Supporting the Unique Mental Health Needs of Military Women

By Jennifer K. Rea, Ph.D.

Mental health is an essential and critical component of an individual’s overall health and well-being.

As the World Health Organization (WHO) states: “mental health is more than just the absence of mental disorders or disabilities.”

They further allude that:

“Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively, and is able to make a contribution to his or her community.”

The promotion, protection, and restoration of mental health and wellness have been recognized as a vital concern among individuals, communities, and societies throughout the world.

The National Alliance on Mental Illness (NAMI) defines poor mental health [mental illness] as: “a condition that affects a person’s thinking, feeling, behavior or mood. These conditions deeply impact day-to-day living and may also affect the ability to relate to others.”

Mental health conditions are far more common than many believe.
In fact, each year:

• 1 in 5 adults (47.6 million people) experience mental illness.
• 1 in 25 adults (11.4 million people) experience serious mental illness.
• 50% of all lifetime mental illness begins by age 14, and 75% by age 24.
• Suicide is the 2nd leading cause of death among people aged 10-34.

Poor mental health is no one’s fault, nor is it the result of one specific [life] event

Research has found several linking factors that determine the level of mental health of a person at any point of time, including genetics, environment, and lifestyle influences (NAMI, 2020). Stressful work or home environments, rapid social change, gender discrimination, social exclusion, unhealthy lifestyle, physical ill-health, human rights violations, traumatic life events as well as biochemical processes and brain structure have all been found to play a role as they impact one’s level of psychological wellbeing (NAMI, 2020; WHO, 2020).

A Glimpse into the Wellness of Our Military

The Department of Defense (DoD) 2018 Health of the Force report provided a snapshot of Servicemember health and wellbeing. The prevalence of mental or behavioral health (BH) conditions (e.g., adjustment disorders, alcohol-related disorder, posttraumatic stress disorder) among Active Duty (AD) Servicemembers were assessed, and findings revealed that:

• 8.3% of AD Servicemembers were diagnosed with a BH disorder in 2018.
• Across all Service branches, mental health diagnoses varied, with the highest prevalence rate in the Army, at 10.7%, followed by the Navy at 7.4%, the Air Force at 7%, and the Marine Corps at 6.5%.

Among both males and females:

• Adjustment disorder was the leading BH diagnosis followed by anxiety disorder and depressive disorder.
• Servicemembers less than 25 years had the highest prevalence of BH disorders.
• 25.2% of women and 16.2% of men (17.7% overall) had a history of a BH disorder.
• Women were more likely to be diagnosed with a BH disorder (12.8%) when compared to men (7.5%).

Mental Wellness of Women in the Military

Considering more women are serving in the military today, additional

Servicewomen are deploying, engaging extensively and actively in combat operations. As a result of the increase in combat experience, military women are more likely to experience heightened mental health risks (Sairsingh, Solomon, Helstrom, & Treglia, 2018).

SWAN’s (Service Women’s Action Network) 2017 mental wellness survey noted that “women’s mental wellness appears to be negatively impacted during military service and this impact follows them after they leave the service.”

More specifically, their findings revealed that:

• 60% believed their military service had a negative impact on their mental wellbeing
• 61% have been clinically diagnosed with some form of depression
• 51% have received a clinical diagnosis of a stress injury
• 20% said they had engaged in some form of self-harm.

Other studies have found similar findings. Among OEF/OIF (Operation Enduring Freedom/Operation Iraqi Freedom) women Veterans, as many as 20% have suffered from PTSD and 14% have reported depression (Tanielian & Jaycox, 2008), while others have experienced anxiety, alcohol abuse, as well as other physical and psychological effects of traumatic brain injury (Koblinsky, Schroeder, & Leslie, 2017).

Notably, female Veterans are two to four times more likely to be homeless than non-Veteran women. Female Veterans are also committing suicide at alarming rates; five to six times the rate of civilian women.

Military women may face additional challenges that have been found to directly impact their psychological health. Those involve:

• Leadership acceptance;
• Unequal power and status;
• Childcare;
• Societal role expectations;
• Sexual harassment, physical abuse, and military sexual trauma (MST);
• Depression during pregnancy or following birth;
• Eating disorders and;
• Ostracism by peers due to gender differences (McGraw, 2017; Psychological Health Center of Excellence, 2020).

The enormous complexities that military women encounter are difficulties that most men typically do not face, and some that do not even cross most people’s minds. Military women are brave warriors that are dedicated to defending our country, but they juggle many “other responsibilities at the same time they’re performing their military duties” (McGraw, 2017).

The way in which women in the military respond to various events is also different; different doesn’t mean better or worse, it just means different. Thus, as we consider supporting the mental health needs of all military women alike (this includes all women who are currently or have previously served), we must first understand that these women will likely face unique circumstances. Such situations can have significant impacts on their overall health and place greater risks to their psychological well-being.

Promising Strategies to Support Mental Wellness Among Military Women

As military family service professionals, you can make a difference in ensuring that military women are fully accepted and respected members of the military community and that they are cared for and understood in our society.

Below are some promising strategies that you might incorporate as you serve Servicewomen and female Veterans. As always, please feel free to share the strategies that have worked for you in your profession – We want to learn from you as well!

1. Begin by sharing this with Servicewomen: ”None of this means that you’re broken or that you, or your family, did something “wrong.”
   
