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Mental Health Hope & Help - 10
Monday, May 27, 2024 4:55AM CDT

Editor's Note: Throughout May, DTN/Progressive Farmer's special series "Mental Health Hope & Help" is exploring the unique mental health challenges people in rural America face, highlighting efforts to overcome stigma and looking at ways farmers and ranchers can manage their mental wellness. This is the 10th story in the series.


Lauren Welter has worked closely over the years with a handful of veterans who come from farm families and returned to the farm after their time in service.

Because of their strong work ethic and other cultural factors that make them great soldiers (or marines, airmen or sailors), rural populations are overrepresented in America's armed services.

Unfortunately, the very factors that make them good soldiers can also make them vulnerable to nonrecovery from post-traumatic stress disorder (PTSD) and other mental health problems following their service.

"Specifically, rural life can easily promote isolation, and round-the-clock working can lead to burying trauma memories instead of dealing with them directly," explained Welter, an Iowa licensed psychologist (and former farm wife) who runs a small group practice with two locations in the eastern part of the state.

"Similarly, substance use (and/or abuse) is often culturally sanctioned, and the real need to prioritize daily farming/family needs can make it easy to ignore mental health problems," she added. "Over time, this all leads to worsening PTSD, depression, anxiety and substance-abuse problems for many rural veterans."

Beyond the general shortage of trained mental health providers in almost all rural spaces, there is a real need for specific training in military culture and combat trauma, in particular.

The primary treatment options rural veterans have come from the U.S. Department of Veterans Affairs Veterans Health Administration (VA), where providers have specialized training working with combat veterans but may lack understanding of the many cultural and lifestyle factors that make it difficult for rural veterans to seek or fully engage with mental health treatment.

For many rural veterans, VA clinics can be several hours away and have long wait lists, while most civilian providers, even if they do have availability and accessibility, have little training in the unique experiences of military culture and combat, Welter explained.

"From my observations, these rural veterans can end up feeling more hopeless and helpless when they do seek care, and they feel misunderstood by providers," she pointed out.


While the exact number of veterans suffering from mental illness or requiring mental health services in America, particularly in rural areas, varies over time and may be influenced by various factors, according to the U.S. Department of Veterans Affairs, in 2020, approximately 5.2 million veterans experienced a behavioral health condition.

It is well-documented that veterans, including those in rural areas, face a higher risk of mental health issues compared to the general population. Here's some food for thought (according to the U.S. Department of Veterans Affairs):

-- Approximately 17% of post-9/11 veterans experience symptoms of PTSD each year.

-- About 20 veterans die by suicide every day, indicating the severity of mental health challenges among veterans. Nearly 1 in 4 active-duty members showed signs of a mental health condition. The suicide rate for veterans is 57% greater than non-veterans.

The most widely publicized mental health challenges veterans and service members encounter are PTSD and depression.

-- Depression affects 20% of veterans. Suicidal ideation or attempts occur in 11% of veterans. In veterans who use drugs, the rates of suicidal ideation and attempts are 18% and 30%, respectively. Suicidal ideation or attempts occur in 8% of veterans who consume alcohol.


Several unique factors contribute to the mental health struggles experienced by veterans:

-- Combat Exposure: Veterans who have been exposed to combat situations and traumatic events during their military service are at a higher risk of developing mental health conditions such as PTSD, depression and anxiety.

-- Multiple Deployments: Veterans who have served in multiple deployments may face increased mental health risks due to prolonged exposure to combat and high-stress environments.

-- Traumatic Brain Injuries (TBIs): Veterans who have experienced traumatic brain injuries, often resulting from explosive blasts or other combat-related incidents, may develop mental health issues. TBIs can cause cognitive impairments, mood changes, and increased vulnerability to mental health disorders.

-- Social Isolation: In rural areas, veterans may face challenges accessing mental health services due to limited availability of resources and lack of proximity to healthcare facilities. This can lead to social isolation, making it difficult for veterans to seek help and support.

-- Lack of Awareness and Stigma: Some veterans may hesitate to seek mental health services due to the stigma associated with mental illness. There may be a perception among veterans that seeking help is a sign of weakness or that it may negatively affect their military career or personal relationships.


"For many rural veterans, VA clinics are several hours away and have long wait lists, while most civilian providers, even if they do have availability and accessibility, have little training in the unique experiences of military culture and combat," Welter said. However, despite these obstacles, rural veterans have several treatment and support options available to them.

-- Crisis Hotlines: Veterans in crisis can reach out to the National Suicide Prevention Lifeline at 988 or the Veterans Crisis Line at 988 (Press 1). To chat online, visit These services provide immediate crisis support and can help connect veterans to appropriate resources.

-- U.S. Department of Veterans Affairs (VA): The VA ( provides a wide range of mental health services specifically tailored to the needs of veterans. This includes individual and group therapy, medication management, specialized programs for PTSD and substance abuse, and 24/7 crisis support.

-- Vet Centers: These community-based centers offer a variety of services, including individual and group counseling, marital and family counseling, and assistance with VA benefits. For more information, visit

-- Military OneSource: This free service ( provides confidential counseling and support to active-duty, National Guard and Reserve members, as well as their families. They offer a wide range of resources, including face-to-face counseling, online chat and telephone support.

-- Local Mental Health Providers: Veterans can seek help from private mental health providers in their local communities. It is important to find providers who have experience working with veterans or with trauma-related issues. You can search for local mental health professionals at, or

-- Support Groups: Veterans can benefit from connecting with other veterans who have had similar experiences. Support groups, both in person and online, can provide a sense of community and understanding. A few examples are the Wounded Warrior Project (, Vets4Warriors (, Blue Star Families ( and U.S.VETS (

Addressing these mental health challenges among veterans, especially in rural areas, requires a comprehensive approach. It involves improving access to mental health services, raising awareness about available resources, reducing stigma and providing targeted support to address the unique needs of veterans in rural communities.


For more articles in this series:


-- Editors' Notebook: "Take Time for Mental Health,"…


-- Mental Health Hope & Help - 1: "Rural Americans Still Face Mental Health Stigma, Scarcity of Resources, But Outlook Is Improving,"…

-- Mental Health Hope & Help - 2: "Farmers Urge Fellow Farmers to Reach Out When Life Overwhelms,"…

-- Mental Health Hope & Help - 3: "Obstacles, Solutions Abound in Rural Youth Mental Health,"…

-- Mental Health Hope & Help - 4: "Gender Differences Exist in Farmer Emotional Health,"…

-- Mental Health Hope & Help - 5: "Be Mindful of a Mother's Mental Health,"…

-- Mental Health Hope & Help - 6: "Mental Health Services Sparse But Still Within Reach in Rural Areas,"…

-- Mental Health Hope & Help - 7: "Suicide Prevention Training Teaches Lifesaving Techniques,"…

-- Mental Health Hope & Help - 8: "Training Empowers Rural Clergy, Other Community Leaders to Respond to Mental Health Crises,"…

-- Mental Health Hope & Help - 9: "Falling Crop Prices Add to Farm Stress,"…

Additional resources:

For more information and mental health resources, visit our "Spotlight on Rural Mental Health" page at…

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