CSJ Celebrates Veterans Day - Veterans Mental Health & Treatment

 November 11 is a day that we take to remember and honor all veterans. These individuals have demonstrated their love for their country by their willingness to serve.

As we reflect on their sacrifices, let us take a moment to reflect on our overall wellbeing. The general well-being of us as a collective can influence our quality of life. Quality of life can be represented by various factors that are unique to everyone. However, everyone is tasked with identifying ways to improve their own quality of life, which might include addressing obstacles that can create roadblocks to obtaining an improved quality of life. Some of these obstacles can be related to mental health.

For veterans, who are often more susceptible to negative mental health outcomes due to exposure to distressing events among other factors, face challenges that need to be addressed effectively by health providers. These health challenges can occur simultaneously and share the same risk factors. The term comorbidity is utilized to describe this phenomenon.

Health challenges that are commonly faced by veteran populations can include the following:
1. Substance abuse
2. Posttraumatic stress disorder
3. Depression
4. Suicide
5. Traumatic brain injury

The experiences of veterans consisting of significant transitional periods can create additional challenges towards improved quality of life. Veterans often experience a period of adjustment to society. This process of reintegration into the community presents can create challenges for veterans in reconnecting with loved ones, finding employment, and returning to school (Institute of Medicine, 2014). Mental health related symptoms can also make it harder for veterans to reintegrate into society.

Families of service members also undergo a period of adjustment post-deployment. For example, household responsibilities or parental roles might need to be readjusted when service members return home. An effective tool that can help ease this transition period includes open communication and reciprocal support (Institute of Medicine, 2014).

It’s important for veterans to seek help as necessary to help them navigate these challenges and in being equipped with tools to better manage mental health symptoms. Therapy can be the first step or tool that veterans can access and utilize to help them effectively address these challenges.

The following include evidence-based sources of support for veterans:

1. Engagement of peers in treatment
2. Mindfulness-Based Stress Reduction (MBSR)
3. Strong social support
4. Psychological protective factors, such as resilience
5. Exposure therapy
6. Pharmacotherapy
7. Suicide crisis lines
8. Comprehensive suicide programs
9. The Screening, Brief Intervention and Referral to Treatment (SBIRT) model

Therapy delivery can be modified to fit the needs of the individual in need of services while
considering their accessibility as well. Face-to-face therapy is a common therapeutic treatment option. However, that option may not be cost effective (e.g., traveling) and people may be more heightened to stigma of receiving therapy. Another alternative to in person treatment include virtual visits.

Telehealth includes phone, texts, mobile applications, and video conference platforms. A study by Blonigen and colleagues (2021) evaluating the role of peers in facilitating the participation of veterans' use of a mobile app 'Stand Down' to help prevent alcohol use found that accountability and support enhanced patient access to care and progress towards less drinking. It is important to note that each modality has its pros and cons. However, the goal is to engage the individual in a treatment modality that will be most suitable for them.
In addition, there is a need for health providers to be sufficiently trained to meet the unique needs of veterans and their families. Clinical practice guidelines from the Department of Defense can help clinicians with suicide risk assessments, determination of appropriate care settings, therapeutic interventions for co-occurring health challenges, and continuity of care such as follow-up visits (Institute of Medicine, 2014).

Support for veteran families is another important consideration, as deployment can be a predictor of negative outcomes such as intimate partner violence and marital conflict, especially when service members show poor psychological symptoms (Institute of Medicine, 2014). Another factor that can impact overall well-being include grief/loss. Death of service members increases the likelihood that families experience negative psychological symptoms themselves.

Additionally, children of service members can become susceptible to internalizing and
externalizing problems as a result of frequent relocation and child maltreatment (Institute of Medicine, 2014). Therefore, families of service members can benefit from resources to help them better understand ways to help veterans and use these resources for themselves to navigate their own unique challenges and experiences.

The following is a list of resources that can be useful to loved ones of veterans and possibly
veterans as well:

• Military Pathways: free psychological health assessments for family members and veteran personnel
• Battle mind (Resilience training): focuses on teaching mental toughness with regard to deployment and transitioning to home life 
• Yellow Ribbon Reintegration Program: helps reserve component service members and their families with obtaining employment and health services
• Wounded Warrior Programs: helps those injured receive appropriate care
• Family-Centered Resiliency: helps military families cope with increased
challenges related to deployment

• https://focusproject.org
• https://deploymentpsych.org/content/building-military-family-resilience
• https://www.militaryonesource.mil/family-relationships/family-life/keeping-your-family-strong/keeping-your-family-strong-essentials/

By Rumbidzai Mushunje

References:
Blonigen, D. M., Harris-Olenak, B., Kuhn, E., Timko, C., Humphreys, K., Smith, J. S., & Dulin,
P. (2021). Using peers to increase veterans’ engagement in a smartphone application for
unhealthy alcohol use: A pilot study of acceptability and utility. Psychology of Addictive
Behaviors, 35(7), 829–839. https://doi.org/10.1037/adb0000598

Institute of Medicine. (2014). Understanding psychological health in the military. In L. A.
Denning, M. Meisnere, & K. E. Warner (Eds.), Preventing psychological disorders in
service members and their families: An assessment of programs. The National Academies
Press. https:// doi.org/10.17226/18597