In the shadow of a global pandemic, the toll on mental health has emerged as a profound concern affecting countless lives worldwide. While numerous studies have chronicled the psychological impact of COVID-19 on civilian populations, a critical section of society—military personnel—remains less examined despite their pivotal role in frontline pandemic relief efforts. These servicemembers often face unique stressors, juggling operational demands alongside the ubiquitous anxieties introduced by the COVID-19 crisis. A groundbreaking longitudinal investigation known as The Army Study to Assess Risk and Resilience in Servicemembers (STARRS) Longitudinal Study confronts this knowledge gap head-on, providing robust data on mental health fluctuations before and during the pandemic among over 10,000 US Army soldiers and veterans.
The research pivots on a comprehensive mental health screening conducted at two crucial time points: pre-pandemic (2018–2019) and throughout the pandemic period (2020–2022). This timing allows for an accurate assessment of the pandemic’s impact on the prevalence of several debilitating mental health conditions, including major depressive episodes, generalized anxiety disorder, post-traumatic stress disorder (PTSD), and panic attacks. The findings reveal statistically significant increases in mental health difficulties, with relative risks that align closely with those observed in comparable civilian populations. This parallel suggests that military personnel, despite their training and resilience, are not insulated from the psychological ravages of prolonged public health crises.
Crucially, the study highlights that these adverse mental health outcomes were not uniformly distributed across the military. Instead, women, Black and Hispanic soldiers, and those hailing from lower socioeconomic backgrounds exhibited the most pronounced increases in mental health challenges during the pandemic. Furthermore, the distinction between Regular Army soldiers and reservists or those no longer actively serving underscores how career trajectories and military status can influence vulnerability to pandemic-related psychological stress. This nuanced understanding of differential impact urges us to look beyond aggregate numbers and consider the intersections of race, gender, economics, and service status in mental health interventions.
In probing the underlying mechanisms, researchers explored the role of pandemic-related stressors—specific factors such as fear of infection, isolation, economic hardships, and occupational exposure—that could potentially mediate the relationship between sociodemographic or career characteristics and mental health outcomes. The analysis indeed found that exposure to these stressors significantly increased the probability of mental health difficulty. However, intriguingly, these factors did not fully account for why certain groups experienced larger increases in symptoms. This suggests that other, as yet unidentified, mechanisms may be prompting or exacerbating psychological distress, signaling the complexity inherent in the pandemic’s mental health imprint on military populations.
Beyond examining direct associations, the study rigorously tested for interaction effects to determine if baseline mental health status or combinations of demographic and military factors amplified the relationship between pandemic stressors and mental health deterioration. The absence of significant interactions points toward an additive rather than synergistic model of risk, meaning pandemic stressors uniformly elevate mental health difficulties across diverse strata regardless of pre-existing conditions or social characteristics. This insight challenges assumptions that prior vulnerability might magnify pandemic impacts, instead painting a more democratized picture of psychological risk during widespread crises.
The implications of these findings are multifold and bear considerable weight for military mental health policy and practice. First and foremost, they corroborate the necessity of accessible, tailored mental health resources during pandemics, especially for those subgroups identified as most vulnerable. The consistent rise in mental health problems highlights gaps in current support systems, underscoring the need for proactive screening, early intervention, and sustained care models that account for the unique challenges faced by military personnel. Moreover, given the similarity between military and civilian patterns, cross-sector collaborations to develop unified strategies could enhance resilience on a broader societal scale.
Technically, this study benefitted from the longitudinal design which strengthens causal inferences between the pandemic and mental health outcomes. The sample size exceeding ten thousand participants enhances statistical power and generalizability across different Army components and veteran subpopulations. The use of standardized diagnostic screening for major psychiatric conditions further lends credibility and precision to prevalence estimates. Of course, the study still faces limitations inherent in observational research, including potential reporting biases and the challenge of capturing the full spectrum of stressors in a rapidly evolving pandemic environment. However, its methodological rigor sets a new standard for military mental health surveillance.
