- [Speaker] WVIA presents Mind Over Matter: Veterans Wounded Within from Serdoni Theater at the WVIA studios in Pittston.

Now, moderator Tracey Matisak.

- Hello everyone and thanks so much for joining us for this very important conversation about veterans and mental health in our region.

Recent Geisinger survey of community leaders across the region identified behavioral health as a top concern.

That is in large part because Northeastern Pennsylvania has higher rates of suicide than the rest of the state and the nation.

This is especially concerning when it comes to military veterans.

Every day in America, roughly 17 veterans take their own lives.

In Northeast Pennsylvania, Carbon County has the highest veteran suicide rate in the state with Wayne Schuylkill, Bradford, and Wyoming counties all in the top 10.

Nationally, post-traumatic stress disorder affects up to 20% of US veterans and many struggle with depression, anxiety, and substance use disorders after returning home.

(upbeat music) And in a few minutes we will meet some people who have graciously shared their own mental health journeys with us and how they have found help and hope in the process.

But first, a closer look at the veterans and mental health in the region, how we got here and how to move forward.

And for that we turn to our expert panel.

Dr. Brian Keller is a clinical psychologist and a veteran of both the US Navy and US Army.

His deployments include Operation Desert Shield and Desert Storm and Operation Iraqi Freedom.

Dr. Keller now practices at Geisinger where he counsels veterans and civilians alike.

Brigadier General Maureen Weigl is Pennsylvania's Deputy Adjutant General for Veterans Affairs.

And in this position, she supervises the administration of State Veterans Programs, reintegration and outreach, as well as other initiatives for more than 700,000 veterans and their dependents.

She also oversees the operation of the Commonwealth's six veterans homes.

And David Eisele is the Director of the Lackawanna County Veterans Affairs Office.

He also heads up the State's Veterans Affairs Association.

Among many other responsibilities, he and his team assist veterans in transitioning to civilian life.

He is a Marine Corps veteran as well.

And now to our panel General Weigl, let me begin with you because so much of your work has been around helping veterans reintegrate into civilian life.

In your experience, what are the biggest challenges that veterans face when they return from active duty?

- Sure.

So I will tell you probably the two scariest days of any service member's life and the audience can agree with me is the first day you join the military and you say, "Oh my goodness, what did I just do?"

and you're at bootcamp.

But then the second scariest day is the day that you leave the service and you think you're liberated and you're free and you walked away from an environment that maybe you didn't serve you anymore and you found other things.

And then you realize, "Oh my goodness!

What did I just do?

Where is the support?

Where's the installation?

Where is the family readiness groups?"

I left the military as a...

Came in as a 17 year old.

I'm leaving as a 24 year old with a wife and children.

Now I think I'm gonna go back to my home.

Make the same money.

There's no housing allowance.

There's no benefits.

And where do I go?

Who's in my state in Pennsylvania, in Lackawanna, and Luzerne County that can tell me where I can find the resources.

And it's not that there's no resources, they're just on their own.

They leave the military.

We help them write a resume.

We do all the transition briefs.

We wish them well.

They come to the community.

We do a 30, 60, 90-day phone call to them to say, "Are you okay?"

But 90 days, like you're still just processing.

Finding a place to live.

Trying to see if you like your first job.

And, they struggle because the support system's gone.

They're used to having a bigger environment of support.

And, now they feel isolated and alone.

And they're back in their communities.

And civilians don't always understand how to take care of veterans.

Only 1% of the population wears a uniform.

And today many civilians don't know veterans.

And, they don't have aunts and uncles that served in World War II and Korean War and Vietnam era so they can't relate.

And you feel like you don't have someone to talk to.

So that's one of the biggest problems for the veterans today.

- Dr. Keller will be talking quite a bit about PTSD tonight and I wonder if you can tell us whether it's possible that some people are maybe genetically predisposed to PTSD?

And, is there any sort of screening mechanism to help identify those people?

- As of now, we're not aware of any genetic predisposition to PTSD and there's not a screening tool that is available.

There have been studies that have shown some genetic components in anxiety in general and depression in general.

And it's the nature versus nurture question coming into play here.

how much is genetic?

how much is what you learned?

Just anecdotally from my own practice, a lot of times when I'm working with a veteran with PTSD, one of the things I'm running up against is how they learn to deal with emotions as they're growing up.

You have a problem, don't bother anybody else with it.

You keep it to yourself.

Don't go see anybody about it that shows you're weak.

All these kinds of messages that they got, they internalized and it could keep them from coming to see somebody or make them wait for a long time before they see somebody.

- Yeah.

Doing them more harm than good, essentially.

David Eisele, we mentioned a moment ago that in the top 10 counties in Pennsylvania for the highest numbers of veteran suicide, 5 of those 10 are in Northeast Pennsylvania.

Do you have a sense of why that is?

Why that is the numbers are so high in this area?

- I think partly because it's a rural area and the counties that were mentioned, it might be a 30, 40 minute drive to the VA.

