Wounds that don’t show may be the hardest to heal

A veteran who had spent half of his life in military service couldn’t get the help he needed, texting that he wanted to kill himself.

His wife was brave; she called the police. That was a hard thing to do but it may well have saved his life. He was arrested on weapons charges and jailed.

The criminal justice system worked well in his case. During his trial, his lawyer requested a mental-health exam for him. His lawyer said his military experiences — he served several tours in Iraq, and last served as a medic — had lasting effects on his mental health: “Our main goal was to get him help and treatment … so he could be a father for his family.”

He was sentenced to time served and five years of probation, and his now getting the help he needs.

The veteran’s wife told his story to our Hilltown reporter, H. Rose Schneider, and we devoted our entire front page to it last week. Veterans deserve to get the medical treatment they need to be whole again.

A physical disability on a returning soldier — and they don’t have an easy time either — can be obvious but mental wounds are hidden.

The veteran’s wife told us that many people equate mental illness with moral failure. That makes it hard for someone who needs help to seek it.

We, as a society, need to move past that. Those of us who have not been to war cannot pretend to know how a veteran feels, but we must be empathetic and supportive.

As a medic in Iraq, the veteran saw thousands of wounded soldiers — with bad burns, severed limbs, or other near-fatal injuries. He was discharged only after he himself was badly injured by an IED, an improvised explosive device.

“Otherwise I think he would have pushed to the limit and died,” his wife said. “Because that’s all he thought he was worth.”

The veteran has sustained multiple traumatic brain injuries, lung damage, and shrapnel damage. When he came home, he was given medicines that didn’t help him. “But fundamentally the American protocol is to throw a drug at it,” she said, of mental illness.

Schneider outlined in her story programs at the Albany Stratton Veterans Affairs Medical Center — which is trying to enroll veterans — and also with Soldier On, which currently has a program at Albany County’s jail and plans to renovate the fromer Ann Lee Home in Colonie to house homeless veterans.

The day Schneider’s story ran, March 1, the RAND Corporation released a first-of-its-kind study, showing that few civilian health providers provide timely, quality care to veterans in New York.

RAND, which stands for research and development, was created after World War II to provide research to the United States Armed Forces and, in addition to the federal government, is supported by corporations, universities, and private individuals and endowments.

Half of New York’s veterans prefer getting care in their own communities, rather than at the VA, according to David Sandman, president of the New York State Health Foundation, which asked RAND to assess the readiness of the state’s civilian health-care providers to deliver high-quality care to veterans.

The VA spends about $6.3 billion each year on benefits and services for New York State’s 800,000 veterans, with nearly half of that spent on medical services.

As the federal government considers encouraging more veterans to use their benefits in community care, the study questioned doctors, nurse practitioners, psychologists, and others licensed health professions about seven measures of readiness.

While more than 90 percent said they could take on new patients, the proportion of providers prepared to care for veterans fell sharply as researchers applied the other measures. And many providers are not prepared to accept VA coverage.

The survey determined that while 92 percent of New York health-care providers were accepting new patients, only 2.3 percent met all criteria for effectively serving the veterans.

Most of the surveyed health-care providers fell short on requirements like being familiar with the military culture or routinely screening for conditions common among veterans.

Only 20 percent reported screening patients for military background. “As a result, many providers are issuing an opportunity to begin a conversation about how having a military history and background might have contributed to their veteran patients’ current medical condition.”

Many people with mental-health problems are not as fortunate as the veteran we wrote about — he has a wife who is doing all that is humanly possible to get him the help he needs. She kept the crime tape on the tree in their front yard, seeing it as a yellow ribbon that would welcome him home.

She told her story in the hope that it would make a difference, that it would start to lift the stigma. We hope it does.

Each of us no doubt knows someone suffering from mental illness, even if we’re not aware of it. According to the National Institute of Mental Health, one in six adults in the United States lives with a mental illness — over 44 million people.

These people need our support — both financially and emotionally. Our president’s current budget proposal would cut the Medicaid program — the main source of public funds for mental-health treatment — which serves more than 70 million people with disabilities or low incomes. It’s the same plan that failed in Congress last year, and would cut about $1.4 trillion of projected federal spending over the next decade, requiring states to fill the gap.

That means states, like New York, would be faced with choices, really tough choices, balancing priorities like nursing-home care against prenatal care, and mental-health help against addiction treatment.

As the federal government passes more costs on to states, the New York State Health Foundation was wise to commission the RAND survey on care of veterans. That survey shows that big changes need to be made in improving care for veterans in community health-care facilities.

As the wife of the veteran we wrote about made clear: Mental illness is not a moral failing. The brain, like any other part of the body, can suffer and need healing. We will be a better society if we provide well for people suffering from mental illness. Veterans especially — having been hurt in service to our country — deserve our support.


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