Stigma Impacts Substance Abuse and Mental Health Care in Veterans
Stigma is one of the most powerful barriers standing between Veterans and the treatment they need. Military culture values strength, self-reliance, toughness, and mission-first thinking. These values serve service members well during active duty. After deployment, those same values can make it incredibly difficult to ask for help with substance abuse, PTSD, depression, anxiety, or other mental health conditions.
According to a 2025 systematic review published in the National Library of Medicine, nearly 60% of military personnel and Veterans who would benefit from mental health care avoid treatment. Stigma, in its various forms, is consistently identified as a significant contributing factor.
Stigma in the Military
Stigma in the military context refers to the negative attitudes, beliefs, and fears that discourage service members and Veterans from seeking help for substance use or mental health problems. Research identifies three distinct types of stigma that affect military populations:
- Public Stigma. The fear of being judged, rejected, or treated differently by peers, supervisors, or the community because of a mental health or substance use diagnosis. In the military, being seen as weak, unreliable, or unfit for duty is a deeply ingrained concern.
- Self-Stigma. The internalized belief that needing help means you have failed, that you should be able to handle it on your own, or that something is fundamentally wrong with you. Self-stigma is particularly strong among Veterans who take pride in their service and identity as warriors.
- Institutional Stigma. Policies, practices, or cultural norms within the military that create real or perceived consequences for seeking treatment. Examples include concerns about security clearance, fitness-for-duty evaluations, promotional opportunities, and permanent medical record entries.
All three forms of stigma interact and reinforce each other. A Veteran who fears public judgment may internalize that fear as self-stigma, which then prevents them from accessing institutional resources that are specifically designed to help.
How Stigma Affects Veterans: The Numbers
The data on stigma and treatment avoidance among Veterans is striking:
- 60% of Veterans who need mental health care do not seek it
- 40% of Veterans with PTSD do not seek treatment due to stigma or fear of disclosure
- The PTSD treatment dropout rate can reach 30%, often driven by stigma or side effects
- Only 50% to 60% of Veterans with PTSD receive adequate care
- 75%+ of Veterans with substance use disorders struggle with alcohol abuse; 25%+ with illicit drug abuse; 24.7% of Veterans with mental illness have a serious mental illness
- 97% of service members who seek mental health treatment experience no negative career impact
Stigma and Military Concerns
The Department of Defense initiated changes to reduce stigma and encourage treatment for mental health disorders and substance abuse. Efforts include a mandate for developing a supportive culture around seeking mental health and substance use services.3 Mental well-being was recognized as a key component of health, and polarized assessments of being either “ready” or “unfit/ill” are being replaced with a continuum of preparedness for service and an increased diversity of supportive personnel.3, 4
The Army has responded by training leadership on how to foster a supportive culture and reduce stigma, in addition to establishing psychological health care services available during non-duty hours, and developing educational material aimed at reducing stigma.3
Combat Operational Stress Control programs incorporate mental health and substance abuse treatment providers into the fitness and preventative services of each unit.5
Embedded Behavioral Health teams have also been established, increasing the number of mental health personnel to foster positive relationships with leadership, encouraging people to talk about mental health, and promoting positive attitudes about seeking mental health and substance abuse treatment.3
Military Pathways is a program designed to improve mental health through self-directed activities available in an online portal, including self-assessments, mental health education, and referral to services.3
The Real Warriors Campaign provides educational materials about seeking treatment for military service members, Veterans, and family members. Materials are shared widely and highlight that mental health and substance use are not uncommon, seeking help is a strength, asking for help does not end a career, and no one is alone in their quest for improved mental well-being.3
Watch our addiction talk where Veterans discuss the stigma of addiction.
Military Stigma Affecting Veterans
Past estimates from the Substance Abuse and Mental Health Services Administration (SAMSHA) have indicated that, of Veterans with substance use disorders, more than three-quarters of them struggle with alcohol abuse and over one-quarter struggle with illicit drug abuse, in addition to 24.7% of Veterans with mental illness having a serious mental illness.6 Although many Veterans struggle with these challenges, roughly 60% of Veterans that would benefit from care do not seek needed treatment—with stigma playing a potential role.2
Military values such as self-sufficiency and prioritizing needs often continue after active duty service, and stigma about mental health or substance abuse treatment may impact a Veteran’s thought process in seeking treatment.7
Efforts to address stigma in Veterans include educating military leadership, changing the culture of seeking mental health care,3 and Veteran-specific programs aimed at decreasing stigma and engaging Veterans in care.7, 8
Common Reasons Veterans Do Not Seek Treatment
Understanding why Veterans avoid treatment is the first step toward breaking down barriers. The most frequently cited reasons include:
- Fear of Being Seen as Weak. Military culture emphasizes strength and resilience. Asking for help with addiction or mental health can feel like an admission of failure. This is the most commonly reported barrier.
- Concern About Career Consequences. Active-duty members may worry about losing security clearance, being passed over for promotion, receiving a negative fitness report, or being medically separated. While these fears are understandable, 97% of those who seek treatment experience no negative career impact.
