Analyzing WH plan to aid veterans suffering from burn pit exposure, suicidal ideations

President Joe Biden said Thursday his administration is moving to make it easier for veterans to get their illnesses from burn pits to be recognized by the Department of Veterans Affairs. Many veterans have suffered after their exposure to toxic air while serving in war zones. Nick Schifrin reports.

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  • Judy Woodruff:

    On this Veterans Day, the Biden administration is moving to make it easier for Iraq and Afghanistan war veterans who were exposed to toxic air from environmental hazards known as — or such as burn pits to qualify for health care and assistance from the federal Department of Veterans Affairs.

    Here's what President Biden said today at Arlington Cemetery:

    Joe Biden, President of the United States: Our administration is going to meet the sacred obligation that we owe you.

    We're going to work with Congress, Republicans and Democrats together, to make sure our veterans receive the world-class benefits that they have earned and meet the sacred specific care, specific needs that they each individually need.

  • Judy Woodruff:

    And Nick Schifrin joins me now for more on this.

    So, Nick, first of all, remind us, what are burn pits that were used in these wars, and what does it mean when the president says the specific needs of each service member?

  • Nick Schifrin:

    Yes, so 3.7 million service members served in Iraq, Afghanistan, and the Persian Gulf all the way back to the early '90s and the Gulf War.

    And many of them were exposed to toxic air, including by burn pits, literally pits where the military would burn everything from tires to styrofoam right next to where service members and lived and worked.

    And veteran groups argued that created toxic smoke that afflicted service members with higher-than-average rates of illnesses, from asthma to cancer. And, for President Biden, this is personal. He believes that his son Beau's brain cancer after service in Iraq may have been caused by a burn pit.

    But of the 40,000 service members who applied for disability compensation or medical care since 9/11 for cancer, 60 percent were rejected. And the VA says there's no scientific proof that those illnesses created — were created by toxic exposure during service. And to determine that link, VA relies on data from the National Academy of Sciences.

    Now, in August, the VA eliminated that threshold for that link for less deadly conditions, like asthma. And, today, the White House is talking about cancers that veterans groups say are linked to toxic exposure during service.

    For cancers, from now on, the VA will look at not only National Academy of Sciences data, but their own real-world data to — quote — "lower the evidentiary burden" to connect cancers with exposure to that toxic smoke during service. The VA has 90 days to look into this and report back.

  • Judy Woodruff:

    So, this is a development.

    So, Nick, what has been the reaction to what the administration is saying?

  • Nick Schifrin:

    The reactions range that my colleague Dan Sagalyn and I have heard from Rosie Torres of Burn Pits 360, who called this today B.S., because of the time it will take, not only the 90-day review, but also another step after that that will require multiple months before anything can change.

    We also spoke to Jeremy Butler of the Iraq and Afghanistan Veterans of America. He called this "a great first step, but it is not enough and it is not fast enough. I completely believe they are working in good faith, but it is just too slow."

    And here's what former Secretary of Veterans Affairs David Shulkin said to us earlier today:

    David Shulkin, Former U.S. Secretary of Veterans Affairs: I don't think it's fast enough. I do think that it's a signal of moving in a different direction and in a positive direction.

    I think what the White House is signaling is, is that the current system is not working, and they want to find a way to change it. What they're suggesting is a new way that I think does make sense, and they want to pilot that. And they want if to lead towards better results.

  • Nick Schifrin:

    But that pilot will take months for cancers, and then, and only then, consider other illnesses.

    Meanwhile, legislation on both sides of the House that would grant a range of benefits for a range of illnesses, that's what veterans groups want to pass.

  • Judy Woodruff:

    So, we will see.

    So, Nick, there is something else that I want — that you have been looking into, another story on this Veterans Day. It's what the White House has called a national security crisis. And that is suicide rates among veterans.

  • Nick Schifrin:

    Yes, the White House, since 2010, 65,000 veterans have died by suicide. And that is eight times the number of U.S. service members who died fighting since 9/11.

    Now, among active-duty, the Department of Defense says 580 died by suicide in 2020, and, since 2015, the suicide rate has increased from 20.2 per 100,000 to 28.7 per 100,000.

    To examine why, I spoke to David Wood, Brigham Young University professor and licensed psychologist, who is in the Reserves and is the operational psychologist for the Utah National Guard.

    What he told me are his personal views and don't represent the Defense Department.

    I asked him earlier today about research he's done and one reason that leads veterans to die by suicide, the loss of connection and purpose.

  • David Wood, Brigham Young University:

    The transition out of the military can be very disconcerting, very disorienting for many veterans and service members. The loss of purpose, loss of camaraderie can be very, very distressing.

