The Invisible Wounds of War
Writer Joseph J. Airdo
On Monday, May 26, as the morning sun rises over Cave Creek Memorial Cemetery, community members will gather to honor those who made the ultimate sacrifice in defense of our nation. The annual Memorial Day tribute, beginning at 8 a.m., will bring together neighbors, veterans, students and Scout troops in a solemn ceremony featuring speeches by military veterans and patriotic songs.
“Memorial Day reminds us of the profound price of freedom and the deep debt of gratitude we owe to those who made the ultimate sacrifice,” says Carefree Mayor John Crane. “It is a time to reflect on their courage and honor their memory with heartfelt appreciation.”
But for an increasing number of visitors, Memorial Day carries a more expansive meaning — honoring not only those who fell in battle but also the thousands of veterans who returned home only to lose their lives to the invisible wounds of war.
In Arizona, where the veteran suicide rate stands at 51.2 per 100,000 people — significantly higher than the national rate of 34.7 — advocates are leading efforts to recognize what many call the “hidden casualties” of military service.
“When the operation ends, the battle doesn’t necessarily end,” says Michael Tapp, president of Daisy Mountain Veterans in Anthem and a military retiree who works to connect veterans with mental health resources through the Service Resiliency Unit of Acadia Healthcare.
“The difference between Memorial Day and Veterans Day is that Memorial Day is designed to honor those who lost their lives in service to the country. Those who came back from active-duty service and still lost their lives as a result of it are equally deserving of that remembrance as those who suffered physical wounds that took their lives.”
As communities prepare for Memorial Day observances, advocates are pushing for wider recognition that the toll of military service extends far beyond the battlefield, with mental health wounds often manifesting years after discharge.
The statistics paint a sobering picture. According to the 2024 National Veteran Suicide Prevention Annual Report, suicide was the second-leading cause of death for veterans under age 45 in 2022, the most recent year with published data. Nationally, approximately 17.5 veterans die by suicide every day — 7.0 among those who received Veterans Health Administration care and 10.5 among other veterans.
Perhaps most alarming is that while the U.S. veteran population decreased by 28.4% from 2001 to 2022 (from 25.8 million to 18.5 million), the average number of veteran suicides per day rose from 16.5 to 17.6 during that same period.
In Arizona, military veterans have a 17% higher suicide rate than nonveterans, underscoring the need for targeted interventions and support.
For many veterans, mental health challenges remain hidden until long after service has concluded, often due to military culture that can discourage seeking help.
“We see this frequently with active-duty service members who fear that admitting they’re struggling could affect their security clearance or flight status,” Tapp explains.
“Most military members are deeply dedicated to their craft and to serving their units and fellow service members. They don’t want to come forward — and I understand this because I was the same way — they don’t want to say, ‘I need help. I’m struggling,’ because they don’t want to be put on light duty. They don’t want to be pulled from their operational responsibilities because they feel they’d be letting down their colleagues.”
Tapp speaks from personal experience, having faced his own post-service mental health challenges.
“I discovered I suffered from anxiety and depression without even knowing what they were,” he admits. “The first time — and honestly, it was the VA that identified this for me — when they said, ‘You’re suffering from anxiety, depression, and PTSD,’ I didn’t even believe it. I didn’t understand that what was happening to me was related to these conditions.”
In recent years, significant legislation has been enacted to address the veteran mental health crisis, though implementation challenges remain. The COMPACT Act stipulates that any veteran — whether enrolled in VA services or not — can go to any VA or non-VA emergency room for emergent suicidal care, with coverage for up to 30 days of inpatient care and 90 days of outpatient treatment.
However, Tapp notes that resource limitations continue to hamper effective implementation.
“There’s a growing crisis in the United States, and specifically in Arizona, which unfortunately is one of the top states leading veteran suicide rates,” Tapp explains. “Resources have been allocated and federal laws like the Mission Act and the Compact Act have been passed to try to address this crisis. Unfortunately, when it comes to the Veterans Administration, much of their effort is hampered by lack of funding.”
The practical effect of these funding shortages is that veterans in crisis may face delays in receiving care.
