(bright music) - And welcome back to "Family Health Matters."

I'm Shelley Irwin.

With me today, Kym Hansen-Duell, licensed social worker therapist at Pine Rest, and Shane Scherer, director of the GVSU Military and Veteran Resource Center, to continue this conversation on veterans and mental health.

How are you involved with Grand Valley, Shane?

- Yeah, so I oversee the Veteran Resource Center.

There's one on the Allendale campus, and there's also one at the Downtown Health Campus, and I'm basically in charge of planning the strategy, the mission, and the programs that the veterans on campus utilize, as well as the administrative tasks as as well, and I'm also the primary resource person and advocate on the academic side too, if they are struggling or need help.

- Do we thank you for your service?

- 100%.

- Well, your service, we'll talk about your story.

Kym, tell us a little bit about you and your role.

- Well, I have been a clinical therapist for over 25 years, and I have fell into that because of my interests really in evidence-based treatments, and really being able to sit down and help people in a more formal way, and I continue to do that at an outpatient clinic in the Traverse City area.

- Why your choice, perhaps niche, of the veteran in your care?

- It's personal and professional.

Professionally speaking, it's just a group of individuals that I really feel passionate about helping.

I also have had the opportunity to participate in some extra evidence-based treatments for trauma, so that kind of sets me up to really be able to work with service members.

And personally, my father was in the military.

He was in the Korean War.

He was a tanker in the Third Herd, very proud, so for that reason, it's also very important to me.

- We'll get into this, but are you busy?

- Just a little bit all the time.

- Yes, yes.

Tell us who are today's veterans, Shane?

- So today's veterans are a very small percentage of the overall US population.

It's 6.4%, excuse me, that's not a very large number, and they span from, we still have World War II veterans, which is awesome, all the way out, many conflicts, to the most recent, you know, Iraq and Afghanistan.

- Yes, let's talk about today's veterans and their challenges, and I'll start with you on any challenges that you see with your- - Sure.

I think anytime you've deployed and are away from home for long periods of time in very stressful situations, it's just a recipe for situations to arise, right?

So in my case, I work specifically with student veterans.

So those individuals are not only coming back, they're trying to go back to school, generally a little older, have families, they don't have the traditional college experience than a normal incoming freshman would have, right?

Their life experience is different, much different than the average student, so they bring a bunch of unique opportunities for growth and things, but there is those things like anxiety and adjustment disorders and PTSD that are all lurking around.

And I think a misconception is, is that everybody that deployed does suffer from some sort of mental health issue, when that's not the case either.

But there is problem, there's struggles across the board, specifically in mental health, and some, you know, have the physical problems with, they may have been a blast injury or loss a limb, or they struggle with burns or things like that, so there are the physical, but there's also those hidden wounds of war that people aren't aware of.

- [Shelley] Who comes to see you, Kym?

- I have a combination of combat veterans, veterans, and I actually have a couple active duty people that I'm currently working with.

And the individuals that end up in my office, typically what brings them in is gonna be problems with sleep and/or substance use, and symptoms of depression, and then that opens, you know, opens the door to us exploring some of the other coexisting conditions, which might include symptoms of PTSD or anxiety.

- I'll stay with you on the mental health side.

What are signs and symptoms that a veteran may need to ask for help?

- I'm gonna go back to sleep, I think is probably the number one, you know, sign someone who's really struggling with sleep, to the point that they have what we'd call functional impairment, so to the point that it really is impacting their everyday life.

And then symptoms of anxiety, that difficulty with really being able to relax, symptoms of depression, decreased energy, motivation, depressed mood and thinking.

And again, a lot of these symptoms overlap with the symptoms of PTSD as well.

- Shane, why do veterans struggle with mental health?

I'm leading the question.

- Yeah, I think because you're so used to a certain way of life while you're in the military, that vigorous structure that you're with all of your buddies, that constant camaraderie.

You have all of the resources at your fingertip.

You don't have to go, excuse me, look outside.

Everything's self-contained in the military, so you're in such a hurry to get outta the military, you're just out processing, and you just wanna be done, and then you're thrown into this big lake, and you don't know where anything is.

