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Mental health and San Diego's military and veteran community

 January 29, 2025 at 5:07 PM PST

S1: Welcome in San Diego. I'm Jade Hyndman on this episode of Wellness Wednesday. We are talking about a new program that helps veterans on their journey to mental well-being. This is KPBS Midday Edition. Connecting our communities through conversation. Well , January is Mental Wellness Month. It's something we should be thinking about and striving for every month of the year. Recently , the University of San Diego's Veteran Telehealth Clinic received funding to increase and expand its services to provide mental health care for California's military community. It's also working to train clinicians to better treat veterans and those connected to the military. I'm joined now by Nick Boyd. He's a professor at the University of San Diego working with its veteran telehealth clinic. Nick , welcome to Midday Edition.

S2: Great to be here. Thanks for having. Me.

S1: Me. Kerry Rogers also joins me. She is an expert in the field of mental health , in the military connected community , and a senior advisor with the program. Kerry. Welcome to you. Thank you. So tell us about the USDA Veteran Telehealth Training clinic that you're a part of. Nick.

S2: So the USDA telehealth Training Clinic has been around for a few years now. It's predominantly served school based children. Um , there was some agreements with different schools across the state , but this particular grant has allowed us to expand our tele mental health services to serve veterans and their and veterans and military connected families , specifically across the entire state , as well as National Guard service members. Yeah.

S1: Yeah. And you just received a grant for that effort. What will that money be used for ? Yeah.

S2: So it allows us to hire a number of staff. So we've been able to hire clinicians , uh , social workers , marriage and family therapists , counselors and psychiatric mental health practitioner. Wow.

S1: Wow. Well , I want to bring in Carrie to the conversation. Carrie.

S3: The federal Department of Veterans Affairs provides services for about half of all veterans in the country. So that means about half of all veterans are not receiving services at the Department of Veterans Affairs. So this clinic and others like it help provide services that those veterans and their families don't receive from the federal government.

S1: Well , what are some of the mental health challenges unique to the military community and veterans ? Nick.

S2: There's some common disorders that we see. A lot of those vary by eras , but but the most common ones that we tend to see are PTSD , depression and anxiety. Um , those over the course of a lifetime is about 7% of the overall population. Um , but then when you start to look at lifetime rates by era , you have about 29% that are OEF , OIF , and then 21% for like Desert Storm , 10% for Vietnam , 3% for World War two , and then getting into depression , it's about 20%. And then anxiety is more recently a study came out , which was pretty exciting out of Yale and found that about 7.9% of veterans have some probable generalized anxiety disorder , um , which is pretty significant considering that the general adult population is about 3%. Yeah.

S1: Yeah.

S3:

S1: Well , what led you to want to work in the field of mental health and veterans ? Nick.

S2: It really is a personal kind of a personal story , but I am a National Guard veteran myself and personally got to sort of experience a lot of the stressors and challenges that that come from being in the military. I never had any desire actually , until much later and being here in San Diego. Um , but my whole professional career has been , uh , strictly working with , uh , either active duty or the veteran population.

S1: And , Kerry , you've worked in the field of mental health care in the military community for roughly two decades.

S3: So it's changed a lot. The country has changed a lot. Certainly we saw a lot of folks at that time in the Department of Veterans Affairs who were Vietnam era veterans. Clearly , it's been a couple of decades. So the group of of veterans that are in the country now is much younger than we used to see. There's a lot more diversity. Women make up a larger portion of the military community than used to pre 911. So a lot of things have changed.

S1: And even during Operation Iraqi Freedom. Weren't there some changes to how the military approached the mental health of active duty members , like there used to be sort of a time period by which they would come when they were home from deployment. They would stay home for a while and then be sent out on redeployment. Um , and that was for , you know , a number of reasons. One , a mental health break. But during Operation Iraqi Freedom , they ceased that and started sending active duty members out on back to back deployments.

S3: So certainly the pace of deployments was quick. People were redeploying very quickly. And at the time , I think people were going out and doing their job right and and doing what needed to be done. What what we see is sort of later.

