The Veterans Guide to Mental Health and Substance Abuse Treatment

Better access to substance abuse treatment for veterans is essential.

Why Don’t Veterans Get Mental Health and Substance Abuse Treatment?

Veterans are disproportionately affected by substance abuse and mental health disorders in the United States. Far too many aren’t getting the help they need. Vets are more prone to substance abuse and mental health problems due to a number of factors. The U.S. military’s over 20 years of deployment in hot zones related to the War on Terror is surely one contributing factor. The past two decades in particular have left tens of thousands of veterans with mental health challenges ranging from PTSD and anxiety to depression and alcohol or drug addiction.  

The truth is there are lots of veterans with substance abuse and mental health disorders who just aren’t getting enough help. At JourneyPure, we believe there are several obstacles that come between veterans and the mental health and substance abuse treatment they need. This article is designed to help inform veterans with addiction or mental health needs and their families. Let’s start by looking at reasons why vets don’t get the mental health and substance abuse treatment they need.

Some Reasons Why Vets with Addiction and PTSD Don’t Get Help:

• Stigma associated with addiction, depression, PTSD and mental health.
• Lack of information about their options for substance abuse treatment. 
• Delays and postponement of treatment services from the VA. 
• Inadequate treatment provided by the VA Community Care Network. 
• A sense of shame or pride prevents them from asking for help. 
• Chronic pain or anxiety that only seems to respond to narcotic meds.
• Concerns about letting people down or falling short of responsibilities.

What is Stigma Exactly?

The sense of stigma or bias may be the biggest obstacle to mental health and substance abuse treatment for veterans. But what is stigma exactly? A stigma is a type of prejudgment or bias held against people. For example, if you thought all people who drive sports cars are careless drivers. That would be an example of bias. If lots of people felt the same way, that could result in a stigma about people who drive sports cars.

Logically we know that all people who own sports cars aren’t the same. All they have in common for sure is the type of car they drive. But our brains instinctively take shortcuts by making assumptions and grouping types of people together. This habit is natural, but also leads to bias. Everyone is biased about something. It’s impossible for a human being to be 100% objective, only a computer can do that. But we try the best we can. The more we can counteract bias, the fairer we can be. Judges and juries are meant to try to avoid bias as much as possible because bias is antithetical to justice and fairness.

How do Stigma and Bias Affect Substance Abuse Treatment for Vets?

Self-stigmatization can rob people of the power of choice. It perpetuates stereotypes and false beliefs. Stigmatization hurts people and prevents them from getting the mental health help they deserve. We often internalize the stigma we are exposed to. This is called self-stigma. In the case of a veteran with a substance abuse problem, they may have held a stigma that people who can’t “handle their liquor” or who lose control of their drug use are weak or immoral. When that veteran suddenly finds themselves in need of substance abuse treatment, a little voice in their head starts telling them that they are weak and immoral.

They may begin to believe that their friends and loved ones will see them that way too. It’s easy to understand how that could take the wind out of anyone’s sails and discourage them from getting help for PTSD, help for drug and alcohol addiction or any other mental health concern. This is why stigmas are so damaging. The military is a place where we’re expected to be strong and self-reliant and follow orders to the T. Military culture has more than its share of peer pressure, and yes, stigma and bias. These ways of thinking don’t just disappear when you leave active duty and become a veteran in the private sector. They tend to stick with you.

How Stigma and Bias Can Block a Veteran’s Path to Recovery:

• Making people feel weak or needy if they ask for help with addiction or mental health.
• Stigmas perpetuate misinformation and myths about mental health and addiction.
• The stigmas make veterans less likely to open up and talk about their experiences.
• They may cause a person to continue trying to manage an unmanageable situation.

Overcoming Obstacles to Addiction Treatment for Veterans

Getting past any stigma or hesitation about asking for help must be job number one. Veterans are often the bedrock in their own families. They may be the sole breadwinner or an emotional safe harbor for others. Often, it’s both. When you’re looked upon to be strong, it can be tough to ask for help. Stigmas surrounding mental health and addiction treatment for veterans are a big reason why. We think the prime reason for these stigmas and biases is misconception and misunderstanding. They aren’t meant to be unkind, they are just misinformed, but they do real damage.

Common Misconceptions Around Veterans with Addiction or Mental Health Disorders:

• Addiction and alcoholism come from a lack of discipline or willpower.
• An addiction to drugs or alcohol is a moral failing and means you’re not a good person.
• Suffering from depression or anxiety means you are mentally weak.  
• The courageous thing to do is grit your teeth and push through pain alone.  

