Total VeteranSocial Isolation and PTSD in Veterans: What the Research Shows
UK ex-serving personnel who reported loneliness were far more likely to have probable PTSD. Here is what the studies show, what they cannot show and where veterans can connect.
- KCMHR 2022 to 2023: 24.2% of lonely ex-serving personnel had probable PTSD, against 3.1% of those not lonely.
- A meta-analysis of 37 US studies found lower social support goes with more severe PTSD symptoms (r = -0.33).
- Peer support groups are not PTSD treatment, according to the VA, and work best alongside it.
- The data are cross-sectional, so they show association and not which comes first.
Social isolation and PTSD go together in the veteran research. In the 2022 to 2023 UK survey of ex-serving personnel, 24.2% of those who reported loneliness had probable PTSD against 3.1% of those who did not. A US meta-analysis of 37 studies found that lower social support goes with more severe PTSD symptoms. These studies are cross-sectional, so they show the two travel together and cannot show which comes first. Both directions are plausible, and the evidence supports addressing connection alongside treatment.
This article summarises published research for general information. It offers no individual medical advice. A GP or mental health professional can assess your own situation.
What the UK data shows
The King's College London Centre for Military Health Research (KCMHR) Phase 4 report asked ex-serving regular personnel about loneliness and social support. About one third (33.6%) reported loneliness and 40.6% reported poor social support. The table shows the share of each group with a mental health outcome.
| Outcome (ex-serving regulars, 2022 to 2023) | Lonely | Not lonely | Adjusted odds ratio |
|---|---|---|---|
| Probable PTSD | 24.2% | 3.1% | 8.1 |
| Complex PTSD | 15.8% | 1.4% | 11.1 |
| Common mental disorder | 53.5% | 14.6% | 6.1 |
| Alcohol misuse | 13.8% | 6.0% | 2.5 |
| Outcome (ex-serving regulars, 2022 to 2023) | Poor social support | Moderate or strong support | Adjusted odds ratio |
|---|---|---|---|
| Probable PTSD | 18.2% | 4.9% | 3.8 |
| Complex PTSD | 11.4% | 2.9% | 3.7 |
| Common mental disorder | 40.8% | 19.0% | 2.7 |
The report found no link between social support and alcohol misuse. The survey measured everything at one point in time. A person with PTSD may withdraw from others, and a person who is isolated may have fewer buffers against stress. The data cannot separate the two. Our article on loneliness and transition risk covers the wider picture after service.
Why relationships are part of the diagnosis
ICD-11 defines complex PTSD to include difficulty sustaining relationships and feeling close to others, alongside problems with emotion regulation and self-concept. The relationship difficulty is a diagnostic feature of the condition. The Danish study of 599 treatment-seeking veterans, published in the Journal of Psychiatric Research, found that being single was a risk factor for complex PTSD compared with no trauma disorder.
The VA Center for PTSD makes a similar point in a continuing education course on social support. Avoidance, irritability, negative thoughts and hypervigilance make it hard to build and keep close relationships. The resulting loneliness and isolation are linked with other mental health problems, including suicidal thoughts, and social support appears to buffer those effects.
Structure and people around you
Cohorts combine one-to-one coaching, a peer Bravo and a written plan for life after service. Coaching works alongside any clinical care you receive.
What the wider evidence says about social support
| Study | What it found | Limits |
|---|---|---|
| Blais et al., European Journal of Psychotraumatology (2021) | Meta-analysis of 37 studies and 18,766 US service members and veterans. Overall correlation between social support and PTSD severity was r = -0.33, so lower support went with more severe symptoms. Support from non-military sources showed a stronger association than support from military sources | Cross-sectional studies. Too few studies examined negative social interactions |
| Gettings et al., Frontiers in Psychology (2022) | Systematic narrative review of 28 studies of PTSD interventions for veterans that involved social connection. Six themes emerged, including peer support, social reintegration, purpose and community, and building trust. The authors suggest these may reduce loneliness and isolation | Only 2 of 28 studies were UK-based and 21 were US-based. Many samples were small, and few studies followed people for six months or more |
| VA National Center for PTSD (course by Galovski, updated 2025) | Describes how PTSD symptoms strain relationships and how social support buffers loneliness and isolation. Reports improvements in PTSD, depression and social support among women veterans in a peer support programme who met clinical cut-offs | Evaluation details such as effect sizes are not given on the course page |
The meta-analysis result matters for families and friends. Non-military sources of support, such as partners, relatives and civilian friends, showed a stronger link with lower PTSD severity than support from military contacts. The authors suggest civilian and home-environment support may protect more against long-term PTSD severity.
What peer support can and cannot do
The VA Center for PTSD says plainly that peer support groups are not treatment for PTSD and have not been shown to reduce PTSD symptoms. They can help members feel less alone, share coping tips, build connections and practise asking for help, and they work best alongside evidence-based treatment. The Gettings review reaches a similar position: connection-focused interventions address loneliness and isolation, and its authors call for more research. Our piece on the Bravo peer support model describes one structured approach.