S1:

S2: Obviously working with that population. But I will say being in the military , being in at the time when those things were changing , the reset period specifically for the National Guard. And I think if I could maybe just make a plug to differentiate active duty from the National Guard , I think oftentimes those two things get lumped together when they're very operationally distinct from each other. But in the National Guard specifically , we were seeing quick turnovers because you had federal deployments , which you would reset for those , but then you'd still have state issues to attend to. So in many instances , there was no reset period. People would be going off orders from a state mission to a federal mission. Sometimes you're simultaneously doing a federal and state mission together. So I think if you were to look at the National Guard community , which is pretty highly under-researched in general , you would find that folks struggle disproportionately more than actually active duty does as a result of that. That , among many other things. Yeah.

S1: Yeah. Well , Carrie , you feel that there is more of a focus on preemptive mental health care.

S3: Over time , I have seen the field shift from an intervention From focus solely and intervention focus to more public health efforts. And , Nick , I don't know if you agree with me about this , but when we talk about suicide prevention , when we talk about mental health , we spend a lot more time talking about resilience , building resilience , building wellness in order to prevent stressors from becoming too much in order to prevent people from becoming overwhelmed or in crisis. So I think a lot of mental health has shifted to being really aware that we can we can often get ahead of these things and trying to focus more resources on keeping people well as well as intervene , intervening once somebody has some difficulties.

S1: This is KPBS Midday Edition. We're back after the break. Welcome back to KPBS midday Edition. I'm Jade Hyndman , continuing our conversation about a new program being offered here in San Diego to help veterans reach wellness. You know , you also say a lot of the differences between military versus like non-military come down to culture.

S3: We don't think about it that way often. And I think folks who have never been in uniform , which includes me , I work with this community. So I have a little bit more experience and insight because I'm surrounded by this community. But those of us who haven't served , I think , really don't always understand that military service and folks who are part of the military connected community are really part of their own cultural group , and there are norms and there are behaviors that are unique to that group of folks. So that is a really important thing to be aware of when we're talking about health and wellness when we're talking about treatment. Nick. You've served. Yeah.

S2: Yeah. No , I think you bring up something really important , which is the. That kind of rings my bell a little bit , which what you're describing , I think also is this is a barrier to care , right ? It's if you look at service members , I mean , they do have a preference for those that serve. Right ? So there's that stigmatization too. That goes I think along with that. But and then there's other just lack of resources , which Kerry kind of talked about in general. Yeah. Just not having access to care.

S1: Well , Carrie , you you also note that women in the military and women who are also veterans at times face specific challenges.

S3: One of the things that I think about often when I , when I think about the women who have served in uniform , is often after they transition out of active duty and are not wearing a uniform , they become much more invisible people. Health care providers often don't ask women if they've served in the military , so women don't always know what benefits and resources they are qualified for. They have earned as a result of serving in uniform. You know , I know people who have who have been approached by folks who have said , well , you know , be sure to thank your husband for his service. When the woman was the veteran and their spouse didn't serve. Um , so I've heard women veterans talk about being the most visible military member when in uniform , because women are still not the vast majority of people who serve. But once they become veterans , they they feel like they become invisible because people don't even think to include them in in veteran status. Interesting.

S1: Interesting.

S2: They also tend to experience mental health symptoms at rates a little bit higher than their male counterparts in most cases. And so I think what Kerry is describing is , you know , really there's there's such a huge need to , to really work to , to bridge that , that gap and to help those particularly female female veterans feel more , I think , supported in the process. Yeah.

S1: Yeah. Well , and so the goal for the veteran telehealth clinic is to to rely on evidence based therapy.

S3: Well , we know this because there's been decades of research at this point on effective behavioral health interventions. Many of them are cognitive behavioral based. Not all of them are. In this clinic , we are really going to emphasize them both. Nick and I are committed to this , as well as our other colleagues at the clinic , to providing what we believe is the best care possible , really the standard of care , and that is treatments that have been well researched and we know work for most people most of the time. Yeah.

S2: Yeah. I just want to add , I'm we're just first of all , just so excited to have Carrie here and and her expertise. I mean , she's been doing this a very long time. And what she said is , is spot on. You know , we're really committed to ensuring that we're providing the best care and that we're training the future mental health field to deliver good care , particularly because I think we're at a time where mental health treatment , we know what what we can do. The problem is that a lot of community providers aren't doing it. And so I think we're we're playing a really too important part. We're serving an important community that we both feel very passionate about. But we're also doing this other thing I think we both feel very passionate about , which is training clinicians and training providers to deliver good mental health treatment. Yeah.

