Mental Health Nursing for Military Personnel and Veterans: Managing PTSD, Anxiety Disorders, and Substance Withdrawal in Acute Behavioral Health Unit

Abstract

This review critically examined the responsibilities of mental health nurses caring for military personnel and veterans experiencing post-traumatic stress disorder, anxiety disorders, behavioural escalation, substance intoxication, and withdrawal within acute behavioural health units. Its purpose was to clarify the clinical, ethical, cultural, and organisational requirements of safe, recovery-oriented care for a population shaped by combat exposure, moral injury, military identity, traumatic brain injury, chronic pain, stigma, and difficult transitions to civilian life. A structured narrative review approach was adopted, drawing on recent international evidence from military, veteran, psychiatric, nursing, addiction, and health-services literature, with attention to findings from Africa and other global regions.

The review found that presentations are frequently complex and comorbid, requiring repeated assessment rather than reliance on a single diagnostic label. Effective nursing practice depends on early recognition of trauma-related symptoms, suicide and violence risk assessment, skilled de-escalation, structured observation, sleep support, medication surveillance, and medically informed withdrawal monitoring. Trauma-informed, veteran-centred, and recovery-oriented approaches were shown to reduce retraumatisation by promoting dignity, trust, collaboration, cultural responsiveness, and the least restrictive intervention. Ethical practice further requires careful capacity assessment, transparent confidentiality boundaries, proportionate risk management, and meaningful patient participation. Continuity after stabilisation emerged as equally important, particularly through family engagement, relapse-prevention planning, medication reconciliation, peer support, and coordinated transfer across military, veteran, civilian, addiction, and primary-care services.

The review concludes that high-quality care requires clinically competent, ethically grounded, and culturally informed nursing systems. It recommends specialist workforce education, standardised trauma and withdrawal protocols, adequate staffing, integrated follow-up pathways, and future evaluation of nurse-led transition models, family interventions, digital support, and patient-reported recovery outcomes across settings.