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Supporting Veterans and Their Mental Health: A National Responsibility

Veterans have served their country with dedication and, upon returning to civilian life, often face numerous challenges that require our support and understanding. Many veterans experience significant mental health issues, including post-traumatic stress disorder (PTSD), depression, anxiety, and substance use disorders. These challenges can hinder their ability to reintegrate into civilian life and maintain relationships, employment, and a healthy lifestyle. Recognizing the mental health needs of veterans and implementing effective support strategies is crucial for honoring their service and supporting their well-being.

The Mental Health Landscape for Veterans

Veterans are at a higher risk of mental health issues compared to the general population. A report from the U.S. Department of Veterans Affairs (VA) indicated that approximately 11-20% of veterans who served in Iraq and Afghanistan suffer from PTSD in any given year, and the prevalence is even higher among those who served in the Vietnam War (U.S. Department of Veterans Affairs, 2022). Additionally, veterans are at an increased risk for depression, anxiety, and substance abuse issues, with research suggesting that over 25% of veterans experience symptoms related to depression and other mood disorders (Hoge et al., 2004).

A primary cause of these mental health challenges is the exposure to trauma and high-stress situations during service. Repeated exposure to combat, violence, and injury can leave lasting psychological scars that are difficult to heal. This stress may also exacerbate pre-existing mental health issues, making it even more difficult for veterans to transition back to civilian life.

Barriers to Mental Health Care for Veterans

While the VA and other organizations offer resources for veterans, barriers to accessing mental health care persist. According to the RAND Corporation, veterans may face significant obstacles, such as long wait times for appointments, stigma surrounding mental health, and a lack of providers who understand military culture (Tanielian et al., 2018). This stigma can prevent veterans from seeking help, as they may feel that mental health challenges are a sign of weakness or that others will not understand their experiences.

Rural veterans often face additional obstacles due to the lack of nearby mental health resources. Research has shown that nearly a quarter of all veterans live in rural areas, where specialized mental health services may be limited (Weeks et al., 2008). Telemedicine and virtual counseling have helped bridge some of these gaps, but there remains a need for more accessible, culturally informed care tailored to the unique needs of veterans.

Strategies for Supporting Veterans’ Mental Health

  1. Increasing Access to Mental Health Services:
    Expanding mental health resources specifically tailored for veterans is essential. The VA and other organizations are implementing initiatives to reduce wait times, increase the availability of telehealth services, and provide alternative therapies, such as art therapy, music therapy, and mindfulness practices (U.S. Department of Veterans Affairs, 2022). Community-based programs can also provide veterans with accessible care, particularly in rural areas.
  2. Building a Community of Support:
    Peer support programs can be highly effective for veterans, as they allow veterans to connect with others who have had similar experiences. Programs like the Veterans Crisis Line and the VA’s Peer Support program connect veterans with trained peers, who provide support, understanding, and guidance. Research suggests that peer support reduces PTSD symptoms and increases veterans’ willingness to seek help (Resnick et al., 2012).
  3. Reducing Stigma through Public Awareness:
    Public awareness campaigns can play a crucial role in reducing stigma around veterans’ mental health issues. Campaigns should focus on educating both veterans and the general public about the commonality of mental health challenges, emphasizing that seeking help is a sign of strength. The VA’s “Make the Connection” campaign is an example of an initiative aimed at reducing stigma and encouraging veterans to pursue mental health treatment (U.S. Department of Veterans Affairs, 2022).
  4. Encouraging Family Involvement and Support:
    Family members can be a crucial source of support for veterans dealing with mental health issues. Programs that educate family members about PTSD, depression, and other mental health conditions can equip them to support their loved ones effectively. Involving families in therapy sessions can also create a support network that extends beyond formal mental health services, which may improve outcomes for veterans (Monson et al., 2006).
  5. Employment and Reintegration Support:
    Meaningful employment can significantly impact veterans’ mental health and quality of life. Programs like the VA’s Vocational Rehabilitation and Employment services provide veterans with job training, career counseling, and job placement assistance, helping veterans reintegrate into civilian life (U.S. Department of Veterans Affairs, 2022). Research shows that veterans who find stable employment report higher levels of satisfaction and mental well-being (Resnik et al., 2012).

A Call to Action

Supporting veterans’ mental health is not only a moral duty but also a way to ensure the well-being of individuals who have made profound sacrifices. By addressing the barriers veterans face in accessing mental health care, expanding peer support networks, reducing stigma, and providing employment and family support, society can help veterans lead healthier and more fulfilling lives. Moreover, these actions honor their service by providing the respect, care, and compassion they deserve.

