Alen Bitzell, who served in the 101st Airborne, fills a backpack full of clothing at the Howard County Stand Down event highlighting services available to veterans held at the UAW685 union hall on Nov, 2, 2018. Information about food, clothing, job assistance, financial assistance, and info on education and housing for veterans was available. Staff photo by Tim Bath
Alen Bitzell, who served in the 101st Airborne, fills a backpack full of clothing at the Howard County Stand Down event highlighting services available to veterans held at the UAW685 union hall on Nov, 2, 2018. Information about food, clothing, job assistance, financial assistance, and info on education and housing for veterans was available. Staff photo by Tim Bath
You can wave an American flag, put a bumper sticker on your car or tie a yellow ribbon around an old oak tree, but a difficult conversation about mental health with a veteran could actually save a life.

In a divisive time in the United States, almost all politicians and civilians can find common ground when it comes to supporting the troops. Yet, veterans are still dying daily due to a lack of mental health services.

In 2016, 6,079 veterans died by suicide across the country, according to data released by the U.S. Department of Veterans Affairs. Seventy of those deaths occurred n Indiana, and more than half of those veterans were 55 or older. 

As bleak as those statistics are, there is somewhat of a hidden silver lining: Indiana’s veteran suicide rate of 16.7 percent is significantly lower than the national rate of 30.1 percent, and even the Midwestern region suicide rate of 28 percent.

So while there is still room for improvement, the Hoosier state appears to be leaps and bounds ahead of the nation. What sets us apart?

Recognizing the signs

Part of the solution to improving veterans’ mental health lies within another persons’ ability to notice the veteran is struggling before a crisis occurs, said Brandi Christiansen, a Navy veteran and executive director of Mental Health America of North Central Indiana. If no one intervenes, a veteran struggling with mental illness can become dangerous to themselves or others.

“We are waiting too long. We are waiting too long to have difficult conversations, we’re waiting too long to get help and identify those warning signs and symptoms,” Christiansen said. “I think we have become complacent as a society.”

According to the VA, about 11 to 20 out of every 100 Operation Iraqi Freedom and Enduring Freedom veterans have post traumatic stress disorder (PTSD). About 12 out of every 100 Gulf War veterans and 15 out of every 100 Vietnam veterans also suffer from PTSD.

PTSD is a disorder that can occur after experiencing a traumatic event, such as life-threatening combat, a natural disaster or sexual assault. There are four major types of PTSD symptoms: re-experiencing, avoidance, arousal and negative changes in beliefs and feelings that can make it difficult to participate in normal day-to-day activities like going to work or spending time with family.

The disorder, and myriad other mental health issues veterans can develop, can lead to crisis if not confronted. Many veterans suffering from the illness may not be willing to come forward on their own.

“Particularly in combat arms, there’s this macho persona that if we admit to PTSD it could be interpreted as a sign of weakness,” said Ken Gardner, an Air Force veteran, mental health counselor and adjunct professor at Indiana University Kokomo. “For some of them, it’s like ‘I didn’t lose an arm or a leg and I’m not in a wheelchair so I should be fine, right?’”

Gardner said with PTSD comes other conditions like depression, anxiety, social anxiety, isolation and self-medication with alcohol or drugs, which compound the issue.

Some veterans may be reluctant to talk about their service or their mental health struggle, especially with a regular civilian or doctor who has never been in the military. Christiansen said many veterans prefer talking to other veterans about their issues because they share similar experiences.

Vets helping vets

Howard County has the largest gathering of veterans in the country. The annual Vietnam and All Veterans Reunion at the Healing Field, held in September, has become a place where veterans can come together and reflect on their time in the service.

But for many veterans struggling with mental health issues, three days out of the year is not enough time to heal.

While some veterans find individual therapy sessions to be effective, Christiansen said the greatest success can be found when veterans can talk to other veterans — whether it’s in small groups or one on one — because they can relate to each other.

“A lot of times, if you are a 60- or 70-year-old Vietnam vet, to pair you up with a young person straight out of college — it’s not really relatable,” she said.

Gardner meets with both residents of Jackson Street Commons - a 27-unit apartment building providing permanent housing and supportive services to homeless veterans - and other veterans in the community who do not have insurance coverage. He said veterans feel more comfortable talking to him as a clinician after learning that he was also in the service.

“I served in Southeast Asia during the Vietnam War, during the Cold War and then during Desert Shield and Desert Storm, so there’s that connection with my fellow veterans in terms of deployments, missions and that sort of thing,” Gardner said. “In the Army they have this thing called your battle buddy, in the Navy it’s your shipmate, in the Air Force it’s your wingman — it’s the concept of leaving nobody behind and we are all in this together.” 

Veterans at Jackson Street Commons have now started to refer Gardner to other veterans because they found his counseling to be beneficial.

“Having vets reach out to other vets is critical for getting them help,” Gardner said, noting that may be the only way to reach vets that won’t come forward on their own for treatment. “I encourage the guys to pay it forward.”

A caring community

North central Indiana is home to dozens of organizations and nonprofits that are dedicated to serving veterans, including the Howard County Vietnam Veterans Organization, the Military Foundation and American Legion to Mental Health America, Family Service Association and DAV.

“Looking at Howard County and Kokomo, it’s a very patriotic community and very supportive,” Gardner said. “There’s an appreciation for veterans without question, and I think it goes back to the fact that Indiana has deployed so many troops over the last 20 years.”

Although the state and community are patriotic, Christiansen said there needs to be a greater community involvement to find and assist the vets that need it most.

“Instead of complaining about flower pots or potholes — I would just say pause, and then volunteer,” she said. “Nothing will bring it home like volunteering.”

While many community organizations already work together to serve the veteran population, there needs to be more advocates for mental health working in the community, Christiansen said. She would also like to see the creation of mental health response teams of police officers, firefighters and EMTs to converge on crisis situations, and taking the person to get help instead of to a jail cell.

When it comes to the VA, Christiansen and Gardner both agree that the government organization is really trying to help the veterans in need of mental health services, but they say there’s just not enough mental health professionals employed to really make a difference with more than 400,000 veterans in the state.

“The biggest challenge that veterans tell me is that when they’ve gone to the VA, there’s a lack of continuity,” Gardner said. “There’s frequent turnover of psychiatrists or therapists that they’ve seen.”

Christiansen said the state needs to create better opportunities for mental health professionals to encourage them to practice here, stay here and develop those relationships with their patients.

“The greatest gift we can give another human being is listening to them,” Gardner said. “If we feel heard, we feel as if we matter — we feel affirmed.”

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