In those rural counties, the federal government's just getting access to internet capabilities for everybody.

In those rural areas, the jobs aren't really robust as it would be in the city like Lakawanna or Luzerne County.

So that not having the feeling of self-worth and not being able to get out there and do that job that you were good at, it just makes it harder.

And then not having the readily accessible mental healthcare poses a big problem for those rural areas.

- We'll be talking much more about all of those topics in just a moment.

But as we have noted, it is not uncommon for veterans to come home with a variety of trauma related illnesses, whether it be PTSD, depression, anxiety, or some combination of all.

Some will develop substance use disorders as they try to cope with their experience.

The navy veterans that you're about to meet are well acquainted with military trauma.

Amber Viola returned to civilian life with a diagnosis of PTSD.

James McClain's mental health struggles nearly cost him his life.

Today, both have leadership roles at the Goldsboro American Legion Post 274, where they're working to eradicate the stigma of mental illness and help their fellow veterans heal.

(gentle music) - If you get cut, you can see the cut.

Everybody can see the cut.

And there's a clear path that you can watch it heal.

You can see it heal.

Don't have that with mental health.

Everybody's experience is different and there's no way to know if you'll recover, how you'll recover.

And it's scary.

(gentle music) (upbeat music) - I actually never wanted to go to military because you give up a lot.

You're deploying over and over and over, over again.

You come out the other side different than you went in.

And not everybody handles situations the same way.

- [Jim] You're treated like a piece of equipment.

You're not treated like a person.

You have a job to do.

You do your job.

You can't do your job, they replace you with somebody who can.

It's that simple.

- I was in charge of the fire party for a while.

For my duty section, I knew that ship.

I cared about it.

It was my home.

And' we got chewed out because the drill didn't go as smoothly as it should have.

I ended up getting removed from my position.

It was a big blow.

It really did hurt.

(gentle music) I turned to alcohol for a while as a way to numb that.

The heavier I drank, the less I cared.

The less I cared, the harder I got to be achieving my goals.

The harder my goals got to achieve, the worse I got.

So I became angrier at home.

A lot more hostile.

I had throw stuff around the house, break things.

My wife issued me an ultimatum to get help or she was gonna take the kids and leave.

So I went and started seeing a doctor and I got deemed unfit for sea duty.

And I was discharged from the Navy 30 days later.

I had an idea of doing a whole 20 years in there, but I seen my Navy career just fallen apart.

I remember tying an extension cord into a noose and walking around my trailer looking for something to tie off to.

Had I found something to tie off to that day, I wouldn't be sitting here.

It was that bad.

That close.

But thankfully, I lived in a trailer and there's nothing to tie off to in a trailer.

At least not they would've supported me and allowed me to drop far enough to actually it.

- Our next speaker is Amber Viola, Commander American Legion Post 274.

- Veterans are suffering.

Active duty military members are suffering.

We are only 7% of the population, but we make up over 18% of suicide death.

(gentle music) Here in NEPA, we have one of the highest veterans populations in the US.

Veteran suicide is epidemic and I feel like nobody cares about it.

And I don't understand why aren't we doing something?

Why isn't it better?

- The other thing is a lot of vets don't want to seek help because they don't want to show weakness.

They took every ounce of strength I could to get the help and to accept the work that the doctors were telling me I had to put in.

I do not have PTSD.

I deal with depression and anxiety.

And those two just play havoc with each other.

- People ask me, why do veterans who haven't been in combat have PTSD?

A lot of people think of veterans as like these done molding crazy people, screaming on a corner because they have PTSD.

And that's what I hate.

I mean, you can get bit by a dog and have PTSD.

You take high blood pressure medicine because you don't want to have stroke.

So like you take your mental health medicine so that you don't drive off a bridge.

And that doesn't mean that like you're inept.

- Mental health even goes beyond suicides.

There's addiction, overdoses.

It all ties in together.

But it's terrible that a lot of us feel like we don't have help or don't have resources.

There's so many different types of therapy out there.

The biggest one for me was cognitive behavioral therapy which helped a lot.

But it wasn't until I'd gone through the second group therapy I went through that I really felt like I wasn't the only one going through what I was going through.

(gentle music) - All those present will stand.

- American legions help foster that sense of community.

And you can sit at the bar at any given night and there's people to have shared experiences.

It's a whole different level for somebody to go, "I know how you felt."

I've been where you are and this is how I help myself.

And I wanna make sure people know that.

At least my Alegion post, they're not alone.

- And we thank James McClain and Amber Viola for their service and for sharing their experiences with us.

You can hear more from both of them on the Mind Over Matter podcast on Apple, Spotify, or wherever you get your podcasts.

We are also pleased to announce that both James and Amber are with us in the audience.

And, Amber is standing by with a question for our panel.

Amber.

- Hi.

Thank you so much.

As Commander of American Legion Post 274, one of my biggest challenges is getting veterans of my generation to come out and be involved in the American Legion and VFWs.

