ‘fourth mission’, defined as the nation's preparedness ‘for response to war, terrorism, national emergencies, and natural disasters’. As fictional responses and oral histories of post-World War II conflicts reveal, there has been a distinct shift in how US veterans perceive the VA in the last seventy-five years. Since 1945, some veterans have lost trust in the VA, with the most notable shift in attitude coinciding with the latter years of the Vietnam conflict, which appears to be a turning point for the relationship between veterans and the VA.

In this chapter, I argue that whereas the first three of the VA's missions are intended to work together to support veterans through their recovery and reintegration and/ or to enable them to maintain a good quality of life after their years in service, there is a notable conflict between these three, which work to support veterans and their families on an individual level, and the last mission, which acts in the interests of the state. It is this incongruence in the VA's overall commitment that I suggest could be at the root of the breakdown in trust between veterans and the federal organization which is intended to support them. This has occurred despite moves by Congress to address capacity limitations in the VA, notably by assisting in the establishment of community-based ‘vet centers’ from the 1970s to provide confidential and free counselling, readjustment and outreach services independent of the VA medical system – today, there are over 360 vet centers located in all fifty states, the District of Columbia and US territories, and approximately seventy mobile vet centers serving rural areas.

In spite of periodic capacity issues, prior to 2001 the Veterans Administration served a relatively low number of veterans returning from conflict, but that number has increased in recent years.