
Veterans who have served in the United States military face unique mental health challenges that can significantly impact their lives and the lives of their loved ones. The most widely publicized mental health challenges veterans and service members encounter are posttraumatic stress disorder (PTSD) and depression.
Research indicates that approximately 14% to 16% of the US service members deployed to Afghanistan and Iraq have been affected by PTSD or depression.
Mental health conditions among veterans require specialized understanding and treatment approaches that account for military culture, combat experiences, and the challenges of transitioning to civilian life. With proper support from qualified mental health professionals, veterans can successfully manage these conditions and lead fulfilling lives.
Table of Contents
- Common Mental Health Conditions in Veterans
- Post-Traumatic Stress Disorder (PTSD)
- Military Sexual Trauma (MST)
- Depression and Anxiety
- Traumatic Brain Injury (TBI)
- Suicide Risk and Prevention
- Additional Mental Health Concerns
- Treatment and Therapy Options
- Support for Military Families
- Barriers to Mental Health Care
- Frequently Asked Questions
- How Therapy Can Help
- References
Common Mental Health Conditions in Veterans
Veterans experience mental health conditions at higher rates than the general population. Other issues, such as suicide, traumatic brain injury (TBI), substance use disorder (SUD), and interpersonal violence, can be equally detrimental in this population. Understanding these conditions is the first step toward seeking appropriate help.
Key Statistics:-
About 6 of every 100 people will experience PTSD at some point in their lifetime, according to the National Center for PTSD, a U.S. Department of Veterans Affairs program.
Veterans are five times more likely to experience major depression than civilians, and 3 in 10 veterans with TBI have depression.
In 2022, there were 47,891 suicides among U.S. adults. These included 6,407 suicides among Veterans (three more than in 2021) and 41,484 among non-Veterans (1,476 more than in 2021).
Post-Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder (PTSD) is one of the most common mental health conditions affecting veterans. Anyone can develop PTSD at any age. This includes combat veterans and people who have experienced or witnessed a physical or sexual assault, abuse, an accident, a disaster, a terror attack, or other serious events.
PTSD Symptoms
PTSD symptoms typically fall into four main categories:
1. Re-experiencing symptoms:- Flashbacks—reliving the traumatic event, including physical symptoms, such as a racing heart or sweating
- Recurring nightmares about the traumatic event
- Intrusive, distressing memories
- Severe emotional or physical reactions to reminders
2. Avoidance symptoms:- Staying away from places, events, or objects that are reminders of the experience · Avoiding thoughts or feelings related to the traumatic event · Avoidance symptoms may cause people to change their routines.
- Emotional numbness or detachment
- Loss of interest in previously enjoyed activities
3. Arousal and reactivity symptoms:
- Being easily startled
- Feeling tense or "on edge"
- Difficulty sleeping
- Angry outbursts or irritability- PTSD is characterized by intrusive thoughts, flashbacks, and nightmares related to past trauma, leading to avoidance of reminders, hypervigilance, and sleep difficulties.
4. Cognition and mood symptoms:
- Trouble remembering key features of the traumatic event
- Negative thoughts about oneself or the world
- Distorted feelings of guilt or blame
- Loss of interest in enjoyable activities
PTSD Prevalence in Veterans
In approximately 10% to 20% of cases, the symptoms may worsen and become persistent, causing significant impairment. Combat veterans have particularly high rates:- Research indicates that approximately 14% to 16% of the US service members deployed to Afghanistan and Iraq have been affected by PTSD or depression.
15% of military personnel who served in Iraq or Afghanistan experience post-traumatic stress each year. 23% of veterans using VA care have had PTS at some point in their lives.
Military Sexual Trauma (MST)
Military sexual trauma (MST) is a critical issue affecting both male and female service members. Military sexual trauma (MST) is defined as psychological trauma that was caused by sexual assault and/or sexual harassment that occurred during one's military service (U.S. Government, 2021).
Prevalence of MST
Recent data reveals the significant scope of this problem:- About 1 in 3 female veterans seen by Veterans Affairs (VA) providers report experiencing military sexual trauma — defined as any sexual assault or sexual harassment that happens during military service.
