Monarch expert shares why some veterans’ challenges aren’t always related to their military service

Posey knows veterans face incredible mental and physical demands on the battle field that can have deep and lasting effects when they return stateside to their civilian and family lives. However, he stresses that is not always the case.

“Not all veterans have problems related to their military service.  In fact, most of them do not.  As a result, we shouldn’t assume that they have post-traumatic stress disorder (PTSD), or are struggling to reintegrate into civilian life,” Posey said.  “Like all the people we support, we want to allow the veteran to tell us his or her story about the challenges have prompted them to seek services.”

However, according to the Substance Abuse and Mental Health Service Administration (SAMHSA), there are some issues that affect veterans at a higher rate than the general population.  This is why it is important to ask about military service when doing screenings or assessments.  While we should routinely assess for these issues with all the people we support, it’s especially important to cover and thoroughly explore the following areas with veterans:

  • Suicide. While veterans only make up about seven percent of the population, they account for about 20 percent of completed suicides.  It’s reported that 22 veterans die by suicide every day.
  • Trauma. Many veterans have experienced significant physical and/or psychological trauma.  SAMHSA and the VA report that between 10-31 percent (this varies depending on when/where they served) of veterans meet diagnostic criteria for PTSD. Aggressive behaviors related to reactivity symptoms of PTSD can result in arrest and involvement in the criminal justice system.  Symptoms related to negative cognition and mood can result in self-medicating through the use of alcohol or other drugs.  Traumatic Brain Injury (TBI) is another veteran’s issue that may bring them into care.
  • Housing and homelessness. As stated above, veterans only comprise 7 percent of the general population, but make up 10 percent of those who are homeless.
  • Substance Use Disorders (SUDs). The VA reports that more than 11 percent of veterans who served in Iraq and Afghanistan have been diagnosed with a SUD.  The number of those with SUDs, but who are undiagnosed could be much higher. 
  • Reintegration into civilian life. Military culture is very different from civilian life.  This requires some adjustment on the part of veterans as they make the transition.  Problems with reintegration may surface later, rather than sooner.  This is because the excitement of returning home to families and loved ones can mask the symptoms of adjustment problems or PTSD. 

When it comes to these and other relevant veteran’s issues, SAMHSA advised that behavioral health and primary care providers do the following:

  • Ask and assess
  • Intervene when there is a need

Clinicians and helping professionals often wonder how they can help.  If you find yourself regularly working with veterans training in military culture and common issues affecting veterans is recommended. 

Lastly, don’t forget veterans who have served in past armed conflicts, Posey cautions.  When we think of veterans, we tend to think of those who served in Iraq or Afghanistan.  However, there are many veterans from World War II, the Korean War, the Vietnam War, the Gulf War and other lesser known conflicts who still struggle with some of the aforementioned issues. 

“I personally knew of a family friend who was a World War II veteran and former POW,” Posey said. “He had never been diagnosed with or treated for PTSD, but even in his late 80s and into his 90s, he was still experiencing significant PTSD symptoms that impaired his functioning from time to time on certain dates or when he encountered a trauma trigger.”