When Johnny comes home 

Sometimes, it takes a village to help a vet.

HELP IS HERE: And around the state.
  • HELP IS HERE: And around the state.

The news has been full of reports recently on health care needs and the gap in services for American servicemen and women, particularly in mental health care.

In June, the scientific publication Journal of Epidemiology and Community Health published a study that found that returning soldiers from Iraq and Afghanistan are twice as likely to commit suicide as civilians.

A House subcommittee responded to that in early July by proposing a suicide prevention bill that would increase outreach and require Veterans Affairs hospitals to offer round-the-clock mental health care.

A researcher at Harvard says the VA is not going to be able to handle the 50,000 injured in Iraq and Afghanistan. (The Pentagon disputes the number of total injured. But it released a study in June saying that 38 percent of soldiers, 31 percent of Marines, 49 percent of National Guard reservists and 43 percent of Marine reservists are reporting symptoms of post-traumatic stress disorder, anxiety, depression and other disorders upon returning home.) A presidential commission is making a national study of the extent of health-care problems for OIE (Operation Independent Iraq) and OEF (Operation Enduring Freedom) vets.

In Arkansas, almost 12,000 veterans have sought mental health care at the Central Arkansas Veterans Healthcare System in the past 12 months, Dr. Jeffrey Clothier says. Of those, 524 were veterans of service in OIE or OEF.

Clothier, associate chief for mental health, says they have come to a top-ranked facility, one doing ground-breaking research in therapy, innovative outreach programs, sickest-patient follow-up to reduce hospital stays and are the initiators of a campaign to make psychological services an essential part of primary care. On top of that, the services are free to those who've seen active duty.

But one of the most talked-about programs at the VA is one that enlists “first responders” — families, friends and others — to recognize signs of stress and help veterans (and their families) get the help they might not otherwise ask for.

“Traditionally, [VA] outreach has been to go to the armory and community center and tell you what we offer,” Dr. Vince Roca, a clinical psychologist in the VA mental services department, said. Because stigma still attaches to mental illness, veterans who are having a hard time acclimating to their regular lives may need encouragement to get help.

But Roca's “Lifeguard” outreach team — made up of clinicians who see vets suffering from post-traumatic stress disorder — takes a different tack. It now works with families — at the armories, community centers — with skits instead of Power Point lectures, group exercises instead of one-way communication, and the sharing of stories from the audience.

Roca calls what he and his team are teaching “life skills,” which sounds a little soporific, but they include often surprising strategies that can have a positive “quick impact” on families, Roca said.

Roca gave an example: He asks the groups, do we get to choose our own thoughts, feelings and memories? “Psychobabble” (Roca's word) says yes, we are in charge of our minds, we can control our thoughts.

So Roca does this exercise: He'll say a word, and look around for the reactions.

Did what popped in their heads get there by way of a checkpoint? No way. Roca says when we're admonished that we're in charge of our thoughts and memories and can choose not to think of the scary or weird, we just feel guilty.

“The idea that you know what you are going to think before you think is silly,” Roca said. Veterans have seen and done things they've never seen before, and are having thoughts they've never had before. To beat themselves up over it is wrong. “As a human being with a pulse,” Roca said, “I do not choose the thoughts I have.”

In one of the skits, four team members are on stage, two playing a husband and wife conversing on the way to a family reunion and two others who speak aloud the couple's thoughts — which of course are often at variance with their words. Roca said the skit is both funny and serious and gives cause for reflection. So folks don't have to take notes, a 50-page workbook is given out to help families deal with what Roca says is “incredible change.”

So far, the response to the presentation has been good. Roca is eager to find how often the “life skills” are acted out and what good will come of the program.



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