Military Transition and Mental Health

Flash Post #8

It’s been a while since I posted. The whole “being in law school” thing has a tendency to interfere with my leisure activities (to the extent this could be called such a thing). I had intended to share my thoughts on memorialization and remembrance, the purposes and the pitfalls, with a post drafted to coincide, progressively, with September 11th, October 12th, and November 11th. To be clear, it was just going to be one post on a subject generally applicable to all such days (and if you’re scratching your head at how October 12th fits, that’s a point of discussion, too), but things just kept on coming up with my courses and the thought of writing a blog post was, for much of that time, something like the prospect of running a 400-meter dash between successive marathons. I mean, if you can run two marathons back to back, you can probably run another 400 meters in the middle, but you probably aren’t going to do very good job of it when judged against what one normally expects out of a 400-meter dash.

This semester, in addition to more traditional courses, I have been continuing my work as a student attorney within the law school’s clinic program. This represents about half of my “course load” for the semester, but most of it is out of class and the load shifts as actual cases progress through a very real court system. Anyway, the clinic is the Veterans Legal Clinic, but the bulk of our work involves providing general legal aid to people who happen to be veterans rather than, say, dealing with veteran-specific issues like VA claims, discharge upgrades, and military records corrections. If you want that sort of thing (the veteran-specific stuff), you might as well go to your local Veterans Service Organization (because the VA sure as shit ain’t gonna help if you ask, they’ll just point you to one of those charities).

All that aside, the courses and the cases and all the reading and writing that entails, I have been jostled into at least writing something this semester by a recent Navy Times article: The services aren’t screening for suicide risk and assuring resources for separating troops, IG finds. I had been thinking about writing on my own experiences with transitioning and gaps in assistance, and this article, based on this recent IG finding, seems as good a springboard as any to share, at least in part, my experiences.

My Story, Disjointed and In a Fit

As I’ve previously shared, I left the military as I was medically retired due to PTSD. My last day in uniform was, if I recall correctly, March 27, 2019. I’ll grant it might have been the 28th or 29th, but it was definitely 2019: that much I am certain of. And yet, to read my DD 214, you might think the year was 2018 because… apparently it’s too hard to generate an accurate DD 214 and afford the separating or retiring service member an opportunity to review it prior to finalizing. Ideally, my DD 214 would have been complete well before my retirement date and I’d have been able to review it in the “Navy Standard Integrated Personnel System” (NSIPS, a Navy website that serves as an electronic personnel file), but then, surprise! surprise!, Navy IT being what it is, that particular NSIPS feature was unavailable throughout my final months, at least for me and the other officer separating from my command around the same time. So instead, someone I had never met and never had a chance to speak with just shit out a draft DD 214 full of errors and, when they couldn’t reach me (even though I was still in the military for a time after it was drafted, and even though I provided my email and cell phone number on my transition paperwork, and they obviously had at least my email because they were able to send me the DD 214 after it was finalized, a full month after I retired), they just put “member not available for signature” in the signature block (that tends to happen when you don’t even bother to try and contact the service member: they become suspiciously “not available”). Hence my DD 214 states I left the military in 2018, vice 2019, and that’s a problem I really do mean to correct some day, but I digress…

The real, or at least the most immediate, of my DD 214 woes was the part where it was finalized a full month after I left active duty and transitioned to the dreaded TDRL. This was a “problem” (and very much a propos the impetus for this blog entry) because, in order to sign up for VA healthcare, you need to have a DD 214. No DD 214, no signing up for the VA. Because how else would the VA know you’re a veteran? Certainly the DOD and the VA couldn’t have a process to just talk to one another, as two government organizations, and let that transition from DOD to VA healthcare happen transparent to the member based on the records that one department generates and the other one needs, neither of which must necessarily pass through the servicemember as a node between the two (especially if the DOD will happily finalize a DD 214 and write “member not available” in the signature block). No. They need the member to take action to apply, using a form provided by the DOD (the DD 214) as proof of eligibility before the VA can do anything at all. Even if, as in my case, they are dealing with a veteran who has, preparatory to retirement from the military for a known service connected disability gone through the Integrated Disability Evaluation System (IDES) with the “Integrated” part referring to the interaction between the DOD’s disability evaluation system on the one hand, and the VA’s on the other: I literally had to already be evaluated and rated for a disability by the VA in order to get my retirement from the DOD, and yet somehow another step was required to ensure I could get the ongoing treatment I needed in transition from the DOD to VA healthcare.

