Addressing Mental Health Treatment Barriers For Veterans

Every 11th of November, the US celebrates Veteran's Day to honor veterans who have served the US armed forces. In fact, the whole month of November is known as Military Family Month, where campaigns that provide resources for military families and veterans happen. According to the United States Census Bureau, there are approximately 16.5 million veterans who make up the adult population in our nation. While veterans have left the battlefield, many still experience the effects of their time served with the lingering effects of physical and emotional trauma. Because veterans, especially those who have seen combat, generally experience more trauma than non-veterans, the rate of mental health disorders, such as depression, anxiety, and PTSD, is much higher. Since 2006, the number of veterans who are receiving mental health care services has increased by 90%. 

So, how can people ensure the mental health services of veterans are prioritized? This article will give you information on how to do just that, including information on in-person and online therapy, as well as understanding the barriers veterans face.

How Stigma Affects Health Care Availability For Veterans

Although most people are highly sensitive to the mental health concerns and invisible disabilities of veterans, there is still a stigma around this topic in the U.S. Mental health, in general, has become less stigmatized in the past decade, which has made more people willing to go to therapy. However, some stigma still exists, especially for marginalized groups. Whether this is a public stigma or internalized stigma, both are an issue. But it may be worse for veterans.

Public Stigma

Many veterans continue to deal with perceived public stigma, which dissuades them from seeking mental health services. Dr. Alicia Lucksted of the University of Maryland School of Medicine notes that many veterans feel as though they are outcasts because of their mental health. She also reports that many veterans believe they are violent or will become violent, unprovoked.

In one study, 44.2% of active duty military soldiers said they were deterred from seeking mental health services because they feared their unit leadership might treat them differently. And 42.9% believed they would be seen as weak. This sentiment could continue through their veteran years. Although there is a difference between true public and perceived public stigma, such high reporting of perceived stigma is a concern. This may point to a culture that may not feel as accepting toward those who are seeking help for mental concerns. Or it may point to a culture where mental health isn’t discussed enough by direct leadership, so it’s still an uncomfortable topic.

Internalized Stigma

One paper by Dr. Dwane Vogt reported that 70% of veterans don’t seek mental health services out of fear of being diagnosed as having a disorder. In the same presentation published by the Department of Veteran’s Affairs by Dr. Alicia Lucksted, veterans said they were angry that they were diagnosed and didn’t want to believe it. They said they feel as though they should “suck it up” and ignore their mental health issues because they knew what they were getting into. Some even believe that because of their veteran status, they are supposed to be strong enough to overcome their mental health issues without help from a mental health provider. This usually isn’t the case, especially in severe cases of PTSD, depression, and suicidal thoughts.

With the label of being “tough” placed on someone for so many years, it can be incredibly difficult to be vulnerable and talk about how you are feeling mentally. It can feel counterintuitive to be in a rugged and intense environment one year and the next to be sitting in a counselor’s office talking about your thoughts and feelings. But it is crucial to note the bravery and grit it takes to connect with a professional despite these outdated cultural norms. 

Treatment Barriers 

Another barrier, which many people are not aware of, is that a veteran can only receive 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 benefits of their service. Although this barrier is less common, it does still exist for this population. As mentioned previously, people facing these barriers can still receive treatment outside of the Department of Veteran’s Affairs. In a perfect world, there would be no barriers for anyone to receive mental health care from counselors and have treatment. However, many groups do experience barriers, even if they are among the nation’s most respected. The biggest barrier for veterans is stigma, as mentioned above. Another, which is discussed below, is the time it takes to get treatment.

Fortunately, veterans receive mental health services from the Department of Veteran’s Affairs, also known as the VA. The cost is not a barrier to mental health treatment, but the time it takes to receive treatment with the VA can be an obstacle. If a veteran needs immediate mental health care attention, they may need to find care outside of the VA they have will have to 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 some type of mental illness or cognitive issues. For veterans of all conflicts, a paper by Miriam Reisman reports that 13.5% to 30% of veterans have PSTD. 11% of veterans report having depression, according to the Department of Veteran’s Affairs. Many studies show this is a much higher rate than among non-veterans. 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 mental illness symptoms, it is critical to note that you are never alone. If you are experiencing any mental health symptoms that are intervening with your quality of life, making it difficult to accomplish daily tasks, or simply need an unbiased and trained therapist with whom you need to talk, consider reaching out for help today. You may live in a remote location, have a busy schedule, or want to stay in the comfort of your own home to receive mental health support. In these cases, online therapy may be the preferred way for you to receive therapy. 

