VA Faces Challenges Expanding Mental Health Care


Army veteran Phillip Faustman sifts through his belongings at a San Diego homeless shelter. Faustman says he attempted suicide three times in two and a half years.
Christopher Maue / KPBS

The following is a report from Steve Walsh, my colleague at the American Homefront Project, reporting on military life and veterans issues.

The Veterans Health Administration is planning to make mental health care more available to help reduce veteran suicide. But veterans advocates worry about the impact on the already strained VA health system.

A recent government study concluded that the majority of veterans who commit suicide are not enrolled in VA mental health care.

Phillip Faustman almost became a part of that statistic. Faustman, who is gay, joined the Army in 2012 after the end of the “Don’t ask, Don’t tell” policy, which barred gay and lesbian troops from serving openly in the military.

“I waited for the repeal, so I joined the Army to prove to myself that I could do it,” he said.

While in the military, he suffered sexual trauma that led to a diagnosis of post-traumatic stress disorder and depression. Discouraged, he left the military in 2015, he said.

“When I first got out, I was alone, and no one was really helping me,” he said. “So I had my suicide attempt.”

Periodically homeless, Faustman did not turn to the VA, in part because he found the enrollment process daunting.

That’s a common problem among new veterans, only forty percent of whom receive VA mental health coverage. Many are discouraged from seeking care because of a complicated process to determine their eligibility. Veterans may have to prove, for instance, that their mental health need is connected to their service.

Without treatment, Faustman attempted suicide three times in less than three years. Continue reading

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Researchers Test Resilience – War Zones To Refugee Camps

syrian refugees united nations photo

Thousands of desperate residents flood a destroyed main street January 2014 in Damascus, Syria, to meet aid workers from the United Nations Relief and Works Agency (UNRWA). The UNRWA was able to complete its first humanitarian food distribution in Yarmouk Camp there after almost six months of siege. (Photo courtesy of UNRWA)

The goal: find the best ways to teach psychological resilience to children, teens and adults living with stress and danger – like a Syrian refugee camp. But resiliency is equally helpful on the home front – in schools and concert halls.

I’m proud to share an article on resiliency research from another Carter Fellow, Emily Underwood, published in Science magazine.

In 2015, in the name of science, more than 800 teenage boys and girls in northern Jordan each allowed 100 strands of hair to be snipped from the crowns of their heads. Roughly half the teens were Syrian refugees, the other half Jordanians living in the area. The hair, molecular biologist Rana Dajani explained to the youngsters, would act as a biological diary. Chemicals embedded inside would document the teens’ stress levels before and after a program designed to increase psychological resilience.

It was a unique experiment. And it was one that suited Dajani, who’s based at The Hashemite University in Az-Zarqa, Jordan. Dajani looks askance at many humanitarian interventions imported from elsewhere. “I’m always skeptical of any program coming in from the outside, which says they can heal or help,” she says. Half-Syrian herself—Dajani’s mother is from Aleppo, her father from Palestine—she was also eager to study the physiological effects of conflict. So when medical anthropologist Catherine Panter-Brick, whom Dajani had met at Yale University in 2012, approached her about putting the resilience-boosting program to the test, she seized the opportunity.

The full article is available here. It shows, despite the continued bombing and chemical warfare in Syria, there are people from scientists to journalists trying to help.

6 Mobile Apps To Help Fight Depression

On 4 September 2006 soldiers with Able Company, 2nd Battalion, 136th Infantry Regiment, hug during a memorial ceremony held for Army Staff Sgt. Joshua R. Hanson, a fire team leader with Able Company, at Mainside Chapel here September 4. The chapel filled with tears when a photo slide show, featuring pictures of the moments that Hanson had spent with the unit was displayed before the last roll call and a 21-shot rifle salute. The memorial consisted of the playing of our national anthem, prayer; a scripture read by Justin D. Knopf, a 24-year-old squad leader from Detroit Lakes, a photo slide show, a 21- shot rifle salute and the playing of "Taps". An inverted M-16A2 rifle was placed in Hanson's homage, with a Kevlar helmet resting on top. Engraved identification tags and a crucifix hung from the rifle's pistol grip. Immediately in front, an empty pair of boots was positioned, while behind the display, the national ensign and battalion colors were displayed. Along the sides were two ammunition cans containing keepsakes from fellow soldiers. The battalion, an Army National Guard unit out of Detroit Lakes, Minn, is currently attached to 1st Marine Logistics Group (Fwd). Able and Headquarters Companies, 2nd Battalion, 136th Infantry Regiment, 1st Marine Logistics Group is deployed with I MEF (FWD) in support of Operation Iraqi Freedom in the Al Anbar Province of Iraq (MNF-W) to develop the Iraqi Security Forces, facilitate the development of official rule of law through democratic government reforms, and continue the development of a market based economy centered on Iraqi Reconstruction. (U.S. Marine Corps photo by Lance Corporal Ryan L. Tomlinson)