So all the things that you're used to and accustomed to are completely upside down, and you have to go seeking those yourself, which, you know, by seeking, you're admitting that there might be a deficiency or a problem, which nobody wants to, you know, I'm guilty of that as well.

I'm lucky enough to have an in-house therapist that lives with me that can help navigate those situations, but I was a big no for a long time that this isn't me, this doesn't apply to me.

So I think it's the self-realization that you need help is really the root cause.

- Well, in a minute, I wanna hear your story.

Where does treatment start?

- It starts with maybe someone seeing their primary care physician and then hopefully a referral, and again, issues like sleep.

Chronic pain is another thing that, a set of symptoms that gets someone in the door and helps us explore.

So you know, whether it's primary care or the encouragement of a spouse or family member, that's where it starts.

We get that person in the door, and then we can do the work.

- Would you share a bit of your story, Shane?

- Yeah, so I deployed in 2009.

There's 11 days left in my deployment.

I was getting ready to go home, and we were in the process of transferring over our unit to the new one.

I was stationed at COP Keating.

Jake Tapper wrote a bestselling book, "The Outpost," later became a movie, pretty much a hot zone for three consecutive tours.

And so while I had just gotten back from the gym, an anti-tank missile blew through an (indistinct) Humvee, landed 12 to 15 feet away from me.

I experienced a severe traumatic brain injury with penetrating head wound.

I ended up having to be sent to a forward operating base, where I had a craniotomy performed by a general surgeon who had never done the procedure before.

He actually called stateside and had to call seven places before a doctor would walk him through the process.

Later, I made it to Germany.

They kept the hole in my head larger, and then I was at Bethesda Navy Medical Hospital for a month, and then the Palo Alto VA for nine months, where I learned to relearn to walk, talk, swallow, and do basic arithmetic.

And then spent a year at Fort Lewis, Joint Base Lewis-McChord being medically retired, doing outpatient therapy.

So the half of my career was training and deploying, and the other half was getting better and being out-processed outta the military.

- Did you deal with mental struggles?

- 100%, but I didn't realize I was dealing with them, and I tried to suppress and push those down.

And it wasn't until I got out and realized I didn't know what I was gonna do next in my life that I realized that this is not, that some of those things did actually exist, right?

Whereas I was just so focused on getting outta the military, I wasn't taking good care of myself.

- You heard the story before, Kym?

Maybe not as, you know, traumatic.

Thank goodness all is well, as we see, but yes?

- Yes, I've heard similar variations of that as well.

- Yes, how are you treating your, I mean, were you diagnosed with a PTSD or?

- Yep, so I have a PTSD rating through the VA.

I suffer from anxiety.

You can hear it my voice, so- - That's nothing new here.

- Right, right.

- Don't take that personally.

- It's associated with the injury, but yeah, and because of the traumatic brain injury, a lot of those things overlap, so it was really hard to differentiate between which particular situation caused what, right?

What symptom, is it PTSD, is it traumatic brain injury?

So yeah, those all exist, and they're all under the umbrella of my mental health journey.

And I have good days and bad days, but I have more good than bad.

- Good.

Kym, how do you take your patients on their journeys?

- You know, like I said, we get 'em in the door, and then we have to develop that relationship.

That's so important.

Maybe they've had experiences trying to seek treatment prior to coming to our outpatient clinic, and so we work on developing that relationship, and then assessing the needs and assessing what's going on so that we can start where they are at, and we start wherever that is, and we can, you know, we take the time we need.

So if we can get that figured out and established, work on that relationship, then the next step is really psychoeducation and sharing of information.

Many of the veterans that make it to my office haven't been formally diagnosed, or haven't had somewhere really explain what their symptoms mean and sort that out, and so I really like to take the time to be able to do that, because that then guides treatment, and it tells us what we need to do next.

- We still hear, I'll go there, of the many veterans to this day committing suicide.

What do you say about that?

- Well, it's absolutely tragic.

You know, we need that number to change.

It's depression, symptoms of depression are, you know, among the top symptoms that veterans struggle with.

