Why women veterans still struggle to get mental health support

She served too

“I didn’t see anyone who looked like me in the brochures. I didn’t feel like I belonged.”said the veteran sitting across from me in a focus group.

I was working at St Pancras Hospital as an Assistant Psychologist, having recently completed a review on barriers to care for women veterans. Whilst writing this review, I discovered that although nearly 11% of serving personnel are women, internal accounts showed that only 5.7% of those presenting to OpCourage, an NHS veteran’s mental health and wellbeing service in London, were women.

This gap reveals something troubling and systemic: services may be available, but they are not always trusted, safe, or designed with women in mind. My internal review for the NHS Veteran Mental Health Service supported the development of focus groups at St. Pancras, aiming to understand barriers to care and improve access to it. In this article I will highlight some of our findings from these focus groups.

The women’s voices shaped this article.

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"Why would I go back to the system that hurt me?”

Many women find veteran-specific services too closely bound to the military, a system they once trusted but which failed to protect them. That failure has a name: institutional betrayal, the feeling of being harmed or abandoned by the very institution meant to safeguard. When trauma is connected to the institution itself, engaging with these services can be deeply triggering.

One of the clearest examples of institutional failure experienced by women veterans is the prevalence of Military Sexual Trauma (MST) - 22.5% of women report experiencing sexual harassment and 5.1% report sexual assault in the UK military. Furthermore, these statistics are likely an underestimate given that many victims do not feel able to report their experiences, and even fewer seek help.

In our focus group, women spoke about staying silent for years even after leaving the army. “What was the point?” one participant exclaimed. “No one believed me inside [the military], so why would anyone outside?”

Research echoes this reluctance. Women veterans are less likely to disclose trauma to providers they associate with the military, fearing judgment, dismissal, or even retaliation. Unfortunately, that fear is not unfounded in many cases. Many women who reported MST saw little consequence for their perpetrators but faced blame or isolation themselves.

When care is offered through systems linked to trauma, accessing help can risk causing a second wound. When reaching out risks more pain, many stop reaching out altogether.

The Culture of Endurance

During our focus groups, women veterans frequently described the pressure to be “as tough or tougher” than their male peers. This pressure to appear invulnerable often extends to the reporting of sexual trauma. In trying to avoid being seen as weak or seeking special treatment, many veterans become hesitant to disclose experiences of assault. Some veterans told us they had ignored their mental health symptoms for years. This internalised emotional suppression presents as one of the most insidious barriers to help-seeking, and it does not dissolve upon discharge.

One woman said, “I didn’t want to be the one who couldn’t cope. You don’t want to be that woman.”

Indeed, within the military this culture of toughness combined with the stigma of seeking mental healthcare, mindsets which disproportionately affect women veterans, explains why women veterans avoid seeking help. This internalised stigma, alongside fears of external judgment, creates another wall between need and care.

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You don't belong here

The fear and risk of being dismissed, disbelieved, or even harassed does not dissipate when women choose to seek mental health services.

Women veterans report feeling poorly understood by civilian providers unfamiliar with military trauma. In clinical spaces, where they expect to feel safe, they have found discomfort or dismissal, and at worst, blame. Many experience significant emotional labour: explaining, justifying, and proving, again and again, that they have been impacted by war. In focus groups, our veterans often felt this disbelief stemmed from a struggle to reconcile societal expectations of a woman’s role with the choice to enter the armed forces. At other times, they sensed it was a tactic to minimise the validity of what they had experienced.

Compounding the trauma they may have endured within the military, one in four women US veterans report being sexually harassed by male patients while waiting for Veterans' Affairs (VA) care (the most comprehensive and integrated healthcare service provider for veterans in the US). Thus, by engaging in a service intended to support their recovery, they risk both their physical safety and being re-traumatised. In other cases, gender-based discrimination, discomfort with male clinicians, and earlier negative experiences stop women from accessing care. This issue is exacerbated on their return to civilian life without clear support systems or recognition of what they have faced within veteran communities. They feel they do not belong in the military, nor outside of it.

Accessing care should not feel like a battle. Nonetheless, for many women veterans, it does, especially when they are already burnt out from having to prove they belong in a system never built with them in mind.

At St Pancras Hospital, the only veteran-specific mental health service in London and its surrounding areas, I was fortunate to work under wonderful clinicians who were trauma-informed and trained in military culture awareness. These values were central to the service. Yet, I could sense how for our women, these spaces still reflected broader systemic issues that could still leave them feeling invisible. Some never returned to us.

Trauma-informed, safety-first, and military-aware environments are essential.  However, even the best services cannot always fully control the atmosphere, such as interactions between patients in waiting areas, deeply ingrained societal attitudes (both internalised and external), or structural issues like clinic layouts, staffing shortages, or resource limitations. Thus, too often, that atmosphere still tells these women: you don’t belong here.

An overlooked barrier:  inconvenience

The barriers aren’t always traumatic. Sometimes, they are just relentlessly inconvenient.

Many women told me about struggling to attend appointments while juggling school runs, shift work, chronic pain, or caregiving. Some were prescribed medication but never offered psychological support. Others couldn’t even figure out how to start.

“The forms, the referrals, the waiting,” one woman said. “It’s like a whole second job,” she joked, but neither of us laughed.

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When services listen

At St Pancras, I saw what happens when services listen. The internal review I wrote on barriers to care became the foundation for a new focus group, where women shared their experiences directly. Their input led to tangible changes: women-only groups, more representative brochures, and the option to choose a female psychologist.

You can’t fix a system overnight, but you can make someone feel heard. I believe that matters.

That is why I wrote the review. That is why I wrote this article. I saw what changed when people listened. I believe more people can.

Final note

Women veterans are not absent from care because of an absence of need. They are absent because care hasn’t always met them with understanding, safety, or respect.

They served. They returned. I think we should finally acknowledge that they deserve better.