Military personnel and veterans willingly risk their lives to protect our society. In the United States, there are more than 22.3 million veterans1 and more than 2.2 million active military service members (including the National Guard and Reserve).2 Among the challenges these men and women face is the risk of developing or exacerbating behavioral health conditions, which include mental and/or substance use disorders.
The 23rd annual National Recovery Month (Recovery Month) observance this September celebrates the effectiveness of treatment services and the reality of recovery. Recovery Month is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), within the U.S. Department of Health and Human Services (HHS).
This year's theme, "Join the Voices for Recovery: It's Worth It," emphasizes that while the road to recovery may be difficult, the benefits of preventing and overcoming mental and/or substance use disorders are significant and valuable to individuals, families, and communities. People in recovery achieve healthy lifestyles, both physically and emotionally, and contribute in positive ways to their communities. They also prove to family members, friends, and others that prevention works, treatment is effective, and people recover.
SAMHSA's efforts to curb behavioral health issues in soldiers, veterans, and their families are guided by its Military Families Strategic Initiative, which aims to ensure access to needed behavioral health services to achieve positive outcomes in this population.3
This document outlines the impact of mental and/or substance use disorders on individuals in the military, as well as the prevention, treatment, and recovery resources available to provide support to these individuals and their families. To learn about the recovery journey of a military service member, veteran, or relative, please visit the "Join the Voices for Recovery" document in this toolkit.
Prevalence of Mental and/or Substance use Disorders
Active military, veterans, and military families are all at risk for developing mental and/or substance use disorders. The rate of behavioral health conditions among military personnel is significant, with serious consequences:
- Mental and/or substance use disorders caused more hospitalizations among U.S. troops in 2009 than any other cause.4
- More than 1,100 members of the armed forces died by suicide from 2005 to 2009 - an average of 1 suicide by a member of the armed forces occurred every 36 hours during that time.5
- Any illicit drug use, including prescription drug abuse, among active-duty personnel more than doubled between 2005 and 2008, from 5 percent to 12 percent.6
Individuals, as well as their friends and family, can help to prevent these disorders by recognizing their prevalence and symptoms and learning more about how these disorders can affect members of the military community.
Understanding Mental Health Problems in the Military
While serving our Nation, hundreds of thousands of soldiers face exposure to combat. These traumatic war experiences can have a direct effect on mental health. The most common mental health problems among active duty service members include post-traumatic stress disorder (PTSD) and depression:7
PTSD is an anxiety disorder associated with traumatic experiences, and approximately 14 percent of service members returning from Iraq or Afghanistan meet the criteria for PTSD.8 Symptoms often include reliving the traumatic event, feelings of emotional detachment, difficulty sleeping, and increased anger or irritability.9
Depression is a condition that involves feelings of sadness or low mood that last more than just a few days, and is a common problem that can occur following trauma. For veterans, depression can be caused by painful memories and feelings about their war experiences.10 Symptoms of depression can include feelings of sadness and hopelessness, loss of interest in activities that were once pleasurable, insomnia or excessive sleeping, and thoughts of suicide.11
Understanding Substance Use Disorders in the Military
While substance use disorders are not as pervasive as mental health problems among military populations, they are still a major health concern.12 The following are signs and consequences associated with substance use among people in the military:
- Failure to fulfill major personal and professional obligations;13
- Recurrent use of substances in situations in which they are physically hazardous;14
- Recurrent alcohol or substance-related legal problems;15
- Persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol or substance use, while this use often continues without stopping;16
- Mood and behavior problems;17
- Financial difficulties;18 and
- Hurt social relationships.19
The Extended Impact on Families
In the United States, there are approximately 700,000 military spouses, and more than 700,000 children have experienced the deployment of a parent.20 Military families play an active role in the recovery of a relative's disorder, while at the same time they may also experience difficulties dealing with situations that can arise due to a family member's deployment, injury, or death. Studies show that longer cumulative lengths of combat deployment, or the total number of days overseas, are associated with more emotional difficulties among military children and more mental health diagnoses among U.S. Army wives.21, 22
To prevent the onset of these issues, families need to identify the signs of mental and/or substance use disorders among loved ones - and monitor for symptoms even after a parent or spouse returns home.
