Caring for Veterans as a Psych Nurse

• A psych nurse in Seattle, Washington, shares her experiences working with the veteran population.  
• Mental health awareness among veterans is essential for healthcare providers to consider.  
• The psych nurse suggests that as part of their transition to civilian life, veterans could be offered assistance in the form of early intervention as it relates to mental health.  

It’s a Tuesday afternoon, and a newly admitted patient is in a busy inpatient psych unit. He, like many other veterans, has had to manage post-traumatic stress that stems from combat. His situation is merged with major depressive disorder, also called clinical depression. This mood disorder causes a persistent feeling of sadness and loss of interest that affects how you think, feel, and behave, which can lead to a variety of emotional and physical problems. 

This veteran went from a thriving man with a family that now includes grandchildren to a shaking, shell of the man he once knew. He states that he’s been struggling with intrusive thoughts, started with drinking, and soon found himself using recreational drugs in excess to cope. 

When that didn’t work, he turned to opiates from a nagging back injury acquired during his service.

On the unit today are also individuals with diagnoses ranging from bipolar disorder and anxiety to schizophrenia. Still, the one thing that resonates through this cohort today is that many use substances to cope with their mental health.

Working as a Psych Nurse

As a psych nurse in an acute care unit, I work with veterans, and while I’ve had other experiences before, working with vets is a whole different challenge.

For one, I was surprised to learn these men and women might not have all served full tours of duty. Some may have been through basic training, and for one reason or another, separated from service, and needed mental health services after that. Some served multiple tours and have visible (and invisible) scars to prove their service. 

Still, the point remains that substance abuse is a reality for many and may have stemmed from receiving pain management for service-related injuries or self-medicating their mental health. 

Many police and first responders now carry Narcan for opiate overdoses, but another drug for the reversal of overdoses could be taken in the same manner: Suboxone. In some areas, you can Narcan off the shelf, as I saw at a Walmart north of Seattle. Who knows if Suboxone will follow suit?

As of June 2023, paramedics in Hennepin County, Minnesota, were carrying Suboxone in their ambulances. This drug is often dispensed in drug rehab clinics or substance abuse treatment facilities and is used to reduce dependence on opioids. I later learned that in 2019 New Jersey became the first state to offer the drug for opioid overdoses as part of a pilot trial. 

Support System

One thing that becomes apparent when caring for veterans is that quite a few lack a support system. Veterans I spoke to also cited this as their reason for seeking out substances to combat feelings of loneliness.  

With continued substance abuse oftentimes comes homelessness, which, already with the current housing crisis, makes the problem ever more pervasive.

Veterans are found to be 1.5 times more likely to die by suicide than adults who were never veterans, according to the American Psychological Association. Reasons for this may include high exposure to trauma, stress and burnout, isolation and loneliness, easy access to and familiarity with guns, and difficulties reintegrating into civilian life.  

Unresolved Solution

The solution to this issue is ongoing. While the pervasiveness of drugs is not showing marked improvement, especially with the availability of Fentanyl and other synthetic drugs, the mental health of veterans needs to be in the spotlight. Perhaps before exiting from service, there could be early-intervention assistance for veterans, if for no other reason than to offer support while they reacclimate to civilian life.

You, or a veteran you know, might need more help with mental health than you realize. This is not to say that the mental health of veterans is more important than the general population. Still, societal awareness is essential since these individuals risked their lives to serve this country

It has made me more aware as a nurse of the human condition of wanting safety, which includes being of sound mind. Sometimes, a way to cope is good until it’s not. This seems to have been the resounding theme among veterans as they come through our unit doors for help.  

The Bottom Line

Mental health awareness among veterans is essential for healthcare providers, as service members are an especially vulnerable population. During admission intake assessments, mental health is, at times, minimally addressed. But service members could be given information on where to get help so they don’t feel alone, or so they have a way to start the conversation of why so many feel alone in their struggle. 

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