From Wounds to Wellness

A research paper published by Boston University in June 2021 found that approximately 7,000 service members had been killed in military operations in the post-9/11 wars. Sadly, that number is dwarfed by the more than 30,000 active-duty service members and veterans who have died by suicide during the same period.

This startling finding was cited at the opening of a panel presentation at the fourth annual Hero's Journey Symposium, presented by the John P. Mayhugh Foundation on September 22. Titled “From Wounds to Wellness,” the panel focused on reducing such tragic numbers by highlighting mental health resources for service members and the barriers that prevent their usage.

Noting that the Steven A. Cohen Military Family Clinic at Easterseals DC MD VA was created to reduce barriers, Senior Vice President and Clinic Director Dr. Anneke Vandenbroek began by noting that obstacles to mental health care are not confined to the military population.

“We have stigma that prevents people from seeking care,” she said. “We have crisis-level care, but not as much primary or preventative care widely available. Not all practitioners are strongly trained in evidence-based practices. And we have a shortage of providers.… It’s a problem culturally, across the whole spectrum,” Vandenbroek explained.

Contributing to those obstacles, said Rebecca Fortgang, postdoctoral scholar in the Harvard University Department of Psychology, is a lack of attention to research in the field. “In 2017, tuberculosis took just over 500 lives in the United States. For each of those lives lost, there was over $800,000 devoted to research,” Fortgang explained. “That’s important work, but contrast it with suicide, where there was about $2,000 spent per life lost. There’s a clear problem with prioritization. We need research to understand what works, for whom, and when.”

Although inroads have been made recently in working to destigmatize mental health – think of top athletes Naomi Osaka and Simone Biles very publicly prioritizing self-care – some environments remain difficult to change. “The military is one of those spaces where it’s been really tricky to move the needle and improve access to care,” said Fortgang.

Opportunities for Healing

Efforts to make it easier for veterans, active-duty service members, and their families to access behavioral health treatment are taking many forms. Rev. Carol Ramsey-Lucas, Chief of the Chaplain Service at the Washington, DC VA Medical Center, discussed the work of her interfaith chaplaincy staff, which takes a spiritual approach to helping veterans heal while also connecting them to other support. Among its programs, the Chaplain Service coordinates group sessions for current and former service members, bringing together those with similar experiences for mutual support.

“What we want is for people to have the opportunity to tell their story in a safe, supportive environment,” Ramsey-Lucas added. “That opportunity to tell your story and have it heard is deeply healing.”

Other resources include Give an Hour, an organization that connects licensed caregivers who donate one hour per week with those in need of mental health support. Brittany Chatman, Program Manager for Military and Veterans Programs at Give an Hour, talked about the recently launched Connect to Hope campaign, which aims to change the culture of mental health care with resources such as the 180 Playbook, a tool for keeping a person’s mindset positive and hopeful.

Active-duty service members, veterans, their families, and caregivers in Washington, DC, Maryland, and Virginia can also seek out the services of the Cohen Clinic, founded to provide accessible, high-quality, evidence-based care to the area’s military population. Building on that mission, the Clinic responds to the particular needs of current and former service members with a team of providers drawn largely from military backgrounds. As such, they have a keen understanding of a culture in which asking for help can be considered a weakness, an attitude that can follow veterans into civilian life.

“Stigma is a challenge in the military population, and when we get out, we take that culture with us,” Vandenbroek asserted.

The Cohen Clinic provides a range of therapies for issues related to the transition to civilian life, anxiety, post-traumatic stress, anger, grief, and much more, with treatment plans tailored to the needs of each client. The services are also highly accessible, with weekend and evening hours. Care can begin quickly, with an initial phone evaluation to help determine the best way forward. Support is also available to ensure that cost is never a barrier to treatment.

Although the onset of COVID-19 threatened to disrupt access to care, Vandenbroek said that about 30 percent of Cohen Clinic clients were already receiving care via telehealth. Since the pandemic began, she noted a few unexpected benefits of delivering confidential care through secure video conferencing. Over the last year and a half, she explained, “We saw lower rates of no-shows and lower rates of cancellation. … We also saw a slight increase in the number of sessions that people were engaging in, and that translates into better outcomes.”

Building upon these positive developments, Vandenbroek conveyed her hope that obstacles to care will continue to fall: “I hope mental health care becomes like going to the doctor for a checkup. I hope telehealth becomes a road to that, I hope reducing the stigma becomes a road to that, and I hope evidence-based care becomes a road to that.”

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