I would ask the panel kind of what are your ideas or kind of how are you guys tackling that issue of declining numbers in legion participation?

And, how do we get younger veterans to want to come out and participate and be active members?

- [Maureen] Thank you Amber.

Dave?

- So the first thing I would suggest is this generation of veterans coming through, they don't want to sit and drink because maybe they had a problem while they were in the service with drinking.

And we kind of helped out a local VFW in Scranton have more family oriented things going on, bring the spouse in into the picture, bring the kids there.

Because once the other spouses get to talk and see that they're not the only ones dealing with that military mindset at home, you'll get the membership because they realize there is a different kind of outlet out there.

- General Weigl, James McClain emphasized how important it is for veterans who are struggling to know that they are not alone.

And that of course has been a theme of this series from the very beginning.

Can you speak to the importance of being in community and how helpful that is on the road to healing?

- Absolutely.

And I first want to say, I think, I envy both of you that you got involved with your American Legion.

Finding a support group, finding folks that relate to you, that you can relate to is key.

Many people don't do that.

To the question, how do you get people involved?

Iraq and Afghanistan war veterans tend to not want to go to the American legions, the VFWs.

All of their memberships are declining.

So it is really important that you find an outlet.

And, I know we're gonna talk about different things to do.

It's critical that all of you understand.

All of us are like you.

Not everybody had the same experience, from a World War II veteran to Korean War veteran, Vietnam veterans.

Dave and I are both Iraq and Afghanistan war veterans.

Our experiences could not be more, more apart.

That doesn't mean our service wasn't relevant.

It does not mean that we don't have shared values and shared opinions.

It just means sometimes you have to find someone that relates to you.

So I encourage all of you to know there is nobody alone.

I've suffered PTSD.

I had a roommate shot and killed when I was a second lieutenant on active duty.

Many people experience it.

And, all of us struggle trying to deal with some of those losses and how to find, overcome depression and overcome incidents.

I would just say know that Department of Military Veteran Affairs, your county, state, your county directors, there are so many resources across the commonwealth and in your communities for you.

And we will walk you through all of those today.

But please know, everybody is here for you.

You are not alone.

All of us have experienced different things in the military and we can help you and share those stories, and help all of us overcome all of those.

- Yeah.

And of course we want to invite the members of our audience if they've got questions to please go right ahead.

We'll get in as many as we can during the time that we have together.

Dr. Keller, Amber made the point that if you have high blood pressure, you take blood pressure medicine, right?

We have a headache, you get headache medicine.

But when it comes to psychiatric medicines, people are reluctant, veterans or not, because of the stigma that has been associated with them.

Can you address a little bit of that?

And, why those medicines can really be a game changer for a lot of people?

- Certainly.

One thing to keep in mind is that the understanding in the field of how to treat veterans with PTSD with medicines is still evolving.

There was a point in time when fast acting anxiolytics or anti-anxiety meds were the things that veterans were given.

And we've only come to understand in the last 10 years, 5 years or so that that's probably not the right way to go.

That could actually exacerbates some symptoms that these veterans are experiencing.

And the medication management side has been transitioning towards antidepressants and those type of meds, which seem to have fewer side effects and they're getting a more efficacious experience with those meds.

- And what might you say to a patient, particularly a veteran, who might benefit from some sort of psychiatric medication, but might be unwilling to take it?

- Oh yes.

That is a tough conversation I've had many, many times.

I just appeal to their sense of logic in that this might help.

I appeal to their sense of there's not a lot to lose.

If you're taking the medications under the guidance of the physician, you're not likely to have serious side effects as you might imagine that you would have.

And I just try and walk them through the process, try to take away some of the anxiety of the process.

Maybe address some of the fears they have.

Sometimes the fears are very well grounded.

Sometimes they're fears that might be just standing in their way and not really helping them out.

- Yeah.

David, James talked about the emotional blow of losing his position and how that just sent him into a downward spiral which is an experience that people in and out of the military can relate to.

What advice do you have for people like James and their families for that matter who have suffered a major loss and need to figure out a way to keep from spiraling?

- Well, that's the thing is he was in a position where he loved going to work every day.

Loved that job.

His brothers were with him.

And for them to tell him, "We can't have you doing this anymore."

It is a big toll.

It's a big hit because now you're taken away from the one thing that you were very good at and you did every day.

I would say find your niche in the community now while you're out and what you're good at, and bring your family together and do it together.

Whether I saw in his video, very good artist.

He's doing awesome paintings with spray cans.

That might be his new niche.

Get your kids involved.

Get your family involved and do that together, and you'll get that self worth again.

And eventually, carry on.

- [Tracey] Yeah.

General.

- And I would like to say, the military doesn't always get it right.

Commanders make mistakes too.

And sometimes when we call someone unfit for duty, it's really an unfortunate event.

That is an individual we probably should have triaged and worked closer with to find out if there's other skills you can use in another environment.

