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State panel pushes to end PTSD stigma

When Jon Worrall suggests to young veterans that they seek mental health care, and they tell him they don’t need it, he turns to them and asks, “Do you think you’re more of a man than me?”

They’re always surprised to hear that Worrall – known as “Chief” – needs and receives care for a traumatic brain injury suffered in service in Iraq. And many of them take the step to get services themselves, he said.

When a state commission on post-traumatic stress disorder and traumatic brain injuries began meeting last year, members found no data to back up what they already believed from experiences like Worrall’s – that the stigma of needing and getting help is the biggest issue facing veterans in the state.

So while they say it’s too soon for concrete recommendations to address that problem, they approved a report Thursday with a recommendation to make the group permanent and expand its membership to include more civilian medical representatives.

“Veterans face an internal stigma that burdens them with perceived weakness and very real isolation in the wake of brain injury and emotional struggles,” the report says. “Educating our communities through public service campaigns and access to information is imperative to address the external sources of shame that drive our wounded warriors even deeper into denial and despair.”

To do that, the commission first had to document the needs of veterans and the barriers to addressing those needs.

The report contains the results of a survey from 1,200 veterans in the state. Thirty percent said they were not getting the help they need because they were embarrassed or ashamed of their need for services. Sixteen percent said they felt misunderstood by their health care providers.

New Hampshire has the fifth-highest veteran population per capita in the country, with almost 11 percent of residents having served in the armed forces.

Of those veterans, only 38 percent are enrolled at Veteran Administration health care facilities and only 25 percent actually receive care there, according to the report.

More may be eligible and not know it, but still, the majority of the state’s veterans are receiving care at civilian health facilities, which are often ill-prepared for the specific wounds – visible and invisible – that veterans carry, said commission Chairwoman Jo Moncher.

“There’s a whole host of provider groups that have not received any military culture education,” she said. “Our goal is to try to bridge that to bring the providers, servicemen and women together, bring the military and civilian providers together so we’re not just sharing information, but weaving services for veterans together to create a stronger continuum of care and a stronger safety net.”

Part of the problem, she said, is that doctors and nurses in civilian health care settings often don’t know when their patient is a veteran, and so can’t ask appropriate questions about symptoms.

The report recommends medical providers ask patients at registration if they’ve served in a branch of the armed forces.

If the commission is made permanent, its goals will be to further study the current situation, through focus groups with veterans, and increase coordination between civilian and military medical providers, including training about VA eligibility.

Six of the commission’s current 23 members are not currently or previously affiliated with the military or veterans organizations. Bringing in more civilian medical officials to the commission’s discussions will help educate doctors, nurses and other health care providers of the needs of veterans and strategies for successfully fulfilling those needs, commission members said.

The group would also develop a peer navigation network of state, federal and local services to help veterans and their peers navigate the health care system.

Several members of the commission who are veterans said they learned about services during their time working on the report that they didn’t know were available.

The commission has already achieved one step toward improving access to care. After veterans responding to the survey said they could not access care at the Manchester VA Medical Center because it didn’t have night or weekend hours, the center expanded the hours for primary and mental health care appointments, according to the report.

(Sarah Palermo can be reached at 369-3322 or or on Twitter @SPalermoNews.)

Legacy Comments1

"Do you think you're more of a man than me?" Wow! Give me a break.

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