In 1944, General George S. Patton delivered a now-famous speech to the United States Third Army, a formation of largely inexperienced soldiers who were preparing for combat duty. In the speech, Patton said, “Each man must think not only of himself, but think of his buddy fighting alongside him. We don’t want yellow cowards in the army.”
While the purpose of the speech was to inspire and motivate young soldiers, the overall message—that to be afraid of dying is “cowardly” and out of place for a soldier—reverberates in the minds of many who have served in the United States Armed Forces.
Stereotypes About Heroism vs. Mental Illness in the Military
In fact, there remains a pretty prevalent stereotype within the military and among veterans that real soldiers “don’t cry.” Just ask Dr. Sachi Ananda. She’s the program director of a specialized treatment track for first responders (also known as “Shatterproof”). In a recent interview, she said that “unfortunately, yes, there are still stereotypes within the military and veterans that tough guys don’t cry”—and that these aren’t going away any time soon:
Many people who go into the military do so because they had parents, grandparents, and/or extended family who were in the military. The standards of what is considered “manly” or “masculine” are generational and then get passed down to the next generation. So it will take a lot of societal changes to break through the generational stereotypes where what’s acceptable in military standards can become more accepting and open of emotional expressions.
These pervasive, largely generational stereotypes about what it means to be a courageous or heroic soldier can obscure the relatively common reality of mental illness in the military. According to a 2014 study in the journal JAMA Psychiatry, nearly one in four active-duty members surveyed showed signs of mental illness—as compared to one in five civilians who live with mental illness.
Unfortunately, it would seem that long-held personal and public stigmas are difficult to overcome and prevent many active duty personnel and veterans from seeking mental health care.
The Importance of Seeking Mental Health Care Services
When someone thinks of the term “healthy,” they likely imagine someone who is physically healthy with good cardiovascular strength, strong muscles, and no diseases that impact their ability to function. However, mental illnesses have as significant an impact on quality of life as physical illnesses. Mental health is an important aspect of holistic health, regardless of whether or not an individual has served in the military.
Unfortunately, mental illnesses rarely resolve on their own. Just as ignoring high cholesterol can lead to serious consequences, ignoring mental illnesses can lead to equally serious, long-term problems.
In addition to causing mental and emotional distress, untreated mental illnesses can have a significant impact on physical health. Multiple studies indicate that high levels of cortisol that the body produces as a response to long-term stress increase an individual’s level of bad cholesterol, blood sugar, and blood pressure. These are all common risk factors of heart disease, which is the leading cause of death in military veterans.
Why Veterans Suffer So Disproportionately from Suicide?
Untreated mental illness may also lead to suicide, the second leading cause of death among veterans. In comparison, among civilians, suicide is the 10th leading cause of death.
What explains this health disparity as well as the others?
“Many veterans went into the military due to having a very strong purpose to serve their country,” Dr. Ananda said. “This purpose is so strong they are willing to give their lives to this purpose. When combat veterans are no longer serving that purpose, they have a greater chance of suicide, as a major risk factor for this is feeling a lack of purpose and meaning in one’s life.”
While mental health care services are important for anyone, they are especially critical for those who have experienced dangerous, high-stress situations like combat. Sadly, however, it’s often the case that “when veterans return from serving, they lack enough support and services to help them with the transition home,” according to Dr. Ananda. “When there is lack of support for this transition, veterans become disconnected from their communities, families, and friends, which leaves them vulnerable to suicide.”
Seeking Help While Serving in the Armed Forces
Unfortunately, many armed forces personnel who would benefit from mental health services are unable or reluctant to seek them out. The reasons for this are complex and unique to the person with the mental illness. However, there are a few common roadblocks faced by many soldiers and veterans that prevent them from getting the help they need.
Roadblocks to Seeking Help in the Armed Forces
Perceived Public Stigma
The very nature of military culture—including the desire to handle one’s own problems without “burdening” someone else—is among the biggest roadblocks that keep military personnel and veterans from receiving mental health care services. Many who would benefit from counseling or medication therapy for mental illnesses like depression or anxiety don’t seek out care because doing so seems shameful and they’re afraid that others will see them as weak.
