Mental Health Stigma Contributes to High Veteran Suicide Rate

Dog tag memorial When soldiers are killed in battle, families grieve and nations mourn for some of their bravest citizens. However, wars claim thousands of lives even decades after agreements have been reached and treaties are signed. According to the U.S. Department of Veterans Affairs (VA), approximately 22 military veterans commit suicide each day in the United States. While physical injuries obtained during military service are often immediately addressed, deep psychological wounds may go untreated for years—silently festering into suicidal ideation or other mental health issues.

Mental toughness is a highly valued trait in the military. Fresh military recruits train for months to toughen themselves physically and mentally because combat situations expose soldiers to many traumatic events such as being shot at, seeing a friend get shot, or seeing death up close and personal.

Despite their diligent efforts to prepare, some soldiers are not able to cope with the intense trauma they may encounter in combat. As a result, they can become severely scarred emotionally and psychologically. With mental injuries left unaddressed or simply ignored, many military veterans discover that going home may be even more difficult than going to war.

Military Suicide Rates

Veteran suicide statistics obtained from the Department of Veterans Affairs indicate that a veteran commits suicide approximately every 65 minutes. This rate translates to over 8000 suicides per year. And as astounding as these figures are, they are likely underestimated. The data used to determine the high rate of veteran suicide in the U.S. has been challenged numerous times as it was obtained from residents of only 21 of 50 American states. Some of the largest states with high veteran populations, including California and Texas, were not included in the Department of Veterans Affairs’ report on military suicide rates.

Military-and-Veterans-Mental-Health-Infographic-GoodTherapy.org

Click to Enlarge Military and Veterans Mental Health Infographic by GoodTherapy.org

Suicide rates among veterans are much higher than those among American civilians. Approximately 20% of all suicides in the U.S. are committed by current or former military personnel, despite the fact that veterans make up only 10% of the population.

While resources for treating posttraumatic stress (PTSD), depression, and other hallmark psychological injuries are available, only 56% of qualified Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans make use of them (2013). Similarly, of the reported 22 veterans who commit suicide each day, only 5 are in the Veterans Affairs Health Care system.

The good news is that we know when veterans do get help, it makes a difference. In 2007, the Veterans Health Administration launched an intensive suicide prevention effort and has since reported a decrease in:

  • Overall rates of suicide among veterans with mental health conditions.
  • Rates of suicide in the 12 months following a survived suicide attempt among veterans.
  • Rates of suicide for veterans ages 35-64, which is one of the highest risk groups.
  • An overall decrease in non-fatal suicide attempts.

The Stigma of Mental Health Care in the Military

Mental health issues and the receipt of mental health care treatment can be highly stigmatized within the military. The military promotes ideals such as self-sufficiency, endurance, mental fortitude, and strength, values that also support the notion—however unfair—that those seeking mental health treatment are deficient, dependent, or weak.

Factors that significantly affect service members’ decisions to seek mental health treatment may include:

  • How higher-ranking officers and non-commissioned officers talk about mental health treatment.
  • The belief that seeking mental health treatment will have negative repercussions on a service member or veteran’s career.
  • The gender of the service member or veteran.
  • The marital status of a service member or veteran.
  • His or her military occupational specialty (MOS).
  • Public expectations of how service members and veterans are supposed to cope with trauma.

Stigmas surrounding mental health treatment, both in the military and outside of it, greatly reduce the number of at-risk veterans that will seek treatment. Lisa Danylchuk, EdM, LMFT, E-RYT, an Oakland, California-based therapist and posttraumatic stress Topic Expert, believes, “Stigmas like these can increase feelings of shame and isolation, which can increase feelings of depression and decrease the likelihood that a depressed or suicidal person will reach out for help.”

In addition to these social pressures, veterans may believe that seeking treatment goes against their core principles and will damage their very identity.

Mental Health Issues Veterans Face When They Come Home

The Department of Veterans Affairs posits that posttraumatic stress, anxiety, depression, bipolar tendencies, and substance abuse are among the most common mental health issues affecting veterans of OEF and OIF.

When members of the armed forces return home, they often experience difficulties with reintegration. The 2014 Iraq and Afghanistan Veterans of America (IAVA) Member Survey states that loss of identity and mental health concerns were two of the top three challenges service members faced when transitioning out of the military. Of the 2,089 Iraq and Afghanistan combat veterans who completed the survey, 53% reported having a mental health injury.

Traumatic brain injury (TBI) is another health concern for veterans that has received much attention from the medical community in recent years, due primarily to the high number of OEF and OIF veterans who have endured blasts and injuries to the head and returned home with symptoms of TBI.

TBI may occur as the result of striking the head with an object, hitting the head during a fall, or, as is usually the case with combat veterans, the head being affected by a nearby blast or explosion. TBI can result in numerous health concerns, including emotional, behavioral, cognitive, and physical deficits. Records indicate that 18% of IAVA Member Survey responders were diagnosed with traumatic brain injury and have reported an increase in anger as well as changes in their personality.

