Gender Differences in Veterans' Mental Health Care Utilization
This literature review examines whether gender affects the utilization of VA (Veterans Affairs) mental health care services among military veterans. Drawing on more than a decade of research, the paper explores the documented need for mental health care among veterans returning from conflict zones such as Iraq and Afghanistan, the signs that indicate when intervention is needed, and how the growing inclusion of women in the military has affected service utilization patterns. The review also considers factors such as rank hierarchy, demographic characteristics, ethnic background, and women's own reluctance to seek care. Cost comparisons between male and female veterans are analyzed, and the paper concludes that both genders require equitable, high-quality mental health support, with particular attention needed for women veterans navigating dual responsibilities at home and in service.
- Introduction: Gender, deployment, and VA mental health care framing
- The Need for Mental Health Care Among Military Veterans: Evidence for growing veteran mental health care demand
- Signs That VA Mental Health Intervention Is Needed: PTSD, depression, and alcohol as intervention indicators
- Women's Military Inclusion and VA Service Utilization: Women's higher outpatient use and pain prevalence findings
- Factors Affecting VA Mental Health Care Utilization by Gender: Hierarchy, demographics, and women's reluctance as barriers
- Cost Differences in VA Mental Health Care by Gender: Minimal overall cost difference between male and female veterans
- Conclusion: Call for equitable, high-quality VA care for all genders
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What makes this paper effective
- Organizes a multi-source literature review into clearly labeled thematic subsections, making it easy to trace how each study relates to the central research question.
- Consistently closes each paragraph with an explicit relevance statement linking the cited study back to the paper's thesis, reinforcing argumentative coherence throughout.
- Balances quantitative findings (cost comparisons, PTSD prevalence rates) with qualitative factors (hierarchy, reluctance, demographics), giving the review both empirical weight and contextual depth.
Key academic technique demonstrated
The paper demonstrates effective use of the annotated synthesis technique: rather than simply summarizing each source in isolation, the author explains how each study contributes evidence to a common thesis about gender-based disparities in VA care. The recurring phrase "this study is similar to the selected topic here since…" functions as an explicit connective strategy, a technique useful for undergraduate literature reviews where making the argument visible is as important as presenting the evidence.
Structure breakdown
The paper opens with a framing introduction that establishes the problem and thesis. The body is organized into five thematic sections: the general need for VA mental health care, indicators for intervention, gender-based service utilization patterns, contributory factors (hierarchy, demographics, reluctance), and cost differentials. A concluding section synthesizes key findings and calls for policy attention. The structure follows a classic funnel pattern—broad context narrowing to specific variables—appropriate for a literature review at the undergraduate level.
Introduction
The career decisions a person makes can have lifelong effects on both their own life and the lives of their family members. Deployment — a defining reality of military careers — can sometimes cause serious harm to a service member's mental health and family relationships (Brooks & Chopik, 2020). For example, a soldier deployed to a war zone may return with lasting mental health consequences, including stress, depression, and excessive alcohol use. The intensity of trauma may increase if a diagnosis is not made in time and can lead to family problems such as divorce, social dysfunction, substance abuse, difficulties in future employment, legal complications, and physical health troubles.
Recently, women's inclusion in nearly all areas of life has grown substantially, and the military is no exception. It is generally observed that women require outpatient health care services more frequently than men for minor illnesses, and the same holds true for reproductive health and depression care. As a result, per-person medical costs for women tend to be higher than for men overall.
When women are deployed to conflict zones, medical costs may be even higher — particularly outpatient and pharmacy costs — due to resulting mental health problems, even though women's overall military health costs may remain lower than those of men. Understanding how VA (Veterans Affairs) mental health costs differ by gender among veterans is therefore important. The central argument of this literature review is that there is a gender difference in the utilization of health care services among veterans, specifically military women. Although women's presence in the military has grown significantly, they are often younger or belong to minority groups, and the benefits they receive relative to their male counterparts reflect persistent inequities. The sections that follow provide a literature review offering sufficient background on this topic.
The Need for Mental Health Care Among Military Veterans
Various studies have confirmed that military veterans who have served in conflict zones such as Iraq and Afghanistan require specialized mental health care. These veterans suffer severe psychological impacts from wartime conditions during their deployment years, and research consistently shows a growing number of veterans seeking mental health support.
