Honoring Their Service: A Report of the North Carolina Institute of Medicine Task Force on Behavioral Health Services for the Military and Their Families (2011)


Our military personnel and their families are heroes who risk their lives in their mission to protect our freedom. There is a strong commitment to ensuring they have the resources they need to complete the mission and return home safely, but a safe return home does not always ensure that they have the services and support they need. The two most common health issues diagnosed in service members of the wars in Iraq and Afghanistan who seek care at the US Department of Veterans Affairs (VA) are musculoskeletal and mental health problems. While excellent systems exist to treat the physical wounds, treating behavioral health problems is often complicated by barriers including stigma, lack of behavioral health providers, and lack of coordination between federal, state, and local systems of health care. This report summarizes the findings of the NCIOM’s Task Force on Behavioral Health Services for the Military and Their Families and the Task Force’s recommendations to improve the provision of services and supports to meet the behavioral health needs of service members in the state when federal resources are not available.

NCMJ Behavioral Health Needs of Military Personnel and Their Families

Based on the Task Force recommendations, the North Carolina General Assembly passed Session Law 2011-185. It was signed into law by the Governor on June 20, 2011.

Full Description

Our service members, veterans, and their families make tremendous sacrifices in their service to our state and nation.  North Carolina has a proud, strong connection to the military.  The state is home to the fourth largest military population in the country, fifth largest military retiree population, and ninth largest veteran population. About 35% of the state’s population is in the military, a veteran, spouse, survivor, parent, or dependent of someone connected to the military. These families live, work, study, and play throughout the state.

Military service members and their families face unique challenges, including multiple deployments and transitions. These frequent relocations disrupt systems of support and interfere with careers and school for military families. In addition to these challenges, these service members and families have a distinct culture. Some aspects of the military culture help service members achieve their mission in stressful conditions, but others create barriers to seeking care when problems arise. The stress of combat and military service has lasting psychological and behavioral effects on our service members and their families. There are estimates that as many as 19% of active and returning veterans have experienced a TBI, 12% to 25% have PTSD, and 20% to 45% have problems with alcohol use.  In addition to TBI and PTSD, many service members experience other behavioral health problems such as depression, panic attacks, and generalized anxiety. Some have suicide ideation, and too many other service members commit suicide. Service members are at heightened risk for interpersonal conflict when they return home. In addition, some service members suffer from military sexual trauma.

The North Carolina General Assembly (NCGA) recognized the need to provide services and supports to meet the behavioral health needs of service members in the state when federal resources are not available. The NCGA asked the NCIOM to study the adequacy of mental health, developmental disabilities, and substance abuse services funded with Medicaid and state funds that are currently available to active and reserve component members of the military, veterans, and their families and to determine any gaps in services. The Task Force received funding from the North Carolina Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Abuse Services through the North Carolina Substance Abuse Prevention and Treatment Block Grant from the Substance Abuse and Mental Health Services Administration.

The Task Force issued 13 recommendations to improve on existing military behavioral health systems, improve access to mental health and substance abuse services for military members and their families, and strengthen the mental health workforce through further training and incentives to enter the field.