Depression and anxiety are also major concerns for veterans. The Anxiety and Depression Association of America explains that veterans may feel out of sync with family and friends, but they should try to avoid social isolation. When veterans are cut off from social support, depressed thoughts may quickly lead to suicidal ideation. According to the IAVA Member Survey, 31% of Iraq and Afghanistan veterans have contemplated taking their own life since joining the military, compared to only 6% prior to joining.

Veteran Mental Health Resources

Though many veterans will experience their greatest mental health struggle after combat, in recent years, a number of mental health services and programs have been established specifically to aid military veterans. Many services within the VA Health Care system are free of charge, and many local mental health professionals and agencies offer their expertise at a reduced cost to veterans. If you are a current or former service member experiencing mental health issues, please reach out to these available resources for assistance:

  • Call the Veterans Crisis Line at 1-800-273-8255. Press 1 to speak to a Department of Veterans Affairs responder. People reaching out for assistance can also chat online or send a text message to 838255. Loved ones of veterans are encouraged to use the crisis line too.
  • Enroll in and obtain VA Health Care, which provides access to numerous mental health services at affordable rates or free of charge depending on the veteran’s economic and discharge status.
  • Participate in regular post-deployment screenings that attempt to assess the mental health of military personnel after their service and encourage fellow veterans to do the same. These post-deployment screenings are designed to identify risk factors and gather data to help other veterans.
  • Seek a qualified local therapist who can offer personalized care. Many therapists have specialized training to help those experiencing PTSD.
  • Reach out to local support groups and veteran service organizations. Support from fellow veterans can aid in successful mental health treatment.

Family members and friends can also help veterans cope with their psychological wounds. Danylchuk encourages veterans to seek mental and emotional support not only professionally, but also within their social circles. Danylchuk recommends to friends and family members of veterans, “Listen with a non-judgmental ear, but don’t push someone to talk about something they are not ready to share. Encourage mindfulness practices like yoga, meditation, tai chi, and qigong. Remind veterans that they are having a normal reaction to an extreme experience, and that their experiences of anxiety, depression, and/or PTSD do not mean something negative about them; it just means they are still processing parts of their experience.”

References:

  1. Anxiety and Depression Association of America. (n.d.). Tips for soldiers and veterans. Retrieved November 15, 2014, from http://www.adaa.org/living-with-anxiety/military-military-families/tips-soldiers-and-veterans
  2. Bagalman, E. (2013). Mental disorders among OEF/OIF veterans using VA health care: Facts and figures. Retrieved from http://fas.org/sgp/crs/misc/R41921.pdf
  3. Iraq and Afghanistan Veterans of America. (2014). 2014 IAVA member survey. Retrieved from http://media.iava.org/IAVA_Member_Survey_2014.pdf
  4. Kemp, J., & Bossarte, R. ( 2012 ). Suicide data report, 2012. Retrieved from http://www.va.gov/opa/docs/suicide-data-report-2012-final.pdf
  5. Miggantz, E. L. (2014). Stigma of mental health care in the military. Retrieved from http://www.med.navy.mil/sites/nmcsd/nccosc/healthProfessionalsV2/reports/Documents/Stigma%20White%20Paper.pdf
  6. United States Department of Veterans Affairs, Employee Education System. (2010). Traumatic brain injury. Retrieved from http://www.publichealth.va.gov/docs/vhi/traumatic-brain-injury-vhi.pdf
  7. United States Department of Veterans Affairs. (2011). VA suicide prevention program. Retrieved from http://www.goyourownway.org/GOYOUROWNWAY/DOCUMENTS/VETERANS/VA%20Suicide%20Prevention%20Fact%20Sheet.pdf
  8. United States Department of Veterans Affairs. (2014). How common is PTSD? Retrieved November 15, 2014, from http://www.ptsd.va.gov/public/PTSD-overview/basics/how-common-is-ptsd.asp
  9. United States Department of Veterans Affairs. (2014). Polytrauma/TBI system of care. Retrieved November 15, 2014, from http://www.polytrauma.va.gov/understanding-tbi/

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  • Angela

    Angela

    November 25th, 2014 at 2:53 PM

    All of the branches of the military profess to be so open minded and willing to help their own, but when you break it down and look at the numbers like this, there has to be some sort of disconnect somewhere. Either there is no help that is available or the veterans think that they will be ostracized for seeking out the treatment so they do not ask for help. There is something going on behind the scenes that is leading to the massive amount of suicide casualties that we are losing among our soldiers on a daily basis. With the numbers looking like that why on earth would you ever want to encourage your own child to join the service?

  • augustus

    augustus

    November 26th, 2014 at 4:06 AM

    Do I think that the stigma of getting mental health care could contribute to the higher than average rates of suicide among soldiers and veterans? Yes, I do, but there are other factors that should be looked into as well. What is their family history? Would there have been a predisposition for suicide anyway regardless of their service? These are things that can’t be ruled out too.

  • Nathan

    Nathan

    November 26th, 2014 at 2:26 PM

    Oh there is plenty of help there for you but you have to be a little sneaky about getting it because I know tons of guys who have said that they would never ask for mental health help because they would be too afraid of what that would do to their chances for going further up in the military. Seems silly and antiquated but there are still those fears that if you ask for help like this then this is definitely going to put a mark on your record and thus you will then be able to advance only so far.

