What were the study questions? Special mental health services have a focus on more intense problems like severe sadness or nerve issues. Doctors and nurses work with patients using longer sessions over a longer period than shorter treatment in primary care. We had two questions in this study. 1) If a Veteran needs special mental health services, does getting mental health care first in primary care increase follow up visits in special mental health services later? 2) If this does help, are there differences by racial or ethnic status of the Veteran? What did we do to answer the questions? We studied data from 437,051 primary care patients who also saw a special mental health doctors or nurses from 2015–2016 in VA. What were the answers to our questions? • Seeing a mental health doctor or nurse in primary care first made Veterans more likely to go to special mental health services if they needed it later. This was more likely for White patients who were not Hispanic or Latino or Latina. • If Veterans saw the mental health doctor or nurse the same day as they talked to their primary care doctor or nurse about a problem, they were more likely to go to special mental health services later if they needed them. This was true for Veterans of all races and ethnicities. • One thing we cannot know is if having a mental health doctor or nurse in primary care to see Veterans right away after they talk about a problem for the first time causes them to use more special mental health services if they need them later.