Mental Health Disorders Are Not Your Fault

Mental health treatment for veterans is a vital service. Treatment for PTSD, depression, anxiety and other issues can improve your quality of life dramatically. It is important to counter the stigmas around mental health treatment because they prevent people from getting better. If you are living with depression or anxiety or other symptoms, you deserve professional help. If you or someone you care about is feeling ashamed or self-conscious about seeking veterans’ mental health treatment, consider this:  If you were experiencing serious symptoms of diabetes, would you hesitate to seek treatment?

What if you were diagnosed with tinnitus and hearing loss, would you feel shame or guilt over it? Of course not. So why do so many veterans avoid asking for treatment for substance abuse or mental health? More often than not, the stigmas we’ve been talking about are to blame. If you or someone you love isn’t getting help because they are worried about what others might think, remember that getting well is the most important thing. In fact, it’s the only thing. Everything else is just noise. No one deserves to suffer in silence from addiction, PTSD or any mental health disorder. Quietly “toughing it out” isn’t courageous or responsible. Getting help is. Facing your fears and pushing through them to grab the hand being offered to you takes real strength.

Addiction is a Mental Health Disorder

If you go to a substance abuse treatment center, one of the first things you will see is different types of people in the program. The truth is that addiction does not care how much money you have or what kind of family you come from. It doesn’t care what grades you got in school, what kind of athlete you were or what your MOS was. Addiction is a mental health disorder that can affect anyone. It is triggered by substance use, but once it is active, it’s pathological. That means it’s a disease. The point is we need to get away from the blame and feelings of guilt and self-pity in addiction. They aren’t helpful. They will only keep you sick.

If you are a veteran who is addicted to drugs or alcohol, give yourself permission to get the mental health treatment you need. Make it your mission. Decide you won’t be knocked off course, no matter what obstacles you come across. Get the substance abuse treatment you deserve. It will play a big part in how the rest of your life looks. Addiction is the most powerful enemy many of us ever face. It’s not a battle you want to fight alone. Remember, you don’t have to and there’s no prize for who can endure the most pain without complaint. There simply isn’t any upside to not getting help. The life you want is within reach. It just takes a little courage, willingness and faith to make the leap.  

Finding Help for the Addicted Veteran

Finding mental health or substance abuse treatment for veterans isn’t nearly as easy as it should be. But we can help you navigate with a few tips. For many veterans, the first option is usually the VA’s Community Care Network.  The CCN is a network of healthcare providers that work with the VA to meet the healthcare needs of veterans that the VA itself cannot. It’s also helpful to know that programs which participate in the VA’s Community Care Network generally have a more streamlined path to admission. In most cases no pre-authorization from the VA is required, for example. The VA itself can provide outpatient counseling as well as psychiatric services, but they aren’t set up for more comprehensive mental health or substance abuse treatment for veterans. That’s where private programs like JourneyPure which accept Tricare and work within the CCN can really save the day. 

Thankfully Congress has taken several measures to help active duty military and veterans with addiction and mental health disorders.. Most notable are the Veterans Choice Act of 2014 and the MISSION Act of 2018 which were passed to give veterans access to mental health, addiction treatment and other services outside the VA as needed. The most common obstacle to getting mental health or substance abuse treatment for veterans we see one someone is willing and working through the system is a mandatory delay by the VA. The VA will try to treat patients within its own system first. Referrals outside the VA, through the CCN are made only when the specific mental health or substance abuse care the patient requires isn’t available within the VA. Anyone who has used the VA knows the system get crowded and long waits are often part of the process. The problem is that in a desperate situation, a veteran who needs substance abuse treatment and mental health care can be asked to wait as long as 28 days for a bed at a VA facility.

Striking While the Iron is Hot

Getting yourself help for addiction or another mental health disorder is tough. Getting help for someone else can be even more challenging. In either case, willingness may come and go. Your loved one or friend may be willing to enter treatment for substance abuse or PTSD one day, only to hesitate the next. Whether you’re looking for help for yourself or someone else, one of the key things to remember is to act decisively when the willingness and opportunity are there. Waiting a month or more for help can really throw a wrench in the works. It is worth thinking about private health insurance, financial support from family and friends or even a short-term medical loan in some cases. The best thing you can do for yourself or the veteran you love is do get your resources and information in place as soon as possible.

Remember:

• Willingness to accept help can be fleeting. Do whatever you can to be ready to act quickly.
• Know where you or your loved one can go for substance abuse or mental health treatment in advance.
• Ask for emotional and spiritual support from your loved ones and people you trust. This can be tough.
• Seek support with the cost of treatment and other bills like rent or mortgage early in your planning.
• Consider family or professional intervention if the person refuses an offer of help.

