Stay-at-home orders enacted nationwide in March were seen as necessary, if unprecedented, as the spread of the novel coronavirus threatened to overwhelm hospitals.
However, the wide societal shutdown also disrupted the support systems and coping routines of many veterans living with physical and mental health challenges, according to experts and veterans organizations. Stress and isolation are major issues — for some, those conditions can lead to thoughts of suicide.
Dr. Neal Doran, who manages the suicide prevention team for the San Diego Veterans Affairs Healthcare System, said stress within the home and the loss of a work routine can be challenging for people living with mental health issues, including post-traumatic stress disorder.
“One big piece of it is not being able to get away from any disagreement (in the home),” he said. “There’s no opportunity to step away and go do something else. Everybody’s routine is disrupted.”
Shari Houser, director of the San Diego Steven A. Cohen Military Family Clinic, agreed. For the families of people living with depression, PTSD and anxiety, their whole lives can revolve around that person’s symptoms, she said. For some individuals, their symptoms can make them feel more isolated even though they’re with their families.
“I think the isolation and the perceived lack of control as well as the constant stressors that are in your home that you can’t get away from can exacerbate PTSD symptoms,” Houser said. “For the average combat vet, this is triggering and they don’t have the perceived control. They can’t get privacy.”
Not everyone’s home life is a happy one, Houser said. Some families are dealing with job losses and marital stress. Some were in the midst of divorce when ordered to shelter in place.
A Cohen Veteran’s Network survey released in April found 70 percent of post-9/11 veterans are concerned about their mental health because of social distancing, and 60 percent said they are concerned about their employment status.
Another mental health challenge is the potential for thoughts of suicide. Doran said it’s too early to say whether the veteran suicide rate has risen during the pandemic.
“At this point, we haven’t seen a shift,” he said. “I don’t think that’s definitive. It doesn’t mean there’s not more distress. Symptoms increase by having to stay at home. For some, it’s been a really stressful time and can increase risk for suicide but so far we haven’t seen those numbers.”
For veterans with limited mobility, these challenges are compounded, according to Tom Wheaton, a Navy veteran who serves as the national treasurer for the Paralyzed Veterans of America. Even though many states, including California, are beginning to reopen parts of their economies, these veterans remain vulnerable to the virus.
“We feel trapped and terrified,” Wheaton said. “It’s still very real — the virus can hit one of our loved ones or our caregivers. We’re susceptible. As the rest of America is getting out of their houses, we’re still stuck at home or stuck in bed.”
Paralyzed Veterans of America has about 16,000 members nationwide, Wheaton said, but advocates on behalf of the 61 million Americans living with disabilities.
People with spinal cord injuries, multiple sclerosis and ALS sometimes have respiratory issues related to those conditions that make them especially susceptible to the virus, Wheaton said.
According to Wheaton, 96 members of the organization have been diagnosed with COVID-19. Fifteen of them, all veterans, have died of the disease.
Wheaton, who lives in Colorado, said members of the organization have had difficulty obtaining medical supplies and getting wheelchairs repaired over the last two months. Mental health and suicide are also a concern.
“There’s a lot of mental health issues,” Wheaton said. “Some are depressed. Harsh depression or post traumatic stress disorder can also lead to thoughts of suicide — it’s our greatest concern as an organization.”
Al Kovach, a former Navy SEAL who lives in Coronado, was injured in a parachuting accident during a 1991 training exercise. He said delays in receiving medical supplies have led him to take risks with his health while waiting for new catheters to arrive.
“I placed an order over the phone and it took longer than expected,” he said. “I had to stop drinking water for two days waiting for them to arrive, which caused me to experience dehydration.”
Kovach, a former national president of Paralyzed Veterans of America, is a board member of the local Cal-Diego chapter of the organization. He said the chapter has been busy keeping in touch with its 425 members in the area.
“We’re in constant contact with our members making sure they have what they need,” he said. “As we call our members, we find there are many feeling isolated and that for those that deal with PTSD on a regular basis, isolation is a trigger for them.”
Kovach lives with his wife and foster child. He said other members are not as fortunate to live with a caregiver.
“In San Diego, it’s been pretty stable,” he said. “However, further north in Murrieta, there’s been a number of veterans that have been struggling to get groceries. Options have been almost totally eliminated for transportation for some of our members.”
Many clinics closed temporarily and large health systems began hosting appointments remotely, including the largest system in the U.S. — the Veterans Health Administration.
Doran, the doctor from the San Diego VA, recommended that anyone struggling with isolation try to establish a routine.
“Establish new routines as much as you can do within public health recommendations,” he said. “Find something you can do that’s enjoyable and make it a routine. For anybody that is feeling stress over this …. don’t keep it to yourself. Share it with somebody you can trust.”
For veterans enrolled in VA healthcare, remote appointments are available as is the La Jolla walk-in clinic.
The Cohen clinic at Veterans Village is now seeing patients remotely. The clinic, which focuses on post-9/11 veterans, will see any veteran regardless of their discharge status as well as their family members.
Houser, the director of the clinic, said calls there are up since the pandemic began.
“We have had a lot more calls and inquiries in general, more emergency and crisis calls from people who are not our clients,” she? said. “The idea there’s no end in sight is really tough for people.”
Kovach said anyone interested in helping paralyzed veterans can donate online at helppva.org.
“If you’re aware of a vet who is paralyzed and at home, reach out,” Kovach said. “Some of them are too proud to ask. It kind of goes against our nature to ask for help.”
Veterans can call the VA’s crisis line at (800) 273-TALK(8255). The San Diego Cohen clinic can be reached at (619) 345-4611.
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