INTRODUCTION
The United States faced two decades of continuous war from 2001-2021, and the media and individuals with personal military connections have elevated public and professional concerns for the mental health of service members and veterans. A growing population of veterans with combat and deployment experience is presenting for mental health care.
The U.S. Census Bureau estimates there are about 19 million veterans.
https://www.census.gov/newsroom/press-releases/2020/veterans-report.html
Since September 11, 2001, 2.8 million active-duty American military personnel have been deployed to Iraq, Afghanistan, and beyond, leading to increasing numbers of combat veterans amongst the population. More than 7% of the U.S. population have served, or are serving, in the military.
https://www.pewresearch.org/fact-tank/2021/04/05/the-changing-face-of-americas-veteran-population/
However, this statistic fails to capture the even greater number of family members affected by military service. Understanding military service and its relation to a client’s physical and mental health can help counselors improve their quality of care and potentially help save a client’s life.
The Department of Defense (DOD) has estimated that 456,293 active-duty service members were diagnosed with at least one mental health condition from 2016 through 2020. Mental health disorders also accounted for the highest number of in-patient hospital days and were the second most common reason for outpatient and ambulatory visits among service members. During this period, adjustment disorders, anxiety disorders, and depression represented 64% of all mental health diagnoses.
https://www.health.mil/News/Articles/2021/08/01/Update-MH-BH-MSMR
COMMON MENTAL HEALTH DISORDERS AMONG MILITARY PERSONNEL AND VETS
Post-Traumatic Stress Disorder (PTSD)
Studies of service members deployed to combat areas have found that traumatic experiences — such as being attacked or knowing someone who was seriously injured or killed — are common. These experiences can cause returning veterans to have disruptive thought patterns, such as difficulty concentrating, reliving traumatic events, or having thoughts of suicide. Veterans may experience sadness or guilt and avoid social situations that remind them of traumatic experiences.
Depression
Depression remains one of the leading mental health conditions in the military. Studies show that up to 9% of all appointments in the ambulatory military health network are related to depression. Military health care facilities saw an increase from a baseline of 11% of members diagnosed with depression to a rate of 15% after deployments to Iraq or Afghanistan.
https://pubmed.ncbi.nlm.nih.gov/17803068/
Suicide
A 2021 report by the Costs of War project at Brown University estimated that more than 30,000 active-duty personnel and veterans of the post 9/11 wars had died by suicide. This is quadruple the number lost in combat.
https://watson.brown.edu/costsofwar/papers/2021/Suicides
Every year, the VA conducts the largest national analysis of veteran suicide rates. Based on data from 2021 – veteran suicide rates increased by 11.6% from 2020.
Substance Use Disorders (SUDs)
Another risk that can arise is veterans abusing substances to cope with the invisible wounds of war. Accessing treatment for substance use disorder remains a challenge, with veterans too often dealing with extensive delays when trying to get help.
Despite public attention over recent decades, SUDs, including alcohol use, remains a problem among veterans and military members. One study on military personnel found that approximately 30% of completed suicides and around 20% of deaths due to high-risk behavior were attributable to alcohol or drug use.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587184/
Collateral Effects – Children in Military Families
According to the National Child Traumatic Stress Network, children in military families face unique stresses. Factors that increase a child’s risk for trauma reactions include:
- Preexisting health and mental health conditions
- Parents who are reserve personnel
- Parents with multiple deployments
- Living far from military communities
- Living in single-parent families with one parent deployed
If the service member is experiencing trauma-related symptoms, the adjustment can be more difficult. Trauma responses of irritability and withdrawal can complicate the adjustment. Children in the household may be affected by the mood and actions of the service member.
https://www.nctsn.org/what-is-child-trauma/populations-at-risk/military-and-veteran-families
STIGMA AND BARRIERS TO CARE
Over 60% of veterans surveyed have never used mental health services.
https://academic.oup.com/epirev/article/37/1/144/423274Experts believe veterans are less likely to seek help with a mental health condition compared to non-veterans due to negative stigmas about seeking such help. Some researchers have noted that documentation of a mental health problem on a person’s record was also a major barrier to help seeking behavior among active-duty military personnel. Many veterans would rather speak with their family than receive treatment.
RESOURCES
For anyone experiencing a mental health crisis, needs immediate assistance, or simply to talk to someone, confidential help is available 24/7:
- The Military & Veteran Crisis Line
https://www.veteranscrisisline.net/ - Military One Source
https://www.militaryonesource.mil/ - The Psychological Health Resource Center
https://www.health.mil/Military-Health-Topics/Centers-of-Excellence/Psychological-Health-Center-of-Excellence - The In-Transitions Program
https://www.health.mil/Military-Health-Topics/Centers-of-Excellence/Psychological-Health-Center-of-Excellence/inTransition - The Military Health System
https://www.health.mil/Military-Health-Topics/Mental-Health
CONSIDERATIONS FOR COUNSELORS
Service members, military veterans, and their families have experiences that many who have not been associated with the military will not experience. Reinforcing the sense of military identity and experiences as positive assets, in addition to recognizing the strengths of other facets of client identities, may heighten both individual wellness and a client’s comfort and autonomy within the civilian community.
https://www.researchgate.net/publication/254356917_Characteristics_and_Effectiveness_of_an_Intensive_Military_Outpatient_Treatment_Program_for_PTSD
