Strategies to Reduce the Mental Load of a Military Spouse: Part 2

In part 1 of this two-part blog post, we learned the various stressors that military spouses face due to military life. We also learned how the concurrent buildup of these stressors can increase a military spouse’s mental load. 

While the Department of Defense (DoD) has made it a priority to address systemic barriers to mental healthcare among service members and their families, minimizing stigma and reducing barriers to care for military spouses still persists (Schvey et al., 2022).

A 2018 study, assessing nearly 10,000 military spouses, found that over one-third screened positive for mental illness (Steenkamp et al., 2018). Rates of post-traumatic stress disorder (PTSD), panic disorder, and alcohol misuse among female military spouses were approximately double those observed in prior studies of civilian women in the U.S. (Steenkamp et al., 2018). 

Barriers to Mental Healthcare for Military Spouses

Despite the unique mental health needs of military spouses, only a few studies have examined barriers to mental health services among this population. A recent study indicated that among male and female military spouses, the most common barrier to mental healthcare was that of logistical factors (e.g., difficulty in getting to where the care is, the amount of time, or the inconvenience of getting care). The same study also found that:

• More than half of the spouses felt skeptical about the utility of the mental health service (e.g., feeling that going for treatment would likely not do them any good). 
• 52% of spouses had attitudes that reflected a preference for self-reliance (e.g., feeling that psychological problems tend to work themselves out without help).
• Approximately a third of the military spouses reported fears of potential negative consequences of receiving mental healthcare (e.g., the possibility that going for care would hurt the career of their service member).
• 32% of spouses internalized stigma about mental healthcare (e.g., feeling embarrassed or bad about themself for needing care). 

An important note from the above study (Schvey et al., 2022) is that spouses who met clinical thresholds on self-report measures of mood and anxiety disorders were significantly more likely to report all four barriers to mental healthcare. This finding is alarming given the significant burden of the mental load and untreated mental health conditions among military spouses. 

Strategies to Increase Access and Utilization and Decrease Stigma

The barriers previously mentioned, in conjunction with prior research (e.g., Eaton et al., 2008; Ribeiro, Renshaw, & Allen, 2022), tell us that continued efforts are needed to increase access and utilization of mental healthcare and decrease perceived stigma among military spouses. Below are a few strategies that service providers might implement as they work with military families:

• Establish a culture of support for mental health. Help military families understand that mental health is a critical component of overall health. Ensure staff are knowledgeable about mental health resources both inside and outside installations and that referrals to these services are accessible and timely.

• Validate their concerns and disentangle the misconceptions or stereotypes. Let them know that they are not “weak” for seeking care and that seeking care will not negatively impact their service member’s career.

• Share telehealth options. Virtual care may help military spouses overcome the previously mentioned logistic barriers and enable greater continuity of care for spouses experiencing relocation. You might also help them find a therapist who understands the unique challenges and needs of military spouses.

• Identify those at greatest risk for difficulties during periods of adjustment. Provide military families with a list of evidenced-based programs that help to prevent the onset and exacerbation of mental illness among spouses during times of transition (deployments, reunions, and reintegration).

Resources

1. Non-Medical, Confidential Counseling | Military OneSource offers free, non-medical counseling through the Military & Family Life Counseling program.
2. Military Mental Health Support & Resources | Military OneSource provides several resources and tools to help address mental health concerns early, such as screening tools from the Department of Veteran Affairs, a Tricare medical treatment facility locator, and information on how receiving psychological health care affects service members’ security clearance.
3. Mental Health Care | TRICARE offers information on mental health disorders, access to a mental health appointments page, information on  mental health care costs, and more.
4. 7 Ways A Strong Support System Impacts a Military Spouse’s Mental Health  |The Armed Services YMCA provides a resource on ways to help military spouses with their mental health needs.
5. Mental Health Services & Education – Give an Hour promotes readiness and resiliency to provide service members, veterans, and their loved ones with confidential, no-cost mental health care services. 
6. Military Stress Impacts the Mental Health of Military Spouses. Here’s How They Cope. – Ready Healthy & Able Powered by HealthyWomen – A blog post to provide information on military partners’ experiences of mental health challenges from the stress of military life. Ready Healthy & Able, powered by HealthyWomen, is the nation’s leading independent nonprofit health information source for women.
7. You Are Not Alone – Mental Health for Military Spouses – A new series just for military spouses, offered by the National Military Family Association. Each month they will explore a new topic chosen by military spouses and will share resources. In this particular month, they focused on mental health awareness.

References

1. Eaton, K. M., Hoge, C. W., Messer, S. C., Whitt, A. A., Cabrera, O. A., McGurk, D., … & Castro, C. A. (2008). Prevalence of mental health problems, treatment need, and barriers to care among primary care-seeking spouses of military service members involved in Iraq and Afghanistan deployments. Military Medicine, 173(11), 1051-1056. https://doi.org/10.7205/MILMED.173.11.1051
2. Ribeiro, S., Renshaw, K. D., & Allen, E. S. (2023). Military-related relocation stress and psychological distress in military partners. Journal of Family Psychology, 37(1), 45-53. https://doi.org/10.1037/fam0001030
3. Schvey, N. A., Burke, D., Pearlman, A. T., Britt, T. W., Riggs, D. S., Carballo, C., & Stander, V. (2022). Perceived barriers to mental healthcare among spouses of military service members. Psychological services, 19(2), 396. https://doi.org/10.1037/ser0000523
4. Steenkamp, M. M., Corry, N. H., Qian, M., Li, M., McMaster, H. S., Fairbank, J. A., … & Marmar, C. R. (2018). Prevalence of psychiatric morbidity in United States military spouses: the millennium cohort family study. Depression and anxiety, 35(9), 815-829. https://doi.org/10.1002/da.22768

Author’s Bio

Jenny Rea, Ph.D., is a military spouse and mom of four kiddos under six years. Jenny consults with OneOp and is an Assistant Professor of Practice in the Department of Human Services and Director of the Certificate in Military Families at the University of Arizona.