When we think of Veterans Day, we often focus on the physical service for our country—the time, the family strain, the stress, the sacrifices. However, much of what veterans deal with occurs when they return home from duty and mental health and substance use issues surface. These are the scars that remain invisible, but ever present.
According to the Boulder Crest Foundation, which treats veterans and educates about the topic of post-traumatic growth, at least 30 percent of combat veterans and first responders are suffering in silence with a range of mental health challenges. Additional research indicates that the 14 percent of veterans who meet criteria for cannabis use disorder have three times the odds of self-injury. Post-traumatic stress disorder is one of the only mental health conditions for which medical marijuana is approved. The veteran suicide rate is alarming. In 2020, 6,146 veterans died by suicide, averaging about 16.8 veterans per day. About one in three veterans with a mental illness experienced serious mental illness (SMI). More than one in ten veterans are diagnosed with a substance use disorder, a rate slightly higher than the general population. Approximately 65 percent of veterans report alcohol as their substance of choice.
Specifically, veterans who served in post-9/11 conflicts have been known to experience higher rates of PTSD, traumatic brain injury (TBI), depression, and substance use disorders compared to earlier veteran cohorts—41 percent screened positive for at least one mental health condition, and 28 percent self-reported a diagnosis in the prior two years.
Given this overwhelming data, how can we best support veterans personally? When you encounter a veteran, you can thank them for their service and allow the conversation to flow from there. Volunteering time and donating to veterans organizations is always appreciated. If you have a veteran friend who is in need of mental health or addiction treatment, encourage them to seek out help and decrease the stigma in conversation. When speaking with a veteran who has served in active war zones, be sure not to ask questions that are too probing or personal. Many veterans have memories that they do not always want to dredge up in casual conversation. Research and learn more about the experience of being a veteran and the nuances among the various military branches. Ask open-ended questions about what they may have learned during their service or about their bonds with other veterans could be more appropriate topics.
Professionally, as therapists, it is key to recognize veterans as a special population with unique needs. There are many trainings and ways to obtain continuing education that are recommended to explore, should you treat these clients in therapy. Here are some clinical suggestions:
Apply evidence-based modalities that have been found to be effective with this population: Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Seeking Safety, EMDR, post-traumatic growth, and more.
Learn veteran cultural competency.
Collaborate and engage with your local VA.
Be mindful that veterans who are addressing service-related trauma may not be appropriate in a general therapy group and should be treated with other veterans and even first responders.
Understand how your office environment, signage, and patriotism all impact their ability to feel supported.
Learn about the challenges of transitioning to civilian life.
Learn some of the terminology specific to veterans and concepts such as moral injury, institutional betrayal, service branches, etc.
Speak directly to veterans and ask them what needs they have for behavioral health treatment.
Try not to appear shocked when they are sharing “war stories” and other out-of-the-ordinary experiences or language.
In honor of Veterans Day, we can choose to look beneath the strong exterior of these warriors and realize that they have had complex experiences and deserve individualized communication and care.
To find a therapist near you, visit the Psychology Today Therapy Directory.