The prevalence of MST among female and male veterans was 44.2% and 3.5%.
Approximately 68.7% screened positive for MST, including 44.9% who reported experiencing military sexual assault.
Department staffers received more than 57,000 MST claims in fiscal 2024, a rise of about 18% from the previous fiscal year, VA leaders told reporters at a press conference Thursday.
Impact of MST
The consequences of military sexual trauma are far-reaching:- One study of over 125,000 veterans found that female veterans who experienced military sexual trauma were 9 times more likely than their counterparts to develop PTSD.
The same study found that military sexual trauma was associated with increased odds of developing anxiety disorders, depression, and substance use disorders.
History of MST was associated with elevated health burden and suicide risk.
MST survivors experience more severe PTSD symptoms compared to veterans who experience childhood abuse, non-MST sexual assault, and even combat (Webermann et al., 2024).
Gender Differences in MST
While MST affects both men and women, there are notable differences:- Veterans Experiencing Military Sexual Trauma Men: 4% Women: 41.5% Veterans Experiencing Sexual Harassment Men: 3.9% Women: 41.1% Veterans Experiencing Sexual Assault Men: 0.5% Women: 10.2%
Male veterans with MST histories had nearly 3-fold increased odds of reporting future suicidal intent, 2-to-3-fold greater odds of screening positive for current posttraumatic stress disorder (PTSD), depression, and generalized anxiety disorder; and nearly 2-fold increased odds of being disabled.
Depression and Anxiety
Depression and anxiety are prevalent mental health conditions among veterans that can significantly impact quality of life and daily functioning.
Prevalence and Impact
The Primary Care-Mental Health Integration (PC-MHI) initiative mandated specific mental health management strategies, including depression collaborative care management (CCM) (e.g., Rubenstein et al., 2010; Tew, Klaus & Oslin, 2010), an approach that outperforms PC-based depression treatment-as-usual (Chaney et al., 2011; Gilbody et al., 2006; Simon, 2009).
VA PC patients often present with high psychiatric burden and relatively high rates of posttraumatic stress disorder (9.3%), substance use disorder (8.3%), and anxiety (4.8%), conditions that co-occur frequently (Trivedi et al., 2015).
Veterans are five times more likely to experience major depression than civilians, and 3 in 10 veterans with TBI have depression.
Treatment Outcomes
Recent research shows promising results for depression treatment:- Veterans receiving Brief CBT with elevated depression scores who completed three or more sessions were found to have significant symptom reductions of 4.6 points (first to last available evaluations).
Effect sizes indicated that reductions in PTSD and anxiety symptoms were medium in magnitude, and reductions in depression were large in magnitude.
Long-term reductions in suicide for Veterans with VHA mental health diagnoses: From 2001 to 2022, suicide rates fell for Veterans in VHA care with diagnoses of: Anxiety: Down by 36.1%. Depression: Reduced by 34.5%. Posttraumatic stress disorder: Decreased by 31.6%.
Traumatic Brain Injury (TBI)
Traumatic brain injury (TBI) has become a signature injury of recent conflicts. The Centers for Disease Control and Prevention (CDC) defines a traumatic brain injury (TBI) as "a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury."
Prevalence and Statistics
The Defense and Veterans Brain Injury Center (DVBIC) reported nearly 414,000 TBIs among U.S. service members worldwide between 2000 and late 2019.
More than 185,000 Veterans who use VA for their health care have been diagnosed with at least one TBI. The majority of those TBIs were classified as mild.
Veterans experience a high prevalence of traumatic brain injuries (TBIs) due to combat-related incidents such as explosive blasts, penetrating injuries, and blunt force trauma. Over 414,000 service members have been diagnosed with TBI since 2000, highlighting the need to understand the implications of these injuries and the neurosurgical challenges in their treatment.
TBI Symptoms and Impacts
Depending on the severity of the brain injury, a person with TBI may experience a change in consciousness that can range from being dazed and confused to losing consciousness.
Common symptoms include:- Conditions stemming from TBI can range from headaches, irritability, and sleep disorders to memory problems, slower thinking, and depression.
