As a recently separated Air Force major and former active-duty behavioral health provider, Kathleen McNamara saw firsthand how service members struggled to access mental health care at the military treatment facility where she worked. By the time a service member calls to seek help, McNamara explained, they’ve already overcome one barrier.
“We call it the 10,000-pound phone call when someone actually does call mental health to ask for help because it’s so hard to be vulnerable,” she said. “Let alone for a service member who lives in a very macho, pull-yourself-up-by-your-bootstraps culture.”
The outcome, however, is less than ideal when the service member is told that instead of immediate care, they will be put on a waitlist to be seen. It is additionally frustrating when even after being assigned to a therapist, appointments are then scheduled about a month out.
At a military installation, the mental health clinic is typically designated for active-duty service members only. But as a behavioral health provider in the primary care clinic, McNamara said she and a team of three contractors saw active-duty service members as well as their families, and retirees and retiree family members. While the team provided short-term, solution-focused care, there was still a gap between the one-on-one therapy patients were seeking.
Mental health barriers
Barriers to mental health care access for service members and their families aren’t limited to a few individuals, according to recent results from the Blue Star Families Annual Military Family Lifestyle Survey. Responses from more than 5,500 active-duty, National Guard and reserve service members, as well as veterans and their families, showed that 40% of active-duty service members encounter waitlists for their own care. Additionally, 44% of those seeking care for a child were waitlisted for mental health care, and 90% were on the list for more than three months.
“There’s a saying that if the Army wanted you to have children, they would’ve issued them to you,” McNamara said. “Although the U.S. has the largest defense budget in the world, the fact that we have these systemic issues tells you how much we value military families. How do we convince people that military well-being matters?”
Lezlie Leslie, the spouse of an active-duty Air Force staff sergeant, said the survey is “pretty accurate” based on her experience. Leslie also pointed out that the unique stressors military families face can lead to an increased need for counseling services that just aren’t available.
“They have free resources at the [Military] Family Readiness Center, but when my spouse and I were struggling in our relationship because he was gone all of the time, it just was not sufficient or what we needed,” she said.
Financial strain
Other key findings in the Blue Star Families survey included that an increasing number of military families are unable to cover housing costs with their allotted Basic Allowance for Housing (BAH). In 2024, only 26% of active-duty families reported their monthly housing costs were covered by BAH, down from 42% in 2020. Junior enlisted families are particularly impacted, with only 36% feeling financially stable compared to 62% of active-duty families overall and 72% of U.S. adults.
Spouse unemployment rates are also a significant concern, according to respondents. Fifty-four percent of active-duty spouses said it is one of the “most pressing challenges their families face.” Almost 80% of active-duty families — an increase from about 63% in 2019 — said two incomes is vital to their well-being.
Visit Blue Star Families to learn more about the 2024 Military Family Lifestyle Survey and their programs.
