How to Access Mental Health Care for Military Members and Veterans

Understanding Veteran Mental Health Challenges

During the course of their career, military members may experience repeated traumatic experiences, which can wear them down and hamper their ability to bounce back.

“Active duty personnel, including soldiers, airmen, sailors, guardsmen, and marines, face unique challenges,” says Ronald Acierno, PhD, vice chair of Veterans Affairs at UTHealth Houston and executive director of the UTHealth Houston Trauma and Resilience Center. “These include working with very dangerous equipment, working in places far from family, and operating in combat zones where other people are trying to hurt and kill them.”

Military culture, which emphasizes strength and resilience, can also lead some to delay or avoid help-seeking because enlisting support for mental health problems might be perceived as a sign of weakness, adds Dr. Acierno.

After active service ends, it can be difficult to adjust to civilian life. While they serve, military members can garner valuable experiences and develop a strong sense of camaraderie, duty, and purpose. “When they depart from the military, it can feel like they’re losing all of that,” says David Riggs, PhD, executive director of the Center for Deployment Psychology at Uniformed Services University in Bethesda, Maryland. “Sometimes it’s hard to find the same sense of meaning when you’re out of uniform.”

Other times, the challenges veterans face are more concrete, says Dr. Riggs. Resources that were readily available to them while in service may become less accessible when they enter a new community where they don’t have strong ties.

Research suggests mental health challenges for members of the armed services do not follow one set pattern or timeline, but symptoms can begin to emerge or worsen during particularly stressful times. Some flashpoints to be aware of are the times surrounding deployment or combat, the transition into civilian life and the years that follow, and periods of interpersonal conflict like divorce.

Among others, common mental health challenges veterans may face include:

• Post-traumatic stress disorder (PTSD) About seven percent of veterans develop PTSD at some point in their lives, according to the U.S. Department of Veteran Affairs. Traumatic events like witnessing severe injuries or deaths in combat, domestic violence, or military sexual trauma can lead to symptoms of post-traumatic stress like trouble sleeping, nightmares, angry outbursts, hyperalertness, and attempts to self-medicate with alcohol or drugs, according to the National Alliance on Mental Illness (NAMI). If these issues persist for longer than a month, they could be a sign of PTSD.
• Depression Nearly 1 in 10 walk-in military health network appointments are for depression, and those who have been deployed are twice as likely to experience depression compared with their non-deployed counterparts. Being away from loved ones, going through combat, and seeing others in danger can increase risk. Symptoms include a low mood, trouble concentrating, and hopelessness, among others, though veterans may notice or present with more physical complaints such as lower energy levels, disrupted sleep, or changes in appetite.
• Suicide Veterans account for 18 percent of all reported suicide cases. Veterans within their first year of separation from military service have a 2.5 times higher risk of suicide compared with service members on active duty. This transition period can be a particularly vulnerable time due to stressors like the struggle to find post-military employment and the resulting financial insecurity and trouble accessing health care, according to a study published in September 2020 in JAMA Network Open. The strongest risk factors for death by suicide in veterans are a history of self-harm, major depression, bipolar disorder, substance use disorder, or other mental health conditions, or current challenges with these issues.
• Substance use disorder (SUD) Of those visiting the VA for health care for the first time, about 1 in 10 qualify for a diagnosis of substance use disorder. The most common substance use issues among veterans are heavy drinking and smoking, though opioid use disorder is also on the rise, according to an article published in August 2017 in Substance Abuse and Rehabilitation. Alcohol and drug use have been associated with about 30 percent of completed suicides as well as 20 percent of high-risk behavior deaths in military personnel.
• Multiple mental health conditions Many veterans do not experience one mental health condition but a combination of them, such as PTSD and substance use disorder. It’s important to address veteran mental health holistically and to consider treatment plans that take these intersecting issues into account.

No matter your experience or the stage of your career, it’s crucial to reach out for support for your well-being.

Signs You May Need Help

It can be difficult to tell when you need support, especially when military culture may lead you to hide or ignore your struggles — even when talking to a healthcare professional.

According to the SAMHSA and the National Institutes of Mental Health (NIMH), the following are signs you or a loved one may need support:

• Trouble sleeping
• Difficulty concentrating
• Loss of interest in activities you once enjoyed
• Appetite changes that result in unintended weight gain or weight loss
• Feeling low or depressed most of the time
• Struggling to get out of bed because of your mood
• Feeling like there is no reason to live
• Feeling unexplained guilt, shame, or failure
• Intense rage or angry outbursts
• Engaging in risky behaviors
• Increasingly using drugs, alcohol, or prescription medication
• Struggling to keep up with day-to-day responsibilities at home, work, or school
• Pulling away from family and friends

If you’ve been experiencing any of the above for two weeks or longer, seek professional help. To reach the Veterans Crisis Line, dial 988, then press 1, text 838255, or open a chat. If you have hearing loss, call TTY 800-799-4889.

You can find treatment for substance use disorder through the VA’s search tool. For treatment outside of the VA, use SAMHSA’s treatment locator or call 800-662-HELP (4357).

If you’re transitioning between mental health care providers or not sure how to access it from where you are located, use InTransition for free, confidential guidance.

The Benefits of Seeking Support

Taking care of your mental wellness is just as important as maintaining physical fitness. Your mental health is essential to help you function optimally and reach your highest potential.

Prioritizing mental health can help you:

• Maintain and build your career inside and outside of military service
• Enhance your resilience and adaptability in service and civilian life
• Improve your physical health and fitness
• Feel less irritable and more relaxed
• Reconnect with loved ones
• Strengthen relationships
• Better support family and friends
• Make meaningful contributions to your community
• Boost your productivity
• Improve your overall quality of life

Promptly addressing mental health concerns could also help you avoid worsening symptoms and regain control of your life.

Types of Treatment

When you’re ready, many effective, evidence-based treatment options are available.

• PTSD can be treated with trauma-focused talk therapy such as cognitive processing therapy (CPT), prolonged exposure (PE) therapy, and eye movement desensitization and reprocessing (EMDR), as well as medication, according to the U.S. Department of Veterans Affairs National Center for PTSD.
• Military sexual trauma can be treated with trauma-focused talk therapy as well. Members of the Department of Defense can contact the Safe Helpline for 24/7 confidential support for veterans and loved ones affected by sexual assault by calling 877-995-5247 or opening a chat online. The VA provides free services and treatment for mental and physical health conditions related to military sexual trauma, regardless of length of service or income. No documentation is necessary, according to the Center for Deployment Psychology. Learn more about how to get help from the VA or other resources here.
• Depression can be treated with therapy such as cognitive behavioral therapy (CBT), medication, and lifestyle changes.
• Suicide can be prevented with therapy, a safety plan, and supportive care. Veterans can receive emergency care free of charge from any VA or non-VA health care facility, whether or not they are enrolled, as a part of the National Strategy for Preventing Veteran Suicide. If you or someone you know is having thoughts of suicide, contact the Veterans Crisis Line, call 988 and press 1, text 838255, start a confidential chat, or go to your nearest VA center or hospital.
• Substance use disorder can be treated with therapy, medication to manage cravings and symptoms of withdrawal and treatment programs. Other conditions like PTSD and depression can also be treated at the same time. Learn more and get help here.

In addition to therapy and medication, peer support groups or group therapy can also be helpful by giving you the space to talk openly about similar experiences and exchange coping tools with other veterans.

For instance, when living with PTSD, it’s common to struggle with avoidance behaviors like not going outside or pulling away from others. Talking to other veterans about how they manage to step out more often can help you move forward too.