Behavioral Health Equity: Responding to the Needs of our Nation’s Veterans

Date: November 08, 2024

Category: Veterans

On Veterans Day, we take time to honor former service members for their willingness to make sacrifices for our nation. Support for all our nation's Veterans is a prominent component of the wide-ranging services provided by the Substance Abuse and Mental Health Services Administration (SAMHSA). An emphasis on Veteran behavioral health (mental health and substance use disorder) care is rooted in the agency's recognition of the unique needs of this population and the collective national commitment to support those who served. If you ask a group of Veterans why they chose to serve, you will hear various responses. Veterans may describe a role model who served in the military, a family legacy of service, feelings of patriotism, a sense of duty to protect others, as well as unique opportunities that military service affords. Those opportunities might include pursuing new experiences, traveling to new places, gaining job skills for the future, and financial security. In fact, the military is among our nation's most diverse employers.

The Diversity of our Nation's Veterans

During World War I and World War II, American Indian people were recruited by the U.S military to develop secret battle communications using their Indigenous languages. "Code talkers" as they came to be known, are credited with contributing to the victories of the United States and its allies. During the World War II draft, more than one million Black men and thousands of Black women were inducted into the military, serving in all branches and all theaters of operations. There is data showing that as many as one out of five transgender Americans have served in the military, which is significantly higher than the rate of the general U.S. population. The Department of Defense demographics survey shows that 18.4 percent of active-duty service members in 2022 were Hispanic or Latino. Additionally, women are the fastest growing group of Veterans, and are projected to make up 18 percent of all Veterans by the year 2040.

The Strength, Resilience, and Patriotism of Minority Veterans

Minority Veterans, including racial and ethnic minorities, LGBTQI+ people, and women, have displayed strength, resilience, and patriotism. Minority Veterans have served honorably in every military conflict, even prior to having the right to vote in this nation. This history of service has also influenced a history of breaking barriers and righting injustices. In 1948, President Harry Truman signed Executive Order 9981 banning segregation in the military and paving a way for the Civil Rights Act of 1964, which 16 years later prohibited discrimination based on race, religion, color, sex, and national origin throughout the United States. Though LGBTQI+ individuals have experienced barriers to serving openly throughout history, in September 2011 "Don't Ask, Don't Tell" was repealed and in June 2024 President Joseph Biden issued a proclamation pardoning service members who were court-martialed in the past based on consensual same-sex relationships.

Minority Veterans and the Impact on Mental Health

Every year, approximately 200,000 men and women leave the U.S. military service and return to life as civilians, and each of them face unique challenges during the transition. Data from SAMHSA's National Survey on Drug Use and Health (NSDUH) (PDF | 1.6 MB) indicate that in 2022, approximately 5.8 million Veterans reported experiencing a behavioral health condition. Despite the legacy of service and contributions to our nation, minority Veterans are more likely to be impacted by psychosocial stressors and behavioral health conditions. In 2021, Veterans who identified as American Indian or Alaska Native experienced the highest suicide rates (PDF | 2 MB) of all racial groups. Of Veterans receiving healthcare at the Department of Veterans Affairs (VA), one in three women and one in 50 men report experiencing military sexual trauma. Additionally, data indicates that Black Veterans are disproportionality impacted by unemployment (PDF | 341 KB) and incarceration (PDF | 400 KB) after their military service. Considering the needs of military-connected families is also crucial. A recent survey of Veterans and their spouses indicated that their top concerns include access to care as well as civilians' understanding of military/Veteran issues.

How Best to Serve the Cultural Needs of our Veterans

To provide the best care and service to each of our nation's Veterans and military-connected family members, it is important to consider the unique contexts of their lives and cultural identities through the lens of intersectionality. When behavioral health providers and community-based organizations are planning efforts to serve Veterans, it's important to take note of the unique characteristics of Veterans in one's community. Multiple data tools, including the Measuring Communities* data portal, provide insight into the unique demographics and needs of Veterans and military-connected families in their respective communities across the nation. Additionally Veteran leaders are creating equity-centered Veteran-serving organizations, such as Minority Veterans of America,** which prioritizes ensuring that "all Veterans receive the care, recognition, and support that they earned."

A Promise to Care for Those who have Served in our Nation's Military and for Their Families, Caregivers, and Survivors

In 1959, the VA adopted a mission statement based on President Abraham Lincoln's second inaugural address: "To care for him who shall have borne the battle and for his widow, and his orphan." In March 2023, the VA announced an updated version: "To fulfill President Lincoln's promise to care for those who have served in our nation's military and for their families, caregivers, and survivors." This revised statement honors and acknowledges all who have served and the family members and supporters who served alongside them.

Let's all work together to strengthen culturally responsive and equitable behavioral health support for all our nation's service members, Veterans, and their families.

How You Can Help

• If you or a Veteran in your life is in crisis, dial 988, then Press 1. Through SAMHSA's partnership with VA, the nation's first three-digit mental health crisis number can readily connect Veterans, service members, and their loved ones to VA's Veterans Crisis Line.
• Search information available through SAMHSA's Service Members, Veterans, and their Families Technical Assistance Center and its Diverse Veteran Populations page.
• Explore resources through the VA's Center for Minority Veterans.
• Review SAMHSA's publications that highlight resources for the Military and Veteran population.

*The Measuring Communities data tool by Purdue University's Military Family Research Institute uses data from over 30 governmental and nongovernmental organizations.
**Minority Veterans of America is featured above as one example of a Veteran-serving organization that serves the public and is consistent with SAMHSA's mission. Numerous similar non-profit organizations exist throughout the nation.