Background There are approximately 20 million veterans living in the United States today (U.S. Department of Veterans Affairs, 2018a). The military conflicts of the Post 9/11 era, such as Operation Iraqi Freedom and Operation Enduring Freedom, increased combat operations and subsequently grew the size of the military, resulting in the largest surge of reintegrating veterans in recent history. The transition from active duty to veteran status often requires service members to move from certainty, routine, community, and a sense of purpose to uncertainty. Reintegrating veterans are vulnerable to social isolation, anxiety, depression, and exacerbations of post-traumatic stress. In comparison to their civilian peers, veterans of these Post 9/11 conflicts experience elevated rates of mental illness and suicide (U.S. Department of Veterans Affairs, 2016). However, struggles with mental health are not unique to newly reintegrating veterans alone. Veterans of prior conflicts also experience a high burden of mental illness (U.S. Department of Veterans Affairs, 2016). For example, in a 2015 assessment of Vietnam veterans, 11.2% had a diagnosis of Post-Traumatic Stress Disorder (PTSD), 36.7% had a diagnosis of major depression, and 2.2% struggled with alcohol abuse (Marmar et al., 2015). Further, in 2016, approximately 65% of all veterans who died by suicide were older than 50 years (U.S. Department of Veterans Affairs, 2016). Moreover, approximately 20 veterans of all conflicts die from suicide each day (U.S. Department of Veterans Affairs, 2018b). According to the Veterans Affairs (2017), suicide risk was 22 percent higher among veterans when compared to their civilian counterparts (after adjusting for the difference in age and sex). The United States Department of Veterans Affairs (VA), academic institutions, and healthcare and community organizations are developing strategies to address this
