Specialized Behavioral Health Treatment Access More Important Than Ever for Service Members & Veterans

By Michael Genovese, M.D., J.D.

Since 9/11, more than four times as many current or former U.S. military personnel have died by suicide as during military operations.

The death by suicide rate for young service members in 2020 was double the rate for civilians of the same age, a trend that hasn’t occurred since during the Vietnam War. 

How might an Active-Duty Service Member or Veteran arrive at the decision to take their own life? Struggling with a return from deployment, an increase in isolation, or a lack of access to proper behavioral healthcare — along with the stigma of pursuing it — are just a few of the many reasons.

Let’s focus further on that last point. Approximately 60% of military personnel who suffer from mental health concerns do not seek help, according to one study. The biggest barriers to treatment? More than 40% of respondents said, “My unit leadership might treat me differently,” or, “I would be seen as weak.”

That mentality of being unable to seek help doesn’t disappear for those who no longer serve. Of the nearly 18 Veteran deaths by suicide per day in 2018, only about 30% of those Veterans received professional mental health treatment.

Racial minorities and women are at even greater risk. Black service members have a suicide rate that is three times higher than that of Black individuals who haven’t served. Female Veterans have a suicide rate that is 2 1/2 times higher than that of civilians.

With posttraumatic stress (PTS) and substance use disorders more common among current or former military personnel than among the general population, it’s unacceptable that so many of these service members either don’t have access to the care they need or don’t think they can use it.

“Mental health is health period,” Defense Secretary Lloyd Austin said during a July visit with U.S. forces stationed in Alaska — where 17 soldiers were suspected to have died by suicide in 2021. “And we have to approach it with the same energy that we apply to other — any other health issue, with compassion and professionalism and resources. And so if you’re hurting, there are resources available.”

Seeking out any means of treatment is naturally better than taking no action, but to provide the greatest benefit possible for service members and their families, these programs need to do more than just address the anxiety, depression, PTS, trauma, military sexual trauma, survivor’s guilt, moral injury, and substance use disorder concerns so many Americans are fighting.

They need to be military-specific.

Fortunately, there are a growing number of accessible options that fit this bill. Acadia Healthcare has programs that are designed exclusively to meet the needs of Active-Duty Service Members, Veterans, and their families at facilities around the nation — many of which are close to military installations.

Not all of these are at the residential level. Facilities are more frequently offering outpatient programs for service members who don’t need 24/7 acute stabilization — or those who may only want to dip their toes in the water of professional intervention.

Acadia has also worked hard to make care more accessible for those who are no longer serving. Many of those same facilities are approved to provide care for U.S. military Veterans through a relationship with the VA Community Care Network. That allows these Veterans greater control of their healthcare, giving them authorization from VA medical staff to access services from other providers within the community.

Many of those Acadia facilities will also benefit from a partnership with PsychArmor, which offers employees a chance to receive training that is specifically designed to support the needs of the military community.

A wider network means more options and a better chance for current or former military personnel to find specialized care at a treatment center like North Tampa Behavioral Health. The Wesley Chapel, Florida, facility’s C.O.R.E. military PTS and substance abuse treatment program allows service members to work with a team of dedicated military and civilian professionals to address their concerns.

Jenna Temple, Psy.D., LMFT, is North Tampa Behavioral Health’s clinical services director. She has designed the C.O.R.E. program with treatment modalities that help each Veteran or Active-Duty Service Member get to the root of their struggles with PTS or addiction. These include:

• Eye movement desensitization and reprocessing (EMDR), a psychotherapy that helps people heal from the symptoms and emotional distress that result from disturbing life experiences

• Dialectical behavior therapy (DBT), a psychotherapy that provides people with skills to manage painful emotions and combines strategies of mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation

• Accelerated resolution therapy (ART), which rapidly moves patients beyond places they’re stuck to grow toward positive change

• Prolonged exposure, which helps patients reduce trauma-induced psychological disturbances and has produced clinically significant improvement in 80% of patients who have chronic PTS

• Cognitive processing therapy (CPT), which helps patients learn how to challenge and modify unhelpful beliefs related to trauma

• Animal-assisted therapy, which has been shown to reduce anxiety, increase mental stimulation, and serve as a catalyst in the therapeutic process

Patients participate in both weekly individual and more frequent group therapy sessions, and Temple’s groups often combine Active-Duty Service Members and Veterans.

“We have seen benefits from offering a mixed milieu, such as an increased peer support,” Temple said. “A Veteran can help an Active-Duty Service Member with transitional anxiety since they have already experienced the transition. The patients can also share resources, such as navigating the VA or other nonprofit organizations.

“The presence of Veterans gives Active-Duty Service Members a window into the future. And having current service members helps Veterans open up more about their experiences.”

It’s easy to say that we have to find a way to drastically lower the suicide rate of those who have served, yet for so long, our best options were half-measures that didn’t address the full scope of the problem. We know that the physical, psychological, and emotional burdens so many service members carry with them deserve specialized attention — and we’re finally starting to understand exactly what that entails.

We’re working hard to reduce the stigma of getting help, both on military installations and by encouraging Veterans to share their stories. We’re providing more military-specific programs that address the concerns that are unique to those who have served. And we’re reducing the financial and geographic barriers that have prohibited so many from reaching out for help through partnerships that make access more widely available.

The brave individuals who have served always made a commitment to put us first. It’s time we do the same for them.

Michael Genovese, M.D., J.D., is a clinical psychiatrist, an addiction specialist, and the chief medical officer of Acadia Healthcare. He previously served as the medical director of the Officer Safety and Wellness Committee of the FBI National Academy Associates, helping equip first responders with the tools they need to withstand, recover, and grow following repeated trauma. He is a diplomate of the American Board of Psychiatry and Neurology and a member of the American Medical Association, the American Psychiatric Association, the American Academy of Addiction Psychiatry, and the American Society of Addiction Medicine.