The current study aim was to examine mental health characteristics in a sample of returning OEF/OIF/OND veterans initially enrolling in Department of Veterans Affairs (VA) health care (N = 1,307), with a particular focus on a subgroup considered at risk for suicide (N = 445). Methods included examination of mental health screening measures and clinical interview data from a VA postdeployment clinic. Half of the sample met criteria for a mental health disorder, whereas 10% reported current suicidal or death ideation (e.g., thoughts of being better off dead or hurting oneself in some way) and 6% reported a history of suicide attempt. Sixty-eight percent of the at-risk subgroup accepted a referral for mental health treatment and a promising majority (78%) of those individuals attended their initial specialty mental health visit. At-risk veterans who accepted mental health referral were more likely to report current suicidal/death ideation; they were also more likely to have a diagnosis of a depressive disorder, anxiety disorder, or posttraumatic stress disorder. Factors associated with mental health appointment attendance included older age, being enrolled in college, and more years of military service. Results highlight the importance of early screening and referral to appropriate mental health follow-up. Implications for clinical practice and increasing engagement in VA mental health services among veterans at risk for suicide are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).