We’ve been asking listeners about what issues would make a difference in their lives.
Listener Natalie Mello tells us she wants better government resources for veterans like her son, who experiences Post-traumatic Stress Disorder (PTSD) and depends on access to mental-health services.
News Director Steve Junker and Morning Edition host Patrick Flanary discussed the issue.
Steve Junker: Natalie Mello lives in Fairhaven. She’s the mother of an Iraq veteran who struggles with PTSD. The disorder affects one in five veterans of Iraq, according to the VA. What was your discussion like with her?
Patrick Flanary: She’s close to her son, who called her out of the blue in 2007 to say he was joining the Army. The news blindsighted his mom, but she supported his choice. She has asked that we not name him for this story.
Mello’s son, who is now 35, spent two years in South Korea, and was later deployed to Iraq. He was honorably discharged in 2012, and had no physical injuries when he returned from overseas. But his mom says he’s never been the same.
"He went off a healthy young man and came back forever changed," Mello said. "He happened to be here celebrating a birthday with me when he had his first episode. He ended up at a hospital in Jamaica Plain. Even when he was active military they wouldn’t take his insurance because he was stationed in Colorado."
Patrick: He lives in central Massachusetts now. But he’s been struggling with PTSD for the past 12 years, dating to his time in Iraq when he was on active duty with the military police. His mom says too many barriers exist when it comes to consistent veteran care, and that many veterans don’t have family advocates helping on their behalf.
Steve: Mello mentioned an episode. What are these like, and what has her son’s experience with treatment been like with the VA?
Patrick: The episodes are brought on by anxiety, which is accompanied by no sleep. And these episodes usually foreshadow a psychotic break. Mello says after her son’s most recent episode, a VA facility within the UMass system took nine days to accommodate him for treatment. Once he had a bed in Worcester, he was moved twice to other facilities, which Mello said was disorienting.
"It seems to me that the state could do something about facilitating some sort of service between when somebody has a crisis and when there is no VA bed available," she said.
Steve: So what are local veterans groups saying about what sounds like a common problem when it comes to state-sponsored veteran care?
Patrick: It turns out this is nothing new. I spoke with Jim Seymour, the executive director of Cape and Islands Veterans Outreach Center. I asked him what should be done at the state level to address the disconnect between veterans and government resources.
"There certainly isn’t a one-size-fits-all solution to this, I don’t believe," Seymour said. "The more severe folks who have psychosis and schizophrenia, they need a professional clinician at that level. The other piece that is a challenge: If folks need inpatient care, there’s very limited resources throughout the Commonwealth."
Patrick: So, not a new problem, this statewide lack of beds for veterans. This is happening even as the Executive Office of Veterans’ Services now operates apart from Health and Human Services. This is new as of March. Secretary Jon Santiago is leading the office, whose mission is to act as the primary advocate on behalf of veterans.
Steve: What does that mean for the focus on the veterans in our region? How do we ensure that they are matched with mental-health services?
Patrick: The Cape and Islands Veterans Outreach Center focuses on what Seymour calls four pillars, and they’re all connected: housing, food insecurity, transportation, and mental-health services and outreach. Seymour says housing should be the state’s priority, that everything trickles down from the ability to afford a home. Veterans don’t exactly knock on the door to his office to say they need help.
"It’s like an onion, as you start to peel the layers back you start to understand: Do they have housing? Do they have food? Are they aware of some of the benefits that may or may not be available to them? Then it leads to a deeper conversation and actually building a relationship," Seymour said.
Patrick: Seymour says he’s not concerned with money and policy around access as much as he is with his organization’s ability to identify veterans’ needs locally.
"We’re optimistic that we will find additional funding sources," Seymour said. "And then the real challenge is identifying what the true need is. Mental-health services is a wide, wide swath of opportunity; some of it can be counseling, psychology, or psychiatric care with medications."
Steve: I guess that begs the question of whether there are enough mental healthcare professionals in our region to meet the need?
Patrick: The answer is no. Counseling services are “booked solid” on the Cape and Islands, Seymour tells me. Even with the surge in telehealth appointments during the pandemic there still are not enough psychiatrists here to prescribe medication. The challenge is recruiting providers, and many aren’t able to afford housing. I spoke to Dr. Louis Chow about the pipeline of professionals. He’s the senior director for the Home Base Training Institute in Boston.
"These are unprecedented times with both the need and the shortage," Chow said. "So the more there are targeted incentives for the behavioral workforce, and also in more rural settings, the better positioned we will be for caring for the needs of our communities."
Steve: So this care at Home Base is private and separate from VA services, right?
Patrick: Right. It offers services at no cost to veterans and their families, and is not affiliated with government resources. Governor Healey in March committed $2 million toward funding Home Base's clinical care and mental-health services.
Chow is a clinical psychologist there and treats service members experiencing what the nonprofit calls “the invisible wounds of war,” including PTSD.
Home Base is where our listener Natalie Mello says she found success with care for her son. Chow tells me that even though we’re not at war right now, the number of veteran PTSD diagnoses has not gone down. Something called “unprocessed trauma” often rears its head at unexpected times, sometimes years after a veteran returns from overseas.
"When somebody does reach out for care, it’s critically important in that moment to meet with an outstretched hand," Chow said. "And I say this as someone who greatly values the VA. But what we clearly know is that not one entity, however large, can do it alone."
Patrick: Taken together, private and public resources to address and treat our veterans’ mental health are in transition. Both Seymour and Chow agree that the new veterans’ affairs secretary position will eventually bridge the outreach and treatment gap for veterans.
