"I didn't want to say I was a Marine," he said.
He struggled with depression and feelings of shame. Later, nightmares got worse and other signs of post-traumatic stress disorder affected his marriage.
One in five Americans face mental health challenges, according to the National Alliance on Mental Illness. Because of stigma, many people-especially veterans-who need mental health support remain hesitant to talk openly about it. Only about half of those who are affected receive treatment.
"I felt like an outsider," Jesse said. "People couldn't understand me, and I couldn't open up to them. I kept everybody at arm's length."
Only years later did Jesse seek help for the mental health issues that resulted from his military service.
Although the majority of America's 22 million veterans do not have a mental health issue, the number of veterans receiving mental health treatment from the U.S. Department of Veterans Affairs (VA) was 1.6 million in 2015. Many of those veterans live in small communities, far from mental health specialists.
To serve the growing need, VA is expanding access to mental health services, especially in rural areas where fewer clinicians practice. VA increased resources and staffing, allocating more than $24 million from VA's Office of Rural Health toward innovative mental health programs for rural areas this year. VA leaders say these programs will provide increased access for veterans like Jesse.
"Long travel times, harsh weather, stigma associated with seeking services and provider shortages all make it more difficult for rural veterans to get mental health support," Gina Capra, director of the VA Office of Rural Health, said. "VA is coming at these barriers from all sides to support rural veterans in accessing the services they earned and deserve."
The targeted funding will grow telehealth programs that bring mental health care closer to home for rural veterans. Telehealth uses secure phone and video technology to link a provider with a veteran, who might be hundreds of miles away at a small local clinic or even in his or her own home. It allows for the same quality of care, without the burden sometimes associated with travel.
The National Telemental Health Center and VA's Telemental Health Hubs make therapy more accessible using telehealth to connect with medical specialists who are trained and experienced in supporting veterans with their unique mental health needs.
In addition to telehealth, VA also supports rural community programs that raise awareness of veterans' mental health needs and how to refer veterans and their families to the VA for services and support.
Chaplain Keith Ethridge leads the VA Rural Clergy Training Program, which educates local religious leaders in rural communities on how to recognize signs and symptoms of mental health issues among veteran parishioners and their families.
"The clergy is a trusted source for counsel and often the first-line contact in small, rural communities. The confidentiality it provides is important to veterans, especially when discussing mental health issues,"Ethridge said.
Veterans can also engage directly with resources online. VetsPrevail.orgcombines social media and expert mental health support for veterans. Make the Connection-VA's national mental health awareness campaign-features personal stories of recovery from veterans. Veterans and their loved ones can visit MakeTheConnection.net to locate resources and hear from hundreds of other veterans who experienced similar challenges.
"The MakeTheConnection.net website features hundreds of other inspiring stories of veteran and family member resilience in dealing with and overcoming mental health and other life challenges," Dr. WendyTenhula, VA's deputy chief consultant for specialty mental health, said.
For the latest news on VA rural programs, visit www.ruralhealth.va.gov.
*Last name withheld for privacy.