About the SMVF TA Center

Since 2010, the SAMHSA Service Members, Veterans, and their Families Technical Assistance (SMVF TA) Center has provided technical assistance support to state, territory, Tribal, military and civilian interagency teams working to strengthen behavioral health systems that serve service members, veterans, and their families.

Technical assistance is also provided to SAMHSA partners and grantees on issues and resources related to the behavioral health needs of service members, veterans, and their families.

What We Do

The SMVF TA Center addresses the behavioral health needs of service members, veterans, and their families by:

• Monitoring evolving trends in the following areas:
  • Behavioral health-focused prevention, treatment, and recovery support needs for both mental health and substance use in service members, veterans, and their families
  • Challenges faced by states, territories, and Tribes.
• Providing technical assistance, training tools, and consultation to teams within states and territories in ways that promote coordination among civilian, military, and veteran service systems
• Identifying, sharing, and encouraging the adoption of promising, best, and evidence-based practices that support the resilience and emotional health of service members, veterans, and their families
• Identifying experts and resources to meet the evolving needs of states and territories related to strengthening behavioral health care systems and services for service members, veterans, and their families
• Supporting the planning and implementation of interagency teams, including the provision of technical assistance before and after the meetings of Policy Academies
• Supporting the training of SAMHSA partners and grantees on issues and providing resources and publications related to service members, veterans, and their families

Key Objectives

The following are key objectives of the SMVF TA Center:

• Strengthening ongoing collaboration at the state, territory, and Tribal level among key public and private (civilian, military, and veteran) agencies and partners that address, or need to address, the behavioral health needs of service members, veterans, and their families
• Providing a centralized mechanism for questions about behavioral health systems for service members, veterans, and their families; and to learn, connect, and share with experts and peers
• Increasing awareness of and access to resources and programs that strengthen behavioral health care systems for service members, veterans, and their families
• Increasing awareness of and coordinated responses to meeting the behavioral health needs of service members, veterans, and their families
• Increasing the implementation of promising, best, and evidence-based practices that strengthen behavioral health care systems for their service members, veterans, and their families

The Need for Support

More than 1.3 million active duty members serve in the five Department of Defense military Service branches: Army, Navy, Marine Corps, Air Force, and Space Force. Over 1/3rd (35.1%) of all active duty members have a spouse and dependents, with 1.5 million active duty family members serving an important role in our military community (2022 Demographics Profile of the Military Community). According to the U.S. Department of Veteran Affairs, approximately 200,000 service members transition to civilian life each year. These Service Members, Veterans, and their Families have answered the call of military service, and we, as a Nation, must stand ready to support them in their time of need.

Just like their civilian counterparts, many service members, veterans and their families will need behavioral health prevention, treatment, and recovery support services. Military-culturally competent community supports are critical because we know the following:

Active Duty Service Members

• In 2021, more active component service members (individuals affected) (n=517,491) had for injury/poisoning than any other morbidity-related category. Mental health disorders accounted for more hospital bed days (n=179,986) than any other morbidity category and over half (51.3%) of all hospital bed days overall (Figures 1a, 1b). Together, injury/poisoning and mental health disorders accounted for over three-fifths (61.1%) of all hospital bed days and about two-fifths (40.8%) of all medical encounters. (Absolute and Relative Morbidity Burdens Attributable to Various Illnesses and Injuries, Active Component, U.S. Armed Forces, 2021)
• Stigma and career concerns are commonly reported barriers to care among service members (Melanie A. Hom, Ian H. Stanley, Matthew E. Schneider, Thomas E. Joiner, A systematic review of help-seeking and mental health service utilization among military service members, Clinical Psychology Review, Volume 53, 2017, Pages 59-78)

National Guard and Reservists

• National Guard and Reserve members have their own unique set of challenges. The National Guard has the 5th largest Army in the world and is the 5th largest Air Force. It has over 458,000 personnel serving in 3,600 communities throughout the country, according to the Adjutants General Association of the United States. Active duty members have a solid support structure when they return home to their base from deployments. This is often not the case for National Guard and Reserve members returning home to civilian communities that frequently cannot relate to their military experiences. These communities may also not have as many resources to meet their behavioral health needs. Reservists are often more isolated than the Guard because they are not tied to any base in their area or state.

Veterans

• The 2023 National Veteran Suicide Prevention Annual Report (PDF | 2 MB) indicated in 2021, suicide was the 13th-leading cause of death for Veterans overall, and the second-leading cause of death among Veterans under age 45-years-old. There were 6,392 Veteran suicide deaths in 2021. This was 114 more than in 2020 (pg. 8). Among Recent Veteran VHA Users experiencing homelessness, the suicide rate in 2021 (112.9 per 100,000) was the highest observed over the period 2001–2021, after increasing 38.2% since 2020. The suicide rate in 2021 among Recent Veteran VHA Users who received Justice Program services was also the highest over this period (151.0 per 100,000) after a 10.2% increase since 2020. (pg. 9).
• Based on the 2022 data, it is estimated that in the past year 3.6 million Veterans had a substance use disorder (18.1%). The data identified a prevalence of mental illness higher among Veterans aged 18-49, for both any mental illness and serious mental illness, than among Veterans aged 50 or older. Additionally, thoughts of suicide were higher among Veterans aged 18-49 than among Veterans aged 50 or older. (2022 National Survey on Drug Use and Health Among the Veteran Population Aged 18 or Older)

Families and Caregivers

• Extended and repeated deployments can cause significant stress to military families. Based on a 2019 study published in Child and Adolescent Psychiatry and Mental Health, parental military deployments can negatively impact the mental health of children. The study found children of parents who were deployed showed more behavioral problems than children of non-deployed parents
• According to RAND’s seminal study on military caregivers in 2014, there is an estimated 5.5 million military and veteran caregivers who provide informal care and support to current and former U.S. service members.
  • Caregivers report higher levels of mental health problems than non-caregivers and have an increased risk for developing depression and anxiety
  • Many caregivers in military families are caring for recipients with “invisible” conditions. Most commonly they are caring for someone with “emotional or mental health concerns” rather than or in addition to physical health concerns (See the Blue Star Families Caregiving in Military Families 2020 Military Family Lifestyle Survey Special Report (PDF | 5.9 MB) )

Call to Action

This is just the tip of the iceberg. Efforts need to be expanded, plans need to be refreshed, and lessons learned need to be shared. At this critical time, we must all work together to improve the capacity of our civilian behavioral health service system to serve service members, veterans, and their families. This can be accomplished by ensuring providers are informed on military culture and adopting promising, best, and evidenced-based practices. Service members, veterans, and their families deserve the highest level of care that can be delivered through an easy-to-navigate, coordinated system that allows them to access quality behavioral health care in their communities.