Veterans with TBIs commonly experience cognitive deficits, including impairments in memory, executive functioning, processing speed, and visual disturbances.
TBI can cause conditions like headaches, irritability, sleep disorders and depression and can play a major role in veterans' mental health.
Long-Term Risks
TBI was associated with an increased risk of all-cause dementia (hazard ratio [HR] = 1.95, 95% confidence interval [CI]: 1.55-2.45), vascular dementia (HR = 2.02, 95% CI: 1.46-2.80), but not Alzheimer's disease (HR = 1.30, 95% CI: 0.88-1.91). TBI is a significant risk factor for incident all-cause dementia and vascular dementia.
Receiving multiple concussions has been associated with greater risk of developing a neurodegenerative disease like chronic traumatic encephalopathy (CTE). Scientists have found an association between CTE and repetitive mTBI in professional athletes and combat Veterans after autopsy.
Suicide Risk and Prevention
Suicide prevention remains the VA's top clinical priority, with concerning statistics highlighting the ongoing crisis:
Current Statistics
In 2022, there were, on average, 131.2 suicides per day among U.S. adults, including 17.6 per day among Veterans and 113.7 per day among non-Veterans. The average number of Veteran suicides per day rose from 16.5 in 2001 to 17.6 in 2022.
61% of Veterans who died by suicide in 2023 were not receiving VA health care in the last year of their life. The suicide rate per 100,000 Veterans rose for both male and female Veterans in 2023.
Among Veterans who died by suicide from 2021 to 2023 and whose deaths were reported by VA suicide prevention teams, the most frequently identified risk factor was pain.
Risk Factors
Among Recent Veteran VHA Users whose suicide deaths occurred in 2020-2022 and were reported to VHA Suicide Prevention teams, VA Behavioral Health Autopsy Program data indicated that the most frequently identified risk factors were pain (53.8%), sleep problems (51.4%), increased health problems (42.5%), recent declines in physical ability (34.3%), relationship problems (33.1%), hopelessness (30.4%), impulsivity (27.1%) and unsecured firearms in the home (27.1%).
Prevention Efforts
The VA has implemented multiple suicide prevention initiatives:- In 2018, the first Trump Administration launched RISK ID, a comprehensive suicide risk evaluation screening that helps VA flag and care for at-risk Veterans. In calendar year 2025, VA completed more than 5.3 million suicide risk screenings, approximately 200,000 more Veterans screened than in calendar year 2024.
VA administers the Staff Sergeant Parker Gordon Fox Suicide Prevention Grants Program, which has provided grants to 95 community organizations across the country since 2022. Together, these organizations have made more than 24,400 referrals for suicide prevention supports, including life-saving emergency service connections for 854 Veterans at high risk for suicide.
Additional Mental Health Concerns
Substance Use Disorders
Veterans face elevated risks for substance use disorders:- Although these mental health concerns are prominently highlighted, it is crucial to acknowledge that other issues, such as suicide, traumatic brain injury (TBI), substance use disorder (SUD), and interpersonal violence, can be equally detrimental in this population. SUDs are characterized by a pattern of drug use leading to distress or impairment.
This can manifest in substance abuse disorders, including alcohol abuse. Some veterans use alcohol and drugs to self-medicate after trauma. Ten percent of Iraq and Afghanistan veterans treated by the VA have a problem with drugs or alcohol.
Sleep Disorders
Sleep problems are highly prevalent among veterans:- Other studies indicate that sleep, neuropsychiatric symptoms, and pain in TBI patients all interact. In one study of 137 veterans who sustained TBIs of any severity, 52% were reported to experience co-occurring PTSD, insomnia, and pain.
Anger and Aggression
Many veterans struggle with anger management:- Frequently, reliving the event can evoke a sense of threat as intense as the original trauma.
- Research indicates that hyperarousal symptoms, including anger, can persist long after treatment completion
Treatment and Therapy Options
The VA and community providers offer various evidence-based treatments for veteran mental health conditions:
Psychotherapy Options
For PTSD:- Research supported by the National Institute of Mental Health has shown that a shorter therapy (written exposure therapy) may be just as effective as lengthier first-line treatments for PTSD.