On 4 September 2006 soldiers with Able Company, 2nd Battalion, 136th Infantry Regiment, hug during a memorial ceremony held for Army Staff Sgt. Joshua R. Hanson, (U.S. Marine Corps photo by Lance Corporal Ryan L. Tomlinson)

The following article comes directly from the public affairs office of the Defense Centers of Excellence: For Psychological Health and Traumatic Brain Injury. The centers are an excellent resource for information on mental health for the whole family: service members, veterans, families, caregivers and health care providers.

For a quick look at depression in the United States, check out these statistics:

With reports like these, we should keep tools to fight depression handy. The National Center for Telehealth and Technology (T2), with the Department of Veterans Affairs, designs tools like apps for your smartphone. And these days, there are few things handier than a mobile app.

However, before you explore the T2 suite of apps, here’s an overview of depression:

Depression

Depression isn’t a simple feeling (sad, down, blue, etc.); it is a serious condition that requires patience, understanding and treatment. Clinical depression is a medical condition and like other medical conditions, it can interfere with a person’s daily life and can make normal functioning a challenge. Depression can vary in type and symptoms.

Signs and Symptoms

  • Intense sadness, feelings of hopelessness
  • Memory lapse, trouble with attention
  • Social isolation
  • Loss of interest in hobbies
  • Thoughts of death, suicide
  • Exhaustion, fatigue
  • Sleep problems (too much or too little)
  • Impatient, fidgety
  • Loss of appetite, changes in weight
  • Body aches (headaches, cramps or digestive problems) without a clear physical connection and no relief even with treatment

Causes

According to the “VA/DoD Clinical Practice Guideline for the Management of Major Depressive Disorder (PDF)”:

“Depression is considered a biological illness but can result from a combination of genetic, biological, environmental, and psychological factors. Trauma, loss of a loved one, a difficult relationship, or any stressful situation may trigger depression, but depression can also occur without an obvious trigger.”

It can present at any age and may co-occur with other medical conditions such as a traumatic brain injury, diabetes or cancer.

Treatment

Health care providers can treat depression. The earlier a person starts treatment, the better the outcome. Treatment involves psychotherapy, medication, or a combination of the two. Without treatment, depression can recur frequently and may become chronic.

“If you experience several depression symptoms that last longer than two weeks and interfere with normal daily activities, it’s time to see a health care provider,” said Cmdr. Angela Williams, chief of evidence-based practice at the Deployment Health Clinical Center. “Most people who engage in treatment for depression get better.”

Fight Depression with Mobile Apps

This list of mobile apps from T2 can help users understand and manage depression symptoms:

  • ACT Coach uses mindfulness and acceptance strategies to help users cope with emotions and symptoms of psychological health conditions.
  • LifeArmor offers information, support tools (such as depression assessments), videos and a symptom tracker. It is the mobile compliment to AfterDeployment.
  • Mindfulness Coach teaches focused attention using guided mindfulness meditation practices. It includes session logs to track progress and educational materials.
  • Moving Forward features problem-solving tools designed to teach life skills.
  • Positive Activity Jackpot helps users overcome depression and build resilience. It uses augmented reality technology to locate positive activities nearby.
  • T2 Mood Tracker helps users monitor and track their emotional health. Results are displayed in an easy-to-understand graph.
  • Virtual Hope Box strengthens coping, relaxation and distraction skills. Users can add personal photos, inspirational quotes, etc., to support positive thinking.