2. Demonstrate concern and understanding through active listening to build trust with Servicewomen struggling with their mental wellness.
3. Ask the right questions and show support. Servicewomen may feel isolated and powerless and may need to talk openly about how they feel about their gender in a masculine-dominated military environment.
4. Provide peer and social support pre- and post-deployment to reduce the negative impact some Servicewomen experience from deployment. For example, you might help establish a social support group or network for military women as they transition to and from deployments.
5. Encourage Servicewomen to seek recovery options — seeking treatment early plays an important role in the recovery process and provides meaningful roles in social life as well as school and work. Additional alternative therapies, such as meditation, yoga, massage therapy, or acupuncture might be helpful for military women as well.
6. Practice regulating negative emotions and other life stressors. For example, you might help Servicewomen draw out their strengths and potential in endurance to weather current or future hardships.
7. Identify personal, relational, and spiritual resources that military women drew on in past times of adversity and identify how they might be helpful now.
8. Facilitate shared meaning-making and mastery. Shift military women’s focus from what has happened to them to what they can do about their situation (from helplessness and victimization to active initiative and empowerment). For example, you might provide them with a hopeful outlook and manageable steps to progress toward achieving personal or career goals.
9. Lastly, become familiar with resources available for military women, especially those with children, or in abusive relationships.

• The Department of Defense Safe Helpline
  A crisis support service for Servicemembers affected by sexual assault that provides live, one-on-one specialized support and information.
• The Military Crisis Line
  Connects a person in need to a trained counselor with a single phone call or click of a mouse.
• National Center for Post-Traumatic Stress Disorder
  Provides research and education on trauma and PTSD with a mission to improve the well-being and understanding of individuals who have experienced traumatic events with a focus on American veterans.
• The National Domestic Violence Hotline
  Offers phone and chat services to anyone who has been affected by relationship abuse, including those who are currently in abusive relationships, those who are working to heal, friends or family of victims and survivors, and anyone who has questions about domestic violence.
• Substance Abuse and Mental Health Services Administration National Mental Health Information Center
  Provides referrals to outpatient, inpatient, and residential treatment facilities, including affordable mental health services.
• The Psychological Health Center of Excellence (PHCoE) 
  Has mental health resources for Servicemembers, Veterans, and their families.

Add these resources to your repertoire in support of female Veterans transitioning out of the military and into civilian life:

• The U.S. Department of Veterans Affairs (VA) mental health resources Information about mental health and support services specifically for female Veterans.
• Vet Centers
  Community-based centers provide a range of counseling, outreach, and referral services to eligible Veterans in order to help them make a satisfying post-war readjustment to civilian life.
• National Call Center for Homeless Veterans
  Hotline to assist homeless Veterans or Veterans at risk for homelessness and give them access to trained counselors 24/7.
• Make the Connection
  VA’s public awareness and outreach campaign to raise awareness of mental health symptoms, conditions, and treatment.
• The National Resource Directory (NRD)
  Connects wounded warriors, injured and ill Service members, Veterans, and their families with national, state, and local support programs.

In the comment section, please keep the conversation going by sharing tools and resources you have found to be helpful as you work with Servicewomen, Servicemembers and their families. Also, stay tuned as we continue to unfold this topic and other themes related to women in the military.

For more resources on helping military families maintain resilience and overcome transition-related challenges, head on over to our Family Transitions page! Also,  check out our webinar series on Women in the Military, with “Women in the Military: Special Contributions and Unique Challenges” as the first  and “Warrior Wellness: Mental Health and Women in the U.S. Military” as the second in the series. Both focus on the unique challenges women in the military face and provide helpful strategies for overcoming them. We invite you to engage with our MLFN Family Transitions team on Twitter @MFLNFT and on Facebook @MilitaryFamilies.

This article was written by Jennifer Rea, Ph.D., and military spouse to an Active Duty Marine. Jenny consults with the OneOp Family Transitions team to support professional development for military family service providers.

References

1. Department of Defense (DoD). (2018). “DoD health of the force 2018 [PDF].” Retrieved from file:///C:/Users/jr/Downloads/DOD%20HOF%20Final%20(4).pdf
2. Koblinsky, S. A., Schroeder, A. L., & Leslie, L. A. (2017). “Give us respect, support and understanding”: Women veterans of Iraq and Afghanistan recommend strategies for improving their mental health care. Social Work in Mental Health, 15(2), 121-142.
3. McGraw, K. (2017, May 15). Female service members and their mental health Blog post]. Retrieved from https://www.pdhealth.mil/news/blog/female-service-members-and-their-mental-health
4. National Center for PTSD. (2020). Traumatic stress in women Veterans. Retrieved from www.ptsd.va.gov/professional/treat/type/trauma_female_veterans.asp
5. National Alliance on Mental Illness (NAMI). (2020). Mental health conditions. Retrieved from https://nami.org/Learn-More/Mental-Health-Conditions
6. Psychological Health Center of Excellence (PHCoE). (2020). Depression. Retrieved from https://www.pdhealth.mil/clinical-guidance/clinical-conditions/depression
7. Sairsingh, H., Solomon, P., Helstrom, A., & Treglia, D. (2018). Depression in female Veterans returning from deployment: The role of social factors. Military medicine, 183(3-4), e133-e139.
8. Service Women Action Network (SWAN). (2018). The mental wellness needs of military women: Community drive solutions. 2018 Report. [PDF]. Retrieved from https://www.servicewomen.org/wp-content/uploads/2018/02/2018-Annual-Summit-Report-Final.compressed.pdf
9. Tanielian, T., & Jaycox, L. H. (2008). Invisible wounds of war: Psychological and cognitive injuries. Their Consequences, and Services to Assist Recovery, 1.
10. World Health Organization (WHO). (2018, March 30). Mental health: Strengthening our response. Retrieved from https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response

 

Photo by Real Simple