- Lack of Awareness. Some Veterans do not recognize that their symptoms (insomnia, irritability, heavy drinking, emotional numbness) are signs of a treatable medical condition. They may attribute these changes to ‘just adjusting’ or ‘how things are now.’
- Distrust of the System. Some Veterans have had negative experiences with the VA or military healthcare and are reluctant to engage again. Others fear that their records will not be kept confidential.
- Belief That Treatment Will Not Work. Veterans who have seen peers struggle or who have tried treatment before without success may conclude that nothing will help. Evidence-based treatments for PTSD and addiction have strong success rates, but this data does not always reach Veterans.
- Not Knowing Where to Go. Navigating the VA system can be confusing. Many Veterans do not know that community care options like AAC exist or that the MISSION Act allows them to use VA benefits at private facilities.
How Stigma Is Being Addressed: Programs and Resources
The VA, the Department of Defense, and nonprofit organizations have developed targeted programs to reduce stigma and encourage Veterans to seek help:
VA and Government Programs
- VA Mental Health Services: Mental health and substance abuse treatment through in-person appointments, telehealth, and online resources. VA providers are licensed specialists, and peer support specialists who are Veterans themselves are available for additional guidance.
- Ending Self Stigma: A VA program offering group sessions focused on reducing self-stigma through evidence-based cognitive strategies. Available at VA medical centers nationwide.
- Make the Connection: A VA-supported initiative that shares personal stories from Veterans who sought treatment and recovered, normalizing the experience of asking for help.
- Real Warriors Campaign: A DoD anti-stigma initiative launched in 2009 that encourages active-duty service members and Veterans to seek help for substance use and mental health. The campaign addresses ‘invisible wounds’ like PTSD, addiction, and depression.
Nonprofit and Community Resources
- Headstrong: Provides confidential, stigma-free mental health services to post-9/11 Veterans and their families at no cost. No VA enrollment required.
- Give an Hour: A nonprofit network of licensed mental health professionals who volunteer their time to provide free counseling to Veterans and their families.
- Veterans Crisis Line: Available 24/7 by calling 988 (then press 1), texting 838255, or chatting online. Free, confidential, and staffed by trained responders, many of whom are Veterans.
- SAMHSA National Helpline (1-800-662-4357): Free, confidential, 24/7 treatment referral for substance use and mental health.
Seeking Help
Many organizations offer mental health services for military personnel, Veterans, and family members. For Veterans, the Veterans Crisis Line is available 24/7 at 1-800-273-8255, then press 1. The Veterans Crisis Line also has options to talk with a professional through online chat or text.
The SAMHSA Help Line is available for those seeking substance abuse treatment. Information specialists are available 24/7 at 1-800-662-HELP (4357), and the website also provides information and resources.
American Addiction Centers (AAC) is also just a phone call away, . We’re available 24/7 to answer questions about your or a loved one’s substance abuse and can provide information about treatment options.
Service Members Seeking Help
- Military Health System has information about mental health services and an online tool to search for local services and support.
- Military OneSource provides information on substance abuse treatment, including how to find and enroll in alcohol and drug abuse treatment.
- Wounded Warrior Project assists service members who are transitioning out of the military, Veterans, and their families with accessing Veterans benefits, physical health and wellness resources, resources for mental health, and finding others in the Veteran community.
Veterans Seeking Help
- VA Mental Health services include mental health and substance abuse treatment through in-person appointments, telehealth appointments, and online information. VA providers are licensed specialists and peer support specialists who are also Veterans are available for additional guidance.
- Ending Self Stigma is a VA program that offers group sessions focused on mental health and decreasing self-stigma through evidence-based strategies.
- Headstrong provides confidential and stigma-free mental health services and support to post-9/11 Veterans and their families.
- Make the Connection offers services including information on mental health issues, local mental health services, and resources.
Veteran Program
The American Addiction Centers Veteran program offers a range of services to facilitate recovery from addiction specifically for Veterans and first responders. Our unique approach includes:
- Group therapy.
- Development of coping skills.
- Nutrition education and exercise.
- Pain management and emotional regulation training.
Though stigma can be a barrier to seeking treatment for mental health and substance abuse problems, military and Veteran-specific programs are available. Specialists in mental health and substance use recovery are here to help. You are not alone.
What You Can Do: For Yourself or Someone You Care About
If you are a Veteran considering treatment, or if you love someone who served and is struggling:
- For yourself: Recognize that what you are experiencing is a medical condition, not a character flaw. PTSD, depression, anxiety, and addiction are treatable. Millions of Veterans have sought treatment and reclaimed their lives. Asking for help requires more courage than staying silent.
- For a loved one: Approach the conversation with care and without judgment. Share facts, not ultimatums. Offer to help make the first call. Let them know that
- For families: AAC offers family therapy as part of its treatment programs. Addiction and PTSD affect the entire family, and healing is most effective when it includes the people closest to the Veteran.
