Someone can experience a mental illness over many years. The type intensity and duration of symptoms vary from person to person. They come and go and do not always follow a regular pattern, making it difficult to predict when symptoms and functioning will flare up, even if treatment recommendations are followed. The symptoms of mental illness often are effectively controlled through medication and or psychotherapy and may even go into remission. For some people, the illness continues to cause periodic episodes that require treatment. Consequently, some people with mental illness will need no support, others may need only occasional support and still others may record more substantial ongoing support to maintain their productivity. The most common forms of mental illness are anxiety disorders, mood disorders, and schizophrenia disorders.
Mental Health and the Veteran
What is Mental Illness?
Mental illness is a term that describes a broad range of mental and emotional conditions. Mental illness also refers to one portion of the broader ADA term mental impairment and is different from other covered mental impairments such as mental retardation, organic brain damage, and learning disabilities. The term ‘psychiatric disability’ is used when mental illness significantly interferes with the performance of major life activities, such as learning, working and communicating, among others.
Study: Thousands of Veterans return with Mental Illness
San Francisco, California. Nearly 1/3 of veterans returning from Afghanistan and Iraq who received care from Veterans Affairs between 2001 and 2005 were diagnosed with mental health or psychological ills a new study concludes. A study carried out by researchers at the University of California, San Francisco and the San Francisco VA Medical Center looked at data from 103,788 veterans.
Of the veterans studied:
• 13% of them were women
• 54% of underage 30
• Nearly 1/3 minorities and,
• Nearly half veterans of National Guard or reserves
• 32,000 10 ( 31% parentheses were diagnosed with mental health and/ or psychological problems psychosocial show problems
• 25,658 received mental health diagnosis
• More than half 56% were diagnosed with two or more disorders
Post traumatic stress disorder was the most common disorder, with the 13,205 veterans who got the diagnosis accounting for more than half 52% of mental health diagnosis.
Post traumatic stress disorder, and anxiety disorder that can occur after the experience or witnessing of a traumatic event, can lead to depression, substance abuse, problems of memory and cognition, and other problems of physical and mental health.
Other mental health problems include:
• 24% with anxiety disorder
• 24% with adjustment disorder
• 20% with depression and,
• 20% suffering substance abuse disorder
But the youngest group studied--veterans 18-24 years of age--appeared to be at greatest risk. “Our results signal a need for improvements in the primary prevention of service dash related mental health disorders, primary prevention of military service-related mental health disorders, particularly among our youngest service members,” the authors wrote. “And because they were young, they are more likely to be of lower rank and more likely to have greater combat exposure than their older active-duty counterparts.”
In addition, the study’s conclusions may not apply generally to all veterans of the wars, since the study included only those veterans who got VA care. Tthe authors warned, “Our results may overestimate the burden of mental health disorders because veterans with mental health disorders may be more likely to seek treatment at a VA facility than those without.”
Stigma and Veterans
Stigma is associated with negative attitudes about psychological health care and poses a significant barrier to seeking help, engaging in care, and completing psychological health treatment.
Several types of stigma influence help seeking: perceived public stigma, self-stigma (also called internalized stigma), and attitudes toward help seeking. These attitudes include the perception of a need for help, stigma tolerance, openness regarding one's problems, and confidence that help will be beneficial. Those who are most reluctant to seek mental health care often perceive the lowest benefits from mental health treatment and have the most treatment-related doubts.
Mental health stigma in the military is strongly grounded in military culture and is linked to a desire to handle problems on one's own. Interestingly, service members who report psychological health concerns are most likely to perceive stigma and anticipate negative outcomes for seeking care, including career harm.
Individuals who experience or witness traumatic events and experience stress reactions that disrupt their psychological well-being may be particularly reluctant to seek mental health care. Concerns about re-experiencing traumatic events and the avoidance of traumatic reminders are a challenge to psychological health care engagement. Other considerations for stigma reduction in military personnel seeking care:
- Confidentiality: Military patients know that much of their medical life is not private. However, in increasing numbers of cases, some mental health treatment is confidential, including mild, transient problems and treatment related to sexual assault.
- Career concerns: Service members' fears that seeking mental health care could negatively impact their careers are significant contributors to stigma in the military.
- Hope: The belief that treatment will not be effective is an important predictor of dropping out of treatment. Hope is among the most important messages a clinician can impart to a patient. Provide patients frequent feedback about their progress and educate them that psychological health disorders are highly treatable; for example, there is a 70–80 percent recovery rate from PTSD in individuals who complete evidence-based treatment.
- Patient-centered care: Many military service members feel uncomfortable seeking mental health care. Provide treatment options and incorporate the patient's preferences for treatment.
- Strength and self-reliance: Inquire about patients' perceptions about psychological health care and whether they think treatment will be effective. Address self-stigma and challenge the belief that handling problems on one's own is a sign of character strength and seeking care is a sign of personal weakness in a warfighter.
Empathic and non-stigmatizing language: While it can be helpful to educate patients about their diagnosis, it's even more important to provide a psychological understanding of how their symptoms developed and convey concern for their well-being.
Timothy Pena initially traveled to NYC at the invitation of RIP Medical Debt founder and U.S. Navy Veteran Jerry Ashton to collaborate for his project, Veterans Mission Possible. Soon after arriving, Tim decided he would rather be homeless in NYC than commit suicide in Phoenix and spent five months in a shelter before obtaining his HUD/VASH voucher for supportive housing while detailing his journey from homeless to homeness with a series of articles called, 'Be the Story'. He has testified before the NYS Department of Veterans Affairs, is a member of the NYC Veterans Task Force and Military Veterans in Journalism, while founding The Forgotten Veteran non-profit. Email: Timothy Pena