Members of our armed services face an increased risk of mental health conditions like PTSD, depression, and substance use disorder. Stressors like the transition into civilian life can lead to worsening symptoms and present barriers to accessing health care. Here’s how to navigate your options.
- More than 1.5 million out of 5.5 million veterans seen in VA hospitals had a mental health diagnosis in 2016, a 31 percent increase since 2004
- Barriers to access, like stigma, unemployment, and shifts between healthcare systems can be addressed with support
- Veterans can cope and recover by using resources, seeking treatment, practicing self-care, and finding community
Veterans who experience military trauma often come home with invisible wounds. Upon their return to civilian life, some may experience hypervigilance, nightmares, or growing conflict with family members. While many can recover with support, others may need additional assistance to feel better.
Rising numbers of veterans are living with a mental health condition, with one in five qualifying for a diagnosis upon their first visit to a U.S. Department of Veteran Affairs (VA) health clinic. Yet fewer than half of those who need help seek professional support, and more than 90 percent of those with substance use disorder are not in treatment, according to a survey conducted in 2020 by the Substance Abuse and Mental Health Services Administration (SAMHSA). Of those who do reach out, almost one in five report challenges accessing care, according to a survey by the Wounded Warrior Project.
Connecting with a mental health care provider can prove difficult due to a variety of barriers, from stigma to provider shortages. Veterans and advocates are fighting for a better system and building communities to help address these problems. Here’s a quick guide to common mental health challenges military members and veterans face when to seek support, and how to take advantage of resources.
If you or someone you know is in crisis or having thoughts of suicide, seek help immediately. To contact the Veterans Crisis Line, call 988 and press 1, text 838255, or start a confidential chat. If you have hearing loss, call TTY 800-799-4889. If anyone is in immediate danger, call 911 and tell them you are dealing with a mental health emergency.
Understanding Veteran Mental Health Challenges
“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.
- 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.
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.
Accessing Mental Health Services as a Military Member or Veteran
When you decide to seek support, you have a variety of options to consider. Depending on your circumstances, you may choose to seek care through the Department of Defense, the VA, your current employer, or other resources.
Accessing Mental Health Services While in Service
“The military has made tremendous strides in acknowledging that holding someone’s mental health issue against them is a bad idea because it discourages help-seeking,” says Acierno. “In response, many service personnel can seek mental health care without consequence to their career.”
If you’re an active duty military member, you and your family are covered by the military health care system. You can find mental health services through the military or participating civilian providers with TRICARE health insurance. If you’re moving between healthcare providers or locations, contact InTransition to review your options.
Beyond traditional psychological health services, you can also use:
- Military OneSource, a free service that points veterans to the most relevant mental health resources for their needs, like confidential counseling
- Military and Family Life Counseling Program, which provides support to military members and their families where they are stationed
- Peer-to-Peer Counseling to talk about your challenges, career, personal life, and more
If a military member is concerned about stigma or reprisal from a superior for seeking help, there are other options. Many nonprofit organizations offer free mental health care near military bases. Acierno advises contacting veterans service agencies in your area, like the Wounded Warrior Project, to find community providers.
Wherever you can obtain it, find professional support. “Take into consideration what could happen if you don’t seek help,” says Justin Baksh, LMHC, a Florida-based licensed mental health counselor and veteran of the U.S. Marines. “If you are worried that a mental health issue might end your career, an untreated one runs a greater chance of that happening.”
Accessing Mental Health Services While Transitioning to Civilian Life
The best choice for mental health care services when transitioning into civilian life will depend on your individual situation. It’s important to research your options and think about the pros and cons of each.
If you qualify for care through the VA, Acierno recommends it. “The reason to seek mental health care from the VA is that the VA mental health service lines have invested millions of dollars in training their providers in best practices for PTSD, depression, sleep, and pain interventions,” he says. “Their care is tailored to veterans.”
To learn more about your options, call or walk into the closest VA health facility. Find yours here. If there are longer-than-usual wait times, the VA can also set you up with a community provider through the VA Community Care Network, says Baksh.
Accessing Mental Health Services Through Other Avenues
Managing Your Lifestyle to Support Mental Wellness
Seeking support and getting a treatment plan is step one. From there, you also want to commit to lifestyle changes that will support your health for the long haul. Here are a few ways to maintain your strength.
