02 September 2013

PTSD and Coming Home

Just an FYI re: VA Mental Health and Counseling:

Back from Operation Desert Storm and seriously injured, with multiple operations not helping things too much, I asked for some advice (counseling) at the Asheville VA Medical Center.

I reached out. I didn't get it. Total extent of their response: I was invited to attend a couple afternoon VA-sponsored picnic on the Medical Center's back lawn complex, with all other veterans being the local Navy Construction Battalion sailors who'd also been overseas. I don't know if any VA staff were present...all that happened was munching on refreshments, a cup of Coke, shaking hands of other vets and that was all. A picnic.

From what I recall, this was the limit of VA outreach in the areas of mental health...shouldn't call it outreach because one had to ask to find out about it. Not really outreach, as there seemed to be nothing except a few "just ask for help" posters had been taped up on walls and elevators. And no follow-up on that request nor subsequent requests for medication.

I was told that, having my back surgery two weeks earlier at Bethesda Naval Hospital, the soonest the VA ortho clinic could see me for care would be about six months. I was prescribed narcotics to last me until then, and I pulled out the wire staples myself

Over the next twenty years, the sole mental health interest in me by the VA has been the occasional question about depression, with heads nodding at whatever my response (sometimes quite intense) and on to the next question on whatever unrelated health form was being completed.

Suggestion: The VA might more effectively prevent veterans' post-deployment suicides by some form of actually doing something. Perhaps, offer their smorgasbord of resources rather than passively wait to be asked or be forced to intervene because of inappropriate veteran behaviors. Practitioners should read the VA's own publications, including their pivotal article identifying PTST among patients who've experienced three or more surgeries. I've had twelve since Desert Storm and more coming.

Every veteran should be approached by a social worker for an informal background assessment and an offer of resources. Every combat veteran and every severely ill or severely disabled veteran must receive social worker intervention, requested or not, as so few veterans grasp the full range of their own issues, and so few grasp the range of VA resources which might help address their needs.

Clearly, PTST should be assumed among various groups of veterans and eliminated by individual evaluation, rather than waiting for problems to come to a boil.

September 12 2013 Update: Not much changed except the posters urging vets to reach out have been updated to "It Takes a Warrior" theme. Even calls to the VA's suicide prevention hotline are problems, and the system's chat feature drops conversations repeatedly. Really, now VA: hanging up the call mid-conversation on a vet who is reaching out for help at 0300 isn't much help!

Do you think it might be better just to switch to calming elevator music??

About Face..
by Smedley D. Butler, Major General, United States Marine Corps, 1936 Two time recipient of the Congressional Medal Honor (regarding WWI soldiers but applicable to all of our wars)
“Boys with a normal viewpoint were taken from the fields and offices and factories and classrooms and put into the ranks. There they were remolded; they were made over; they were made to ‘about face’, to regard murder as the order of the day. They were put shoulder to shoulder, and through mass psychology, they were entirely changed. We used them for a couple of years, and trained them to think nothing at all of killing or of being killed. Then suddenly we discharged them and told them to make another, “about face.” This time they had to do their own readjusting without mass psychology, without officers aid and advice, without nation-wide propaganda. We didn’t need them any more. So we scattered them about without any speeches or parades. Many too many, of these fine young boys are eventually destroyed, mentally, because they could not make the final, “about face," alone.

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