Every veteran has internalized a set of values that allowed them to endure hardship, overcome obstacles and find resilience in their service. But those same values can also make it difficult for them to ask for help when they’re experiencing mental health concerns.
The teamwork they forge builds close bonding that can discourage seeking outside help; selflessness allows them to put their mission and comrades first but may prevent them from prioritizing their own health; a commitment to excellence drives their motivation but also creates a constant push toward perfection.
As the partner of an active-duty service member and a licensed therapist who works with veterans, I have seen firsthand the challenges current and former military members face in finding appropriate care.
We frequently thank veterans for their service, but I would challenge us all to show that thanks by listening to the mental health needs of the military and veteran community, learning about the impact of military life, and supporting organizations that are on the ground doing the work.
About 11% to 20% of veterans who served in the wars in Iraq and Afghanistan reported experiencing post-traumatic stress disorder, according to the U.S. Department of Veterans Affairs. And about half of veterans who have served since 9/11 reported in a survey from Pew Research Center that it was somewhat or very difficult for them to readjust to civilian life following their military service.
I have also learned how little many people seem to understand about military life’s effect on service members’ families. I was struggling with postpartum depression while my partner was stationed overseas but was told that “I signed up for this.” Feeling disconnected from civilians is a common struggle.
Veterans continue to experience trauma and depression, but care for themselves and their families has become harder to access. During the pandemic, referrals to my clinic more than doubled. Yet many clinicians don’t have a complete understanding of military culture and often hold misconceptions about this community, creating a barrier to providing adequate treatment to military members.
Licenses to work in mental health care often require some form of cultural competency training, which typically focuses on race, ethnicity, geography, sexual orientation and spirituality. But rarely has the training included the military fully as a culture or discussed the intersectional identities the military community holds. When providers are not properly trained in understanding the military community, their ability to provide effective, culturally competent care can be strained.
Lack of cultural competency in the community can make veterans feel isolated from their care providers. Myths, like the false perception that all service members and veterans have or develop PTSD and that having PTSD means someone will be violent, can contribute to stigma that prevents many from seeking help.
Many veterans are reluctant to obtain mental health treatment due to the prevalent military culture that espouses the Warrior Ethos, a set of commitments to mental strength in service. These beliefs make it difficult for veterans and service members to admit experiencing depression and anxiety.
It is often assumed that the health care needs of America’s military community are being met within government systems such as the VA. However, many veterans who choose to access services in the community outside of the VA find they are ineligible for care due to a dishonorable discharge. In decades past, veterans had been separated from service due to mental health conditions and sexual orientation, and their discharge had been labeled dishonorable.
Options for seeking care can be even more limiting for family members, who are often not the focus of veteran resources. Few health care providers accept TRICARE, the U.S. Department of Defense’s health insurance program, or have a proficient understanding of military culture, and wait times can be excessive.
Asking for help can be challenging under optimal circumstances. Imagine being told you must wait months for care.
Although options like telehealth have helped break down barriers to seeking mental health care, more work needs to be done. Together, we can build a better system for active military members, veterans and their families, which includes access to timely behavioral health care and empowered providers knowledgeable about the unique challenges as well as strengths of this community.
Dr. Nichole Ayres is the clinic director at the Steven A. Cohen Military Family Clinic at Valley Cities in Lakewood, part of Cohen Veterans Network. The Cohen Clinic at Valley Cities provides confidential, high-quality therapy, and local referral support services to post-9/11 veterans, service members, including National Guard and Reserves, and their family members. Care is available regardless of discharge status, role while in uniform, or combat experience. As a military spouse of over 13 years, Ayres is also an active member of the JBLM community supporting military families through the challenges of deployment and redeployment.