Find Veteran-Friendly Health Services
Prioritize your overall well-being by finding local health services for veterans. Use the VA’s My HealtheVet to access your health records, find providers, and track progress in a health journal.
Compared with the general population, veterans report feeling more socially isolated. Those who report moderate to high levels of social isolation are four to five times more likely to be readmitted to a psychiatric hospital than those who report low levels of social isolation, according to a study published in April 2023 in the Journal of Mental Health. To regain a sense of community and maintain ties with your tribe, contact veterans or veterans groups. You could start with your local vet center, Veterans of Foreign Wars (VFW) post, or American Veterans (AMVETS) post. Reach out to others as well, like a religious or spiritual advisor, local nonprofit organization, or interest group.
Talk About Your Experiences
Talk to your loved ones about what you’re going through. They may not always understand your experiences or your perspective, but it’s helpful for them to hear where you’re coming from and how they can support you, NAMI notes.
Adopt and Maintain Healthy Habits
Cover the fundamentals with a healthy diet, regular exercise, good sleep hygiene, and stress reduction techniques like meditation. Taking care of the basics can help support you in your recovery and reduce the risk of worsening symptoms.
Optimize Your Mental Health
Use the Real Warriors Psychological Health Resource Center to find tools to improve your mental health. There, you can chat with a trained psychological health resource consultant for free, personalized advice.
A Note for Family and Friends
If you’re concerned about a military member or veteran in your life, support is available and you can make a difference. “It’s important to love and care for the person without smothering them or making them feel singled out,” says Baksh. Rather than demanding they get help, he says, describe what you’re noticing and express your support. You could say: “You don’t seem to be happy lately. Do you need someone to talk to?” or “Have you thought about using the VA benefits you have?”
Ultimately, the key is to show that you love them and care about their well-being, to be patient yet persistent, and to keep showing up. You can get personalized advice on how to approach your loved one about mental health concerns from Coaching Into Care. Call 888-823-7458 to chat with an advocate or find tips on how to start the conversation here. In the meantime, serve as a model by taking care of yourself. For support, contact the VA Caregiver Support Program at 855-260-3274 or learn more online.
The Bottom Line
A rising number of military members and veterans need support for their mental health. Many resources are available, but it’s essential to combat stigma and create clear pathways to care. The passage of time and community can help heal some wounds. But in many cases, counseling or therapy is also essential for recovery. If you’re hesitant to seek support or your loved ones have expressed concerns, be open-minded and consider shifting your perspective. Being willing to ask for and accept help is a sign of strength, as is taking advantage of resources to become stronger and more resilient.
Mental Health Resources for Veterans
- Veterans Crisis Line Get 24/7 confidential support from trained crisis counselors. Call 988 and press 1, text 838255, or open a chat. If you have hearing loss, call TTY 800-799-4889.
- Safe Helpline Get confidential support for veterans and loved ones affected by sexual assault. Call 877-995-5247 or open a chat online.
Help Finding Treatment
- Veterans Health Administration Locator Call 877-WAR-VETS (877-927-8387) or use these search tools to find VA locations or in-network community care providers, PTSD treatment programs, or substance use disorder programs.
- Substance Abuse and Mental Health Services Administration (SAMHSA) Find substance use disorder programs outside the Department of Defense or VA. Use the treatment locator or call 800-662-HELP (4357).
- InTransition Use this resource for help finding mental health care when between service providers or locations.
Support for Loved Ones and Caregivers
- Coaching Into Care Call 888-823-7458 to get advice on how to encourage a veteran in your life to seek support or mental health care. Find tips on how to start the discussion here.
- VA Caregiver Support Program Call the Caregiver Support Line at 855-260-3274 or learn more online.
- National Call Center for Homeless Veterans Get support for veterans who are homeless or at risk of becoming homeless at 877-4AID-VET (877-424-3838) or learn more online.
- Woman Veterans Call Center To find resources for women veterans, call 855-VA-WOMEN (855-829-6636) or learn more online.
- VHA LGBTQ+ Health Program Connect with a local LGBTQ+ veteran care coordinator or learn more online.
- VA Self-Paced Online Training Use free VA courses to learn how to manage adjustment issues and life challenges, cope with anger and irritability, and parent effectively.
- Real Warriors Psychological Health Resource CenterFind tools and get online coaching to improve your mental health.
- Mobile Apps from the VA National Center for PTSD Download mobile apps like PTSD Coach to support your treatment plan and recovery.
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