There are some really interesting studies on, you know, trying to help and work with people.

And there's a man by the name of Thomas Joiner, a PhD who is in the military, who has some really interesting information and insight into how we can help veterans and mitigate that suicide rate.

- [Shelley] What do you have to say about the topic?

- It's a tough one for me.

I've lost one of my battle buddies, Paul Saliva, to suicide, so it's near and dear to my heart as far as advocacy and people getting out there and whatever can be done to help.

- We hear also the correlation with substance abuse.

Talk about that.

- Yeah, so that, I think that's a crutch.

I was guilty of it, excuse me.

I couldn't do anything without, social, if there was an alcohol present, I wasn't going, because that was the only way I could put myself in a room with multiple people I didn't know and feel comfortable enough to interact.

Otherwise, I would just be home.

Like that was the status quo for a long time until I realized that I just needed to stop drinking, which has happened, and has been a game changer in my life.

- Yes.

Kym, do you work with your patients on recognizing triggers?

- Absolutely, absolutely.

One of the treatments that is been considered to be the most effective when it comes to symptoms of PTSD, is prolonged exposure, and in working with people on those treatment protocols, we do a thorough interview, and it starts really with that understanding of again where they're at, and we explore the triggers, we talk about the avoidance behaviors, and those things that really impair their functioning.

- What about the difference of men versus women in your services?

- You know, this might be interesting.

There are more men that come to see me for help than women, and I don't know what that means.

Perhaps it means women seek help in other ways.

I'm hoping that's what that means, but the majority of veterans I work with are male.

- Back to what you do for Grand Valley, talk a little bit about who you're serving, and how this conversation- - Yeah, so I serve the student veterans and military connected family members.

I help with a wide range of things, so I make sure that they're connected to their benefits, that the prospective students are aware of the benefits that GVSU has to offer.

I cross collaborate with other departments to make sure that we have an inclusive military and veteran-friendly campus.

I'll advocate for any and all of my student vets with whoever that needs to be if there's any problems academically to try and square away any situations, and I'm their primary point of contact.

If they have any problems, that's what I do.

I fix 'em or try to.

- And male and female both in this?

- Everybody, and we are very inclusive.

However, whoever, whenever, you just reach out, and the only thing you have to have done is raised your right hand and sworn the oath that you'd protect this country.

- Kym, what are you doing for the caregiver?

- That's very important.

That process of reintegration impacts, obviously, the family as much as the service member, and so I also have a number of family members that I work with, children, teens, young adults that I guess you'd be considered, could be considered caregivers, and obviously, you know, being deployed, all the things that go along with that, whether it's moving around, trying to adjust to new location, for kids, new school, new social connections, we work on helping with that in therapy as well.

Communication is so very important, and we work on really, you know, helping families improve and enhance that communication as a way to mitigate some of the difficulty with all those things that go along with, you know, being a family member of a veteran or service member.

- You mentioned benefits, Shane.

I trust mental health benefits is a topic that hopefully they exist, and hopefully there's more?

- Absolutely, there are mental health benefits.

There's a checklist when you come to me that we go through to make sure that you're squared away financially with school, that you're squared away health-wise with the VA, that you have gotten your, or are working on your disability rating if there's anything that can work towards that, and so there are benefits.

There's also benefits outside of the VA, like the vet center in town that can, it's totally separate, so they're not sharing files.

Whatever you say in there is not being brought back to your primary care.

It's a safe space, and then obviously, if people wanna utilize the university counseling center for anything, we can walk over and hand off a student veteran, right directly to somebody if that's an immediate need.

- Off the wall kind of question, Kym, I've heard there's a high correlation between the homeless and veterans, or perhaps the gentleman or gentle woman with his sign, "I'm a veteran, please help."

How do we handle that?

- Absolutely.

Unfortunately, we don't have a lot of those folks coming in our front door.

They're just, you know, not in a position.

They don't have healthcare insurance.

- [Shelley] They don't have a rides.

- Yeah, absolutely, so you know, I think it'd be nice that if there was more outreach and more opportunity.

I'd love to, you know, have a motor home, a mobile vehicle.

