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    New Ways of Healing: Military Psychiatry and Veterans’ Mental Health

    Nov 2 2023

    “I’ve always been the matriarch of my family. Everybody comes to me for everything, and it was the same way in the military, and I pride myself on that. I’ve helped a lot of people and always encouraged them to come to me. But when I needed help, I was smiling on the outside while suffering on the inside,” said Tonya Oxendine, a U.S. Army veteran and spokesperson for the Wounded Warrior Project (WWP).

    Since 2003, Wounded Warrior Project, a 501(c)(3), has been changing outcomes for veterans by supporting their transition from service to civilian life through programs that nurture physical and mental recovery. It facilitates three programs that rehabilitate veterans’ mental and emotional well-being: Warrior Care Network®, Project Odyssey®, and WWP Talk.

    The APA Foundation’s Melvin Sabshin, M.D., Library and Archives is launching an exhibit exploring the history of military psychiatry on Nov. 10, 2023. Ahead of the library exhibit launch, the APA Foundation sat down to speak with Tonya Oxendine and Erin Fletcher, Psy.D., the Warrior Care Network Director at WWP, to learn how psychiatric care for veterans has evolved and what advancements still need to be made.

    Tonya Oxendine, Warrior Speak® Spokesperson, during and after her service in the U.S. Army.
    Tonya Oxendine, Warrior Speak® Spokesperson, during and after her service in the U.S. Army.

    Oxendine spoke to APAF about her experience with the Warrior Care Network and shared the story of how she found WWP:

    “I served 30 years in the United States Army and earned the highest promotion for my field. I was a drill sergeant at Fort Jackson, I was a master paratrooper in the 82nd Airborne Division, and I was a battalion command sergeant major leading over 1,500 soldiers. When I came back from Afghanistan in 2012, it did something to me. Stuff just started to unwind at that point, and I didn’t pay any attention, because I’ve always just been driven by my mission and done what I needed to do. But in 2012, my life started to unravel. It was like a rainstorm overtook my soul. In 2013 or so, I was looking out my office window and told my colleagues that I was getting ready to run an errand and I would see them tomorrow. I drove towards a bridge and intended to drive off it. I knew I couldn’t swim, and I would die. At that point, I don’t know what happened, but I credit my resilience and mental fortitude. I turned that car around, drove to Ft. Belvoir, went to the mental health counter, and said ‘I need help.’ After working with me and my therapist, the doctor there recommended Wounded Warrior Project to me, and that’s how I got involved. That’s when my healing started.”

    The mental fortitude demanded of veterans is as necessary after service as it is during service. Often when seeking care, veterans are faced with challenges and must overcome the barriers of both cost and stigma to connect to the resources they need and begin the healing process. Wounded Warrior Project helps address the cost barrier by covering all costs associated with its treatment programs.

    When veterans participate in Warrior Care Network, which requires them to leave their homes for two weeks for an accelerated evidence-based PTSD treatment experience, WWP completely covers any costs associated with the travel or with being away from home. For example, if a participant needs to board their dog while they’re participating in Warrior Care Network, it will cover the cost of the boarding. The same applies to the cost of travel.

    Stigma related to mental health can be even more difficult to overcome, especially for veterans. Asked what she would say to fellow veterans who are reluctant to admit that they are struggling, Oxendine said, “I know it’s tough to reach out and ask for help, but nobody will know we’re suffering if we don’t. Closed mouths don’t get fed. We’ve got to dig down deep and know that if we don’t try to reduce this stigma associated with mental health, it’s going to continue to be dangerous. There’s going to be someone to catch you and hold you up – I promise.” Other key pillars of reducing the stigma associated with seeking mental health care are increased access to healthcare, increased research and advocacy, increased community engagement, and more people like Tonya who are brave enough to take that first step and share their experiences.

    Advancements in psychiatric care have significantly improved mental health outcomes for veterans, but more progress must yet be made. 2020 data from the U.S. Department of Veterans’ Affairs (.pdf) shows that more than 5,000 veterans have died by suicide every year since 2001.

    Dr. Erin Fletcher shares details of the shifting approach to veterans’ mental health. “One thing that has changed is that care providers aren’t using a cookie cutter approach to treatment. Treatment is better tailored, and the treatment planning process is more collaborative and intentional. For another, there’s a lot we’re doing to reduce stigma, but having a group with the sway of the American Psychiatric Association saying that depression is no different than having high blood pressure, that’s where we want to elevate this conversation. There are some key nuances in the veteran community that should be respected and kept at the forefront, but the foundation of all of it is that mental health and wellness is a human experience.”

    Dr. Elspeth C. Ritchie, an APA member and retired Colonel who serves as Chair of Psychiatry at Medstar Washington Hospital Center, shares Dr. Fletcher’s hope for the future. “As the field evolves, there are more and more strategies to invite veterans into treatment, and then encourage them to stay and get better. Some of the different approaches include a focus on activities to enhance connection with each other, working with animals, yoga, and other exercises. As a former Army psychiatrist who is still practicing in the field, it is exciting to watch the many programs blooming. Nevertheless, as always, more needs to be done.”

    To learn more about the history of psychiatric care for veterans, visit the APA Foundation’s Melvin Sabshin, M.D., Library and Archives exhibit virtually or in person.

    For more information, see the National Center for PTSD (Dept. Of Veterans Affairs). For more information about programs for post-9/11 veterans and their families, visit Wounded Warrior Project.