Many veterans return home from combat with mental health issues and are hesitant to seek treatment because of the stigma that surrounds mental illness in the military community. As a result, many veterans live with challenging and even debilitating, but treatable, conditions. Fortunately, social workers and other mental health professionals across the country are working with the Department of Veterans Affairs and other organizations to break the stigma and help veterans access the treatment to which they are entitled.
Military Mental Health Challenges and Stigma
Many veterans experience mental health challenges when they return from service. Common issues include depression, suicidal thoughts, anxiety, sexual trauma, post-traumatic stress disorder, bipolar disorder, schizophrenia and substance abuse. Sometimes these issues manifest in dramatic fashion, but many times the symptoms are subtle. Some common symptoms include:
- Changes in sleep, appetite, sex life or weight
- Headaches or other physical pain
- Muscle tension or weakness
- Decreased motivation, energy or interests
- Difficulty with attention, memory or concentration
- Anger, irritability or short-temperedness
- Feelings of worthlessness, guilt, hopelessness or helplessness
- Misusing drugs, food, alcohol or sex
- Overspending money to cope with emotions
The VA has comprehensive services to help combat these challenges, but many veterans never take advantage of them because of a stigma in military culture against reporting issues and seeking treatment.
According to the American Psychological Association, about one-fifth of people returning from combat zones report symptoms consistent with mental health issues, but only about half of them seek treatment. This is likely due to the perception that reporting a mental health issue will have negative career implications for soldiers, resulting in loss of security clearances, demotions or outright expulsions. A 2006 Military Medicine study found that only 3 percent of soldiers who sought mental health treatment had negative career side effects, but the stigma and the impression that it is commonplace persists. As a result, many veterans return from combat with undiagnosed mental health issues and do not seek treatment. It is important for social workers to understand this large and growing population and how to best give veterans access to resources and treatment. The VA is leading efforts to destigmatize mental health issues and has many resources for veterans, veterans’ families and for military social workers, including a guide of veteran services, a public awareness campaign and a Community Provider Toolkit.
Resources from The Department of Veterans Affairs
The following principles, from the Guide to VA Mental Health Services for Veterans and Families, form the foundation for the VA’s approach to veteran mental health treatment:
- Focus on recovery. Empower veterans to take control of their lives with honor and respect.
- Holistic coordinated care. Effective mental health treatment incorporates body and soul, and holistic care should include helping veterans have healthy interpersonal relationships, find satisfying work, eat nutritious food and exercise regularly.
- Principal mental health provider. Having one person who guides and coordinates all aspects of treatment makes life simpler for veterans and helps them reach the all of the appropriate care providers.
- Around-the-clock service. Emergency mental health care is available 24 hours a day, seven days a week, either at a VA medical center or local non-VA hospital.
- Care close to home. The VA is adding more rural and mobile clinics in order to expand access to care. It is also leveraging technology to provide telemedical care to those who can’t easily access clinics.
- Care that is sensitive to gender and cultural issues. Health care providers at the VA are trained to deliver culturally competent care that takes into account military culture, ethnic backgrounds, gender and sexuality differences.
- Evidence-based treatment. Care providers are required to use only up-to-date, evidence-based treatment.
- Family support. Treatment is focused on veterans, but the VA will educate families, and sometimes incorporate them into veterans’ treatment.
The Department of Veterans Affairs has a public awareness campaign called Make the Connection, which uses personal testimonials to encourage veterans to connect with mental health resources and discover ways to improve their lives. The main features of MaketheConnection.net include:
- Resources and Support.This tool helps veterans locate information and the support centers closest to them.
- Clinicians. This series of videos helps veterans understand the latest in mental health treatment and provides stories from other veterans to show that they are not alone in their struggle.
Working with Military Populations
Screening for clients’ military experience is not common in traditional behavioral health screenings, and veterans may not always volunteer this information, so it is important for you to ask. This can help inform treatment planning and ensure that the veteran is aware of and has access to the network of health care and support to which he or she is eligible. Social workers should open with a simple, “Have you ever served in the military?” and “Do you have a close family member who has served in the military?” If they answer yes to either of these questions, you can move on to some or all of the follow-up questions suggested in the VA’s Community Provider Toolkit.
Military experience can be formative of a veteran’s values, perspective and way of life. Each branch has its culture, along with its own challenges and history. That is why it is critical for you to understand your clients’ branch, place and time of service, and military occupation. Showing that you have taken the time to better understand military culture and its nuances can be tremendously reassuring for clients. The VA’s Community Provider Toolkit has a course External link for understanding the military experience, which is a great introduction to military cultures.
According to the National Association of Social Workers (NASW), the need for social workers addressing challenges in the military population has increased significantly in recent years, due in part to an aging veteran boomer population and consistent conflict abroad. Working with military populations is complex, which makes the demand for social workers even more critical. The NASW’s “Standards for Social Work Practice with Service Members, Veterans, & Their Families” is an important document for social workers who intend to work with military or veteran clients and should be paired with other VA resources as an introduction to treating military populations.
Veterans are likely to experience mental health challenges when they return home, but due to stigma in the military and society, many will not seek treatment. Social workers around the country are working with the Department of Veterans Affairs to break this stigma and give veterans access to the information, resources and treatment they deserve. Military social workers, students or other mental health professionals who intend to treat veterans can begin with resources like Make the Connection, the VA’s Guide to Mental Health Services for Veterans and the NASW’s standards for working with military populations. This is an area of high demand, and social workers and other mental health professionals have the potential to make a huge difference in the lives of our nation’s veterans.