Address Prejudice to Help Military Members on the Road to Recovery
Social prejudice, or fear of being exploited or judged for mental and/or substance use disorders, can interfere with the desire of individuals with behavioral health conditions to seek treatment and support. For example, in 2008, approximately 12.9 percent of all military personnel believed that if they were to seek mental health counseling through the military, their careers would be damaged.23 Perceptions about behavioral health problems can change, however, and research shows that the most effective way of countering prejudice and discrimination is by sharing one's personal experiences with others.24
Opportunities for Prevention, Treatment, Recovery, and Support
Many States have policies in place to respond to the needs of veterans, and in 31 States, substance use disorder treatment and service providers are required to screen for veterans' mental health status and in 40 States, health care providers screen patients to determine if they need mental health assessments.25 The Department of Defense (DOD) and U.S. Department of Veterans Affairs (VA) promote the integration of behavioral health and primary care to help reduce prejudice, improve access to high-quality behavioral health services, and provide a proven "best practice" for treating depression and PTSD.26
Additionally, the VA has devoted $37.7 million to placing psychiatrists, psychologists, and social workers within primary care clinics27 and has recruited nearly 3,800 new mental health employees, including 800 psychologists.28 Despite an influx in mental health care professionals, only 20 percent of all military personnel received mental health counseling in 2008.29 Army personnel were the branch most likely to have received some sort of mental health counseling (24 percent), compared with personnel in the Marine Corps (20 percent), Navy or Coast Guard (17 percent), and Air Force (16 percent).30
With the help of treatment and the support of family and friends, those in the military can and do overcome mental and/or substance use disorders and sustain happy, healthy, and productive lives.
Additional Recovery Resources
A variety of resources provide additional information on Recovery Month, mental and/or substance use disorders, and prevention, treatment, and recovery support services. Use the toll-free numbers and websites below to share your experiences, learn from others, and seek help from professionals. Through these resources, individuals, including family members, can interact with others and find support on an as-needed, confidential basis.
– Leads efforts to reduce the impact of substance use and mental disorders on communities nationwide.
SAMHSA's National Helpline, 1-800-662-HELP (4357) or 1-800-487-4889 (TDD) – Provides 24-hour free and confidential treatment referral and information about mental and/or substance use disorders, prevention, treatment, and recovery in English or Spanish.
SAMHSA's "Find Substance Abuse and Mental Health Treatment" Website
– Contains information about treatment options and special services located in your area.
SAMHSA's "Considerations for the Provision of E-Therapy" Report
– Shares extensive information on the benefits, issues, and success of e-therapy.
SAMHSA's ADS Center
– Provides information and assistance to develop successful efforts to counteract prejudice and discrimination and promote social inclusion.
National Suicide Prevention Lifeline, 1-800-273-TALK (8255) – Provides a free, 24-hour hotline available to anyone in suicidal crisis or emotional distress.
Veterans Crisis Line, 1-800-273-TALK (8255)
– Connects veterans in crises and their family and friends with VA responders through a confidential, toll-free helpline and online chat.
United States Department of Veterans Affairs - Mental Health
– Maintains and improves the health and well-being of veterans through health care, social services, education, and research.
Army Substance Abuse Program (ASAP)
– Provides guidance and leadership on alcohol and drug abuse prevention, education, and training programs for soldiers and their commanders.
For more information, read the in-depth version of this guide. Information about treatment options and special services in your area can be found by calling 1-800-662-HELP (4357) or 1-800-487-4889 (TDD), as well as at http://www.samhsa.gov/treatment.
Inclusion of websites and resources in this document and on the Recovery Month website does not constitute official endorsement by the U.S. Department of Health and Human Services or the Substance Abuse and Mental Health Services Administration.