“Funding shortages are essentially forcing the VA back into a backlog situation because they can’t process referrals when they don’t have the money to pay for them,” Tapp adds. “It’s become increasingly difficult over the past year or two for veterans to receive the referrals they need when seeking behavioral health services.”
In some communities, veteran-led organizations have stepped up to fill gaps in the system.
“It’s crucial as a community that we as veterans take care of each other — that we understand the sacrifices and the emotional and mental toll our service has taken,” Tapp says.
Beyond VA services, organizations like Disabled American Veterans and the Wounded Warrior Project provide critical support, sometimes even funding mental health treatment at civilian facilities when VA services are unavailable.
Notably, these local intervention efforts have saved lives.
“Within the past year, I’ve worked with a local veteran who turned to alcohol to manage his PTSD from his time in service,” Tapp recounts. “When we first became aware of him, he was intoxicated and threatening to take his life with a gun. A local Army veteran engaged with him one-on-one, made him safe, and helped him sleep it off.”
This initial intervention was just the beginning, as addressing the underlying conditions required further steps.
“Together, we were eventually able to get the gentleman suffering from both alcoholism and, more importantly, the underlying PTSD to a treatment facility,” Tapp continues. “The veteran completed a treatment program and is doing great now.”
But for every success, there are tragedies that underscore the urgency of the problem.
“Just a couple months ago, an active-duty service member aboard a Coast Guard cutter, while deployed on a drug interdiction patrol in the Pacific off the coast of Mexico and California, took his own life by leaping from the ship,” Tapp shares.
“The damage done to those around that person — knowing they felt they had to end their life — is equally catastrophic to the family, friends and fellow service members and veterans who would have dropped anything to help.”
For family members and friends, recognizing warning signs is crucial. Tapp advises watching for changes in behavior such as reclusiveness, disinterest in activities previously enjoyed, increased alcohol consumption, and unusual irritability or anger.
“What’s ironic about this is that service members are trained to handle extremely intense, sometimes life-threatening circumstances with clear-mindedness and well-thought-out responses,” Tapp says. “But then years later, a veteran might experience someone cutting them off in traffic and have an immediate overresponse to that circumstance. That’s a key indicator that person is struggling and needs to talk to someone.”
He emphasizes that combat experience isn’t a prerequisite for service-related mental health challenges.
“I often tell veterans who never served in a combat zone that this doesn’t exclude them from service-related mental health challenges,” Tapp explains. “I’ve worked with veterans and active service members who actually feel guilty because they were never sent to a war zone.”
The routine dangers of military service — even in noncombat roles — can be traumatic, though many service members don’t recognize this until later.
“We do very dangerous things as part of our normal job, and because they’re routine, we often don’t recognize how dangerous they are until we’re not doing them anymore,” Tapp notes. “That’s when those compartmentalized memories start to seep out, and suddenly you’re struggling.”
As Memorial Day approaches, advocates such as Tapp are calling on communities to expand their understanding of service-related sacrifice and loss. With June designated as National PTSD Awareness Month, the holiday provides a timely bridge to ongoing advocacy efforts.
Tapp’s message is clear: “If someone is struggling with suicidal ideation, PTSD, or however it’s manifesting itself, take them to the hospital or an emergency room — that’s what kicks off the process. It’s hard for someone to do the right thing in that moment because they might worry about forcing a stigma on that veteran, but not taking them to an emergency room is far harder to live with if their mental health continues to deteriorate.”
Expanding Memorial Day observances to include recognition of these “hidden casualties” represents not only a more complete honoring of sacrifice but potentially a lifesaving conversation about mental health resources.
“The connection to Memorial Day is that we now commonly recognize that mental health wounds exist long after military service has ended and long after discharge from active duty,” Tapp says.
“Veterans suffering from suicidal ideation and PTSD — which are closely connected — deserve to have their struggles acknowledged. When they unfortunately lose their battle within, those numbers should be counted as casualties of the military service or campaign they fought in.”
Memorial Day Ceremony
Monday, May 26 // 8 a.m. // Cave Creek Memorial Cemetery // 36400 N. Pima Road, Carefree // Free // carefree.org
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