Despite ongoing efforts by both DoD and VA – work that is likely to significantly alter mental health treatment for decades to come – the warrior culture still has trouble accommodating the idea of psychological injury. Many service members who suffer choose not to pursue care – some for purely pragmatic reasons. Until just a few years ago, a history of mental health treatment was officially considered a block to promotion within the service branches.

Today, the warrior culture still has a long way to go toward acknowledging psychological injury, but Kemp said the tide is beginning to turn. “Having senior leaders like Mr. [Secretary of Defense Leon E.] Panetta and VA Secretary [Eric K.] Shinseki actually talk about these issues is a huge, groundbreaking step.” The VA’s Make the Connection campaign, launched in 2011, features veteran-narrated vignettes about personal experiences in the mental health system. “It’s available on Facebook and YouTube,” Kemp said, “and actually has gotten more hits than any of our other Facebook pages or online options.”

Both the VA and DoD report that suicidal service members and veterans who seek and stick with mental health treatment are more likely to stay alive. One of the perennial knocks on the two agencies, of course, is that despite how great their mental health services are generally acknowledged to be, they’re not terribly easy to access. In a December 2011 hearing before the House Committee on Veterans’ Affairs, several experts offered testimony describing difficulties in implementing national initiatives at the regional and local levels. Overall, these experts called for a more integrated and streamlined approach – a key recommendation of both the CNAS and the RAND studies.

At a January 2012 briefing, the Defense Suicide Prevention Office – stood up four months earlier by the Pentagon as part of its prevention efforts – enumerated about 900 activities and policy changes that had been executed so far by the government and military to build resiliency, reduce stress, and prevent suicides among service members. It’s a number that speaks both to the Pentagon’s passionate determination to reach out and help service members, and to the necessity of speaking to service members and veterans with a single helpful voice.

Bringing all these programs together with a shared set of goals and strategies can only improve service delivery, and help service members and veterans alike recognize that many people care about their welfare, and that increasingly there are options available that can help them to overcome suicidal thoughts.

“I think we have made huge strides in public perception and in stigma reduction,” said Kemp. “And I think the next step is to convince people that treatment actually works. We’re starting to get some evidence that all of these things we’ve put into place over the past several years – like an enhanced treatment plan, a crisis line, and recovery-oriented interventions – all of those specific interventions are making a difference. Among the people in the VA who are getting those services and are involved in mental health treatment, we’ve been able to at least hold the rate steady, if not decrease it in some populations and age groups. I think there are many reasons to hope that this problem is about to get better.”

Members of the military, veterans, and their families should contact any of the following military support resources if they believe they’ve experienced or seen warning signs of suicide:

• Military OneSource Crisis Intervention Line: 
1-800-342-9647
• The Defense Centers of Excellence (DCoE) for Psychological Health and Traumatic Brain Injury: 
1-866-966-1020
• National Suicide Prevention/Veterans Crisis Line: 
1-800-273-TALK (8255), press 1 for military
• Wounded Soldier and Family Hotline: 
1-800-984-8523
• Vets4Warriors: 1-855-VET-TALK (838-8255)

This story was first published in The Year in Veterans Affairs & Military Medicine 2012-2013 Edition.