Online therapy is an available, affordable, and convenient option that has been shown in several research studies to be just as effective as in-person therapy and equally beneficial. For example, a research trial published the Journal of Clinical Psychology compared the efficacy of online therapy for veterans with combat-related PTSD in relation to in-person therapy. The results of the study revealed that home-based telehealth therapy was equally effective as the standard in-person treatment, with both showing significant reduction in symptoms of PTSD. Researchers added that online therapy offered the added benefits of addressing stigma- and geographic-related barriers to treatment, including travel time and cost. 

At BetterHelp, we recognize the barriers that veterans may face when it comes to setting up sessions with mental health providers. We are thrilled to offer one month of the free therapy for veterans, available here: https://www.betterhelp.com/veterans/.

Take a look below for some therapist reviews, from other veterans who have experienced success with telehealth.

“I'm a wounded combat veteran who's spent the last 17 years dealing with the effects of multiple combat tours. Initially, I walked into counseling because my wife and I wanted to tune up our marriage. Eventually, some issues arose from the military experience that I wasn't dealing with and had buried for years that were affecting all aspects of my life. I'd done therapy before for PTSD, but there were "soul wounds" I was having a tough time processing. Luckily, Larry is a military chaplain who understands the struggles of soldiers and suggested EMDR together. I'd heard good things, but man... it's changed my life. Larry was able to cut through the BS with me and we worked hard on areas I've kept long guarded. Incorporating my faith in the healing process has been essential too. I can't recommend this man enough!”

Learn More About Larry Van Hook

BetterHelp also offers financial discounts to veterans and military soldiers. It also usually takes less than 24 hours to get in contact with a licensed therapist on BetterHelp’s platform. Working with an independent-sector therapist that specializes in the mental health concern in question may be the option with the least number of barriers for veterans.

Common Questions

For people who are outside the veteran or military community, veteran mental health services can be confusing. For some, at first glance, the Department of Veteran’s Affairs seems to be fully supporting veterans’ mental health for free. Whereas for others, the Department of Veteran’s Affairs is failing to provide mental health services. The questions and answers below can give some insight into how the Department of Veteran’s Affairs handles mental health care.

How Long Does It Take To Get Health Benefits As A Veteran?

The Department of Veteran’s Affairs is responsible for the mental health services of veterans. Veteran Centers, which are across the United States, offer counseling with professionals who specialize in treating veterans. Most often, they treat readjustment issues and post-traumatic stress disorder. However, a study in 2017 found that it can take about eighteen days on average for someone to get an appointment at their local Veteran Affairs center with a provider. 

Because suicide is the second leading cause of death among post-9/11 veterans, veterans need to get mental health services quickly. Eighteen days is a long time for someone who is dealing with symptoms of severe PTSD or suicidal thoughts. Fortunately, there is immediate help via phone, text, or chat at 988 available when you are in a mental health crisis.

If you are experiencing suicidal thoughts, seek immediate guidance by calling 911 or call the national hotline. The National Suicide Prevention Lifeline is available 24/7 at 1-800-273-8255. You can also text “START” to 741741 for the Crisis Text Line, which will connect you to a trained volunteer within five minutes.

How Can I Support The Veteran Community?

It can be difficult to ensure mental health care is more inclusive for veterans because their mental health services are primarily run by the Department of Veteran’s Affairs. Fortunately, there are ways you can support a veteran in your life. First, if you know a veteran and their mental health seems to be declining, do not be afraid to speak up and offer some simple outreach. Sometimes, a veteran need to be assured that it is not a sign of weakness to need mental health treatment or seek out mental health resources. They also may just need someone to listen to them to talk about how they are feeling. This could encourage them to take the next step to get help for their mental health.

You can also suggest that they make an appointment with their local Veteran’s Affairs office. Ensuring they get the help they need is the best form of support possible. If they had a bad experience with their Veteran’s Affairs office, suggest an affordable counselor online or nearby. Many veterans do not seek help outside of the VA, so educating them about their other options is important.

