Veteran and military mental health: care, TRICARE and family support

Service experiences, transition to civilian life, family demands and health concerns can overlap. This guide offers practical next steps for veterans, active duty members and the families beside them, starting with your experience rather than assumptions about military service.

01 / After service

Military service is context, not a diagnosis

Veterans have a wide range of experiences and care needs. An assessment may consider sleep, mood, trauma, pain, substance use, relationships, medical history, and current safety. PTSD is one possibility, not the default explanation for distress after service. If you hold a security clearance and have questions about seeking care, see care for first responders and security clearance holders in Maryland.

DSM-5-TR criteria help clinicians evaluate specific conditions. Moral injury describes distress related to events that conflict with deeply held values and is not itself a DSM-5-TR diagnosis. A provider should ask what an experience means to you, distinguish overlapping concerns, and discuss a plan in plain language.

Military training rewards pushing through, self-reliance and keeping problems inside the unit, so asking for help can feel like it goes against what you learned. Studies of service members returning from combat deployments found that concerns about stigma, such as being seen as weak or being treated differently by leaders, were common among those who screened positive for a mental health concern (Hoge et al., New England Journal of Medicine). Reaching out can start with one conversation about what has changed.

02 / PTSD, moral injury and sleep

PTSD, moral injury and sleep after service

Trauma-related symptoms after service can include vivid reminders, avoiding places or conversations, and feeling constantly on guard. Trauma-focused therapies have evidence for PTSD. Ask how a provider chooses an approach and what training they have.

The VA/DoD clinical practice guideline for PTSD (2023) recommends trauma-focused psychotherapies such as Cognitive Processing Therapy (CPT), which works with beliefs about blame, guilt, safety and trust; Prolonged Exposure (PE), which gradually approaches memories and situations you have been avoiding; and Eye Movement Desensitization and Reprocessing (EMDR), which pairs focused recall of a memory with eye movements or tones. These are structured approaches, and how a person responds varies. Our guide to evidence-based therapy approaches explains how these and other methods compare.

Moral injury can follow events that conflict with deeply held values, such as things you saw, did or could not prevent. It may bring guilt, shame, anger or a sense of betrayal. You can talk about it without first deciding whether it is PTSD.

Some service members also live with the effects of a blast-related or other mild traumatic brain injury (concussion), such as headaches, trouble concentrating, irritability or sensitivity to light and noise. TBI and PTSD can occur together and share some symptoms, so tell a provider about any blast exposure or head injury and keep your medical team involved.

Sleep problems are common after service and can feed irritability, low mood and trouble concentrating. A short record of sleep patterns and daily effects gives a provider useful information for assessment.

When sleep trouble lasts for months, the VA/DoD insomnia guideline (2025) recommends cognitive behavioral therapy for insomnia (CBT-I) and suggests it over sleep medication as a first-line treatment. CBT-I works on sleep timing, habits and the racing thoughts that keep you awake. Nightmares and possible sleep apnea are worth mentioning too, since they are assessed differently.

Substance use can show up alongside trauma symptoms, poor sleep or low mood, sometimes as a way to cope. It is worth naming early, because an assessment can look at both together. The VA offers substance use treatment for eligible veterans, and TRICARE covers substance use disorder care, with referral rules that depend on your plan. Our guide to substance use disorder and dual diagnosis explains how substance use and mental health concerns can be assessed and treated together.

03 / TRICARE basics

TRICARE mental health basics

We accept TRICARE. What you need before a first visit depends on your plan, your status and the service.

TRICARE says active duty service members need a referral and pre-authorization for civilian mental health care, apart from emergencies. Many other beneficiaries can schedule outpatient therapy with a network provider without a referral, but rules vary by plan, provider and service.

Before booking, check your plan details with TRICARE or your regional contractor, and ask intake what information they need from you. This is general information, not benefits advice.

Outside TRICARE, Military OneSource offers free, confidential non-medical counseling to service members and families, generally up to 12 sessions per issue, at 800-342-9647. It is short-term support for everyday stressors, not treatment for a mental health condition, and confidentiality has legal limits, such as safety concerns.

For veterans and former service members, VA's free emergency suicide care (COMPACT Act) covers emergency care for an acute suicidal crisis at a VA or non-VA facility, including transport, up to 30 days of inpatient or crisis residential care and up to 90 days of outpatient care, with no VA enrollment needed. Eligibility depends on discharge and service history, and VA sets the rules. If you are in crisis, call 911, go to the nearest ER, or call or text 988.

04 / PCS moves and deployment

Planning care around PCS moves and deployment

A permanent change of station (PCS) can interrupt care. Before a move, ask for copies of records and a current medication list, and plan how appointments will continue. After arriving in Maryland, check referral needs for your plan before your first civilian visit.

Deployment affects the whole household. Children may react with changes in sleep, behavior or school, and the partner at home often carries more responsibility. Talking through routines and support before, during and after deployment can help, and family members can seek care in their own right. See our care for veterans and military families.

Families enrolled in the Exceptional Family Member Program (EFMP) can ask how care for a family member’s needs will continue through a move.

EFMP enrollment is mandatory for active duty service members whose spouse, child or other dependent has qualifying medical or educational needs, so those needs are considered during assignments. Medical needs are documented on DD Form 2792 and a child’s early intervention or special education needs on DD Form 2792-1, and enrollment is updated every three years or when needs change. Before a PCS move, keep copies of evaluations, treatment plans, a current medication list and any IEP or IFSP, and ask your installation EFMP office how to hand off care to the gaining installation.