First-line treatment stays the same. The VA/DoD guideline (Version 4.0, 2023) strongly recommends individual trauma-focused therapy: cognitive processing therapy, prolonged exposure or EMDR. NICE guideline NG116 recommends individual trauma-focused CBT for adults, and the NHS lists trauma-focused CBT, EMDR and antidepressant medication. NICE also advises extra time to build trust with people with complex presentations.
Ways to reconnect: named services
| Service | What it offers | Contact |
|---|---|---|
| Op COURAGE (NHS England) | Veterans Mental Health and Wellbeing Service. Self-referral, GP referral or charity referral. For England residents who served at least one full day in the UK Armed Forces | Regional phone numbers on the NHS veterans page, for example North 0300 373 3332, Midlands 0300 323 0137, London 020 3317 6818 |
| Combat Stress | Free, confidential helpline for veterans, families and carers, open 24 hours a day, every day | 0800 138 1619, combatstress.org.uk |
| Togetherall | Anonymous online peer community with trained counsellors, 24/7, for serving personnel, reservists, veterans and families | Listed by the NHS, togetherall.com |
| NHS talking therapies | Self-referral from age 18 in most areas, no GP referral needed. Can help with PTSD | Via NHS PTSD page |
| Vet Centers (US) | Ask about local support groups; the VA Center for PTSD points to them for peer groups | Via your local VA facility, which also runs Peer Support Services |
| Combat Call Center (US) | Talk to another combat veteran | 1-877-WAR-VETS (1-877-927-8387) |
Families can use the VA Center for PTSD guide for family and friends, which suggests learning about PTSD, considering family therapy when home conversations are hard, and using crisis lines when needed. Read more in our articles on reconnecting with family after service.
UK: call Samaritans free on 116 123, any time. Combat Stress runs a free 24-hour helpline for veterans and families on 0800 138 1619. Op COURAGE, the NHS veterans mental health and wellbeing service for England, takes self-referrals through regional teams listed on the NHS veterans mental health page. In an emergency call 999, or call 111 and choose the mental health option.
US: the Veterans Crisis Line is open to veterans and the people supporting them. Dial 988 then press 1, text 838255, or use the online chat.
What to do this week
- Save the Combat Stress helpline (0800 138 1619) and Samaritans (116 123) in your phone.
- England: self-refer to your regional Op COURAGE team or ask a GP to refer you.
- US: ask your local VA facility or Vet Center about peer support groups and Peer Specialists.
- Tell one partner, relative or friend what helps and what does not when you are struggling.
- Join one regular, structured activity or group this month and attend it three times.
Questions people ask
Does isolation make PTSD worse?
Does social support reduce PTSD symptoms?
Is peer support a treatment for PTSD?
Where can UK veterans find support for loneliness and mental health?
How can families help a veteran who withdraws?
- King's College London Centre for Military Health Research, "Health and Wellbeing Cohort Study, Phase 4 Report" (2024). https://kcmhr.org/pdf/Phase_4_Health_and_Wellbeing_Cohort_Study_Report.pdf
- Blais et al., "Self-reported PTSD symptoms and social support in U.S. military service members and veterans: a meta-analysis", European Journal of Psychotraumatology (2021). https://pmc.ncbi.nlm.nih.gov/articles/PMC8725779
- Gettings et al., "Exploring the Role of Social Connection in Interventions With Military Veterans Diagnosed With PTSD: Systematic Narrative Review", Frontiers in Psychology (2022). https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2022.873885/full
- Folke et al., "Risk factors, comorbidity and social impairment of ICD-11 PTSD and complex PTSD in Danish treatment-seeking military veterans", Journal of Psychiatric Research (2023). https://napier-repository.worktribe.com/output/3110593/risk-factors-comorbidity-and-social-impairment-of-icd-11-ptsd-and-complex-ptsd-in-danish-treatment-seeking-military-veterans
- US Department of Veterans Affairs, "Social Support to Reduce Risk of PTSD and Other Negative Outcomes" (ptsd.va.gov, updated 2025). https://ptsd.va.gov/PTSD/professional/continuing_ed/social_support_reduce_risk.asp
- US Department of Veterans Affairs, "Peer Support Groups" (ptsd.va.gov, accessed October 2026). https://www.ptsd.va.gov/gethelp/peer_support.asp
- US Department of Veterans Affairs, "Help for Family and Friends" (ptsd.va.gov, accessed October 2026). https://www.ptsd.va.gov/family/support_family_friends.asp
- NHS, "Mental health support for veterans, service leavers and reservists" (accessed October 2026). https://www.nhs.uk/nhs-services/armed-forces-community/mental-health/veterans-reservists/
- Samaritans, "Contact a Samaritan" (accessed October 2026). https://www.samaritans.org/how-we-can-help/contact-samaritan/
- Veterans Crisis Line, "Chat" (accessed October 2026). https://www.veteranscrisisline.net/get-help-now/chat/
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