We must continue to advocate for policies that support veterans’ mental health, fund research into effective treatments, and raise public awareness about the unique challenges veterans face. Providing veterans with the resources and support they need to thrive is one of the most meaningful ways we can repay them for their service and dedication to our country.

This article has been written by John S. Collier, MSW, LCSW. Mr. Collier has over 25 years of experience in the social work field and is based in London Kentucky through Southeast Kentucky Behavioral Health, LLC. Mr. Collier may be reached by phone at (606) 657–0532 extension 101 or by email at john@sekybh.com.

References

Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351(1), 13-22.

Monson, C. M., Schnurr, P. P., Stevens, S. P., & Guthrie, K. A. (2006). Cognitive-behavioral conjoint therapy for PTSD: Pilot results from a community sample. Journal of Traumatic Stress, 19(3), 289-299.

Resnick, S. G., & Rosenheck, R. A. (2012). Integrating peer-provided services: A quasi-experimental study of recovery orientation, confidence, and empowerment. Psychiatric Services, 63(6), 541-547.

Tanielian, T., Jaycox, L. H., & RAND Corporation. (2008). Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery. RAND Corporation.

U.S. Department of Veterans Affairs. (2022). PTSD: National Center for PTSD. https://www.ptsd.va.gov

Have You Ever Thought You Forgave Someone Only to Find Out You Hadn’t? Understanding Forgiveness and Its Complex Layers

Forgiveness is often considered a vital step toward emotional healing, allowing individuals to release resentment and move forward. However, many people experience situations where they believe they have forgiven someone, only to later realize that the lingering feelings of hurt and resentment suggest otherwise. This phenomenon highlights the complexity of forgiveness, revealing that it may not be as straightforward as it initially seems. The purpose of this article is to explore the nature of forgiveness, the reasons why individuals might struggle with genuine forgiveness, and the implications of unfinished forgiveness on mental health and well-being.

Understanding Forgiveness

Forgiveness is typically defined as a conscious, deliberate decision to release feelings of resentment or vengeance toward a person or group who has harmed you, regardless of whether they actually deserve it (American Psychological Association, 2023). Research on forgiveness indicates that it involves both cognitive and emotional processes, meaning it isn’t just about letting go mentally; it also involves genuine emotional healing (Enright & Fitzgibbons, 2015).

Forgiveness can be separated into two main types: decisional forgiveness and emotional forgiveness (Worthington, 2006). Decisional forgiveness is the conscious decision to forgive someone and act as if the hurt no longer impacts the relationship. Emotional forgiveness, however, involves truly letting go of the negative feelings and emotional responses associated with the hurt. It is possible for an individual to experience decisional forgiveness without achieving emotional forgiveness, which can explain why some people believe they have forgiven someone only to later realize that they haven’t fully done so.

Why Forgiveness Can Be Difficult to Fully Achieve

There are several reasons why genuine forgiveness may be challenging to accomplish. Some of the most common factors include the following:

1. Residual Resentment: Even after making a decision to forgive, individuals may still hold on to lingering negative feelings. Research by McCullough et al. (2003) suggests that emotional forgiveness is a gradual process that unfolds over time, rather than an instant event. Unresolved anger, sadness, or betrayal can resurface, especially when triggered by related events or memories.

2. Self-Protection Mechanisms: For some individuals, holding onto resentment serves as a psychological defense mechanism to prevent future harm. By not fully forgiving, individuals may feel they are protecting themselves from further hurt (Wade, Hoyt, & Worthington, 2014). In this sense, forgiveness might feel like vulnerability, as it involves letting go of a protective barrier against potential future pain.

3. Mistrust and Lack of Reconciliation: Forgiveness does not necessarily mean reconciliation. When the person who caused harm has not taken responsibility, offered an apology, or changed their behavior, individuals may find it difficult to move toward true emotional forgiveness (Exline & Baumeister, 2000). The absence of reconciliation can lead to doubts about forgiveness, as it feels unfinished or insincere without mutual effort.

4. Reliving Past Trauma: Certain offenses may be tied to deeper emotional wounds or traumas. If the original hurt triggered past trauma, forgiving can be even more difficult because it involves working through multiple layers of pain. Research indicates that people who have experienced significant trauma often struggle with forgiveness, as unresolved trauma complicates the healing process (Toussaint, Worthington, & Williams, 2015).

