Stress, PTSD and Mental Health of Veterans and Soldiers

By Marilyn Lash, M.S.W.
Lash and Associates Publishing/Training, Inc.

Signs of stress and PTSD in the military 

As service members and veterans come home from Iraq and Afghanistan, many have psychological issues related to traumatic stress and post traumatic stress disorder (PTSD).  

• More than 90% of soldiers and Marines returning from Iraq reported stressors of…
  • roadside bombs
  • length of deployment
  • handling human remains
  • killing an enemy
  • seeing dead or injured comrades
  • being unable to stop a violent situation. 
• 30% of troops returning home from Iraq reported some type of mental health problem, including
  • anxiety
  • depression http://www.lapublishing.com/depression–brain-injury-family/
  • nightmares
  • anger
  • difficulty concentrating. 
• 15-17% of troops returning from Iraq in 2004 experienced acute stress or post traumatic stress disorder (PTSD).  http://www.lapublishing.com/PTSD-blast-brain-injury/

The stigma of mental health

Mental health treatment has always been carried more stigma or “baggage” than treatment for physical conditions in the U.S.  Common misperceptions in the general population are that seeking therapy, counseling or even medication for emotional help is a sign of weakness.  Even most private health insurers have strict limits on the scope and number of mental health services allowed.  There is a general belief among the public that those who seek mental health treatment are unstable, disturbed, and mentally ill.  This stereotype leads to patterns of avoidance by friends, neighbors and coworkers.  It contributes to denial by individuals and delays seeking treatment.   

This stigma makes it even more difficult for soldiers and service members to ask for help in a military culture that stresses being strong and avoiding signs of vulnerability or weakness. 

PTSD screening in the military

 The military has made a serious effort to address psychological issues among troops.  Despite this, there is still a lag of soldiers actually seeking help.  Before returning to their home stations, all soldiers undergo mandatory psychological and medical screening.  Based on the results of the psychological questionnaire to assess PTSD, depression and alcohol abuse, soldiers may be required to have an interview with a mental health professional.  Those who indicate medical symptoms are referred to medical professionals. 

Soldiers are more reluctant to report psychological problems, especially when returning with their units.  The findings are striking… 

• Only 38-45% of troops newly diagnosed with mental health problems were interested in receiving help.
• Fear of stigmatization and concern about barriers to getting psychological help was twice as likely among troops who scored positively compared to those who did not.
• Only 23-40% of troops who reported interest in seeking help during the previous year had actually received professional treatment.

Beliefs about mental health and mental illness

Beliefs that psychological distress is a sign of weakness are also linked to the perception that individuals are responsible for their problems.  There is a common belief among civilians and service members that individuals should be able to control their psychological symptoms through choice, determination, and sheer will power. 

Consequently, it is easy to see why service members fear exclusion by comrades if they report symptoms of PTSD or other emotional distress.  Seeking treatment may be avoided or delayed due to apprehension about its stigma and reactions of comrades. 

Interventions for reducing stigma in the military 

Organizational policies and programs directly impact whether service members seek mental health support.  Concerns about losing a job or security clearance are barriers to seeking mental health treatment.  Anonymity and confidentiality are other concerns reported by soldiers. 

Leaders and supervisors have a critical role in identifying and helping soldiers receive mental health support and treatment.  If leaders emphasize the importance of early mental health treatment, service members are more likely to seek help because it has less negative associations.  Leaders are instrumental for creating a climate where mental health problems such as PTSD are recognized and early treatment encouraged and supported.

References:

Greene-Shortridge, TM, Britt, TW, and Castro, CA. (2007). The Stigma of Mental Health Problems in the Military. Military Medicine, 172, 2:157.

For more information, see:

Understanding the Effects of Brain Injury, Blast Injury, Concussion and PTSD

Blast injury, PTSD and brain injury guide for families and caregivers on the consequences of concussion in veterans. Used by many VA Hospitals and Army Medical Facilities.

Healing Together

By Suzanne Phillips, Psy.D and Dianne Kane, D.S.W.

Book for couples coping with effects of trauma and post-traumatic stress disorder (PTSD) from war, brain injury, violence, accidents, crime or health problems.