More than one-third of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans experience mental health problems, including post-traumatic stress disorder (PTSD).2 These diagnoses can severely complicate transition into civilian life and predispose veterans to substance abuse as a means of self-medicating, difficult interpersonal relationships, homelessness, and even imprisonment.3
Veteran Treatment Courts—implemented in more than half the states—have successfully substituted treatment and rehabilitation plans in lieu of jail time.4 Despite this success, we must wonder—is there a way to mitigate the risk of veteran criminality before these men and women leave the service?
Trauma in the Ranks
We often assume veterans leave the military more broken than when they initially enlisted and that combat trauma explains the emotional and psychic hardships they experience after separating. The truth is traumatic stress is prevalent throughout society, not just among veterans. Among the general population, 25 percent of individuals have experienced a traumatic event by the time they reach adulthood. The difference is only about 7 percent of the population will develop PTSD, while more than 30 percent of veterans suffer from post-traumatic stress.5
Traumatic stress strongly correlates to veteran incarceration. By examining male veterans in jail diversion programs, researchers found that 93 percent had experienced some kind of significant trauma in their lives, and that 55 percent met the requirements for a diagnosable trauma disorder. The majority of these service members served during OEF/OIF or during Operation Desert Storm (or both), and about half of them had been deployed at least once, meaning many had seen combat or indirectly experienced the stress of war. Of the 93 percent of veterans who experienced trauma, a surprising 77 percent stated they had experienced some traumatic event before the age of 18.6
While the vast majority of “justice-involved” veterans indicated they had been traumatized long before they donned a uniform, research indicates military life exacerbates traumatic stress. Regardless of where the issues begin, the fact is veterans are more likely than the general population to suffer from trauma-related disorders and are over-represented in incarcerated populations. The success of jail deferment programs further suggests veteran criminality may develop from unaddressed mental health concerns.
Catch-All or Catch-Few
The best hope for OEF/OIF veterans with mental disabilities is to take advantage of Department of Veterans Affairs (VA) healthcare. Now more than ever, VA providers are trained to employ evidence-based therapies to those struggling with mental health issues. Unfortunately, studies show that only a quarter of veterans with mental health diagnoses attend a full course of VA treatment. Significant numbers of veterans remain untreated, and they are at a comparatively higher risk of committing crimes.
Veteran Treatment Courts can catch some of those who slipped through the cracks and provide vital treatment in lieu of jail time. Still, this demonstrates an over-reliance on judicial institutions to perform medical functions. More important, not all veterans in need will find themselves at the court’s doorstep, leaving thousands to struggle without mental health support.
To combat veteran criminality before it occurs, we must take preemptive action. Waiting until military personnel reach veteran status and providing treatment after they enter the justice system is too little, too late. We must treat our service members before they separate.
To start, leadership must combat the command-centric barriers to treatment, such as fears about career progression. Supervisors must encourage subordinates to seek help, allow them time to make appointments, and permit work projects to “shift to the right” as needed. Leaders must share positive testimonials of their own mental health challenges and treatments to facilitate help-seeking behaviors. Our services also must create a culture that bolsters the courage to “see something and say something” when we see a fellow service member struggling. Primary care providers, as part of annual physical health assessments and post-deployment exams, must become more attuned to the warning signs of mental illnesses, and then turn treatment over to mental health practitioners.
Providing timely and appropriate mental health care before service members separate is the key to putting mental illness-related veteran crime away for good.
1. Quil Lawrence,“Defying Stereotypes, Number of Incarcerated Veterans In U.S. Drops,” NPR.org, 7 December 2015, npr.org/sections/the two-way/2015/12/07/458501774/defying-stereotypes-number-of-incarcerated-veterans-in-u-s-drops.
2. Catherine Hearns, “Predictors of Operation Enduring Freedom/Operation Iraqi Freedom veterans’ engagement in mental health treatment,” Military Medicine vol 178 no 11 (November 2013), 1183-1187.
3. Jesse Barton, “Home Free: Combating Veteran Prosecution and Incarceration,” Justice Policy Journal vol. 11, no. 2 (Fall 2014), 1.
4. Robert Russell, “Veterans Treatment Courts” Touro Law Review vol. 31 no. 3 (March 2015), 385-401.
5. Stephen Hartwell et al. “Trauma Among Justice-Involved Veterans,” Professional Psychology: Research & Practice vol 45 no 6, (December 2014), 425-432.