But the military, unfortunately, commanders don't always want to take the time.

And it's just not a cohesive environment to do that because you have mission.

You have to hurry up and do stuff.

And, they just don't have the time.

But it's unfortunate.

It is not on you.

It's our system.

And we have not fixed that system.

And that's where the Department of Defense really, we talk about stigma.

That is one of the areas of stigma they need to overcome is to make commanders understand that taking care of that individual, making sure they can thrive in the military and if not in your unit, find a unit for them.

And more importantly, make sure that when they leave the military, they are prepared to be successful citizens.

And we didn't do that.

We do transition assistance, but we don't help folks that struggled on active duty prepare for transition.

And, that is not on you.

That is something that Department of Defense internally needs to look at.

And we have to destigmatize that with commanders.

And, they are working towards that.

They've come a long way.

Give them a little time.

But the ship doesn't turn really quickly, as you know.

But they are getting there.

But please know that is not on you.

That is on the leadership of the Department of Defense.

- Yeah.

We'll have more to say about that as well as the creative pursuits that David just mentioned a moment ago.

In fact, we have another story that we'd like to share with you.

And that is this, that he fought in the Korean War and almost didn't make it back.

Joseph Barna is a Marine Corps veteran from Freeland, who, like so many others, came home with scars on his body and mind.

And it was hard to talk about what happened in the war.

But Joseph Barna found solace in writing.

His letters, stories, and book have brought comfort to veterans and their families across the region.

- My name is Joe Barna.

I'm a Marine Corps veteran of the Korean War.

I was drafted.

I was supposed to go to the Army, but I ended up being a Marine which today I'm very proud of the choice they made for me because I found out who I was and what my life was supposed to be when I come home.

First day, they gave us a haircut.

They shaved all of our hair off our head.

53 guys, I was in my platoon.

I would come on our prayed field.

We looked around and everybody looked like they were the same.

Looked like all twins.

So then that day I knew that there was nobody different than nobody else.

I wish people today would feel that way about it.

I served in Korea for 13 months, 1952, '53.

(bomb explosion) A lot of veterans, they hold too much back.

They shouldn't hold it back, I don't think, because what they did so many others could never do.

I mean, what I did, I don't think many could have done what I did.

I'm not proud of it.

I mean, I never thought I'd do what I did in Korea, but I had to because I wanted to live.

(bomb explosion) (gentle music) There was no winner in Korea.

Both sides lost.

They called time out to bury their dead and cure their wounded.

(gentle music) There's a lot of grays in Korea, believe me.

Many veterans come home.

They have scars.

Some scars on the inside, some on the outside.

I worship the men with the scars on inside.

And I try to speak for them.

I've written some stories about my experiences.

And I started about 10 years ago, I guess, when I wrote my first story.

I tried to hold it in, but I met a doctor one time, a woman doctor whose father was killed in Korea.

And, he was also a Marine.

And I spent nine months every month, spent an hour and a half, two hours with her.

And she had told me, "Joe, what you did, don't ever be ashamed of talk about it, because so many others could never do that."

So I let it out.

It might help you.

So then, I began writing.

And I do believe it helped me get rid of the devils in my mind.

You are all truly missed by all of us who God gave a few more years of life to remember all of you who gave your all.

It's never easy to go back to something of battle you faced and try to erase the crying of the wounded or the silence of the dead.

I often wonder, why wasn't it in me, not you?

As I look at a picture of you, I remember what true friendship really was.

And we'll never be forgotten.

David said, "Why don't you write a book?"

(explosions and gunfires) The book is called God Made Angels and Navy Corpsmen.

If someone is wounded in a Marine Corps in a mountain in Korea, you lay there and you bleed.

And the only person who could stop that blood from coming on on that Korean soil is if you have a lucky enough to have a Navy corpsman near you.

The one night I had was 21 years old.

He never got to be 22.

His name was John Kilmer and he stopped the bleeding.

He saved my life July, 1952.

I'm still here.

I owe him my life.

I owe him all the years I lived.

And I'll never forget him.

I have written quite a bit of articles over the years.

It helps the older, the veterans, release some of the tension that they're holding back.

The devil that's in their mind.

I don't know how many more I'm gonna write, but I still gotta a pen full of ink so I'm gonna go.

I'm gonna go till the blow caps over me.

Because the vets, they should not ever be forgotten.

They gotta be remembered for the honor they earned.

God bless all of you.

Rest in peace.

And to all my former Marine brothers, Semper Fi.

That's how I feel.

It's my feelings.

- And we thank Mr. Barna for his service and also for touching so many lives through his writing.

Before we reconvene with our panel, we do have a question from our audience.

- Hi there.

As a veteran myself, I did not experience the trauma of battle, but I remember that day getting out of the military and all of the uncertainty.

How can we as community members, family members and support systems support that transition and people finding their way and support healthy living?

