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Veterans Day 2020: Veterans receiving new methods of treatment for PTSD and other behavioral health concerns

Fayetteville Observer - 11/3/2020

Nov. 3--This story is part of our special Veterans Day section, which will run in print Sunday, Nov. 8. Look for more stories from this special publication throughout the week.

The Global War on Terror often fails to end for service members once they redeploy home to the United States.

They often bring shards of war back home with them, both physical injuries and mental issues that can prove difficult to overcome.

For some soldiers, their behavioral health reveals a significant prevalence of traumatic brain injury, post-traumatic stress disorder and other psychiatric symptoms such as anxiety and depression.

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Mental health issues have drawn a lot of attention during this war, and in response, new programs and forms of treatment have been developed on the homefront to combat them.

Dr. Michael West serves as deputy installation director of Psychological Health for Fort Bragg.

In terms of programs, he said, efforts are ongoing to improve access to healthcare.

"There are really two prongs to this," he said. "One prong is to treat the identified issues and, second, improve performance and optimize readiness. It's not just a matter of treating those with issues. If they don't have traditional behavioral health issues, how can we help them perform at a higher level? Those are programs we're working on now at Fort Bragg in the Department of Behavioral Health."

More recently, West said, the focus has shifted to readiness. He believes that behavioral health in the military is shifting more to total force fitness.

"Which is not just helping people recover when they have issues," he said, "but having people strengthen their ability to be resilient. To tolerate stress. To take someone who is weak in a certain area and build them up."

This total force fitness care may require a focus on communication skills, leadership skills or the ability to interact with people at home. It involves working with service members to become more resilient rather than simply strive for recovery.

Take a good soldier, West said, and make them even better so they can perform at a higher level.

Besides this primary focus on readiness, physicians are using evidence-based treatments, West said. Those treatments have been shown by science to be effective in treating trauma, depression or anxiety.

"Science tells us what to do in terms of what we need to do," he said. "The skill on how to apply them is very important and is an art that we mix with the science."

"Overall, soldiers do very, very well," West said. "We're also addressing family members with this. A ready soldier has a ready family. We're not just dealing with the people wearing the green suits. It's the whole family unit. When they're doing well, soldiers are doing well."

West said "a very small percentage" -- roughly 20% of the soldiers -- develop PTSD symptoms from the war, but much of that will resolve on its own and never require behavioral health intervention. Most symptoms resolve on their own. But other conditions also can spring from trauma, such as anxiety and depression.

Shannon Lynch, spokeswoman for Womack Army Medical Center, said the post has the Fort Bragg Intrepid Spirit Center that's largely for active-duty soldiers. She called it "a one-stop shop for traumatic brain injury, post-traumatic stress disorder and pain management."

The Intrepid Spirit Center utilizes "a holistic, multidisciplinary approach to better determine the cause of persistent post-concussive symptoms," the Womack Army Medical Center states online. "They provide comprehensive treatment for functional deficits associated with concussion/ traumatic brain injury. Team members meet regularly to discuss individualized patient goals and progress, making changes as needed to ensure maximum recovery."

The Fayetteville Veterans Affairs Medical Center, too, is integrating what it calls whole health clinical care into its various regimens of traditional behavioral healthcare.

"Whole health isn't a program or service. It's an approach to care," said Christina Vair, director for Whole Health for Salisbury and network sponsor for the Veterans Integrated Service Network 6. "Whole health is for all veterans and a way for the VA to provide care in a variety of settings.

"It focuses on how we meet each veteran where they are at. What matters to them. We're asking the question -- not 'what is the matter with you?' It's 'what matters to you?'"

The Fayetteville VA falls into the Veterans Integrated Service Network 6, a region that includes all the Veterans Affairs medical centers in North Carolina and Virginia.

She said the Fayetteville Veterans Affairs Medical Center is in its third year of offering whole health clinical care.

"We're trying to integrate this model of care into the VA," Vair said. "I think the biggest challenge has been engaging (the more traditional) physicians. Veterans want this kind of care. It's about the mission and purpose in life. It's another piece of this whole health model. We're making sure we're bringing new approaches."

Those whole health approaches include acupuncture, Tai Chi and yoga.

"These are valuable ways ... to work with chronic pain and mental health concerns," she said. "We're cutting down on the use of pain medication and offer the service as an alternative. It's how to have a better outcome and not need these harmful and addictive drugs."

Veterans who participate, Vair said, have a three-fold reduction in opiate medications.

This approach to care is applicable to all generations of veterans, she said, and whole health coaching is offered to anyone with health concerns.

Anthony Guido, a spokesman for the Steven A. Cohen Military Family Clinic at Cape Fear Valley, said the biggest thing this year during the COVID-19 pandemic is the delivery of CVN Telehealth via the Zoom platform.

"All care is delivered online now," he said.

Since the start of the pandemic in mid-March, the Cohen Veterans Network has treated more than 3,000 new clients, almost all remotely via CVN Telehealth, according to the website.

"It's the same high-quality therapy we're always offering in clinics," Guido said. "We've had really good results. Even better results for people doing it at home."

Mark Gronski, a clinical social worker specialist, is the hospital administrator who oversees clinical services for Behavioral Health Care at the Cape Fear Valley Medical Center.

"We've got programs throughout the service line, with veterans particularly," he said.

In conjunction with the Fayetteville Veterans Affairs Medical Center, Gronski said, a number of services are available for the military veteran. These include individual, family and group therapy on an inpatient and outpatient basis.

"These are ongoing services we provide," he said. "Hopefully, in the next month or so, teenagers of military veterans will be connected, too. We're working and conducting new outpatient group therapy to help them be more productive. This is not just for veterans, but active-duty folks, as well."

Staff writer Michael Futch can be reached at mfutch@fayobserver.com or 910-486-3529.

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