Lastly, many non-profits support veterans. You can choose to donate to non-profits that support houseless veterans, veterans with disabilities, or suicide prevention. The options are endless if you would like to support veterans in this way.

Are There Other Solutions Than Therapy?

As mentioned above, many non-profits support veterans. One is Paws for Vets - a non-profit organization that connects rescued animals and a veteran in need. Emotional support and service animals are highly regarded amongst those with mental illnesses and disabilities. In some cases, people with a mental illness or disability struggle without their animals. Paws for Vets can be an excellent solution for veterans who are looking for companionship or they need a support animal that can calm them down amid an anxiety attack.

Another non-profit that veterans can turn to is Stop Soldier Suicide. This non-profit provides assessments, mental health tools revolving around depression and suicide, and long-term assistance. Its mission is to reduce the number of suicides by veterans per year. If a veteran is suicidal and cannot wait 18 days to get into the VA, this non-profit is a resource. You also can reach out to them on behalf of a suicidal family individual, which is hard to find in a mental health resource.

In addition to these two non-profits, there are many crisis lines for veterans. Military One Source has an excellent page that shows reliable crisis lines veterans can call. There are separate lines for domestic abuse, homelessness, general military crises, and more. If you or a loved one are a veteran and are dealing with a crisis, these lines can be great, immediate resources.

What Percentage Of Veterans Have Mental Illness?

If you are a veteran experiencing mental illness symptoms, it is critical to note that you are never alone in your struggles, no matter how much you think you are.

According to the , one-third of military soldiers returning from Operation Enduring Freedom have some type of mental illness or cognitive issues. For veterans of all conflicts, a paper by Miriam Reisman reports that 13.5% to 30% of veterans have PSTD.

11% of veterans report having depression, according to the Department of Veteran’s Affairs. Many studies show this is a much higher rate than among non-veterans. The National Alliance on Mental Illnesses (NAMI) reports veterans are five times more likely to have depression than non-veterans.

What Mental Illnesses Do Veterans Have?

Veterans can have all different types of mental illnesses, just like other Americans. However, some mental illnesses are more common amongst veterans than the rest. NAMI says that the most common three are PTSD, depression, and traumatic brain injuries.

PTSD is the most prevalent, even if the veteran has a less severe case. Many people believe PTSD is experiencing traumatic flashbacks that send the survivor into a panic. However, many other symptoms are not as noticeable. These include:

• Difficulty sleeping

• Intrusive thoughts and involuntary memories

• Being irritable or angry often

• Blaming yourself for the traumatic events endured

• Feeling detached

• Having an exaggerated startle response

In addition to the most common three, veterans may have other mental illnesses at the same time. According to the same paper by Miriam Reisman, 74% of Vietnam veterans with PTSD also had a comorbid Substance Use Disorder. The paper also reported that 63% of veterans with alcohol and drug use disorders also had PTSD. So, it’s safe to conclude that PTSD is often linked to other disorders, at least in veterans. Even without PTSD, all these mental health concerns should be monitored and given more awareness.

How Does The VA System Support Veteran’s Mental Health During And After Their Service?

The Department of Veteran’s Affairs does a good job supporting the mental health of most veterans. For one, the VA’s mental health services are completely free. They offer many different forms of health care such as primary care, dermatology, cardiology, and mental health services at no cost to veterans. Many bases have a hospital that provides health care to active military soldiers and their dependents for free or low cost, and the Veteran’s Affairs office does as well for veterans. Considering many veterans struggle to maintain a stable job, free mental health services are helpful.

There are almost 1,300 VA offices in the United States. So, most veterans have a VA office within an hour from them. Because finding a health center with both therapy options and a doctor to prescribe mental health medication is challenging to find in some rural areas, this is a very supportive feature.

Why Do So Many Veterans Have PTSD And Other Mental Health Disorders?

According to the Mayo Clinic, post-traumatic stress disorder happens after a traumatic event, whether you experience it or witness it. A large number of veterans manage PTSD because they have witnessed and/or experienced a traumatic event. Even veterans that have not been deployed may witness trauma, including sexual assault, harassment, or something that happened during training. Military is a high-stress environment and events happen that affect the mental health of military soldiers and veterans.

Many veterans also have depression, anxiety, or substance use disorders in their lives outside of active service. For some, this is caused by traumatic brain injuries, often considered the “silent epidemic” because they frequently happen and are not easily identified.