Mental Health Challenges for Veterans in Rural America – Help for Our Heroes
To all our veterans who have served in the armed forces, we at Rural Minds wish to express our gratitude for the courage, strength and sacrifice you and your families have made to defend our country and keep us safe. We realize that some of you may still be struggling with both emotional and mental battles after leaving military life, as well as encountering barriers in accessing mental health support. And for the 4.4 million veterans who live in rural communities across the country, the challenges of accessing mental health services are likely to be even greater.
In this blog post, we share national and rural statistics to help raise awareness of mental health challenges facing our nation’s veterans, and provide resources for additional mental health information and support.
Post-traumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) in Veterans
Someone can develop PTSD after experiencing or witnessing a traumatic event, such as combat, physical or sexual assault, or a terrorist attack. PTSD symptoms include having flashbacks of the event, feeling tense or on edge, struggling to feel positive emotions, having difficulty sleeping and engaging in risky behaviors. In trying to cope with PTSD, some people drink alcohol or use drugs. The overuse of these substances can develop into a substance use disorder (SUD).
The following statistics help provide an understanding of the impact PTSD and SUD have on our military veterans:
Veterans are more likely to develop PTSD compared to civilians. At some point in their lives, 7% of veterans will have PTSD. And among veterans, those who were deployed are more likely to develop PTSD than those who were not. (1)
PTSD is more commonly diagnosed among veterans who are enrolled in the Veterans Affairs (VA) healthcare system: In 2021, of the 6 million veterans treated by the VA, 10% of the men and 19% of the women were diagnosed with PTSD. (1)
The number of veterans with PTSD also varies by service era. For example, 29% of veterans who served during Operations Iraqi Freedom and Enduring Freedom experienced PTSD, whereas 21% of veterans who served during the Persian Gulf War experienced PTSD at some point in life. (1)
Veterans who are readjusting to civilian life or dealing with the stresses of deployment are at a higher risk for drug and alcohol addiction. (2)
27% of veterans in VA care who are diagnosed with PTSD also have SUD, while more than one out of every four veterans with PTSD also have SUD. (3)
Veterans are 1.5 times more likely to die from opioid overdose compared to the general population. (2)
Veterans Are at Higher Risk of Suicide
Veterans are more likely to die by suicide than civilian adults. The reasons for this include veterans’ exposure to traumatic events, stress, burnout, isolation, loneliness, easy access to guns and difficulties in adapting to civilian life. (4)
In 2020, there were 6,146 veteran suicides, which is about 17 deaths by suicide per day, according to a 2022 report by the Department of Veterans Affairs. This rate was 57% higher than for non-veteran U.S. adults, when adjusting for population age and sex differences. (5) In addition, rural veterans are about 20% more likely to die by suicide compared to urban-based veterans. (4)
Mental Health Challenges of Rural Veterans
The following demographics highlight the challenges faced by veterans living in rural America, according to data from the U.S. Department of Veterans Affairs Office of Rural Health: (6)
Nearly 25% (4.4 million) United States veterans who return from active military careers live in rural communities.
61% of rural veterans are enrolled in the VA healthcare system and 58% of this group have at least one service-related health condition.
54% of rural enrolled veterans are 65 years or older.
44% of rural veterans earn less than $35,000 per year.
Veterans face barriers to accessing mental healthcare that are unique to rural areas including:
Staff shortages in rural facilities.
Hospital closings due to financial considerations.
Travel and transportation issues due to geography and distance.
Limited broadband internet, with 27% of rural veterans not having internet access in their homes.
Lack of insurance that covers mental healthcare.
The stigma associated with mental health conditions stops them from seeking help.
Limited understanding of military culture and behavioral healthcare needs of veterans.
One study (7) used national survey data to look at the utilization of mental health treatment among military veterans with a mental health condition living in rural areas and found that compared to veterans living in urban areas, rural veterans had:
70% lower chance of receiving any mental health treatment.
52% lower chance of receiving outpatient treatment.
64% lower chance of receiving prescription medications.
Providing Access to Mental Healthcare for Our Heroes Living in Rural America
The VA has recognized the need to provide access to care for rural veterans, allocating 32% of its healthcare budget to rural veteran care.6 In addition, the VA has addressed rural access challenges to mental healthcare for veterans living in rural America by developing partnerships with rural health clinics, community health centers and hospitals, as well as creating community-based outpatient clinics, using mobile VA clinics, and delivering care via telehealth.
In some cases, veterans, their families, and caregivers aren’t aware of the healthcare benefits available to them. For veterans who face challenges to accessing mental healthcare services, here are some of the resources available for support:
Veterans Connected Care Programs
The VA is working to provide veterans with the tools and resources needed to access quality healthcare when and where they need it. The Office of Connected Care brings the latest virtual care tools to veterans, expanding their care beyond the traditional office visit. These programs include telehealth services, VA mobile apps, and My HealthVet web-based personal health record for veterans.
– Click here to learn more about the VA Connected Care program.
– Click here to learn about VA Telehealth Services.Veterans Services for PTSD and SUD
If you have experienced a traumatic event and have PTSD symptoms for more than three months, or if you are concerned about your alcohol or drug use, talk to a healthcare professional about treatment options. Effective treatments are available, and recovery is possible. VA Medical Centers have PTSD-SUD specialists that have training to treat both PTSD and SUD.
