As the nation honors its war dead on Memorial Day, U.S. Sen. Ron Wyden spoke with some of the men and women whose job it is to help veterans and others avert suicide and substance abuse.
The Oregon Democrat spoke via video conference call with staff members of Lines for Life, a nonprofit based in Portland that maintains crisis intervention lines, one of which is for veterans. Others are for youth, older people, racial and ethnic minorities and substance abuse.
According to a U.S. Department of Veterans Affairs report issued Nov. 12, the daily average of veterans who take their own lives was 17.6 in 2018. VA said it detected no uptick as a result of the onset of the coronavirus pandemic eight months earlier.
Still, Wyden said, that 2018 daily average would suggest 60 veterans will die by their own actions by the close of Memorial Day weekend.
"It is urgent business to attack veterans' suicide with every single tool in our toolbox because the numbers are so stark," Wyden said. "Each of these suicides ripples out so many times over. Lines for Life is the gold standard in making a real difference."
Wyden had planned to visit the Portland offices, but Senate business kept him at the U.S. Capitol on Friday, May 28.
"With Memorial Day in our sights this weekend, we are thinking about the veterans we serve and their families," Dwight Holton, chief executive officer of Lines for Life, said in his introduction.
Assistant Director Deborah Zwetchkenbaum estimates she has fielded more than 5,000 calls, 1,000 of them from veterans or their families, during her 12 years at Lines for Life.
"Picking up the phone can be really difficult, especially for people in the military trained in military culture and used to bringing themselves up by their bootstraps," she said.
"When people do find the courage to pick up that phone … even when people are getting ready to act on their lives, what I have seen is that turnaround. When someone reaches out and calls, some part of them wants to live. Miracles happen."
She said people are familiar with the term post-traumatic stress disorder, but there is another side.
"We do not hear enough about post-traumatic growth. That is what we learn every day on the crisis lines," she said. "You are in that dark tunnel and cannot see the light. But the light is there. When people call, our crisis workers are coming in with a flashlight … and we are going to find the way out together."
Wyden himself has no military service. But his father — Peter Wyden, a refugee from Nazi Germany — enlisted during World War II after nagging the Army that it needed German-language specialists to write anti-Nazi propaganda. He served in the Psychological Warfare Division.
For his part, Wyden said the work done by Lines for Life and treatment services is valuable.
"They stay with people," he said. "They help them navigate the system."
But Wyden, whose brother Jeff had schizophrenia — their father told that story in a book published in 1998 — said he was dismayed to learn from Holton that insurance companies continue to resist claims for mental health services on a par with those for physical health despite a 2008 federal law for parity.
A year ago, Wyden was the top Democrat on the Finance Committee — he is now its chairman — when he asked the Government Accountability Office to look into why claims for mental health services by providers at Oregon Health & Science University and elsewhere were not being paid promptly. Providers then told Wyden they suddenly got paid.
A GAO report April 30 confirmed there were problems, although the pandemic may have limited the data.
"I do not think there is a fair shake for mental health and their providers when bills are so stacked up that they get into the newspaper, and then bills get paid," Wyden said.
Staff members told Wyden that the pandemic has had an effect on veterans, even if it is not reflected in some of the numbers.
"When it comes to veterans and suicide deaths, isolation is the killer," Ryan Seymour, military services training specialist, said. He is a veteran of the Oregon Army National Guard and Afghanistan service.
Shannon Pullen, also a military services training specialist, said isolation has resulted in veterans and others reverting to use of alcohol and other drugs.
"They find themselves drinking again," she said. "Their substance abuse issues are coming back when they might have been in a better place with it just a short time ago."
Despite desegregation of the U.S. armed forces almost 75 years ago and President Joe Biden's recent appointment of the first Black defense secretary since the services were unified — also 75 years ago — Darryl Turpin said the pandemic has exposed persistent unequal treatment of racial and ethnic minorities in the services. Although non-Hispanic whites still account for a majority of service members, about 40% are not.
"We know there is a large (minority) contingent in the military," Turpin, director of equity and engagement, said. "This is something we cannot continue to ignore now that COVID-19 has exposed the mental health crisis in our community and how systemic barriers created by racism are inflicted on service members."
Turpin said the workforce for mental health and substance abuse treatment must include more people of color — but even that is not enough. He said his intent is for all professionals, regardless of color, to undergo additional training to have the skills to help all people who seek help.
"We have to have culturally responsive services specifically targeting that group," he said.
Holton said that goal could be advanced with a potential state certification for professionals who undergo such training, so that more people in the mental health workforce can respond to others.
"We are in a world where, when people are comfortable asking for help, there is help to be given," he said. "When we are still in a world where people are embarrassed to ask for help, they are not going to get it."
Ian Michael's father and uncle both had military service, and Michael himself went from high school into the Marine Corps before his discharge. He has lived in Oregon just a few months.
"I came to Oregon with this thought process that everyone understood military culture," Michael, military liaison for Lines for Life, said. "When I asked questions, it was quite shocking that people are so disconnected from the military."
Michael and Seymour said the services are still better at training people for war than for transitioning back to civilian life.
"When you go into the military, they hand you camouflage so you can hide and a rifle so you can kill. When you get out of the military, they hand you a piece of paper and say go get some signatures," Michael said. "If we can equip someone to kill, we can equip someone to start their career.
"We give them all of these weapons to defend our country. Where are the weapons they can use to defend themselves?"
Seymour said transition work should not be limited to the Department of Veterans Affairs, which provides 9 million veterans with care. The other 12 million fall under Medicare, the federal program of health insurance for people 65 and older, and for some people with disabilities. He said training of Medicare providers should complement the VA.
He said that extended training could avert future personal crises.
"We often miss opportunities. We can help people prepare for crises, because humans experience crises," Seymour said. "If we can prepare them in calm waters before the storm, I think we can make a significant dent in suicides in the community."
Wyden said he is considering proposing an expansion of mental health services under Medicare.
Donna Libemday, director of prevention, said veterans and others need help to make their way through what appears to be a complex system of services.
"The gap is how you navigate that system," she said. "When you are hurting and you are scared for yourself and your family members, or your family member is hurting, it's not an obvious route."
Holton sees hope in the national implementation of 988, starting in July 2022, as the national three-digit number for Americans to call crisis intervention lines, connect them with help and where to find it.
"It is an exciting opportunity to significantly transform the way we do crisis in Oregon," he said. "We're going to make it easier for people to find help in a crisis, and when they find it, it's going to be the right kind of help, delivered by the right kind of person at the right time.
"That does not mean there will be an avalanche of crisis. There will be an avalanche of hope."
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