"Part of the PTSD symptomatology for the veteran is the tendency to want to isolate. ... PTSD is a collective wound, which means I cannot take care of it myself. I have to ask for help. I need allies. I will be crushed under the weight of it. It’s a devastating wound.”
— closing celebrity keynote speaker Brian Delate, actor, filmmaker, playwright, and Vietnam veteran
Though the Substance Abuse and Mental Health Services Administration (SAMHSA) is a small agency within the Department of Health and Human Services, retired Navy reservist Kathryn Power, M.Ed., SAMHSA regional administrator, admitted she sees a divide between the military and civilian sectors. It’s important, Power said, to take a public health approach because it’s not just the military population that’s affected; it’s affecting their families and their communities, too.
“We encourage local and state ownership in these populations,” Power said. “It’s important for all of us to be together in this, to create better partnerships across the civilian and military divide, to learn more about each other, to talk about how culture is different in the military and culture is different on the civilian side, and how culture is very different in each specific service.”
Terri Tanielian, senior social research analyst, RAND Corp., agreed. From a research point of view, she pointed to the effects on individuals, family, and society if mental health issues are left untreated. Many people will live “full and well-functioning lives” with these disorders for years, Tanielian said, but others won’t, which can lead to consequences that affect the individual and family.
“Think about this as a cascade of consequences that then ripples to society, and we then see increases in other areas of concern, such as suicide, such as homelessness, and other risky behaviors,” Tanielian said. “There’s a ripple effect if we don’t intervene early.
“We have a lot of good treatments that have been demonstrated to be effective in bringing symptom reduction and facilitating recovery for these particular conditions, so we need to ensure all our returning servicemembers and veterans and their families have access to them,” Tanielian continued. “We need to ensure that access means access to quality.”
But with multiple systems of care — through the VA, DoD, the Department of Health and Human Services, and public and private sectors — designed to address these conditions, the panelists agreed those organizations need to place more emphasis on making sure there is no wrong door when a veteran decides he or she needs help.
Capt. Richard Stoltz, USN, director, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, highlighted an effort to put behavioral health providers in primary care clinics to allow for immediate treatment. There are efforts under way, Stoltz said, to have therapists assigned to primary care clinics where all they do is pay attention to people who seem to have a psychological overlay and attempt to get those people more engaged in treatment.
“Sometimes people come for treatment, but they leave after just a couple of visits and don’t follow through in a way that will allow them to better heal,” Stoltz said, pointing to other tailored initiatives, such as in-home treatment and periodic check-ups over the phone, to ensure treatment is progressing as it should be.
It all comes down to education, according to Debbie Paxton, M.S.N., R.N., mental health advisor, U.S. Marine Corps Wounded Warrior Regiment, and spouse of Assistant Commandant of the Marine Corps Gen. Jay Paxton. Paxton noted educating veterans and their families is a key starting point to encourage those with mental health issues to seek the treatment they need.
“Our job is to make sure that when our brave men and women come home that they get the care and the understanding that they need, not only from their families, from their friends, and from their coworkers but also from the entire community as they transition into a successful civilian life. The more people understand about mental health, the better prepared we all are to help remove the stigma associated with seeking treatment.”
— closing keynote speaker U.S. Sen. Bernie Sanders, chair, Senate Committee on Veterans’ Affairs
56 MILITARY OFFICER NOVEMBER 2013
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