This research also opens fertile ground for future investigations. Deciphering the unidentified factors that transcend commonly measured stressors will be pivotal in crafting more effective interventions. Potential areas include exploring organizational culture, access to social support, and nuanced psychosocial dynamics unique to military life. Additionally, longitudinal follow-up beyond the pandemic timeframe could illuminate the persistence or amelioration of observed mental health declines, guiding long-term recovery efforts. The intersectionality of identities and socioeconomic variables further warrants deeper, disaggregated analyses to refine targeted preventive measures.
Beyond the academic and policy circles, the human dimension of these findings resonates profoundly. Military personnel serve their countries often under intense pressure and sacrifice, and the pandemic has layered unprecedented challenges atop already demanding roles. Recognizing the psychological struggles they endure emphasizes a collective responsibility—both within the military establishment and civilian society—to marshal resources and empathy in support of their mental well-being. It also highlights the universal scars pandemics can inflict, bridging the divide between military and civilian experience.
In sum, the pandemic has indiscriminately challenged mental health worldwide, with military populations experiencing comparable patterns of increased anxiety and mood difficulties as civilians. Yet, the study’s nuanced revelations about unequal impacts across demographic and occupational groups remind us that uniform crises do not produce uniform outcomes. Mental health strategies must therefore be as multifaceted and inclusive as the populations they serve. As the world prepares for future health emergencies, these insights offer a vital blueprint for resilience-building in the ranks.
The STARRS Longitudinal Study thus stands not only as a scientific milestone but also a clarion call to action. Its comprehensive, evidence-based portrait of mental health dynamics during COVID-19 lays the foundation for nuanced, effective care for those who bear the weight of national security and public health alike. Ensuring mental health resources are accessible throughout the military community is imperative, as the findings clearly demonstrate the cost of inattention—both human and operational. As we navigate recovery and prepare for future crises, this research equips policymakers, clinicians, and communities with critical knowledge to safeguard psychological resilience among our armed forces.
Ultimately, understanding that military mental health trajectories during the pandemic mirror civilian experiences with layered disparities invites a unified approach to public mental health. It dismantles notions of invulnerability and highlights shared vulnerabilities that transcend occupational boundaries. The challenges posed by the COVID-19 pandemic offer a profound lesson: mental health support systems must be adaptive, inclusive, and anticipatory to effectively buffer against the multifaceted stressors of pandemics, especially in populations tasked with protecting society.
This decisive contribution from Kessler, Millikan-Bell, Edwards, and colleagues enriches the scientific community’s understanding of how global crises shape mental health across diverse contexts. By illuminating the intersections of sociodemographic factors, military career characteristics, and pandemic stressors, the research charts a complex but actionable path forward. As health systems evolve post-pandemic, incorporating these insights will be critical in fostering mental wellness in one of society’s most essential and vulnerable groups—our soldiers and veterans.
The findings poignantly underscore the universal vulnerability faced by humans in the grip of a pandemic, transcending the military-civilian divide. They remind us that mental health is a cornerstone of individual and collective well-being, especially in times of global upheaval. As ongoing waves of health crises inevitably challenge societies anew, the lessons from this study serve as both a warning and a guide, advocating for robust mental health infrastructure responsive to the realities lived by those who serve and protect.
Subject of Research: Effects of pandemic-related stressors on mental health outcomes in US Army soldiers and veterans during the COVID-19 pandemic.
Article Title: Effects of pandemic-related stressors on anxiety and mood difficulty during versus before the COVID-19 pandemic in US Army soldiers and veterans.
Article References:
Kessler, R.C., Millikan-Bell, A.M., Edwards, E.R. et al. Effects of pandemic-related stressors on anxiety and mood difficulty during versus before the COVID-19 pandemic in US Army soldiers and veterans. Nat. Mental Health (2025). https://doi.org/10.1038/s44220-025-00505-4
Image Credits: AI Generated