If you, or someone close to you, are experiencing depression, please talk to your health care provider. For more information about depression and available resources in your area, contact the 24/7 DCoE Outreach Center. Professional health resource consultants stand ready to help you access information specific to your needs. Call today: 866-966-1020.

Art Therapy in Action at Veterans Open Mic Night

Veterans Open Mic night with co-hosts playwright Linda Parris-Bailey (center) and Andrea Assaf (right).

Veterans Open Mic night with co-hosts playwright Linda Parris-Bailey (center) and Andrea Assaf (right).

Beyond the battlefield and the barracks, some of Florida’s 1.5 million veterans have had trouble transitioning to civilian life. Yet, there are signs that poetry, art, music and performance are helping veterans adjust.

With Veterans’ Day approaching, we bring you their stories this week in a special edition of Florida Matters.

These are highlights from the October 2014 <a href=”http://art2action.files.wordpress.com/2014/03/veterans-open-mic-flyer-2014-vfp.pdf”>Veterans Open Mic Night</a> at Tampa’s <a href=”http://www.sacredgroundstampa.com/”>Sacred Grounds Coffee House</a>. Military veterans meet there every first Sunday to share their talents and stories.

Cheldyn Donovan is a Vietnam Veteran who has experienced homelessness, PTSD, social phobia, but he finds playing the guitar eases his symptoms.

Cheldyn Donovan is a Vietnam Veteran who has experienced homelessness, PTSD, social phobia, but he finds playing the guitar eases his symptoms.

The WUSF <em>Veterans Coming Home</em> project partnered with <a href=”http://art2action.org/veterans-in-tampa/”>Art-2-Action Tampa Veterans</a> to bring you this evening of poetry and music with military veterans.

The emcees for the evening were Andrea Assaf, director of Art-2-Action, and guest playwright Linda Parris-Bailey who wrote the play, Speed Killed My Cousin, about returning veterans.

The highlights feature veterans Charla  Gautierre, Cheldyn Donovan and Marc Reid. Listen below to the Florida Matters 30-minute special show featuring the veterans as performers which aired Nov. 4 and Nov. 9, 2014.

 

5 Things to Know About Suicide: #1 Ask Straight Out

Photo courtesy of DCoE website.

Photo courtesy of DCoE website.

They’re called “responders” – the folks at the other end of the Veterans Crisis Line. But they aren’t the only ones serving on the front-line of suicide prevention.

As a society, as colleagues, as friends, as family, we cannot leave the work of suicide prevention to the “responders” alone.

It is up to all of us to act or at least “ask” if we see someone unduly stressed according to psychologist, Dr. Caitlin Thompson, deputy director of suicide prevention at the Department of Veterans Affairs.

“If worried – asking people straight out saying, ‘I’m so concerned about how you seem to be, have you been thinking about suicide at all?'” Thompson advised. “It’s just that simple really to just ask the question that can be a very scary question.”

It’s time to stop being “scared” and start becoming informed.

Here are tips from the Defense Suicide Prevention Office website:

How to ask the question

There is no evidence to suggest that asking someone if they are having thoughts about hurting themselves causes suicide. When asking about this, be direct – for example, ask “Are you thinking about killing yourself?” or “Are things so bad that you’re considering suicide?”

Remember, if you never ask, there is no way to intervene and get the person help. Even if they aren’t thinking about it, they will know you are concerned about them and what they are going through.

You don’t need to be an expert

A common myth about suicide is that you can’t do anything if someone is suicidal because you’re not an expert. This isn’t the case. You don’t need to be an expert in psychological health to recognize when someone you care about is having a hard time.

Know the warning signs

The best way to prevent suicide is to recognize troubling signs. Some of the most common warning signs to look for in an individual include:

  • Expressing hopelessness, like there’s no way out
  • Appearing sad or depressed most of the time
  • Feeling anxious, agitated or unable to sleep
  • Neglecting personal well-being
  • Withdrawing from family and friends
  • Losing interest in day-to-day activities
  • Frequent and dramatic mood changes
  • Expressing feelings of excessive guilt or shame
  • Feelings of failure or decreased performance
  • Feeling like there’s no reason to live
  • Increased alcohol or drug abuse
  • Talking about death

