By Jodie Ellis-Hart
“No one is put on this earth to take another human life.” (male Vietnam veteran)
“I feel like I’m in a constant fight between war mentality and being a human. I couldn’t be a human for two years, and it’s hard to get that humanness back. It feels weak wanting to.” (male Iraq veteran)
“When you’re in a war zone you turn into an animal. I had to turn off my emotions. You become an asshole, but you still follow the chain of command. I’m realizing that I need to start thinking differently.” (female Iraq veteran who returned from her deployment in 2007.)
“I came to the realization that I may have to kill a child when I knew that, someday, I wanted to be a mother, to have a child.” (female Afghanistan veteran)
These are some of the thoughts shared with me within the past few months alone in the course of my work as a licensed clinical social worker, providing outpatient mental health services to veterans.
Veterans who struggle with such moral injuries and inner conflict need someone to listen to them. They need someone who they know without uncertainty that they can trust. Like healthcare chaplains, I provide a safe place for them to share their innermost struggles: memories of their experiences, actions they may or may not have taken, atrocities witnessed, conflicting thoughts and feelings about their experiences, and stories they may not feel safe sharing with their own spouse of decades.
My role is that of a mental health provider, but I always hope that social workers in other roles are equally mindful, patient, aware and compassionate listeners. A VA clinic has numerous resources to help with our patients’ varying psychosocial issues, including primary care social workers assigned to each of our primary clinics. All veterans enrolled in primary care are typically scheduled to meet with a primary care social worker, who does a full psychosocial assessment and will provide the veteran with information and refer them to the appropriate services if needed.
We have a team of primary care/mental health integration providers who are assigned to each clinic and are available for “warm handoffs” and scheduled appointments if a patient needs brief mental health services. These providers are usually available to meet with the veteran within 30 minutes for a mental health assessment – which makes follow-up much more likely than telling someone they have to wait several weeks.
We increasingly offer more alternative healing and whole health options to our veterans, such as yoga, Brazilian jiu-jitsu, aromatherapy and Zentangle classes, numerous recovery groups and equine therapy (referred out). And we have recreation and art therapists who offer an array of different classes and socializing opportunities to veterans, such as biking, art classes, and social skills building.
Our VA supportive housing team assists veterans in need of housing and/or at risk of homelessness. They act as case managers in helping veterans find and maintain appropriate housing. The Community Resource and Referral Center is a facility for homeless veterans to come in to shower, do their laundry, use computers, and get other assistance. The VA main hospital houses two clothing rooms, a men’s and women’s, for veterans in need of clothing, and we quite often have available gift cards for gas, Goodwill, Walmart, grocery stores and restaurants.
Upward Bound is a program that assists veterans with schooling needs, and we have many programs that assist veterans with job-related issues, including creating a resume, finding and maintaining employment, and a Compensated Work Therapy program which provides a supported employment counselor for veterans with a chronic mental health diagnosis.
But even with all the resources available, it’s a matter of veterans coming in, getting a thorough assessment, and being willing to use the services available to them. I have seen a number of veterans go from homelessness and unemployment to being able to independently provide for themselves via VA eligible resources.
So many veterans have lost so much: their youth, innocence, belief in humanity, belief in their government, faith, belief in God and/or religion. We need to help them identify and mourn what they’ve lost and help them transform their grief, if they’re willing to go there, and if we are very good, compassionate companions. If we are unequivocally good stewards.
Jodie Ellis-Hart, LCSW, is a general outpatient mental health provider and behavioral health interdisciplinary coordinator at Milwaukee VA Medical Center.