I mean, don’t get me wrong. I think the prevalence of PTSD among the troops is at times overstated, as if every time a veteran suffers a setback it must surely be PTSD (as if veterans, unique among humans, aren’t capable of having problems in their lives without also having PTSD). And inasmuch as I believe that veterans’ mental health really is a serious issue that needs more attention, I have long suspected–and there is some evidence to back this up–that depression is far more common among veterans than PTSD (not unlike actual people, I suppose: in truth, I think mental health in general deserves more attention, not just for veterans). But, back on topic, it just so happens that I actually was not only diagnosed with PTSD, but diagnosed while in the military, rated for PTSD as a disability, and retired from the military because of PTSD. In order to get my retirement form the military, my diagnosis of PTSD was first arrived at by a team of DoD psychologists, and then confirmed by an independent contractor, a VA representative, and a Navy Physical Evaluation Board made up of a trio of senior officers. My treatment records also documented a history of suicidal ideation. So you’d think, surely, that someone leaving the military with PTSD and suicidal ideation, with a service-connected disability rating already agreed upon by the DOD and the VA, would have a ROCK SOLID transition plan to ensure continuity of care, never mind that pesky DD 214, right?

Nope.

By the time I had my DD 214 (late April of 2019, a month after I left the military) and could finally begin to apply for VA healthcare, I was in such dire straits that the effort was almost too much to endure. Here, I’m going to refrain from going into much detail because it’s too much to write. I mean, I cannot yet put into words how frustrating, even how traumatizing, it was to have to slowly claw my way to getting signed up with the VA after that month in the gap. Part of what made it so traumatic was that even though the VA had already evaluated me for disability (so they obviously would have had their own records of my condition, right?) and the DOD of course had mounds of paperwork documenting my condition as well, it was like every time I sought care I had to explain anew what exactly my problem was. Which meant I had to explain my PTSD. Which meant I had to continually, and needlessly, “retread” my trauma–to strangers–all for the sake of bureaucracy.

At some point I became so unhinged, in seeking to sign up for VA healthcare just so I could refill my medication (which was running out–they gave me a three month supply back in February and it was looking like it’d be July before I’d get to see someone) that the suicide prevention hotline called me (one of the VA customer service reps I had gotten frustrated with, to their credit, deduced that I was in somewhat of a crisis and contacted the veterans suicide prevention hotline to reach out to me, which helped; not because I needed one more person to tell my story to, but because they actually took action on my part and helped remove some of the barriers that were keeping me from getting care). It’s almost as if leaving the military and finding myself in that “gap” of transition, seeming to grow wider as I despaired, was its own kind of trauma. And I don’t say that lightly. When part of getting the help you need–and are entitled to–involves having to revisit your trauma so that They, the bureaucracy, can “help you,” that may explain why some veterans end up in a chasm. While certain bureaucratic obstacles might seem slight and eminently reasonable when viewed from a dispassionate perspective of “administrative efficiency,” the reality can be anything but for those most in need of care. A speed bump might as well be a brick wall when there’s that on one side, a bottomless pit on the other, and a narrowing path in between.

In summation, there’s a lot of nuance and a lot of details I don’t want to go into (because it’s still kind of raw), but… yeah, I endorse the IG’s finding, as relayed by the Navy Times, that services aren’t screening for suicide risk and assuring resources for separating troops. Because if you can’t even ensure that someone with known, diagnosed, and rated service-connected PTSD and suicidal ideation doesn’t fall through the cracks, then you are probably missing much larger swathes of the veteran population afflicted by either (a) undiagnosed PTSD or (b) other, perhaps more common, mental health conditions like depression, anxiety, and adjustment disorder which also pose a risk for suicide.

But on the bright side, in my despair I found…