Learn what to do

If you don’t ask, there’s no way to intervene and get help. Experts suggest the following advice for family and friends who suspect someone is suicidal:

  • Trust your instincts that the person may be in trouble
  • Be willing to listen
  • Ask direct questions without being judgmental (“Are you thinking about killing yourself?” or “Have you ever tried to end your life?” or “Do you think you might try to kill yourself today?”)
  • Determine if the person has a specific plan to carry out the suicide
  • Don’t leave the person alone
  • Don’t swear to secrecy
  • Don’t act shocked
  • Don’t counsel the person yourself
  • Get professional help on the phone or escort the person to a counselor, chaplain or other professional mental health provider
  • Remove potential means of self-harm

Know how to get help

Free, confidential help is available 24/7 through the Military Crisis Line (also known as the Veterans Crisis Line and National Suicide Prevention Lifeline) at 800-273-8255 (military members and veterans press 1).

You can also online chat with a Military Crisis Line responder or send a text to 838255.

Even if there’s no immediate crisis, trained counselors can offer guidance on how to help someone and point you to services (for mental health and substance abuse) and resources (suicide prevention coordinators).

A lot of circumstances can contribute to mental health issues, but there’s help online.

A Green Beret Busting Myths About PTSD

Saint Leo University veteran student Brian Anderson is willing to talk about his experience with post-traumatic stress to bust myths held by the general public.

Saint Leo University veteran student Brian Anderson is willing to talk about his experience with post-traumatic stress to bust myths held by the general public.

The U.S. military is downsizing. The war in Iraq is over, and combat troops are due out of Afghanistan by the end of next year. So more than 1 million service members are expected to enter the civilian workforce in the coming years.

That’s why two veterans are on a mission to help employers and the community in general separate fact from fiction when it comes to post-traumatic stress disorder.

First, not every veteran has PTSD. It affects only an estimated 20 to 25 percent of combat veterans, according to Saint Leo University associate professor Dr. Jim Whitworth, a 21-year Air Force veteran with a Ph.D. in social work.

There’s a lot to understand about post-traumatic stress and the best teachers are those with the diagnosis. However, most veterans are not comfortable talking about their traumatic experiences.

That’s where the bravery of Brian Anderson shines through. He is willing to share what can be painful details so clinicians, the public and employers have a better understanding of returning veterans.

Anderson joined the military because of September 11th. His first hitch in the Army was as a photo-print journalist with the 82nd Airborne Division. Anderson then became a Green Beret.

“I killed my first man on Dec. 31st 2008. And, you know, at that point it was more of a high-five type experience.  I was psyched. I was really pumped about it,” Anderson said. “The second deployment, I went in, our very first fire-fight was eight hours long. And we killed 39 Taliban that day and we had a couple of our guys wounded. Continue reading

PTSD Myths vs. Reality Workshops for Employers, Public

Air Force veteran and Saint Leo University faculty member Dr. Jim Whitworth, Ph.D.

Air Force veteran and Saint Leo University faculty member Dr. Jim Whitworth, Ph.D.

Some military veterans report that employers are hesitant to hire them due to worries about post-traumatic stress.

So St. Leo University, 30 miles north of Tampa, is offering two free workshops to human resource professionals, mental health experts and the general public who want to learn more about “Post-Traumatic Stress Disorder in the Workplace.”

Dr. Jim Whitworth, Ph.D. and member of the Saint Leo University social work faculty, will lead two workshops on the myths versus reality of veterans diagnosed with PTSD.

Air Force veteran and social work faculty member, Dr. Jim Whitworth, will lead both half-day workshops on the “Myths versus Reality” of veterans diagnosed with PTSD.

“The truth is is that it’s just a normal person in many cases dealing with that abnormal incident that with time and good support they can get better,” Whitworth said. “And of course, they bring all these great strengths to the table as well that we know about military members that they have a high commitment to their employers in many cases and lots of attention to detail.”

The workshop on Wednesday is scheduled 8:30 a.m. to 12:30 p.m. and focuses on employers and businesses looking to hire veterans. The Thursday workshop is geared more for mental health professionals and also is set from 8:30 a.m. to 12:30 p.m.

Both workshops are free but require registration. You can find details at the Saint Leo website.

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