I could just hit the road, and maybe that's been done, but I think that's definitely a population that struggles with access to service.

- Does that come up in your comments?

- Not as much.

The realm I'm working in, everybody is pretty much, you know, a student veteran.

Some live at home if they have to, or some of their wives are, they're dual income, so they have- - What about the stigma?

What do you have to say about that?

- In regards to what, specific mental health and veterans?

- Yes.

- That- - You mentioned being too tough to ask for help.

- Sure, that's real, and I also think that lots of people associate, you know, PTSD with somebody having a crazy flashback at a restaurant where they're diving under the table and low crawling, and that might happen, and that's not the overwhelming majority of people that struggle with mental health issues that are veterans.

But I mean, I think everything helps, and encouraging anybody that you know that is a veteran that might be struggling is you're not, they might not take it at first as a wow, thanks for doing that, but it means something to everybody at the end of the day that you care, so.

- What about control versus cure, what is your job?

- You know, I think we strive for symptom management and improved functioning.

I wish there was cure, but I think cure, so to speak can look like helping someone get back to that place where they're, you know, able to again function, live their best life as it is, you know, interact with family members and society in a way that works for them.

You know, cure, a lot of the symptoms and conditions that we struggle with are, there's really, cure is not a thing, it's just the management.

- Yeah, and your thoughts on the stigma or maybe other myths to dispel?

- Yeah, in talking with some of the individuals, the veterans that I work with, it's interesting.

I have an age span of individuals, and I can definitely see the trend that the stigma, we're going in the right direction with the stigma.

However, some of my older veterans, you know, they talk about really not being able to access help in mental health needs while they were, you know, in active duty.

The message, and understandably so, it sounds like is, you know, you have a job, you have a mission, do what you need to do to get that done.

You know, we'll deal with that later, or we don't have time to deal with that now, versus some of the younger veterans that I have, they've had different experiences.

So I think we're trending in the right direction.

My younger guys feel like there's just been more discussion, more talk.

The assessment process at separation has changed in a more positive way.

They're connected often with someone for even if just a brief period of time.

So I think we're going in the right direction for sure.

- General question, how else can the community help our veterans, Shane?

- I think the way you can help is just- - I mean, should I send cookies overseas?

- Yeah, I mean, cookies are always great.

I think just I mean, not all veterans, I'll be honest with you, want to hear, "Thank you for your service."

Shocker, and that it's a case by case basis, and while that is a very common thing to say, maybe just, I mean, if you want to thank 'em, it's thank 'em for volunteering opposed for their service, 'cause service members are willing or veterans are willing to volunteer to wear the, you know, wear the uniform that it takes, opposed to thanking 'em for their service.

- You know, I think- - Because life happens, change a witness event.

- I think that outside the military, you know, that is a little bit of a challenge, I would look and hope that, you know, the military itself continues to work on prevention, being more, you know, active when things are going on.

I think, you know, post-deployment and post-separation, I think the more rural areas are the areas that really struggle with being able to provide services, and that's something we see in northern Michigan.

So the more we can get services to people who don't live near a metropolitan area, whether it's a telehealth type of service, or you know, a vet center, I think, you know, we can get to that early, get to that within that short window of time after they have separated, I think that's the closest thing we can really get to prevention.

- Shane, what happens when your students graduate?

- Hopefully, they go on to do great things.

There's Connected Still, the university through the alumni veteran group, so we hold onto 'em, we keep 'em for as long as possible, and hopefully, they'll come back and still participate, be mentors, be resources, but we don't ever let 'em go.

They're Lakers for life.

- Yes, as both are.

What about resources?

If I'm a veteran who's watching, and maybe wants to reach out or find out more information.

I'll start with you, Shane.

- Yeah, so I'd always start at the VA. That's the baseline if you need anything, 'cause they're most equipped out of anybody to get you services sooner than later.

There's national non-profits, the Wounded Warrior Project, The Mission Continues, RWB.

If you want to get involved as a veteran in, those are more peer organizations that allow you to still have that interaction with your, you know, military connected group, so those are some resources, but if anybody's struggling, I would start with the VA. - Where would you send us?

