Veterans’ need for mental health care. Traumatic experiences, notably the types of trauma women Veterans uniquely experience, such as military sexual trauma (MST), make women more likely to be vulnerable to PTSD and co-morbid depression, more likely to experience a longer duration of PTSD symptoms, and in general, have a more pronounced reaction to trauma.
Women who serve in the military are also increasingly exposed to both the physical and psychological trauma of combat and its aftermath, particularly as women serve in broader military roles and as the nature of warfare changes, with a lack of a demarcated “front line". Furthermore, women Veterans endorse more trauma outside of the military, compared to their civilian women and Veteran male counterparts. The literature suggests almost all female Veterans experience a traumatic event at some point in their lives, with estimates as high as 93%.
While a robust body of research describes the prevalence of and predisposing factors for women Veterans’ mental health conditions, less is known about how women Veterans' experience these events, and how these events shape their identity. Understanding women Veterans’ identity is crucial to understanding their mental health needs and mental health decision making. Therefore, the purpose of this study is to assess and understand the experiences and identities of women Veterans before, during, and after military service that ultimately led to the use of mental health outpatient services.
Methods: This study used Grounded Theory qualitative research methods to characterize and describe how women veterans (WVs) use mental health outpatient services to reconstruct and reclaim their identity and sense of self when confronting multiple forms of trauma throughout the lifespan, including combat trauma, intimate partner violence (IPV), and military sexual trauma(MST). Community dwelling women Veterans were recruitment from online and in-person recruitment from August 2015 to March 2016. Participants eligible for this study were women ages 21-65 who served in the regular armed forces, and attended at least one mental health outpatient visit in VA services or community-based services within the 12 months of recruitment.
Results: Twelve women Veterans revealed meaningful stories on their experiences of trauma and their use of mental health services.From the in-depth interviews, the process of reconstructing, reclaiming identity and sense of self was revealed. This includes identifying and recognizing trauma, defining transitions as changes in the structure of the environment, understanding changes in the roles and notions of gender based, and military based identities, and actively seeking out the stability inherent within structures such as the military. A broader Grounded Theory Process model emerged, linking the categories of Trauma, Transitions, Identity and Structure.
Conclusion: The findings of this study, combined with the pertinent literature indicate the pervasive presence of traumatizing events throughout the life of women Veterans, the mental health burden these women experience, and the importance and centrality of their military experience in molding their identity and sense of self. Despite the male-centered military and Veteran culture, women Veterans are joining and transitioning out of the military more than any other time in history. Their presence demands recognition of their experiences, and treatment that respects their backgrounds, service history, gender, and mental health needs. The development of the major concepts of “Trauma”, “Transitions”, “Identity”, and Structure” offer another aspect of understanding the social worlds and significant interactions that shape the lives of women Veterans. These concepts give voice to their powerful and impactful stories have been silenced or ignored, and lay the basis for further research, practice, and policy change that can positively impact the lives of women Veterans and their families.