As a result, the costs associated with mental health care visits per veteran have also risen (Harpaz-Rotem & Rosenheck, 2011). This trend includes newer veterans, for whom retention in care is especially important so that their ongoing service capacity can be maintained. This body of research affirms that military veterans need specialized VA mental health care, leaving little ambiguity on that point.
It is also accurate to assert that the negative impacts of combat environments are observed in both male and female VA military personnel, regardless of whether they have received mental health care. Depression frequently becomes part of a veteran's experience upon return and requires dedicated attention. Rates of PTSD were found to be three times higher among military veterans who had received mental health care compared to those who had not (Vaughan et al., 2014).
A key reason for such disparities may be that VA mental health care services were not fully meeting veterans' treatment needs. This gap could be narrowed by improving the quality of mental health services and increasing enrollment, given that a large population of veterans still does not have access to or use these services. Research in this area is directly relevant to the present topic, as it examines the effects of VA mental health care on both recipients and non-recipients, independent of gender.
Signs That VA Mental Health Intervention Is Needed
Post-deployment health care encompasses numerous factors that form the basis for determining when mental health care intervention is warranted. One recent study established that military personnel in warzone deployments consisted primarily of older White men (Adams et al., 2019).
The visible signs of mental health disorders identified in the literature include suicidal ideation, depression, post-traumatic stress disorder (PTSD), and excessive alcohol use. Veteran identity and years of military service were found to be prominent factors in assessing the need for VA services. Older veterans, despite having lower incomes, were more likely to use alcohol and were more strongly eligible for VA services. This research is relevant to the current topic because it identifies the key factors used to assess veterans' need for VA services.
Women's Military Inclusion and VA Service Utilization
Veterans in any field serve for a number of years in their chosen career and expect certain returns after their service. While discussions of veterans often focus on the military, the concept applies across other career fields as well. In the military context, there has been a growing number of women seeking VA medical health care, including for chronic non-cancer pain. One study found a gender difference in prescription patterns between younger and older veterans (Weimer et al., 2013). Women recorded higher rates of clinic visits, and the prevalence of pain was higher in females than in males. This difference was largely attributed to women's greater use of VA health care services relative to men. This study provides meaningful grounding for examining gender difference in VA mental health care utilization.
A related study examining men and women receiving VA medical health care for chronic pain similarly found that women used higher rates of outpatient services in the context of chronic pain within the VA system (Kaur et al., 2007). Multiple studies have demonstrated that women tend to be less tolerant of pain stimuli and exhibit higher levels of distress when experiencing pain, including tissue injury.
This finding reflects a clear difference in VA service utilization among women, compounded by the fact that patients with higher rates of depression also received more outpatient care. This research is relevant here because it indicates that a patient's psychological state shapes the level of VA health care they receive, with gender acting as a mediating variable in how pain is experienced and managed.
Men and women differ physically and mentally and experience pain to varying degrees. A study conducted by Haskell et al. (2009) examined gender differences in the overall prevalence of pain, with pain levels ranging from slight to moderate among participants at a VA outpatient clinic. Results indicated that during the first year of deployment, women were less likely to report moderate to severe pain, though they were slightly more likely than men to experience it over time. This suggests that women may not be deployed directly to combat positions, but they participate in equally demanding supporting roles in the same areas and face comparable conditions. Notably, the rate of persistent pain was lower in women than in men. This study is relevant to the present topic because it documents gender-based differences in pain prevalence, which directly informs an understanding of how men and women differ in their use of VA medical health care.
Conclusion
The literature reviewed above makes clear that military men and women require uniform medical intervention. Service in the armed forces exposes both genders to the same demanding and often traumatic circumstances. In recent years, women have joined the military in greater numbers. While they may not always be deployed directly to front-line combat positions, they serve in close proximity to conflict areas in vital supporting roles and are exposed to comparable conditions.
The negative effects on their mental health are significant and must be addressed promptly, particularly because women returning from service must often resume roles as primary caregivers at home. If they return with depression, PTSD, or suicidal ideation, it will be difficult for them to pursue future employment, manage daily household responsibilities, and provide the attention their children need.
Key findings from this literature review include the following: there is an undeniable need for mental health care among both male and female VA military veterans; several clear signs exist that indicate when care is required, including PTSD, depression, suicidal ideation, and excessive alcohol use; the growing inclusion of women in the military has led to increased use of outpatient services; and factors such as hierarchical rank, demographics, and women's own reluctance all influence VA mental health care utilization by gender. Cost differences between genders are minor and do not meaningfully distinguish overall utilization patterns.
