When we think about alcohol or substance abuse in the military, most of us jump to familiar explanations: PTSD, deployment trauma, combat stress. These are the headline drivers we expect to see on intake forms and clinical assessments. But lurking quietly, often unnoticed and unspoken, is another powerful risk factor, one that rarely makes it onto the paperwork or into clinical interviews: boredom.
I was recently talking to a civilian community mental health provider, and she asked me if I thought veterans were utilizing mental health care more due to both the VA MISSION Act and the VA COMPACT Act. I thought about it briefly and responded (acknowledging that I had no evidence to support my answer) that it usually takes years for change following laws like these. Then I paused to really think about how much I have heard about either of these veteran-focused acts/laws in my role as a psychologist or as a veteran, and the answer was: not much. So I thought this would be a great topic to share with our community of providers.
Moral injury remains a murky concept, despite the growing body of literature on this important topic. While there’s not a consensus on exactly what moral injury is, Phelps et al. (2024) describe it as enduring psychological, social, and spiritual distress that can occur when individuals are exposed to high-pressure situations that violate or clash with their deeply-held moral beliefs or values. Moral injury may stem from one’s own actions or inactions, the actions of others, or a perceived betrayal by trusted leaders or institutions. In military contexts, including those with complex rules of engagement, moral injury may occur after engaging in or witnessing acts that conflict with one’s sense of right and wrong, such as causing harm to civilians, being unable to prevent the loss of life, seeing human suffering, or feeling deeply misled by command.
Sleep isn’t just a personal health issue for service members; it’s a mission-critical factor that affects unit cohesion, operational performance, and overall force readiness. Yet for years, military culture sent a different message. Pushing through exhaustion was worn like a badge of honor, and phrases like “I’ll sleep when I’m dead” were all too common. Sleep deprivation was seen as a sign of toughness rather than a threat to mission success. Thankfully, the conversation is shifting.
Most of us have struggled with getting enough sleep at some point, but when you compare sleep habits between civilians and service members, the difference is striking. While about a third of the general population reports not getting the recommended seven hours of sleep per night, the number jumps to more than 85% among service members.