- Cognitive Processing Therapy (CPT) - Helps veterans understand and modify trauma-related thoughts
- Prolonged Exposure (PE) - Gradually helps veterans face trauma-related memories and situations
For Depression:- Acceptance and Commitment Therapy for Depression (ACT-D) can help Veterans overcome their emotional pain by promoting positive actions and choices that align with their values. Through this therapy, you may increase your ability to recognize and achieve what truly matters most to you in life.
Cognitive Behavioral Therapy for Depression (CBT-D) is a structured, time-limited therapy that can help Veterans with depression develop balanced and helpful thoughts about themselves, others and the future. CBT-D can help you modify your thought patterns to change negative moods and behaviors.
Interpersonal Psychotherapy for Depression (IPT-D) is focused on identifying and evaluating relationship issues that may be the cause or result of depression.
Cognitive Rehabilitation for TBI
We identified 8 articles meeting full criteria (total participants = 564; 97% of whom had a history of mild TBI).
There is evidence of cognitive improvement in V/SMs with TBI histories after participation in cognitive rehabilitation. Clinician-administered interventions focusing on teaching strategies may yield the greatest cognitive improvement in this population.
Compared to control groups, participants showed a small, but significant, improvement in overall objective neuropsychological functioning after cognitive rehabilitation interventions. Participants showed a small, but significant, improvement in overall objective neuropsychological functioning after cognitive rehabilitation interventions.
Innovative Treatments
For Treatment-Resistant Depression:- "Esketamine represents the only currently FDA-approved approach that holds the promise of being a breakthrough," said Dr. Somaia Mohamed, associate director of VA's Northeast Program Evaluation Center (NEPEC), associate professor of psychiatry at Yale University, and principal co-chair of the study. "If it produces greater remission rates, has more sustained benefits with fewer side effects, and lower health-related costs, the benefit to thousands of Veterans and millions of other patients would be substantial." The study is the first to evaluate the comparative effectiveness and cost effectiveness of esketamine as compared to aripiprazole, according to Mohamed.
A noninvasive treatment, TMS is used to change activity in the brain. TMS uses magnetic pulses to stimulate specific regions of the brain, which may improve the patient's mood and ease symptoms of depression.
Support for Military Families
Military families also face unique challenges and can benefit from specialized support services:
Family Therapy Programs
Our Enduring Families program provides free individual, couples/marriage, and family psychotherapy for veterans and their family members, as well as child-centered play therapy for children ages 4 and older. This program focuses on the veteran and their family's unique needs ranging from coping with symptoms of PTSD, depression, anxiety and substance use to teaching effective decision-making, parenting and communication skills.
The outpatient clinic at Home Base has served more than 4,000 patients: 3,031 veterans/service members and 1,025 family members since its inception in 2009, with the number of patients seeking care growing year over year. In 2023, the clinic provided care to 656 veterans/service members and 108 family members as compared to 513 veterans/service members and 78 family members in 2022.
Caregiver Support
We recognize the important role of family caregivers in supporting the health and wellness of Veterans. Find out if you may be eligible and how to apply for the Program of Comprehensive Assistance for Family Caregivers (PCAFC).
- Eligible caregivers can receive:
- Monthly stipends- At least 30 days of respite care per year. Respite is a period of rest or a break from caregiving.
Access to telehealth therapy sessions through our virtual psychotherapy program for caregivers (VPPC).
- Training and support services
Supportive Services for Veteran Families (SSVF)
Grantees will be expected to leverage supportive services grant funds to enhance the housing stability of very low-income Veteran families who are occupying permanent housing. In doing so, grantees are required to establish relationships with local community resources. Therefore, agencies must work through coordinated partnerships built either through formal agreements or the informal working relationships commonly found among successful social service providers.
The Supportive Services for Veteran Families (SSVF) program aims to improve very low-income veteran families' housing stability. SSVF provides outreach and case management services and assists participants in obtaining VA benefits and other public benefits. Veterans may qualify for short term rental assistance or assistance with first month's rent, security deposit and/or utility assistance.
