PTSD: National Center for PTSD

Other experiences that fall into the category of MST include:

• Unwanted sexual touching or grabbing
• Threatening, offensive remarks about a person's body or sexual activities
• Threatening and unwelcome sexual advances

The identity or characteristics of the perpetrator, whether the Servicemember was on or off duty at the time, and whether he or she was on or off base at the time do not matter. If these experiences occurred while an individual was on active duty or active duty for training, they are considered by VA to be MST.

How common is MST?

VA's national screening program, in which every Veteran seen for health care is asked whether he or she experienced MST, provides data on how common MST is among Veterans seen in VA. National data from this program reveal that about 1 in 4 women and 1 in 100 men respond "yes," that they experienced MST, when screened by their VA provider. Although rates of MST are higher among women, because there are many more men than women in the military, there are actually significant numbers of women and men seen in VA who have experienced MST.

It is important to keep in mind that these data speak only to the rate of MST among Veterans who have chosen to seek VA health care; they cannot be used to make an estimate of the actual rates of sexual assault and harassment experiences among all individuals serving in the U.S. Military. Also, although Veterans who respond "yes" when screened are asked if they are interested in learning about MST-related services available, not every Veteran who responds "yes" necessarily needs or is interested in treatment. MST is an experience, not a diagnosis, and Veterans' current treatment needs will vary.

How can MST affect Veterans?

MST is an experience, not a diagnosis or a mental health condition, and as with other forms of trauma, there are a variety of reactions that Veterans can have in response to MST. The type, severity, and duration of a Veteran's difficulties will all vary based on factors like:

• Whether he/she has a prior history of trauma
• The types of responses from others he/she received at the time of the MST
• Whether the MST happened once or was repeated over time

Although trauma can be a life-changing event, people are often remarkably resilient after experiencing trauma. Many individuals recover without professional help; others may generally function well in their life, but continue to experience some level of difficulties or have strong reactions in certain situations. For some Veterans, the experience of MST may continue to affect their mental and physical health in significant ways, even many years later.

Some of the experiences both female and male survivors of MST may have include:

• Strong emotions: feeling depressed; having intense, sudden emotional responses to things; feeling angry or irritable all the time
• Feelings of numbness: feeling emotionally "flat"; difficulty experiencing emotions like love or happiness
• Trouble sleeping: trouble falling or staying asleep; disturbing nightmares
• Difficulties with attention, concentration, and memory: trouble staying focused; frequently finding their mind wandering; having a hard time remembering things
• Problems with alcohol or other drugs: drinking to excess or using drugs daily; getting intoxicated or "high" to cope with memories or emotional reactions; drinking to fall asleep
• Difficulty with things that remind them of their experiences of sexual trauma: feeling on edge or "jumpy" all the time; difficulty feeling safe; going out of their way to avoid reminders of their experiences
• Difficulties with relationships: feeling isolated or disconnected from others; abusive relationships; trouble with employers or authority figures; difficulty trusting others
• Physical health problems: sexual difficulties; chronic pain; weight or eating problems; gastrointestinal problems

Although posttraumatic stress disorder (PTSD) is commonly associated with MST, it is not the only diagnosis that can result from MST. For example, VA medical record data indicate that in addition to PTSD, the diagnoses most frequently associated with MST among users of VA health care are depression and other mood disorders, and substance use disorders.

Fortunately, people can recover from experiences of trauma, and VA has effective services to help Veterans do this.

How has VA responded to the problem of MST?

VA is strongly committed to ensuring that Veterans have access to the help they need in order to recover from MST.

• Every VA health care facility has a designated MST Coordinator who serves as a contact person for MST-related issues. This person can help Veterans find and access VA services and programs. He or she may also be aware of state and federal benefits and community resources that may be helpful.
• Recognizing that many survivors of sexual trauma do not disclose their experiences unless asked directly, VA health care providers ask every Veteran whether he or she experienced MST. This is an important way of making sure Veterans know about the services available to them.
• All treatment for physical and mental health conditions related to experiences of MST is provided free of charge.
• To receive free treatment for mental and physical health conditions related to MST, Veterans do not need to be service connected (or have a VA disability rating). Veterans may be able to receive this benefit even if they are not eligible for other VA care. Veterans do not need to have reported the incident(s) when they happened or have other documentation that they occurred.
• MST-related services are available at every VA medical center and every facility has providers knowledgeable about treatment for the aftereffects of MST. MST-related counseling is also available through community-based Vet Centers. Services are designated to meet Veterans where they are at in their recovery, whether that is focusing on strategies for coping with challenging emotions and memories or, for Veterans who are ready, actually talking about their MST experiences in depth.
• Nationwide, there are programs that offer specialized sexual trauma treatment in residential or inpatient settings. These are programs for Veterans who need more intense treatment and support.
• To accommodate Veterans who do not feel comfortable in mixed-gender treatment settings, some facilities have separate programs for men and women. All residential and inpatient MST programs have separate sleeping areas for men and women.

In addition to its treatment programming, VA also provides training to staff on issues related to MST, including a mandatory training on MST for all mental health and primary care providers. VA also engages in a range of outreach activities to Veterans and conducts monitoring of MST-related screening and treatment, in order to ensure that adequate services are available.

How can Veterans get help?

For more information, Veterans can:

• Speak with their existing VA health care provider.
• Contact the MST Coordinator at their nearest VA Medical Center.
• Call Safe Helpline at 1-877-995-5247 to get confidential one-on-one help. Safe Helpline provides 24 hour a day, 7 day a week sexual assault support for the Department of Defense community.
• Contact their local Vet Center.
• Veterans should feel free to ask to meet with a provider of a particular gender if it would make them feel more comfortable.
• Veterans can also learn more about VA's MST-related services.