- [Tracey] General, I'd like for you to answer that question because we had a little conversation about that earlier.

- It really comes down to all of us understanding what the resources are.

I'm fortunate.

I know all the county directors.

I know the American Legions, the VFWs.

I know the presidents.

But for all of you in the audience, we don't do a great job of educating community and families on what's available.

So in Pennsylvania, we're very fortunate.

We have PA VETConnect.

So if you can remember anything today, PA VETConnect, That is where you can find all the phone numbers, addresses, zip codes to all of your county directors, to all of the American Legions, VFWs that are in your community.

To all of the non profit agencies, many of you are here in the audience today together with veterans, to the Valhalla, to Camp Freedom, to all the Lackawanna companies here, to Heroes Heartstone.

I mean all of the nonprofits, if you wanna know how to take care of a veteran or get them into one of my Gino Merli Veteran Centers or one of my veteran centers.

If someone needs to have long-term care, PA VetConnect is where you go.

And that's what people don't know.

So for all of you, just share with everyone, PA VetConnect.

Pass the word.

Tell them we're here.

Tell them to go to your county directors.

We can help you get your benefits and give you the access to the resources you need.

- Yeah.

And our community partners too.

- Yes.

- Like Geisinger that- - Yes.

- On there, they have little niches that we didn't know about until they got on PA VetConnect which is, there's a food pantry.

Not many people know about that.

Geisinger started up and you can get food in a hurry if you need it.

- Yeah.

So it's not that the resources aren't there.

It's about knowing where they are, where to look.

- I got it.

- Yes.

- To find them.

- Yeah.

Dr. Keller, I was struck by what Joseph Barna said about the fact that he took to writing to address, as he put it, the devils in his mind.

What is it about creative pursuits like writing that can be such a healing thing when it comes to trauma?

- I think at the heart of it was he found his way of talking about his experience.

A lot of times veterans are compelled to just not say anything.

I know that I've worked with a lot of folks who are, "Well, I can't tell my spouse about that.

Can you imagine telling my spouse?

They would be so scared.

They would be upset."

You have well-meaning people coming up on the street and asking you questions like, "Did you kill anybody?"

It's a tough question to answer and one that most vets don't want to answer.

And so they learn to kind of keep things to themselves.

If they're lucky, they have a comrade in arms in the local community that they could disclose things to.

But a lot of times, it's just kept to themselves.

And I think that these artistic pursuits like this marine found, was his opportunity to finally express what happened and talk about it in some way.

- Yeah.

And help other people.

- Exactly.

- By doing the writing.

- Yeah.

- David, Mr. Barna talked about the Navy corpsman who saved his life, but didn't make it home himself.

And I'm wondering, in the work that you do and you see so many veterans, do you see that there is a sense of survivor's guilt for those who made it home but left buddies behind?

- There's a lot of survivor guilt and "Why was it him and not me?"

That a lot of veterans ask that question is "Why was my best friend's number up and I got to come back?"

And I think about that often too as like, why did I get to get injured and come home?

And I found my purpose doing what I'm doing now and reaching out to veterans like we talked earlier.

I didn't know where to go when I got out.

And just by the luck of talking to somebody, they were like, "Go to your county office.

There's a lot of resources.

They could tell you about education.

They could tell you about jobs."

And I went down there and here I am today paying it forward and in remembrance of friends I lost.

And hey!

There was a reason that you survived.

And the best you could do for your friend is remember them and carry the re around by doing something else for another veteran.

- Well Christopher Smith served his country in Iraq during the 2003 US invasion.

Years later, he returned to Scranton with post-traumatic stress disorder and a traumatic brain injury.

The complications from his injuries cost him dearly.

He lost his marriage, his home, and precious time with his children.

But Christopher's story didn't end there.

Today he is a college graduate who is dedicating his life to helping his fellow veterans heal their minds by exercising their bodies.

(upbeat music) - My name is Christopher Smith.

I am the Warrior Strong Scranton team lead and resident yoga instructor.

I am an Iraqi freedom veteran.

I deployed during the invasion in '03.

I missed the first year of my first daughter's life.

I missed the first year of my second daughter's life.

I separated from the military in 2009.

It wasn't really prepared to jump back into civilian life as quickly as I would've liked.

There's not really much of an exit strategy once you leave service.

In order to support myself, I had to work constantly so I wasn't home.

And because of having to work so much after coming home, I basically missed the first year of my third daughter's life.

And my family were pretty adamant that I had changed.

And my excuse or answer to them was, "Well, been to war.

Of course I've changed.

How could I not?"

I was having issues that I wasn't dealing with and wasn't ready or prepared to deal with caused the dissolution of my marriage and separation from my children.

During that time period for a while, I was homeless.

I didn't think there was anything wrong with me.

Part of the process of going through the VA.

I was diagnosed with PTSD and TBI or traumatic brain injury.

I got in with Catholic Social Services who found me placement with a VA rent control apartment building down on Olive Street.