Types of Mental Health and Substance Abuse Treatment for Veterans

If you or a veteran you care about is wrestling with substance abuse, it’s good to know your options. Often a co-occurring disorder like depression or something trauma related such as PTSD or anxiety is present. That makes the need for treatment even greater. Dual-diagnosis treatment is care which addresses both addiction and a co-occurring mental illness at the same time. Overall, treatment for a veteran with addiction or mental illness is generally divided into several categories. Mental health and substance abuse treatment for veterans is delivered according to what are called levels of care. These levels are based upon the number of hours per day or days per week a patient is receiving treatment.  The first two are “inpatient” levels of care, meaning that patients remain in a medical facility overnight.

They receive a full day (at least 6 hours) of treatment at least 5 days a week and they take their meals and sleep overnight in the same facility.  The inpatient medical detox is the most intensive phase and it is usually necessary for anyone who is actively using a controlled substance or alcohol. This is where you get 24/7 medical attention to safely come off of alcohol or any drug which has withdrawal symptoms. That is a must for comfort and safety. Especially in the case of alcohol or sedatives and benzodiazepines like Xanax and Klonopin because they can cause deadly seizures in withdrawal if you stop abruptly. But a detox done in a medical setting is generally fairly comfortable and very safe.

The ASAM Levels of Care:

• Inpatient Medical Detox.
• Residential Addiction Treatment (RES)
• Partial Hospitalization Program (PHP)
• Intensive Outpatient Program (IOP)
• Outpatient Counseling (OP)

Why IOP and PHP Treatment for Veterans Are Popular

As explained above, the inpatient medical detox part of treatment really is a must for anyone who drinks or uses drugs that have withdrawal symptoms daily. In some cases, detoxing may be done on a step down outpatient basis, but only when recommended by a doctor.  But after the medical detox procedure is completed, the options for a veteran’s substance abuse treatment open up considerably. The most intensive next step would be residential addiction treatment, where you still sleep overnight in a medical facility. But many people seeking treatment now opt to move to the Partial Hospitalization Program or PHP phase immediately, or soon after a medical detox. There are a few reasons why. One is that a PHP offers a similar 6 hours a day, 5 day a week therapy and treatment schedule to an inpatient residential program. The key difference is that at the end of the treatment day, patients do not sleep overnight at the treatment center.

Instead, they go to a supportive living house (sometimes called sober living) to spend their off-hours and sleep overnight. Supportive housing offers them a safe, comfortable home-like environment where rules like curfews are enforced and random drug tests occur to maintain peace and order. Some patients find the home-like surroundings a little less “institutional” feeling than staying at the treatment center. In some cases, patients are able to return to their own homes at the end of the treatment day (if they live locally). The other key benefit to IOP and PHP for veterans is cost. The per day cost for treatment is lower than inpatient care. This means that insurance may be more likely to approve more total days of treatment. Or, if you are a self-paying patient, it could save you a tidy sum while still allowing you to get the time in substance abuse treatment that you need.  

Advantages to IOP and PHP Treatment for Veterans:

• More flexible living arrangements.
• Less “institutional” accommodations.
• Similar number of hours of treatment and therapy per week as residential treatment.
• Lower cost per day means insurance may be more likely to approve more days of treatment.
• Less cost per day means a lower overall bill for self-pay patients using a loan, savings or family funds.

Where Do We Go from Here?

The next step is to begin a plan to get yourself or your loved one the help they need. That doesn’t need to be too complicated or difficult. Remember to start by considering any obstacles to getting help and how you might remove them. Whether it’s stigma or worries about who will look after pets while someone is in treatment or how to pay for care. Make a list of what’s in your way if anything. Then next to each item, a possible solution.

After that, make a list of your “pros” and assets. What do you have working in your favor for you or your loved one to get help? Who might be willing or able to help financially with treatment? Who might be able to take care of pets, water plants, watch children or make sure the electric bill gets paid? Who can you go to for emotional and spiritual support right now? That all may still sound like a lot. If so, we understand completely. It’s hard to know where to begin or to get started sometimes. If that’s how you feel, just give us a call at (800) 311-1677 and we’ll talk it out together and help you figure out what to do next. That’s what we’re here for.

JourneyPure Helps Veterans Recover

We hope your found our Veterans Guide to Mental Health and Substance Abuse Treatment helpful. There is a lot of information to absorb and you may still have some questions after reading the guide. If so, you are welcome to call us at JourneyPure at (800) 311-1677. We have a great deal of experience in treating veterans with addiction and mental health disorders, in fact we specialize in it.

Our compassionate staff can answer your questions about veterans’ substance abuse treatment, medical detox, levels of care, supportive living and much more. JourneyPure programs have helped thousands of people like you or your loved one build a solid foundation in recovery. We can help you too. We understand addiction and mental health disorders at JourneyPure. Most of us are either in recovery ourselves or have family members who are. Many of us are also veterans or in military families. We want to help, but you have to make the first move and pick up the phone.