by Austyn Kobs, English MA student (North Carolina State University) and USAF Veteran, NCIOM Staff
The transition from military to civilian life presents a critical juncture for Veterans, often shaping their long-term mental health outcomes. While the Department of Veterans Affairs (VA) provides essential services, there remains a significant gap in accessibility, cultural competency in civilian health care, and comprehensive community-based support. This article highlights key data and findings regarding Veterans’ mental health struggles, emphasizing the importance of bridging the gap between institutional and community resources.
The first 12 months following a service member’s separation from active duty have the potential to be extremely tumultuous. While the various branches of the military provide resources like the Active Duty Transition Checklist and the Department of Defense Transition Assistance Program [1-2] to help Veterans with transitionary hurdles (e.g., the need for housing, financial preparation, and relocation assistance during the separation process), there are countless other factors that can blindside Veterans. These factors include difficulty finding prompt employment, loss of community, and acclimation to civilian life, all of which contribute to feelings of isolation and a marked increase in reported stress. Data shows that the transition period following military separation is marked by heightened mental health risks, including increased suicide rates. The 2024 National Veteran Suicide Prevention Annual Report reveals that suicide rates in the first 12 months post-separation have risen sharply, from 34.8 per 100,000 Veterans in 2010 to 51 per 100,000 Veterans for those who separated in 2019 [3]. These statistics underscore the need for targeted interventions during this vulnerable period.
Compounding this challenge is the issue of access to mental health care, especially for Veterans living in rural areas. While the VA offers mental health and intervention services, many Veterans face logistical barriers such as lengthy wait times and significant travel distances, as VA Secretary Denis McDonough noted during a VA press conference in early January of this year [4]. According to data from the US Census Bureau, a disproportionately high percentage of North Carolina’s Veteran population, 36.23% compared to the US average of 23.84%, reside in rural areas where access to VA facilities is limited [5]. This geographic challenge highlights the necessity of community-based mental health support to supplement federal efforts.
While the VA plays a crucial role in Veteran care, its capacity is often stretched. During the VA press conference on January 8th, 2025, Secretary McDonough acknowledged that budget constraints and staffing shortages would challenge the department’s ability to meet the ever-increasing demand for Veteran treatment. One potential solution to this limitation, pitched by both Secretary McDonough and Deputy Secretary Tanya Bradsher, is to improve coordination between the VA and civilian health care providers [4]. However, research indicates that many civilian providers lack the cultural competency training that would help them better understand Veteran experiences and needs, limiting their effectiveness in treating Veterans [5].
Additionally, while Veterans do have options for care, the requirements and qualifications can be convoluted, and many Veterans are unaware of these provisions [4]. For example, excessive drive and wait times can qualify a Veteran for community care, however these numbers change depending on the type of care required. For primary care or mental health services, Veterans qualify for community care if they cannot be scheduled at a VA health facility within a 30-minute drive from home and within 20 days from scheduling; for specialty care, these numbers jump to 60 minutes and 28 days. It is worth noting that for any of these cases, a Veteran must first seek approval from their VA health care team before these options open up [6]. Addressing this knowledge gap could significantly enhance access to care.
One of the most pressing issues affecting Veterans is isolation, particularly among those in rural communities. Social isolation is a known risk factor for mental health decline and suicide. Data from the 2024 National Veteran Suicide Prevention Annual Report shows that Veteran suicide rates remain disproportionately high, with an average of 17.6 suicides per day in 2022 [3].
A significant contributing factor is firearm accessibility. Firearm suicide rates among Veterans surpass those of all other suicide categories. The report notes that firearm ownership is significantly higher among Veterans (45%) than non-Veterans (19%), making firearm safety and suicide prevention initiatives a crucial aspect of addressing Veteran mental health [3].
Community-based outreach and intervention programs have shown promise in addressing these challenges. The VA’s National Strategy for Preventing Veteran Suicide program emphasized the importance of partnerships between clinical services and community-driven initiatives [7]. Similarly, the Governor’s and Mayor’s Challenges to Prevent Suicide Among Service Members, Veterans, and Their Families aim to establish multiple touchpoints for Veteran engagement at state and local levels [8].
One key initiative within these programs is the Community Engagement and Partnership for Suicide Prevention strategy, which funds and trains Community-Based Interventions Program Managers to develop localized, evidence-informed suicide prevention strategies [8]. These efforts recognize that while systemic change is necessary, grassroots engagement remains essential in reaching at-risk Veterans.
Veteran mental health requires a multi-faceted approach that incorporates both systemic and community-led efforts. Data shows that the transition to civilian life is a high-risk period during which Veterans could benefit from targeted support, particularly in rural areas. Addressing the disconnect between VA and civilian health care, reducing isolation, and implementing effective community engagement strategies are all necessary steps toward improving health outcomes for Veterans. By leveraging existing programs and increasing awareness of available resources, stakeholders can work together to create a more comprehensive support system for those who have served.