I started seeing a counselor at the Scranton Vet Center and slowly was able to recognize that "Yes, I had been to war, but there were things that I needed to address because of the experiences I had."

I utilized my GI bill to get my degree in Nutrition and Dietetics through Marywood University.

For me, my mental health journey actually started picking up and becoming a motivating factor for me during my time at Marywood.

After I graduated, I stayed at Marywood.

I was one of the utility mechanics because I was secretly waiting for the position of Director of Military and Veteran Services to open up.

And when it did, I applied for it.

And I spent two and a half years there as the Director of Military and Veteran Services.

I was in charge of finding programming for veterans to help with mental health.

I had connected with Equines For Freedom and they had given me the name of an organization called Warrior Strong.

Warrior Strong comes to mental health from a different avenue.

We focus on mental health through camaraderie and through physical fitness.

For a lot of vets, the bonding experience when you get in is having to go through bootcamp and the always lovely physical activities that they have you do through that.

Going through those types of stressful situations and then meeting people who know what those stressful situations are, but then engaging in physical activity really helps open a lot of veterans up.

One of the things for me that's most beneficial for my mental health is being able to show how working on your mental health can be more than just beneficial to feeling better, but to doing better.

All of this is to say that if you are having a hard time retransitioning back into civilian life, if you're having issues with what you experienced or if you just need somebody to talk to, I would recommend that you do it.

Don't keep everything bottled up inside.

It either explodes at inappropriate times or you retreat further and further into yourself until you get to the point where you see no way out under hope.

In this world we only have each other.

Why not help each other?

It's way better than being angry at each other all the time and it's less stressful.

Veteran suicide is a big deal.

Talk to somebody, whether it's a friend, a spouse, a counselor, a fellow veteran, and look for those programs that will help you.

They're there for a reason.

It's not a handout.

Most of the time you sign the contract for it so you're entitled to it.

And for those organizations outside of that realm, they wanna help you.

They're there to help you.

Utilize them.

(upbeat music) - And we thank Christopher Smith for his service and we are delighted that he happens to be with us tonight, and has a question for our panel.

Chris?

- Yes.

So as you saw, we we're coming... My organization that I'm working with, we come to the mental health aspect from less than traditional form.

And I'm wondering, is there any interest in the VA system to maybe start incorporating those different types of avenues?

Because trying to put a round hole through a square peg doesn't always work.

And sometimes people need a little bit of a different way to get to the help that they need as opposed to a cookie cutter kind of approach.

- Absolutely.

There is no right answer to help someone refine their passion and their purpose and their feeling of that they're worth again.

That is something you have to do as a self journey.

Whether you like to run, whether you want to do yoga, whether you want to go to counseling, join the American Legion, whatever works for you to reconnect with yourself is what you need to do.

And the VA has supported many organizations that are into the arts.

I met a group yesterday that does music therapy.

We talked about folks writing their own books, writing poetry, doing yoga.

We will support any of those opportunities for veterans to rehab, to refine themselves, to repurpose themselves.

So absolutely we can help you grow what you're doing and pass the word out and let other veterans in this community know that you're available to help them.

Because for some people, that's what they want to do.

And folks wanna lose weight, they'll say, "What's the best exercise?"

Right?

And it's the one you're going to do.

So it's the same thing mental health.

What resonates with you?

What doctor do you enjoy going to?

What therapist can you talk to?

It's someone you can connect.

And that's the same thing with the type of therapy.

I pass it over to the expert here.

(laughs) - As we're talking, I'm struck by a common element in the videos that we've been watching.

And that is the personality elements that are at the heart of people who raise their hand and join up with the military.

There are folks who see things that are bigger than themselves at play.

There are people who want to serve.

There are people who want to take care of other folks.

And I think a lot of folks when they leave the military, they feel like they've left all that behind them.

And right down to everyone who we've seen in the videos to the three of us on this panel, right?

Veterans finding a new purpose, a way of helping others, a way to kind of still scratch that itch of being a part of something bigger than them, helping out folks who are in need.

That's a very important and very powerful thing.

And I'm thinking back to the question of how do we get more folks into the legion or the VFW?

Maybe letting them know that it's not just sitting around and telling stories.

It's giving back to the community.

I'm thinking of Team Rubicon, right?

The veterans who go to natural disasters.

They love doing that stuff because they feel like they've got purpose again.

You can't ignore the core parts of you.

If you are someone who's always been someone who takes care of others and serves others, that's still a part of you.

And you can find some real healing and progress in tapping back into that.

- I think the other thing that is such a big part of what Christopher does is the physical activity, right?

The yoga, getting together with other veterans and engaging in physical fitness.

Can you, Dr. Keller, talk about how physical fitness and physical activity can itself be a part of the healing process?

- Absolutely.

It's a very underrated part of the healing process because anxiety at its core is this fight or flight mechanism that's getting triggered, right?

Exercise burns off those stress hormones, burns off that excess adrenaline, provides some muscle relaxation and really gives a person an opportunity to clear their mind.