Barriers to Mental Health Care
Despite available resources, many veterans face barriers to accessing mental health care:
Common Barriers Include:
- Stigma: There is a significant stigma against seeking care for mental health disorders in the active-duty population, primarily due to the fear of potential repercussions on their military career. Although specific circumstances may necessitate notification of an active-duty patient's Commanding Officer, most routine mental health care does not.
- Geographic barriers: Rural veterans often have limited access to specialized services
- Lack of awareness: Many veterans are unaware of available resources- Veteran-centered barriers to VA mental healthcare services use.
- Trust issues: Some veterans struggle to trust providers who haven't served
Addressing Barriers
The BeThere peer assistance program, in partnership with Military OneSource, offers support to service members (including National Guard soldiers and Reservists), their families, and transitioning Veterans up to 365 days after separation or retirement. Through this program, you can talk privately with peer coaches who are Veterans, service members, or military spouses. To talk with a peer coach, call Military OneSource's free, confidential peer support services at 800-342-9647.
Implementation efforts of Brief CBT resulted in rapid uptake and significant clinical impact on Veterans. Rural outreach efforts, including targeted training for CBOC providers and use of tele-mental health, enhanced availability of EBP services for rural Veterans.
Frequently Asked Questions
What percentage of veterans have mental health issues?
In a 2022 study, 38% of veterans had a code on their medical record for a common mental health disorder. This number does not include undiagnosed mental health conditions, which means the actual number is likely much higher.
Can veterans get mental health treatment outside the VA?
Yes, veterans have multiple options for mental health care. They can receive services through the VA system, community care programs funded by the VA, or private mental health providers. Eligible service members, Veterans, and family members can visit one of our Vet Centers to get free individual and group counseling. You don't have to be enrolled in VA health care or receive disability compensation to use these services.
How long does PTSD treatment typically take?
Treatment duration varies by individual and treatment type. Given the high dropout rates that plague trauma-focused treatments such as PE and CPT, these preliminary results are of interest, and they may suggest that briefer, less structured approaches can be efficacious for combat veterans while increasing treatment retention. Overall, this study provides preliminary support for the use of community-based interventions for combat-related PTSD, depression, and anxiety.
Are family members eligible for mental health services?
Yes, many programs include family members. EHVP's centerpiece service is a two-week intensive outpatient program, which is provided at no cost to veterans, service members, or their families.
How Therapy Can Help
Mental health treatment has shown significant effectiveness for veterans:
Evidence of Effectiveness
From 2001 to 2022, suicide rates fell for Veterans in VHA care with diagnoses of: Anxiety: Down by 36.1%. Depression: Reduced by 34.5%. Posttraumatic stress disorder: Decreased by 31.6%. Alcohol use disorder: Fell by 13.7%.
A total of 688 Veterans, 174 rural (25.7%), received 2,186 sessions (average of 3.5 sessions per Veteran). Veterans receiving Brief CBT with elevated depression scores who completed three or more sessions were found to have significant symptom reductions of 4.6 points (first to last available evaluations).
Finding the Right Therapist
When seeking a mental health professional, veterans should consider:
- Providers with military cultural competence
- Experience treating trauma and PTSD
- Understanding of military sexual trauma
- Familiarity with VA systems and benefits
- Willingness to coordinate with other providers
Getting Started with Treatment
Veterans can access mental health services through multiple pathways:
1. VA Medical Centers: If you're already using VA medical services, ask your primary care provider to help you make an appointment with a VA mental health provider. If you're not already using VA medical services, contact your nearest VA medical center or Vet Center to talk about your needs.
2. Vet Centers: Provide readjustment counseling in a non-medical setting
3. Community Care: VA-funded care in the community when VA care isn't available
4. Crisis Support: This service is private, free, and available 24/7. To connect with a Veterans Crisis Line responder anytime day or night: Call 988 and select 1.
5. Private Therapists: Many therapists specialize in veteran and military issues
Remember, seeking help is a sign of strength, not weakness. With appropriate treatment and support, veterans can overcome mental health challenges and build fulfilling post-service lives. The key is finding the right combination of treatments and support services that meet each veteran's unique needs.
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