5. Expectations and Idealized Forgiveness: Cultural and religious beliefs often encourage forgiveness as a moral or spiritual obligation, creating pressure to forgive quickly or completely (Enright & Fitzgibbons, 2015). However, when individuals try to “force” forgiveness due to external expectations rather than genuine emotional readiness, they may mistake the decision for actual healing. Over time, this dissonance between expectation and reality can become evident, revealing incomplete forgiveness.

Signs of Unfinished Forgiveness

Realizing that one has not truly forgiven can manifest in various ways. Some common signs include:

• Ruminating on the Hurt: When individuals continue to think about the offense or replay events in their minds, it may be a sign that forgiveness has not been fully achieved. Persistent rumination indicates unresolved emotional processing, suggesting that genuine forgiveness has not yet been reached (Toussaint et al., 2015).

• Negative Emotional Triggers: Experiencing anger, sadness, or resentment when thinking about the person or event can indicate unfinished forgiveness. Emotional triggers often reveal hidden feelings that were not addressed in the initial forgiveness decision (McCullough et al., 2003).

• Difficulty in Maintaining Positive Interactions: Struggling to feel positively toward the person involved or finding it challenging to engage in meaningful interactions can indicate that forgiveness remains incomplete (Wade et al., 2014). True forgiveness often includes an element of goodwill or empathy toward the other person, even if reconciliation is not achieved.

Strategies for Genuine Forgiveness

For those who realize they have not fully forgiven, several approaches can help facilitate emotional forgiveness:

1. Self-Compassion and Patience: Allowing oneself to feel and process emotions without judgment is essential. Genuine forgiveness is not a quick process; it requires patience and self-compassion (Worthington, 2006).

2. Therapeutic Support: Therapy can provide a safe space to explore lingering emotions, especially for those dealing with trauma-related forgiveness struggles. Techniques such as cognitive-behavioral therapy and forgiveness therapy can aid in processing and releasing negative emotions (Enright & Fitzgibbons, 2015).

3. Practicing Empathy and Perspective-Taking: Research shows that empathy can promote forgiveness by helping individuals understand the other person’s motivations and perspectives (McCullough et al., 2003). This does not excuse harmful behavior but can foster emotional release.

4. Journaling and Reflective Exercises: Writing about feelings, thoughts, and experiences related to the offense can help bring clarity to unfinished forgiveness. This process can encourage emotional expression and insight, paving the way for genuine forgiveness (Toussaint et al., 2015).

Conclusion

The journey toward forgiveness is complex and personal. Many people believe they have forgiven, only to later discover that deeper emotions remain unresolved. Recognizing this experience is an important step in the healing process. Genuine forgiveness requires emotional processing, self-compassion, and, at times, professional support. While decisional forgiveness may happen quickly, emotional forgiveness is often a gradual, layered experience that unfolds over time. By acknowledging the intricacies of forgiveness, individuals can work toward authentic emotional healing and peace.

This article has been written by John S. Collier, MSW, LCSW. Mr. Collier has over 25 years experience in the social work field. He currently serves as the executive director and provider for outpatient services at Southeast Kentucky Behavioral health based out of London Kentucky. He may be reached at 606-657-0532 extension 10 one or by email at john@sekybh.com

References

American Psychological Association. (2023). Forgiveness. Retrieved from APA Dictionary of Psychology.

Enright, R. D., & Fitzgibbons, R. P. (2015). Forgiveness Therapy: An Empirical Guide for Resolving Anger and Restoring Hope. American Psychological Association.

Exline, J. J., & Baumeister, R. F. (2000). Expressing forgiveness and repentance: Benefits and barriers. In M. E. McCullough, K. I. Pargament, & C. E. Thoresen (Eds.), Forgiveness: Theory, Research, and Practice (pp. 133–155). Guilford Press.

McCullough, M. E., Worthington, E. L., & Rachal, K. C. (2003). Interpersonal forgiveness in close relationships. Journal of Personality and Social Psychology, 73(2), 321–336.

Toussaint, L., Worthington, E. L., & Williams, D. R. (2015). Forgiveness and Health: Scientific Evidence and Theories Relating Forgiveness to Better Health. Springer.

Wade, N. G., Hoyt, W. T., & Worthington, E. L. (2014). Forgiveness interventions: A meta-analytic review of individual and group applications. Counseling Psychology Quarterly, 27(4), 431–452.

Worthington, E. L. (2006). Forgiving and Reconciling: Bridges to Wholeness and Hope. InterVarsity Press.