When they're engaged in the exercise also, a lot of times their worries, their concerns aren't bombarding their brain.

They're thinking about what they're doing.

They're thinking about talking with their buddy who's doing the same crazy yoga pose.

(laughs) So there's a lot to be gained from physical activity.

- Kinda get you out of your head and into your body.

- Exactly.

- Right.

- Which is relieving in itself.

David- - Another thing if I could add with Warrior Strong too, it's not always all physical.

A few months ago I was talking to Tom, the founder of Warrior Strong, and I kind of giggled when I was talking to him because he's like, "We have this new program on our app."

It's You breathe.

And I was like, "Get out."

What do you mean you breathe?

Veterans have been coming into my office saying, "Hey, you know what?

That app that you told me about just breathing, it felt like something melted away just by refocusing on something else.

So I was like, that's something that we need to get a broader scope on because there's a lot of veterans that might be wheelchair bound or just they don't have the capability of doing the physical exercise, whether it's yoga or hiking or biking.

This breathe, learning to reset yourself is a huge, huge help.

- Yeah.

I have one of those apps and I can attest that there's a lot of power to a few deep breaths.

That's amazing what that can do.

By the way, if you have had these kinds of struggles, we want you to know that you are not alone.

If you need someone to talk to or you'd like to explore treatment options, dial 211 to speak with a caring person who can help.

David, I wanna come back to you because one of the points that Christopher made was that when he came back home, he didn't feel like there was much of an exit strategy.

That was the term that he used.

And I saw you and General Weigl sort of nodding toward each other.

Can you address that?

The sort of, the lack or perceived lack of an exit strategy for so many veterans when they do come home and now they're thinking what happens now?

- Yeah.

I mean veterans at the time of getting out processed, they're tired of being told what to do.

They're ready.

They did their thing and they're ready to get out.

But most veterans went in right after high school because they wanted to better their lives, serve, have purpose.

They change in the military, but they're still kind of getting taken care of.

And then when it's time to go, you're handed papers and say, "Go to your local offices and kind of figure it out."

So you have that Uh-oh moment at the time you're getting out.

It's like, "I don't have my staff sergeant telling me what to do anymore.

I can do my own thing, but what am what's my new purpose?"

So it's like the doctor said anxiety, depression plays a big, big role in oh my...

I made this decision, but what do I do now?

- Yeah.

And who am I now that I'm not part of the military?

Yeah.

General Chris mentioned that he was diagnosed with a traumatic brain injury after his time in Iraq.

And apparently, that is not uncommon.

So much so that you yourself were deployed there to do some research around that.

Can you share a little bit of what you learned in that process?

- I can.

So Vietnam era, we learned that many service members suffered post-traumatic stress.

The type of combat, the type of environment they win.

Iraq offered a different unique situation for service members.

Folks being impacted by IEDs, RPGs.

Those are rapid concussive forces on the body.

It's similar to having a concussion.

So a traumatic brain injury, a mild traumatic brain injury, you could be on a convoy.

You could be in the number five vehicle.

The first two vehicles get hit.

What is the multiple times that you've been exposed to a blast exposure or that rapid concussive force on your body that would cause long-term disability with mild traumatic brain injury, traumatic brain injury?

And we did a lot of studies.

So many of the service members now will have these MACE exams where they, before you go out on a mission, they'll make sure that they'll look at your cognitive abilities.

And when you come back from an IED exposure to see if you've been impacted and you have mild concussions.

What's the long term impact?

If you've been on a team that detonated those explosive devices and you've done that for a living long term, what is the exposure?

So what we studied is trying to figure out how veterans who did not identify, because many veterans were in a blast exposure.

They went right to solving the problem, right to going into sniper mode, securing the era, taking care of the folks that were injured, physically injured.

And then when they got back, they didn't wanna say they had a concussion because you can't go back out on a mission again.

So they hid their injuries.

But long term, what are those symptoms?

And people were confusing PTSD for traumatic brain injury.

In the beginning, when you're having depression, anxiety issues, they might seem similar until you do a different test and you realize.

So you had to treat behavioral versus concussion type injuries.

And those are invisible wounds of war that we've learned about.

But people suffer from from many of those and they have different symptoms as I'm sure the doctor can explain.

That was an issue that we had from Iraq and Afghanistan that was very unique because of all of the explosive devices.

- David, I want to talk about something that Chris said and Amber said as well.

Chris said veteran suicide is a huge deal.

Amber said veterans suicide is such a big deal and I feel like no one cares.

Can you talk about how the military is addressing it because it is a huge problem.

- The military is trying to put more and more resources over the years out.

I mean, I've been doing this job for well over 10 years and I've seen the change.

And on the VA side of things, they're trying to make it easier to get access.

Now we have #988 to get to the veterans crisis line quicker, faster, and get you that resource that you need.

So there people are do care and we're trying.

It's just...

