Supporting Military and Veteran Caregivers

Video Transcript

Rajeev Ramchand. Codirector, RAND Epstein Family Veterans Policy Research Institute, RAND Corporation

Yesterday, RAND released America's Military and Veteran Caregivers: Hidden Heroes Emerging from the Shadows. I had the honor of leading this study. The study estimates that there are 14.3 million military and veteran caregivers. This estimate surpasses past estimates of military and veteran caregiving in the United States. Many people caring for those in need of support do not identify as caregivers. But previous research has largely relied on a person identifying as a caregiver in order to be counted as one. Our updated approach relies on people describing the caregiving tasks they perform. We are including caregivers who may not identify as such. This may include individuals caring for aging spouses, individuals caring for their friends with mental health conditions or substance use disorders, or non-family members who may take on caregiving roles for their friends and neighbors.

One important distinction we found was that 26% of these caregivers are caring for service members and veterans age 60 and under. And these caregivers and their experiences are very different from those who care for someone over age 60. Between 40 and 60% of military and veteran caregivers reported that their caregiving entails helping the veteran cope with stressful situations, manage sudden changes in mood or avoid triggers of anxiety or anti-social behavior. But these tasks only scratch the surface of what these caregivers do to help service members and veterans struggling with emotional and behavioral issues, including thoughts of suicide. The problem is that many policies and programs overlook military and veteran caregivers to those with mental health and substance use conditions.

Eligibility requirements are often based on activities of daily living, such as helping a person bathe or instrumental activities of daily living, such as grocery shopping or housework. But these may be inadequate for describing what many military and veteran caregivers do. First, we must ensure that policies and programs directed to support military and veteran caregivers, including those run by the VA, support those caring for individuals with mental health and substance use diagnoses. Second, we must promote programs to caregivers in ways that do not require them to identify as caregivers in order to partake in them. Caregiving takes an emotional toll. 43% of military and veteran caregivers to those age 60 or under make criteria for depression, nearly four times that as non-caregivers. Expanding telehealth may increase access to mental health care for more people, but its benefits will only be fully realized when interstate licensure agreements are worked out. Integrating mental health into primary care, like models such as collaborative care, is also a critically important step.

The research supports these "no wrong door" policies. So, when a caregiver goes in to seek support for the first time, the person that they're talking to, whether that's at the VA or at a VSO, be aware of these benefits or at least be thinking about these benefits so that they can help the caregiver figure it out. And so those who are kind of, you know, raised their hand to help support caregivers, ensuring that they have that knowledge and can help them apply for those programs, I think that would be a tremendous asset.