Minimizing the Need for Help
Military service members are trained to be independent and to put their job in front of their own needs. As admirable as that is, that “me-last” mentality may be a key reason that so many don’t seek mental health services. For an individual that has served in combat and has perhaps seen friends lose limbs or even die in the line of duty, it may be difficult to recognize that they need and deserve access to mental health care services, even though they may have survived combat seemingly unscathed.
Fear of Jeopardizing Their Career
Many military personnel are reluctant to seek out mental health care for fear that doing so will negatively impact their career, such as causing them to lose security clearance or even being discharged from service. While this may have been a valid concern at one point, recent decades have brought dramatic changes in how the Department of Defense views mental health conditions.
When someone with a mental health illness becomes aware of a real or perceived public stigma, agrees with the stereotypes, and applies them directly to their own situation, the public stigma becomes internalized. Internalized stigma is particularly difficult to overcome because it may lead an individual to believe that by seeking mental health care services, they’re admitting to weakness.
All of these roadblocks appear “with many veterans and active military personnel on some level with varying severity,” Dr. Ananda said. In her view, though, “the biggest barrier to mental health treatment” is “the perceived public stigma about mental health disorders,” which she views as a contributor to the other roadblocks to seeking help.
“If mental health disorders were better understood in society and there was not a negative stigma to military having these disorders, they would not fear coming out about the need for help,” Dr. Ananda said. “Employers would understand that when veterans get help for mental health disorders they can become highly productive employees. If mental health disorders were seen as treatable disorders rather than signs of weakness or poor character, there would be less shame and internalized stigma.””
Making Mental Health Services More Accessible for Military Personnel and Veterans
Meanwhile, hundreds of thousands of military personnel are living with combat-related mental health problems. For many of these people, the perceived lack of resources can make it difficult to get the help they need. Addressing stigmas and accessing available resources are essential steps for those living with combat-related mental illnesses.
The Department of Defense has tackled the issue of mental health through numerous anti-stigma campaigns, including one called “Real Warriors. Real Battles. Real Strength.” This campaign, which launched about a decade ago, featured PSAs to explain how effective treatment is available for mental health issues. Measures like these, along with an increased awareness of how mental illnesses disproportionately affect those who have served or are serving in the military, can improve access to necessary mental health services.
Along with reducing stigmas associated with seeking mental health services, the Department of Defense has taken steps to give servicepeople confidence that they’ll receive confidential care that won’t have negative career repercussions. Under 2014 rules, talking to a doctor about mental health concerns, asking about the need for a diagnosis, or seeking treatment cannot affect an individual’s military career. The Department of Defense follows privacy guidelines set down by the Privacy Act and HIPAA that ensure a patient’s privacy in most situations. In fact, those who receive help for combat-related issues don’t have to answer “yes” on the Defense Department’s security clearance questionnaire.
Utilizing Available Resources
Military service members and veterans have access to more resources than ever to help them get the mental health services they need. These include:
- Military OneSource: This free, confidential service is provided by the Department of Defense and addresses a broad range of concerns facing service members and their families. Help is available 24 hours per day, seven days per week by calling 1-800-342-9647.
- The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE): This center provides information regarding mental health, PTSD and traumatic brain injury. The center can be contacted 24/7 at 1-866-966-1020.
- U.S. Department of Veterans Affairs Mental Health Resources: This department provides information about mental health and support services for veterans.
- National Resource Directory (NRD): This directory, which operates in connection with the Departments of Defense, Labor and Veterans Affairs, connects service members, veterans, wounded warriors, and their families.
Resources like these complement professional treatment and can help improve outcomes for military personnel and veterans living with mental health issues.
Getting Help with FHE Health
With the prevalence of mental illness among active duty military personnel and veterans, finding a trustworthy mental health professional who understands the unique challenges is essential. Comprehensive mental healthcare that addresses mood disorders, depression, anxiety disorders, and chemical dependency as they pertain to those in the military is vital for overall health and quality of life. FHE Health specializes in supporting and uplifting those who have served our country, providing patient-centered care in a safe, confidential setting.
As a team that serves at the forefront of mental health care, we offer state-of-the-art treatment that integrates medical, psychiatric, and clinical components for a holistic approach. If you or someone you love is living with mental trauma resulting from service in the armed forces, FHE is here to help. Connect with a member of our intake team by calling (844) 274-6558 or use our online contact form to request a call. We’re available around the clock, seven days per week to help you or a loved one get the necessary help.