It's a very hard thing to figure out because even in my...

I used to blame myself.

Like, I'm in this office.

I'm trying.

What more can I do to make this stop?

And then over the years I realized like unfortunately on some, the mental health aspect of it is so bad.

There's nothing a provider can do to stop it.

But we now, we won't quit.

We're gonna keep trying.

- And Dr. Keller, for friends and family of veterans who may be at risk for suicide, what do they look for?

How can they be supportive?

How do they get help for the people they love?

- Yes.

Reaching out to the veterans organizations is a good start.

It's very difficult for a family member to know when to intervene.

And a lot of times it just comes down to just gut feeling.

Being with the veteran for long enough, you are most likely to be able to tell when there's been behavioral changes, when there's been cognitive changes, ways of thinking that have changed.

And you're probably...

If you're a family member, one of the folks who are most likely to be able to with just gut instinct, know that something is wrong and reach out to somebody.

- General Chris's recommendation to his fellow veterans who are struggling was talk to somebody.

Talk to a family member.

Talk to a friend.

Talk to a therapist.

Talk to somebody.

But also to take advantage of the resources and we have talked about that.

I wonder if you might be willing to underscore that point about how important it is for veterans to identify and be able to take advantage of the kinds of resources that are out here that they might not even know about.

- Absolutely.

So what I would say to veterans and to every one of the audience is whether you were a marine kicking down doors, being all badass, wonderful medical doctor who served in the Navy, in the Army, or just an admin officer, your service was relevant.

If you were a female nurse in Vietnam and in Korean War and no one recognized your service, no matter what job you did, if you raised your right hand to support and defend the constitution of this great country, whatever job we asked you to do and you did, your service was relevant.

And we are here for you.

We are here to make sure you have access to all of your benefits, to all of the resources.

There are numerous resources available in every community.

I'm confident of that from being in my job for the last two years.

I've met so many wonderful partners.

Geisinger, all of the nonprofits.

We work in Pennsylvania with all of the other agencies, Department of Aging Health, human services.

Everybody is helping us combat issues that veterans face, whether it's homelessness, suicide, female veterans trying to reintegrate.

You need to know we care and there are tons of resources.

Find your county directors.

Find your American legions, your VFWs.

PA VETConnect is where you can go and we will help you synchronize whatever need you have to the resources that you need.

There's employment opportunities, so many opportunities.

Please know that you're not alone.

Know that we're here.

Know that we have lots of resources from the federal, state, government, and the counties to help you.

- And if they're not on there, reach out to us so we can put them on there.

Because there's a lot of different things that are out there that maybe we didn't come across yet and it needs to be known.

Reach out to myself or General Weigl and we'll make sure we get that resource on that PA VETConnect.

- Dr. Keller, Chris made a distinction between feeling better and doing better.

Can you unpack that a little bit for us?

What's the difference?

- (chuckles) Sometimes you got to fake it till you make it.

(chuckles) A lot of times you'll do better before you start feeling better, right?

A lot of folks are immobilized by the thought, "Well, I'll get back to my life.

I'll get back to these things once I start feeling better."

And if they wait for that, it may never come.

A lot of times it's the doing better that starts the feeling better process to put it simply.

- Yeah.

Good point.

Before we wrap up our conversation, I'd like for each of you to leave our audience with a final thought, whether that's a resource that you can recommend or something that you think would be important for them or for their family members to be aware of.

David Eisele, I'll start with you.

- Yeah.

I would just like to say like, remember you are not alone and you're not weak by coming out and saying something.

And for immediate help, #988.

The veterans crisis line will get you somewhere or get somebody to you to help.

- [Tracey] Right.

General.

- I wanna say thank you for your service.

No matter what you did for our military, we appreciate everything you did.

There is a wise man in the audience who taught me that all of us served.

And when we served, we found a purpose bigger than ourselves.

We found passion and we had people that surrounded us and took care of us.

And just know you might be trying to struggle finding your purpose and your passion again, but the people are here for you.

And we will make sure you get the resources you need.

- [Tracey] Dr. Keller.

- I would add that you have earned the right to get as close to normal for you as when you entered the service.

All right?

And that's what these services are for.

All these programs that are being offered is to get you back as close to good as we can get you.

And you've earned that right to take advantage of these services.

Don't feel like you're taking someone's place or misusing the service or anything like that.

Be confident that you raised your right hand.

You swore the oath.

You earned the right to get put back to good.

- Well, I think that is an excellent note for us to wrap up our conversation on Dr. Brian Keller, Brigadier General Maureen Weigl, David Eisele.

I want to thank each of you for your service.

Thank you all for being part of tonight's program and for your ongoing work with veterans in the area of mental health.

For more information on this and other mental health topics, please visit wvia.org/mindovermatter where you'll also find information about our podcast.

And remember, you are not alone.

On behalf of WVIA, I'm Tracey Matisak.

Thanks so much for watching.

(bright music) (audience clapping)