The current status of the problem is that both military men and women experience significant mental health challenges, yet government agencies and mental health professionals must respond with greater urgency and higher-quality services. Women veterans face a particularly complex transition back to civilian life, taking on homemaking and childcare responsibilities that can be severely compromised by untreated service-related mental health conditions. If the after-effects of deployment are long-lasting, entire families suffer. It is therefore essential that the VA provide military women — and all veterans — with high-quality mental health care that enables them to function effectively both in service and at home.
References
Adams, R. E., Urosevich, T. G., Hoffman, S. N., Kirchner, H. L., Figley, C. R., Withey, C. A., Boscarino, J. J., Dugan, R. J., & Boscarino, J. A. (2019). Social and psychological risk and protective factors for veteran well-being: The role of veteran identity and its implications for intervention. Military Behavioral Health, 7(3), 304–314. https://doi.org/10.1080/21635781.2019.1580642
Allore, H. G., Ning, Y., Brandt, C. A., & Goulet, J. L. (2013). Accounting for the hierarchical structure in veterans' health administration data: Differences in healthcare utilization between men and women veterans. International Journal of Statistics in Medical Research, 2(2), 94–103. DOI: 10.6000/1929-6029.2013.02.02.03
Brooks, C. & Chopik, W. (2020, June 17). Research finds deployment affects mental health of veterans differently. Michigan State University.
Duggal, M., Goulet, J. L., Womack, J., Gordon, K., Mattocks, K., Haskell, S. G., Justice, A. C., & Brandt, C. A. (2010). Comparison of outpatient health care utilization among returning women and men veterans from Afghanistan and Iraq. BMC Health Services Research, 10(175). https://doi.org/10.1186/1472-6963-10-175
Harpaz-Rotem, I. & Rosenheck, R. A. (2011). Serving those who served: Retention of newly returning veterans from Iraq and Afghanistan in mental health treatment. Psychiatric Services, 62(1), 22–27. DOI: 10.1176/ps.62.1.pss6201_0022
Haskell, S. G., Brandt, C. A., Krebs, E. E., Skanderson, M., Kerns, R. D., & Goulet, J. L. (2009). Pain among veterans of Operations Enduring Freedom and Iraqi Freedom: Do women and men differ? Pain Medicine, 10(7), 1167–1173. https://doi.org/10.1111/j.1526-4637.2009.00714.x
Kaur, S., Stechuchak, K. M., Coffman, C. J., Allen, K. D., & Bastian, L. A. (2007). Gender differences in health care utilization among veterans with chronic pain. Journal of General Internal Medicine, 22(2), 228–233. DOI: 10.1007/s11606-006-0048-5
Koo, K. H., Madden, E., & Maguen, S. (2015). Race, ethnicity, and gender differences in VA health care service utilization among U.S. veterans of recent conflicts. Psychiatric Services, 66(5), 507–513. https://doi.org/10.1176/appi.ps.201300498
Leslie, D. L., Goulet, J., Skanderson, M., Mattocks, K., Haskell, S., & Brandt, C. (2011). Healthcare utilization and costs among male and female veterans in the year after service in Afghanistan and Iraq. Military Medicine, 176(3), 265–269.
Maguen, S., Ren, L., Bosch, J. O., Marmar, C. R., & Seal, K. H. (2010). Gender differences in mental health diagnoses among Iraq and Afghanistan veterans enrolled in Veterans Affairs health care. American Journal of Public Health, 100(12), 2450–2456. https://doi.org/10.2105/AJPH.2009.166165
Vaughan, C. A., Schell, T. L., Tanielian, T., Jaycox, L. H., & Marshall, G. N. (2014). Prevalence of mental health problems among Iraq and Afghanistan veterans who have and have not received VA services. Psychiatric Services, 65(6), 833–835. https://doi.org/10.1176/appi.ps.201300111
Weimer, M. B., Macey, T. A., Nicolaidis, C., Dobscha, S. K., Duckart, J. P., & Morasco, B. J. (2013). Sex differences in the medical care of VA patients with chronic non-cancer pain. Pain Medicine, 14(12), 1839–1847. https://doi.org/10.1111/pme.12177
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