Addressing the Stigma in Women Veteran Mental Healthcare: The Most Visible Servicemembers But Most Invisible Veterans

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Women are the fastest-growing demographic group in the military, and the population of female military service members and veterans is over 2 million in the United States today.

While women only make up 17% of US active-duty forces and about 10.5% of the current veteran population, this percentage is expected to grow exponentially over the coming years.

Given current trends, it’s predicted that women will compromise over 18% of the total US veteran population by 2042.

The Facts Behind Women Veterans Mental Health

Recent population survey studies suggested that between 44 and 72 percent of veterans experience high levels of stress during their transition from service to civilian life.

These stresses include anything from:

  • Securing employment after service
  • Interpersonal difficulties during employment
  • Adapting to schedules of civilian life
  • Conflict relations with family, friends and others
  • Legal difficulties

Transition stress has also been found to predict both treatment seeking and later development of mental and physical health problems, including suicidal ideation. 

These rates of mental and physical health problems were found to be higher for women veterans in most studies.

The two most common primary service-connected conditions women veterans face are Post-traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD), which along with migraines and back pain, accounted for almost a third of all the service-connected disabilities for women veterans in 2020.

Other staggering mental health statistics among women veterans included:

  • One in four women veterans experience military sexual trauma (MST) while in the service, a staggering difference between men which is one in one hundred. 
  • One in five women enrolled at VA screened positive for MST. 
  • They are also nearly twice as likely to become homeless than their male counterparts, as well as more likely to become single parents.
  • Women veterans are six times more likely to die by suicide than women who did not serve. The current rate is 14.8 per 100,000.

Research also shows that women’s military experiences and responses differ vastly from men, and place them at a unique and often higher risk for mental health concerns. 

Reasons for this include anything from exposure to different trauma, gender socialization, emotional learning and memory processing.

Barriers to Mental Health Support for Female Veterans

Between 2003 and 2012, the usage of VA healthcare by women veterans increased by nearly 80 percent, with women utilizing mental healthcare services more intensively than men.

500,000 women were utilizing VHA benefits in 2019.

Yet women veterans still face barriers receiving and utilizing benefits, especially those for mental health. And they only make up 8% of all users of healthcare at the VA. 

Women face a variety of unique barriers to mental healthcare at VA, largely related to challenges associated with being a woman in a traditionally male-dominated system, as well as issues that are specific to military sexual trauma (MST).

Some of the obstacles and barriers to treatment included things such as:

  • Access to care (location, type of clinic needed, etc.)
  • Parenthood/childcare
  • Funding issues for women’s health
  • Lack of gender specific programs for care
  • Lack of women doctors available
  • Feeling discluded from the community

Additionally, during interviews conducted at VA medical centers, women veterans often reported feeling frustrated at having to prove they were veterans (it is often assumed that a female at the VA accompanying a male, is the wife of a veteran) and not being acknowledged as a combat veteran.

Women also reported feeling uncomfortable in VA health facility waiting rooms, where they are outnumbered by men, and reported unwanted sexual attention while in VA facilities, which can be especially upsetting for women who sustained MST while in service.

Data from the National Academy committee survey of post-9/11 veterans analyzed the reasons why men and women who had mental health needs reported that they did not use VA mental health care services.

In general, both men and women veterans were aware of VA mental healthcare benefits and how to apply for them, but the major difference was that women were significantly more likely to report that they believed they weren’t entitled to or eligible for VA mental healthcare (52 percent of women versus 34 percent of men).

Addressing the Needs of Women Veterans

According to a report put out by the DAV on health challenges faced by veteran women, there are key areas the VA should focus on to improve their health services, especially mental healthcare services.

They found that between 2000 and 2015, the proportion of women veterans seen at VHA facilities who had a mental health encounter increased from 23 to 40 percent of the population who served.

In the same time period, the percentage of women veterans utilizing mental health services increased fivefold, while utilization by men only increased twofold. 

What the VA Presently Provides

In 2018, the VA launched a targeted program to address the issue that all women (patients and staff alike) are treated with respect in their facilities.

Their policy now states that “mental health services need to be provided … in a manner that recognizes gender-specific issues can be an important component of care.”

For instance, women veterans utilizing mental health services often reported that their symptoms intensified during life events where hormone levels are known to fluctuate, including premenstrual (42 percent), pregnancy (33 percent), postpartum (33 percent) and menopause (18 percent).

The VA provides initial and periodic screening to every primary care patient for depression, PTSD, military sexual violence (PTSD) and problem drinking. 

Veterans who screen positive for any of these conditions are referred to a mental health practitioner for further evaluation.

The goal was to have same-day, integrated primary care and mental health practices that allow a mental health practitioner to meet with patients who screen positive before they leave, or at minimum within 24-hours.

Mental Health Still a Huge Concern for Women Veterans

Even with all of this in place, in several surveys in recent years, it was found that only two-thirds of women veterans who indicated they needed mental health care sought it at the VA. 

In one specific survey, over 48 percent of the women veterans that participated stated they didn’t believe the VA provided quality mental health services.

In response to these recent surveys, the National Academy of Sciences Committee recommended that the VA should develop a comprehensive five-year strategic plan for mental health services. 

It should address providing accessible, high-quality, integrated mental health care services. 

The increasing number of women in the military is leading to a proportional rise in the number of female veterans, and it is estimated that by 2042, women will comprise 18% of the total US veteran population. 

However, the transition from military to civilian life can be highly stressful and presents unique mental health challenges for women veterans, with rates of mental and physical health problems higher for women veterans than their male counterparts. 

Women veterans are also six times more likely to die by suicide than women who did not serve. 

Women face several obstacles and barriers to mental healthcare at VA, including a lack of gender-specific programs, inadequate access to care, funding issues for women’s health, and lack of women doctors available.

The VA has made progress in addressing these issues by increasing the number of women-only clinics and integrating mental healthcare into primary care. 

It has also launched a targeted program to ensure that all women (patients and staff alike) are treated with respect in their facilities. Nevertheless, much more needs to be done to provide appropriate and effective mental healthcare services for women veterans. 

There is an urgent need for more gender-specific programs, more women doctors, and greater access to care. 

Women veterans have served their country with honor and distinction, and it is imperative that they receive the mental health support and services they need and deserve.

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