How to amplify coverage of veteran suicide and National Guard health care

When retired U.S. Army Command Sergeant Thomas Campbell hit rock bottom and tried to take his life, he was battling PTSD, a traumatic brain injury, family conflict and financial strains. But the story he shared at AHCJ's fall summit was one of hope: He recovered, thanks to access to proper care and support.

Unlike Campbell, who as an active Army service member had access to military-provided medical care, many National Guard members lack stable health care, which can include mental and behavioral health because of the dual worlds they live as civilian and soldier, panelists said during a session about veteran suicide.

After working alongside a National Guard unit during his final deployment, Campbell was disheartened by the many barriers members face in obtaining sustained quality, affordable health care and mental health support.

With an average of about 17 veterans dying by suicide daily, the National Guard health

care accessibility crisis in particular needs to be highlighted more in health care reporting, said Lara Salahi, panel moderator and AHCJ's beat leader on health equity.

Suicide deaths in the Reserve component are already pacing greater than the Active component this year, and have increased compared to 2023, according to the Department of Defense.

"I found out the Army didn't have a great program for our reserve and National Guard components. We have the army mental health program, but … it wasn't conducive to that geographically dispersed area," he said, noting that National Guard members often lack full-time health benefits.

With an average of about 17 veterans dying by suicide daily, the National Guard health care accessibility crisis needs to be highlighted more in health care reporting, said Lara Salahi, panel moderator and AHCJ's beat leader on health equity.

Adding to the complexity of the issue, National Guard suicides are undercounted in Department of Defense data due to the lack of reporting of National Guard members when not on duty status, said panelist Allyson Solomon, a retired brigadier general, and former assistant adjutant general.

The National Guard, traditionally regarded as a part-time force that provided domestic emergency response, is now relied upon for sustained and prolonged domestic activations and foreign deployments, operating more like a full-time force, said Solomon. The structure of health care delivery of Guard members hasn't caught up to this new model, she said.

Unlike active duty members, National Guard members rely on private health care insurance, Solomon said. Guard members who are dependent on TRICARE Reserve Select, for example, must pay monthly premiums, copays and deductibles, said Salahi, who wrote a three-part series on "suicide and the science of resilience in the National Guard."

"And you all know from your reporting, the cost can prohibit people from accessing the care that they need, regardless of whether it's a cut finger or mental health," Solomon said. "Dental [insurance]l is one of the biggest things that we found that people [in the National Guard] don't have."

Busting myths and reintegration strategies

Panelist Philip Held, a research director for The Road Home Program, which is dedicated to tackling veteran mental health challenges, talked about how fears of stigmatization and career consequences prevent military personnel from getting help.

"There's so many myths about what it means if I'm now getting help. What are the consequences? What will my peers think about me? What will my command think about me? Will I still be able to deploy? Will I be able to continue to serve? Will I be able to keep my security clearance?" he said.

When it comes to helping veterans reintegrate more easily into society, Held said the Defense Department, the VA and private insurers need to be involved in efforts to provide people with more options to high-quality health care services.

Panelists emphasized the need to address the root causes of PTSD, better support systems for veterans, and better quality clinical trials for novel treatments.