– Click here to find a VA PTSD program in your state.
– Click here to find a VA SUD program in your state.Veteran Community Care
The VA provides healthcare services to veterans through community providers when the VA is unable to provide veterans with the care they need. There are specific eligibility requirements for Community Care, including the availability of care through a VA facility and the needs of individual veterans.
– Click here for more information about Veteran Community Care.
– Click here to find a Community Care provider near you.Veterans Self-Check Quiz
The Department of Veterans Affairs and the National Suicide Prevention Lifeline joined with the American Foundation for Suicide Prevention to develop the Veterans Self-Check Quiz – a safe and easy way to see if stress and depression may be affecting you. The Self-Check Quiz takes about 10 minutes to complete. A VA Chat Responder will review your quiz and leave a personal response on the secure website. Follow-up services are available if you want them.
– Click here to learn more about the Veterans Self-Check Quiz.Veterans Crisis Line
If you are a veteran in crisis or concerned about one, the Veterans Crisis Line is there for you. Dial 988, then press 1 or text 838255 for free confidential support 24/7, 365 days a year. You don’t have to be enrolled in VA benefits or healthcare to call. When you call the Veterans Crisis Line, you will be connected to someone who is qualified to support veterans.
– Click here for more information about the Veterans Crisis Line.
Mental Health Resources for Veterans:
National Veterans Foundation (NVF) Lifeline for Vets
The NVF Lifeline for Vets helps veterans, their family members, and active-duty service members with needs including PTSD counseling, suicide intervention, medical treatment, VA benefits, employment, training, legal aid, and more.Mental Health America (MHA) – Military Mental Health
MHA provides several mental health resources for the military and their families on this webpage.National Alliance on Mental Illness (NAMI) – Homefront
This is a free online suite of resources for caregivers, family members, and military service members and veterans designed to increase understanding, communication, wellness, and advocacy skills.PTSD Alliance
PTSD Alliance is an association of advocacy and professional organizations for individuals suffering from post-traumatic stress disorder (PTSD). The PTSD Alliance seeks to increase awareness and educate PTSD sufferers, their families, and the public about the prevalence, diagnosis, and treatment of this serious health condition.Real Warriors Campaign (RWC)
The Department of Defense’s RWC was established in 2009 as a public health campaign designed to decrease stigma, increase psychological health literacy, and open doors to access to care by encouraging seeking help for mental health among active-duty service members, veterans, and their families.The Veterans Crisis Line
The Veteran’s Crisis Line is a free, confidential resource available to any veteran. If you are a veteran in crisis or concerned about one, there are caring, qualified Veterans Affairs responders standing by to help 24/7. Call 800-273-8255 (press 1), text 838255, or chat online.U.S. Department of Veterans Affairs: National Center for PTSD
This website provides information and resources related to post-traumatic stress syndrome (PTSD).US. Department of Veteran’s Affairs: Vet Centers (Readjustment Counseling)
Vet Centers provide readjustment counseling and outreach services to veterans who served in a combat zone. In addition, services are also provided for their family members.
References
U.S. Department of Veterans Affairs. PTSD: National Center for PTSD. Accessed at: https://www.ptsd.va.gov/understand/common/common_veterans.asp#:~:text=PTSD%20is%20slightly%20more%20common,7%25)%20will%20have%20PTSD.
U.S. Government Accountability Office. Veterans Health Care: Services for Substance Use Disorders, and Efforts to Address Access Issues in Rural Areas. Published Dec. 2, 2019. Accessed at: https://www.gao.gov/products/gao-20-35
Understanding PTSD and Substance Use. National Center for PTSD. Accessed at: https://www.ptsd.va.gov/publications/print/sudptsdflyer.pdf
DiAngelis T. Veterans are at higher risk for suicide. Psychologists are helping them tackle their unique struggles, American Psychological Association. Monitor on Psychology. Nov. 1, 2022. Vol. 53; No. 8. Accessed at: https://www.apa.org/monitor/2022/11/preventing-veteran-suicide#:~:text=These%20veterans%20are%20an%20important,PhD%2C%20a%20community%20psychologist%20who
U.S. Department of Veterans Affairs. 2022 National Veteran Suicide Prevention Annual Report. Accessed: https://www.mentalhealth.va.gov/docs/data-sheets/2022/2022-National-Veteran-Suicide-Prevention-Annual-Report-FINAL-508.pdf
U.S. Department of Veterans Affairs, Office of Rural Health. Rural Veteran Healthcare Challenges. Accessed at: https://www.ruralhealth.va.gov/aboutus/ruralvets.asp#:~:text=Almost%20a%20quarter%20of%20all,to%20reside%20in%20rural%20communities
Utilization of Mental Health Services by Veterans Living in Rural Areas. September 2016.The Journal of Rural Health 33(3) DOI: 10.1111/jrh.12221. Accessed at: https://www.researchgate.net/journal/The-Journal-of-Rural-Health-1748-0361?_tp=eyJjb250ZXh0Ijp7ImZpcnN0UGFnZSI6InB1YmxpY2F0aW9uIiwicGFnZSI6InB1YmxpY2F0aW9uIn19