“A man who is good enough to shed his blood for his country, is good enough to be given a fair deal later.” - Theodore Roosevelt
That quote is part of the emblem for the North Dakota Department of Veterans Affairs (NDDVA) which was established in 1945. The mission of this department is “to assist veterans of North Dakota and their dependents in obtaining all benefits to which they are entitled, both federal and state, either by direct contact or through the assistance of county veterans service officers, tribal veterans service officers, or national service officers”. This mission is highlighted most during the month of May which is National Mental Health Awareness month.
Langdon City Commission Chair Jerry Nowatzki shared his experiences when he was active duty in the Navy. Nowatzki was stationed on submarines which is an incredibly stressful environment. He shared that looking back on his time in the service, he and his shipmates all drank alcohol in excess to self-medicate. That level of drinking continued for Nowatzki and the majority of his close friends after they retired.
“Some of us developed anxiety problems after retirement, others depression, and we continued the self-medicating. I was lucky, my wife and I realized I had a mental health problem, and I chose to be proactive about it. I sought professional medical help for anxiety, and I no longer drink,” Nowatzki shared. “I’ve lost 3 close friends to alcohol-related health problems. I’m glad I sought help when I did. There seems to be a stigma about asking for help. All the branches of the military and the Veterans Administration try extremely hard to break the wall of pride or stubbornness between a solder, sailor, airmen or marine and the help some of them desperately need.”
The history of mental health needs among service members is a long one with each generation of soldier being more and more vocal about their needs for assistance. But difficulties remain for active duty service members and veterans alike when seeking treatment for mental health issues. More than 1.7 million veterans received treatment in a VA mental health specialty program in fiscal year 2018. A study by the Substance Abuse and Mental Health Services Administration revealed that less than 50 percent of service members and veterans receive one or more benefits or services from VA. Some of the barriers veterans face include:
• Personal embarrassment about service-related mental disabilities
• Long wait times to receive mental health treatment
• Shame over needing to seek mental health treatment
• Fear of being seen as weak
• Stigma associated with mental health issues
• A lack of understanding or lack of awareness about mental health problems and treatment options
• Logistical problems, such as long travel distances in order to receive this type of care
• Concerns over the veteran mental health treatment offered by the VA
• Demographic barriers and false perceptions based on these demographics such as age or gender
Cavalier County Veterans Service Officer Leon Hiltner has helped many veterans throughout his years to receive the services they need, including mental health. Hiltner shared that he believes that mental health is a major concern for not only the VA but the country as well.
“I have dealt with mental health issues in my occupation here. Applying for PTSD or even traumatic brain injury, we’ve had those claims come across the desk. I have used the resources provided me by the State of North Dakota and VA. I actually have on my phone the crisis hotline in case someone calls me when I’m not in the office,” says Hiltner.
Mental health is an all encompassing term, but there is a pattern of conditions that have been noted to affect veterans more. The RAND Center for Military Health Policy Research has found that 18.5 percent of the vets who served in either Iraq or Afghanistan suffer from either major depression or post-traumatic stress disorder (PTSD). Within those two categories, 19.5 percent of vets have experienced a traumatic brain injury. These three service-related disorders, alone, have an enormous impact on the demand for veteran mental health treatment, and efforts to help have increased.
“It’s a big national effort to recognize the mental health issues in a veteran and address it so that the outcome isn’t devastating. It’s a top priority in the VA. Mental health issues results in a lot of suicides,” Hiltner said. “There is a stigma attached to veterans and people in general that if they have a mental health issue that they’re weak, and that’s not the case. It’s a medical issue, and it just happens to be on the mental side instead of the physical side of a person."
A 2013 report of mental health care for veterans found that the mental health workforce had insufficient capacity to address the needs of service members, especially those returning from active duty service overseas. In addition, the study found that the existing workforce lacked sufficient training in evidence-based practices, and there were inadequate organizational systems and tools to support mental health quality improvements. Veterans from rural communities are at a particular disadvantage as they face challenges such as limited options for assessment and treatment and providers’ lack of awareness of military culture.
“Veterans can talk to other veterans. That doesn’t seem to be a stumbling block as far as veterans are concerned. They do have a hard time talking to people that don’t understand their experiences - in other words, somebody who isn’t a veteran,” Hiltner shared. “Recently, we had a bit of a setback. We have what we call the Vet Centers, and they’re associated with the VA indirectly. One of the staff members, who is basically a counselor, was cut because of funding within the last year. That was a major blow because that resource is important for our area of veterans to contact the Vet Center and have help available that is relatively close by.”
Hiltner shared that this “bad deal” has had an impact on area veterans to reach the services they need. He does note that the Cavalier County Veterans Service Office does participate in a federally funded program that provides transportation for veterans to any medical appointment at no cost to them. This local program, operated by the NDDVA, is one of many services and programs implemented to assist active duty service members, veterans, and their families.
NDDVA Commissioner has issued a Challenge on Suicide Prevention that only involves 25 minutes of your time viewing a suicide prevention video. The video was a collaborative effort between the Veterans Administration and PsychArmor Institute to educate viewers with the basic knowledge of what the signs may be for someone who is struggling with the thoughts of suicide, and it provides ideas on how to help.
There is a more high tech approach as the VA has rolled out apps for phones. VA Mobile Health aims to improve the health of veterans by providing technologies that expand clinical care beyond the traditional office visit. These apps are developed for both veterans and VA care teams, offering safe and secure mobile access to patient data and providing more opportunities for veterans to be active participants in their health care. To access available apps, visit the VA App Store.
The few resources provided within this article only serve to remind the community that there is still so much more that can be done. It starts with ending the stigma among veterans and civilians alike in regards to mental health and those who seek assistance and care for these conditions.
“The mental health issue has actually come a long way within the veteran community, but it still has a long way to go. If we could accept the fact that a mental health issue isn’t a sign of weakness in people and change how people respond to someone who has a mental health issue, that would be a big improvement. We, meaning the people, have to get over the fact that mental health shouldn’t be stigmatized,” Hiltner says.
A special note from Hiltner to the community is that there will be a Memorial Day program aired at 10 a.m. on the local radio station featuring the guest speaker and Hiltner reading the names of Cavalier County veterans who have died. Hiltner also encourages the community to stop by the American Legion to view the display honoring these veterans.