S1: Yeah. And I know that there are a number of treatments out there. I mean , you in a number of approaches to it , outside of medication and even outside of therapy.

S2: But I would say mindfulness is kind of a buzzword right now. Right. And I , you know , and I think there's an important place for that conversation. And it is important because it does work. And then there's like the practicality of like , how do you actually do that ? Right. Most people think of these big , big things when we think about mindfulness. And I think , for me , what what I find to be helpful is just trying to find moments in the day to be present , um , for a little bit. Right. Just listening to the sounds around you outside or taking a break and just walking around. I mean , those could be simple things that can make a difference. And , you know , you're not going to have this huge maybe over , you know , significant shift , but it's a matter of just kind of giving yourself space to , to sit with things so that you're not constantly caught up in , in the go and the go and the go of , of kind of daily life. Yeah.

S1: Yeah.

S3: And again , practicing what you preach. I can totally get caught in this , but , um , you know , eating well , exercising some , um , trying to get good sleep. One of the biggest predictors of wellness , though , is , um , social connection. Yeah , absolutely. So it's really protective for people to have others in their life that they feel supported by and that they can support. So certainly I think that that's something that in addition to , you know , getting professional intervention when people need it. That is something that I think we will be encouraging folks to be paying attention to as they're coming in for intakes , as they're working with us.

S1:

S3: Department of defense also has lots of great mental health and wellness resources. Um , there is a nonprofit organization in San Diego called Psych Armor that has fantastic education and training resources available for those who serve , as well as those who work with folks who serve. There's a nonprofit in San Diego , a new one called Strengthened Service , that's also providing mental health coaching and and treatment for military connected families. So there are places out there people can always contact two , one , one as well. There's a lot of opportunities. There are people there who really know the the resources in the community are more than happy to help people find what they need.

S1: Before we go , you mentioned women in the military , women veterans. And I'm curious to know if you all are , what you're hearing from women who are in the military and who are veterans , given the policies and ideologies coming out of the white House right now.

S2: I have I can't say I've heard anything. I can make speculations and assumptions , but I haven't heard anything directly. I mean.

S4: It's very early.

S2: It's early. Yeah , yeah , it's early. I mean , what we know is that the military is not different than any other place. It's quite diverse. It's reflective of the communities in which they they are both from the reserve side , National Guard side , to the active duty side. So these types of policies have significant issues. Kerry talks about the importance of social support. Another way we look at that within the military is unit cohesion. And when you have policies like that , that rips apart good unit cohesion and you don't feel supported , there's significant mental health consequences that will eventually see the outcome of that.

S3: And we'll be here waiting to offer what we can. I do think that it's very hard to know right now.

S2: It is. Yeah. Well.

S1: Well. Well , it's something we'll definitely continue to watch. And of course , we'll include links on our website for resources. Should military veterans or anyone in the military community need help ? You can find that at pbs.org. Nick Boyd is a professor at the University of San Diego in the field of clinical mental health counseling , working with the University of San Diego's Tele mental health training clinic. Nick.

S2: Thank you.

S1: Thank you. And also , Carrie Rogers is a psychologist working with the military community here in San Diego. Carrie , thank you so much for being here.

S3: Appreciate you having us.

S1: That's our show for today. I'm your host , Jade Hindman. Thanks for tuning in to Midday Edition. Be sure to have a great day on purpose , everyone.

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Veterans of various wars hold the colors at the wreath-laying ceremony at Miramar National Cemetery to honor all veterans who served from Nov 1, 1955, to May 15, 1975, San Diego, March 29, 2022.
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Veterans of various wars hold the colors at the wreath-laying ceremony at Miramar National Cemetery to honor all veterans who served from Nov 1, 1955, to May 15, 1975, San Diego, March 29, 2022.

January is Mental Wellness Month. On Midday Edition Wednesday, we have a conversation about mental wellness in the military and veteran community in San Diego.

Two local mental health experts connected to military communities talk about recent efforts to increase access to mental health care, and what challenges military members and veterans commonly face.

Guests:

Resources: