Military veterans experience “excessive wait time” for medical care, leading to higher incidences of preventable hospitalizations and death, according to a scientific research council.

Drawing on the findings of recent government and scholarly studies, a report issued this week by the Institute of Medicine paints a picture of a healthcare system that is understaffed, undertrained, and inaccessible.

For instance, veterans seeking mental-health care at one site had to wait, on average, 86 days to see a psychiatrist, according to the report. And veterans living in rural areas may not have access to any psychiatrists at all, the report said.

The Institute of Medicine’s report comes a couple of weeks after the Government Accountability Office testified that Department of Veterans Affairs (VA) employees manipulated records to understate the wait times for medical appointments. In once clinic, for example, employees made it appear as though there was no wait time when, in reality, veterans experienced six- to eight-week delays for appointments, the GAO said.

Congress commissioned the study by the Institute of Medicine, which is part of the National Academies. The National Academies is a non-profit organization that often provides advice to Congress on scientific and technical issues.

While the Veterans Health Administration (VHA), the healthcare arm of the VA, requires that veterans seeking mental-health care be able to get a doctor’s appointment within 24 hours, the VHA has no “reliable and accurate method” to make that happen, the report said, citing findings from the VA Office of the Inspector General.