Addressing Mental Health Treatment Barriers For Veterans
On the 11th of November, the US celebrates Veterans Day to honor veterans who have served the US armed forces. November is also known as Military Family Month when campaigns that provide resources for military families and veterans occur.
According to the United States Census Bureau, approximately 16.5 million veterans make up the adult population in the nation. While veterans have left the battlefield, some may continue to experience the effects of their time served, potentially remembering physical and emotional trauma. Because veterans often experience traumatic events, the rate of mental health conditions like depression, anxiety, and post-traumatic stress disorder (PTSD) can be high in these communities.
To understand veterans' treatment barriers and how their experiences may impact their mental health, it can be helpful to look at current public stigmas and ways they can overcome these challenging beliefs.
How stigma affects healthcare availability for veterans
Although some people may be sensitive to the mental health concerns and invisible disabilities some veterans have, there are still stigmas surrounding this topic in the US. General mental healthcare has become less stigmatized in the past decade, making more people willing to go to therapy. However, veterans may face the following stigmas that make it difficult to reach out for help.
Public stigma
Some veterans experience perceived public stigma, which may dissuade them from seeking mental health services. Dr. Alicia Lucksted of the University of Maryland School of Medicine notes that many veterans feel like outcasts because of their mental health. She also reports that many veterans believe they are violent or will become violent unprovoked.
Public stigma can point to a culture that may not seem as accepting toward those seeking support for mental concerns. In addition, it can indicate that mental health is not discussed enough by direct leadership and peers in veterans' circles, making it an uncomfortable topic for some.
Internalized stigma
In a study by Dr. Dwane Vogt, researchers reported that 70% of veterans don't seek mental health services out of fear of being diagnosed with a mental illness. In the study by Dr. Alicia Lucksted above, veterans who did receive care said they were angry that they were diagnosed and didn't want to believe it. They felt they should "suck it up" and ignore their mental health symptoms because they "knew what they were getting into."
Some veterans may believe that, because of their veteran status, they are "supposed to be strong enough" to overcome their mental health challenges without help from a mental health provider. However, due to the nature of conditions like PTSD, depression, and anxiety, it can be challenging to cope healthily and reduce symptom severity alone.
Veterans may form these beliefs due to social pressure to be "tough" and silently cope with all challenging events. Instead of talking about emotions with their peers, veterans may have memories of silence and internalized fears. In addition, being in a rugged and intense environment one year and in an office with a counselor the next might feel confusing and insulting. However, despite these stigmas, it can take bravery and grit to connect with a professional despite outdated cultural norms.
What other treatment barriers do veterans face?
Another barrier to mental healthcare is that a veteran can only receive insurance-covered mental health services from the VA if they were honorably discharged, whether it be categorized as a medical or general discharge. Veterans with an "other than honorable discharge" may be eligible for some benefits, but not all. Those who were discharged dishonorably lose all health insurance benefits of their service. However, people facing these barriers can still receive treatment outside of the Department of Veterans Affairs if they pay for a personal insurance plan or out-of-pocket for services.
The cost of VA treatment is often not a barrier for veterans. However, the time it takes can be an obstacle. Some people report months to years of waiting for an appointment with these services. Veterans who require immediate mental healthcare may seek care outside of the VA or pay for these services.
Reaching out for help
According to the American Psychology Association, one-third of military soldiers returning from Operation Enduring Freedom have a mental illness or cognitive challenge. Another paper by Miriam Reisman reports that 13.5% to 30% of veterans from all branches have PSTD. In addition, according to the Department of Veterans Affairs, 11% of veterans have depression. These rates can be in higher concentration in veteran groups than in non-veteran communities; as the National Alliance on Mental Illnesses (NAMI) reports veterans are five times more likely to have depression than non-veterans.
If you are a veteran experiencing symptoms of a mental illness, you're not alone. If these symptoms interfere with your quality of life, make it difficult to accomplish daily tasks, or cause fear, consider contacting a licensed therapist. If you face the above barriers, live in a remote location, have a busy schedule, or want to stay in the comfort of your home to receive support, you can also try methods like online therapy through platforms like BetterHelp.
Online therapy is an available, affordable, and convenient option proven as effective as in-person therapy and equally beneficial. A research trial published in the Journal of Clinical Psychology compared the efficacy of online therapy for veterans with combat-related PTSD concerning in-person therapy. The study results revealed that home-based telehealth therapy was equally as effective as the standard in-person treatment, with both showing a significant reduction in symptoms of PTSD. Researchers added that online therapy offered the benefits of addressing stigma and geographic-related barriers to treatment, including travel time and cost.
Takeaway
What is a mental health problem for veterans?
Veterans can face a variety of mental health challenges. Some of the most common include:
- Posttraumatic stress disorder (PTSD)
- Generalized anxiety disorder
- Panic disorder
- Depression
- Substance use disorder
- Side effects of traumatic brain injuries
Do veterans have higher rates of mental illness?
Certain mental illnesses may be more common among veterans than civilians. In a 2022 study, researchers analyzed data on 2,576 veterans and civilians who sought mental health care in the U.K. They found that the veterans were “significantly more likely” to have been diagnosed with mental illnesses like anxiety, depression, psychosis, and personality disorders.
What is the mental health stigma among veterans?
Military service members often face pressure to be “tough,” which can carry over to civilian life. As a result, combat veterans may avoid seeking mental health care due to feelings of guilt about their symptoms. Some may also believe being diagnosed with a mental health condition will make them “weak,” or that they should be responsible for managing their symptoms alone. This stigma may make it harder for veterans to seek care.
Why is veteran mental health important?
Serving in the military can take dedication, courage, and sacrifice. It can also expose service members to stress, trauma, and physical injury, contributing to mental illness. This can affect many areas of their lives, from their relationships with family members to their physical health. Ensuring veterans’ mental health needs are met can be important for helping them transition back to civilian life.
How can I help a veteran with mental illness?
If you know a veteran experiencing a mental illness, the following strategies may help you support them:
- Encouraging them to seek care if they haven’t done so
- Not pressuring them to talk about their symptoms or service history if they aren’t comfortable
- Ensuring they have information on mental health resources, like the Veterans Crisis Line, VA health care, and local services
- Offering to help them attend mental health appointments if needed
Other, more general forms of support may include:
- Donating to organizations that support veterans’ mental health
- Volunteering for a mental health organization
- Educating yourself and others on mental health challenges affecting veterans
How does PTSD affect a veteran's mental health?
PTSD can have significant effects on veterans’ mental health. Military personnel who have seen combat may experience distressing symptoms like flashbacks, panic attacks, or nightmares. Those who have experienced military sexual trauma may wrestle with feelings of guilt or shame. PTSD can also contribute to mental illnesses like depression, anxiety, chronic pain, and substance use disorder.
Does the military care about mental health?
It may be important to remember that the military includes multiple organizations, such as the National Guard, the Army, the Marines, and the Navy. Many of these branches do provide resources to promote mental health among service members, and VA benefits include mental health care.
However, mental health stigma may make veterans less likely to seek care. Furthermore, veterans who were dishonorably discharged may not be eligible for mental health services.
Why do veterans isolate themselves?
Several mental illnesses that commonly affect veterans can lead to self-isolation, including:
- PTSD
- Generalized anxiety disorder
- Social anxiety disorder
- Phobias
- Depression
Veterans may also isolate themselves because they are having challenges readjusting to civilian life. After leaving military service, veterans may be separated from their long-time friends and coworkers. They may also find it harder to meet new people without the structure and routine of the military. All of these factors can contribute to self-isolation.
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