- I certainly agree.

I would also add an organization that is called Star Behavioral Health.

So they are a private nonprofit organization.

I'm not sure if you've heard of them.

- [Shane] I have not.

- And they were grant funded initially.

The goal was to provide military VA mental health training to civilian clinicians, and help the civilian clinicians with, you know, military sensitivity is what we call it.

And somehow, I got connected with this group initially, and the cool thing about this group is there is, you can go to Star Behavioral Health website.

They have a registry of all of us that are civilian clinicians across the country, and that is how I have actually been able to meet a lot of the veterans I work with.

I'm on the registry, they call Pine Rest, we set up an appointment.

So that's another resource that's out there in addition.

And of course Pine Rest, you know, our outpatient clinic and services as well.

- You did mention telehealth.

Has that been a positive form of treatment these days?

- I mean, I think it has been.

It again helps with that access to individuals who live in more rural communities.

It has helped me see veterans from all across the state.

It's a convenience, you know, rather than driving somewhere, pop on for a telehealth session.

So I think it's something that's been very helpful, and again moving in the right direction.

- All right, Shane, what do you leave us with?

- What do I leave us with?

Well, if you are a veteran interested in going back to school, please check out our website, GrandValley.edu/\military for all the resources.

My contact information is on there.

If you have anything you want, need anything, please reach out.

And if you're a veteran that is struggling, please, please seek out somebody or something to improve your situation.

- What are veterans studying when they go back to school?

- Everything, everything.

I'd say the overwhelming majority is engineering, nursing, the hard sciences, the STEMs, but yeah, I got 'em in all areas of academia.

- Wonderful, and your website is?

- Grand Valley, GVSU.edu/\military.

- Yes.

The first step toward receiving mental health care is the realization that you may need help, expand on that.

- [Kym] Absolutely.

- Closing comments, - And that's where it starts, and so I think family members, friends, we just, you know, we can't force it.

One of my guys I work with said, "You know, there's this challenge between over inclusion and under inclusion when someone separates," and so we just have to be there and listen, and look for that opportunity to help head someone in the right direction, whether it's again hooking up with the VA, or you know, someone like myself who, civilian clinician, but just, you know, be there and listen, you know, but pay attention.

- And Pine Rest is structured in that if one is in Traverse City, they can come see you.

- They can come see me, or we can do a telehealth session if you live in the state.

Like I said, my favorite group of people to work with is veterans.

They're good soldiers.

They're really engaged in the treatment once we get 'em going.

- [Shelley] Tell us a little more about your dad.

- He was awesome.

(all chuckling) He was a very proud Korean War veteran, was stationed at Fort Knox in a training company, drove tanks, and he also, he's a pretty giant guy, so it was pretty amazing to me that he got himself squeezed into that little tank.

He also boxed for the military, so you know, learned a few moves from him, that was fun.

But he passed away a few years ago, but very, very proud of his time in his service.

- Yes, and back to you, Shane, real quick.

We are losing our World War II vets, so if you know of one, get their story as soon as possible?

- Get their story, and get them on a honor, excuse me, honor flight.

This is out of, usually outta DC, and they get to go fly around and see all the monuments, and if you know a World War II vet, please connect them to the honor fights, 'cause that's something that they deserve and should get to do, and they will accommodate any and all scenarios to make it happen.

- And you said you did wanna go out singing the Army fight song?

♪ First to fight for the right ♪ (all chuckling) - I was just joking.

(laughter continues) You could do that, but, oh, we're out of time.

Go Army, right?

Thank you both.

What is your best website again, please?

- It would be just PineRest.org.

- Yes.

- The Traverse City Clinic does have its own webpage, and I have information on there if, you know, explaining what I do and kinda how I do it.

- [Shelley] And lastly, how important is this topic to discuss?

- It's extremely important.

These are individuals who have, it's the ultimate sacrifice, and so we owe them.

We owe them everything that we can do to be there and help.

- That's why we bring on you, thank you very much.

Thank you for watching our "Family Health Matters."

I'm Shelly Irwin, take care.

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