Hope and Healing for Veterans and Service Members

Source: ratucette from Pixabay, royalty free

Thousands of veterans and active-duty service members are suffering from mental health conditions originating from their military service. The United States faced two decades of war. Census reports estimate that there are roughly 21 million veterans.¹ Since September 11, 2001, 2.8 million active-duty American military personnel have been deployed to Iraq, Afghanistan, and beyond, leading to increasing numbers of combat veterans among the population.² Baek (2024) estimates that over 50% of the 21 million veterans in the U.S. with behavioral health challenges are not having their needs met due to stigma and other barriers to care.³

There are many hotspots throughout the world, including Ukraine, Palestine, and Israel. People who are not necessarily well-prepared for military service have been called to duty. What makes these conflicts different for the U.S. veteran is that those other military personnel are fighting within their own countries. Their families are in harm’s way, and there have been thousands of civilian deaths in addition to the deaths of those actively serving.

The Exceptional Nature of Military Service

There is an exceptional nature to military service in that service members can be exposed to an array of potentially traumatizing experiences. Wartime deployments can result in witnessing severe injuries and/or violent death, sometimes occurring suddenly and not always to intended targets, resulting in the death of civilians, including children. Active duty military members are at risk of experiencing other traumas, such as interpersonal violence, racism, and physical and sexual abuse.

For U.S. veterans, there is a knowledge that in previous wars, such as World War I and World War II, there was a clear front line. Those in the back were safe from enemy fire and could carry on their assignments without fear of attack. However, in recent conflicts, there is no “front line.” A service member is potentially in danger “inside of the wire” as well as “outside of the wire.” They can be standing in the chow line waiting to eat one minute and the next minute be under attack. This results in service members needing to stay at a high level of arousal and tactical readiness, which can wreak havoc on the nervous system. The combat zone can be an intense place where troops deal with having to move very quickly and make split-second decisions that involve life and death, as well as standing down and waiting for long periods. "Hurry up and wait” is a clear reality in war zones. Many service members have described the contrast of intense fear and terror followed by long periods of incredible boredom. There can be significant physical challenges with being sleep deprived, enduring extreme temperatures of hot and cold, and transporting and carrying heavy packs weighing 60-80 pounds.⁴

Traumatic Losses, Grief, and Guilt

Troops in the combat zone can face traumatic losses, grief, and guilt. They can be involved in an intense firefight in which they lose buddies. The images of the loss are searing, but there is no time for the troops to process the experience lest they compromise their tactical readiness. They may be charged to collect the body parts of their buddy whom they just saw in the chow line. These troops may have to make decisions that impact their spiritual and moral beliefs. Life-and-death acts that are black-and-white in the civilian world are not so clear-cut in combat, where one may have to choose between killing a potentially innocent civilian and protecting one’s entire unit (Halvorson, 2010).⁵

Creating a Safety Net of Peers and Professionals

In addition to traditional professional mental health counseling, interventions can be created to complement the usual delivery system of mental health services. This can create a wider safety net as many veterans and active-duty service members are not “psychologically oriented.” Assistance from a peer who has knowledge of how military service affects the mind and body can be a portal for healing. Veterans and active-duty service members may be amenable to learning simple wellness skills that teach them about the biology of stress and trauma from a peer. The paradigm shift from “pathology or mental weakness to biology” can provide a new awareness about how not only their mind but also their body was affected by military service. This awareness has the potential to reduce shame and stigma.^5.

A Promising Pilot Study

A pilot study looking at treating veterans through the Community Resiliency Model (CRM)—developed by our team at the Trauma Resource Institute—was published in 2024. This longitudinal pilot study evaluated the impact of the CRM on veterans’ behavioral health and daily functioning. CRM wellness skills can be taught to active-duty service members and veterans. The skills apply cross-culturally and can be utilized within the United States and within international conflict zones. A sample of 46 English-speaking, ethnically diverse U.S. veterans were recruited for this pilot study. Repeated measure analyses showed that CRM skills significantly decreased distress and increased well-being. Researchers also found strong short-term results for measures of daily functioning with a significant longer-term impact on participants’ ability to control their feelings of being "amped up." Most (82%) participants maintained and continued to use the CRM skills daily to weekly and had positive reactions to the program. Across their analyses, the results of this pilot study suggest that providing CRM training to veterans is a feasible, efficacious, and well-received approach to help address much-needed veteran behavioral health.³ There is a need for further research.

Hope and Help

When a wider net is cast with peers and professionals working together to serve veterans and active-duty service members, we may have the potential to reduce the barriers and stigma to receiving care for mental health conditions. There can be renewed hope for the possibility of greater healing. The Veterans' Administration and Vet Centers can provide support to veterans. In addition, private therapy can be helpful outside the VA system with a mental health practitioner schooled in how the body is affected during military service, like those trained in somatic-based approaches. You can find therapists by reviewing the Psychology Today Directory. To learn more about CRM, click here. For immediate support, the 988 Crisis Line for Chat/Text is available 24/7.