  • Morgan

    Morgan

    November 26th, 2014 at 3:34 PM

    One hopes that with this sort of information coming out on a regular basis, that this will encourage those who need help to seek it out and those who would look down on the ones needing that kind of help to think twice about the words and actions that they may use against them. This is nothing to be ashamed of, nothing that you should have to be afraid of, it is something that most of us will go through at some time in our lives.

  • Olivia C.

    Olivia C.

    November 27th, 2014 at 8:17 AM

    tHe military will probably be one of the last entities which still as a whole looks upon those with mental illness as being weak and not fit for service.

    Even though this has been proven time and again to be far from the truth, there is something very inherently against seeking out professional help when you are a soldier, it is ingrained in you that this is something that you should keep to yourself and keep quiet about.

  • Frank

    Frank

    November 27th, 2014 at 1:29 PM

    One big problem that I see is that we expect these men and women to be tough, to not allow these things to bother them..We forget that they are only human too and seeing things like this day in and day out could be harmful to any one of us. We forget that there is pain in life and that even though we may all experience it in a different way, the point is that we all experience it at some point.

  • victor

    victor

    November 28th, 2014 at 8:54 AM

    most of you make it sound like this is something that should be so easy, admit to weakness in a way that you know if you do then your chances of career advancement are ruined.

    maybe it is this easy when you are a civilian but for a soldier like me, you can’t ever admit to any kind of weakness or fear without having the chances for upward movement seriously impeded.

    i don’t like to think that this is the case but i think that anyone who has ever lived this life will be able to tell you that this is all true.

  • Janet

    Janet

    November 28th, 2014 at 2:23 PM

    There are things that those in this line of work see that should not have to be experienced by us all. There fore they know things and in all likelihood have ad to do things that they feel are unforgivable and would never be understood by anyone else. I think that this is why there is often such shame as well as hesitation to share their stories with others.

  • Chrissa

    Chrissa

    November 29th, 2014 at 11:00 AM

    even with all of the attention that this subject gets? a little surprised that it is still so troublesome

  • elliott

    elliott

    November 29th, 2014 at 12:07 PM

    So does the VA ever go back and take a look at these numbers to determine if those who are committing suicide have ever sought out any help on the mental health front while in service? Surely they would have to take a good look at that because this is how they are going to know if the outreach and the message that they are trying to get out to those in their military family are actually sinking in and getting through, or if they perhaps need to change up their tactics and try something different so that more people could get help when they need it.

  • LLoyd

    LLoyd

    November 30th, 2014 at 11:00 AM

    Those wounds that are beneath the surface and cannot be seen, those are so often the reason behind the high rates of suicide… they are the ones that could so easily be addressed and remedied when they are talked about and understood, but if they are left to fester and grow, nothing good can ever come from that.

  • maude

    maude

    November 30th, 2014 at 3:29 PM

    My dad was one of those men who came back from overseas and was never the same. My mom said that when he left he was so easy going and laid back but when he came back home he was a totally different person. He never wanted to talk about what he saw and as a result he carried so much of that that haunted him around for far too long, longer than he could eventually stand to cope with. To him suicide seemed like the only solution, the thing that could end his pain and shield the family from any enduring harm. Or so he thought.

  • D L

    D L

    December 1st, 2014 at 10:11 AM

    It’s a tragedy that so many service members struggle with mental illness or suicidal thoughts. And a shame that more media sources don’t pay attention to this issue. Thank you for sharing this. I’m passing it on

  • Anon

    Anon

    December 2nd, 2014 at 9:15 AM

    Victor I know what you saying. My buddy got treatment for depression and his career was over. No chance of promotion. The military is lying if they say they don’t care about that.

  • Sister of Suffering Soldier

    Sister of Suffering Soldier

    July 3rd, 2016 at 4:20 AM

    I just got a text at 1:03am from my Sister who is currently an active member of the military! She sent me a message stating “I want to kill myself!” I told her she needs to talk to someone, seek help, there is a solution! Her reply baffled me and made me angry, she told me that they stigmatize soldiers that need mental health help. She just sounds hopeless, powerless, like theres no other option but to end her life! Is this how we treat those who pay the ultimate sacrafice, leave their familys to make sure we are safe! I’m disgusted! I kept her on my cell and proceeded to call the veterans crisis line, she ended up hanging up on me! After I was asked a series of questions by the person on the other line, the person on the other end hung up with me and called my sister! Out of fear my sister did not reach out and tell her how she really felt, she said she was fine! NOT TRUE, SHE’S NOT FINE I COULD HEAR IT IN HER VOICE! THe lady called me back and said there was not much they could do if she doesn’t state she’s suicidal! Not to mention the fact that we live in two totally different state and I don’t have an address where she resides! WHAT CAN WE DO TO STOP THIS, HOW MANY MORE OF OUR COURAGEOUS SOLDIERS HAVE TO TAKE THEIR LIVES BEFORE SOMEONE DOES SOMETHING!

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