    It's hard to replicate that same experience that was very orienting, very reassuring in the military service. And there is that sense of disorientation that can be really upsetting.

  • Nick Schifrin:

    You also write about veterans who face a crisis, and then make rash decisions. Talk about that.

  • David Wood:

    Yes.

    Dr. Craig Bryan at The Ohio State University has helped us understand that many individuals, they face an emotional crisis and don't have a clear idea or a coping plan for how to deal with that. And so one of the ways he's helped us as clinicians is to create what's called a crisis response plan, so that, when a crisis does occur for a veteran, there is a game plan for trying to cope with it the best they can, which always includes connection with others and a connection with emergency services, such as a suicide crisis line.

  • Nick Schifrin:

    Talk about how, in these crises, access to firearms plays a part in this.

  • David Wood:

    The main problem is that, when a veteran attempts suicide with a firearm, obviously, it has a high lethality rate, whereas other means or other methods to try to take one's life are not as lethal.

    And we have to be creative too, because many veterans and service members in particular don't want to have restriction to their firearms. And so we have to have creative solutions that help the veteran or service member say, you're in a crisis now. Is there some way we can put a lock on the gun, store the ammo separately, or give it to someone?

  • Nick Schifrin:

    How does post-traumatic stress exacerbate some of these problems that we have just discussed?

  • David Wood:

    Post-traumatic stress can definitely contribute to that sense of disconnection, a sense of disconnection, also a loss of purpose, a sense of foreshortened future.

    And then, also, there can be recklessness and impulsivity as a part of PTSD. So, really, it does contribute in many ways.

  • Nick Schifrin:

    And have you seen death by suicide increase when it comes to what's known as moral injury? Can you explain what that is and whether that is playing a part in this?

  • David Wood:

    Yes, moral injury is essentially either a service member or a veteran who has violated their own sense of values, or they have seen the violation of values in others.

    And that can create some emotional injury, which we call moral injury. And that can contribute as well, because that can help — that can undermine a person's sense of worth or integrity, and also maybe create a sense of alienation or disconnection from one — from people that they would normally — or previously trusted.

    One example that comes up a lot, or one specific example is a battle buddy, a fellow soldier was sent into a combat scenario by a commander, and that individual was killed. And the assessment on the back end, the hindsight, was that that was not necessary, that was rash, or that was not helpful. And that creates a really strong lingering sense of anger and betrayal.

    Another example is when — in combat operations when enemy combatants engage children or seemingly noncombatants, such as local farmers or individuals, they oftentimes are — because of rules of engagement, are shot or killed. And that can create a real lingering sense of violation of one's values as an example.

  • Nick Schifrin:

    And those feelings, of course, continue long after the service members have left combat.

  • David Wood:

    Very much so. Yes, it lingers for a long time.

  • Nick Schifrin:

    Let's talk about some solutions.

    The White House recently unveiled a new strategy to prevent military veteran suicide. It called suicide rates a — quote — "national security crisis." And the strategy calls for improving firearm safety, expanding high-quality crisis care, as well as follow-on mental health support, and addressing mitigating factors, like financial strain, a lack of housing.

    Are those the right steps?

  • David Wood:

    I think those are on the right track. Programs can help. Treatment can help. Support systems can help, such as the crisis lines.

    I also think, though, that there are things that happen in the white space, such as really having meaningful connection. Programs, policies, support systems aren't going to ever replace that sense of meaningful connection and the sense of meaning, purpose, and personal worth.

  • Nick Schifrin:

    And speak about your personal experience. What are you focused on in your clinical practice?

  • David Wood:

    Definitely, values, connecting the veteran to personal values.

    The values is the idea that gives them a sense of importance for living, meaning, purpose, and personal worth, and also kind of that internal compass. We find that, when we can connect that individual to their values, that gives them the long-term view, and helps to kind of calm down that sense of crisis and urgency that would otherwise take them off track of those values.

    One in particular who had three different factors, major disruption in relationship was very, very distressing, and then feeling like a burden to others, he would say things like, I don't feel like a — I feel like I have been a lousy friend to you as my friends and people are better off without me around.

    And in critical moments, I was able to help him, this individual. He would say, hey, I'm in a bad place, and just kind of sitting with him, talking with him, talking him through it, bringing that sense of — that sense of urgency and suicidality down. It clears the air for connecting to those values, like, hey, this is not what I want to do.

  • Nick Schifrin:

    And zooming back out, can there be structures in place to provide those values to so many veterans and active-duty who need to remember them?

  • David Wood:

    I do think that that needs to be a focus of any intervention or program to really get the veteran back to their own values, not necessarily providing it to them, but probably more like helping them rediscover it.

  • Nick Schifrin:

    Dr. David Wood, thank you very much.

  • David Wood:

    My pleasure.

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