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The struggle and rising need for veterans to get mental health care

Old Veterans Affairs Department hospital in Denver
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The guilt felt by Connor McDaniel's father, David, is overwhelming.

"He had more personality than a whole bunch of people put together. I miss him terribly. I miss him every day," David said. "I'm his father. I'm supposed to protect him, even from himself, and I failed. It's very, very hard to deal with."

Last year, the 26-year-old veteran sent his last email to his loved ones.

"He felt like his entire life would've been a series of bad experiences."

His family tried to stop him. His father called law enforcement for help.

El Paso County sheriff's deputies found McDaniel first, where he provoked them to shoot and kill him.

The district attorney's office ruled the shooting was justified.

David is now fulfilling a promise to his son — that he would never be just another number.

"My son made it very clear in his note to us that he didn't want to be a gun violence statistic, a veteran suicide statistic," he said.

David McDaniel wants to ensure every veteran receives access to mental health care after they return home. And data shows the need is rising.

The Department of Veterans Affairs projects a 32% spike in outpatient mental health care over the next 10 years. And one-third of veterans who received care from the VA were diagnosed with at least one mental health condition.

But there are barriers to treatment. Stigma and shame are two of them, according to Bob McLaughlin with the Mount Carmel Veterans Service Center.

"It's about resiliency, right, and when that breaks — when people feel that they're weak — that's against the culture," he said.

In a 2018 study from the peer-reviewed BMC Health Service Journal, researchers found a majority of veterans were worried about what others would think if they sought treatment.

University of Memphis President Michael Rudd also says troops on active duty can face consequences for reaching out for help.

"Ultimately, the concern is about the impact on career progression, the impact on your deployability, the impact on all sorts of things in terms of advancement," he said. "That's how stigma is maintained."

Some veterans told the BMC that fear lingers long into retirement.

In an effort to erase stigma, the VA created a national campaign called "The Veterans Know," where former service members encourage each other to take charge of their mental health.

"It really is quite empowering to hear veterans talk about their struggle, how they became aware of the struggle and then all the different kinds of ways that they got help," Department of Defense Mental Health National Director for VA Christopher Loftis said.

Even when veterans look for treatment, the BMC study found that many had little confidence in the VA health care system.

Veterans who were interviewed pointed to "appointment problems, staffing issues," and "limited follow-up" from providers and staff.

"It's just starting to build back up into another waitlist scandal," Concerned Veterans of America Coalitions Director Joshua Stanwitz said.

Before the problem hits a crisis point, like the waitlist scandal in 2014, Navy veteran Paula Pedene accused VA officials in Phoenix of lying to the federal government about shorter appointment wait times.

An audit from the VA Inspector General found systemic problems throughout the VA, discovering the average wait was 115 days and at least 40 veterans died without the chance to see a doctor.

"There was 111 VA facilities that were using the same methodology and manipulating the wait time data to make them look good," Pedene said.

VA Secretary Eric Shinseki stepped down in the wake of the scandal and then-president Barack Obama signed 19 executive orders to improve VA hospitals.

On its website, the VA says it implemented new methods of calculating average wait times to be more accurate so patients can check how long it will take to see a provider.

The wait times change daily, but when we last checked within 50 miles of Chicago, the wait was anywhere from 9 to 13 days.

Under the VA Mission Act of 2018, which aims to provide broader access to health care, veterans should only wait a standard of 20 days after requesting a mental health appointment.

Rural areas face unique geographical hurdles, like Sioux Falls, South Dakota.

When we last checked, there is one treatment facility in the area with a 15-day wait.

The center with the second-earliest availability is 95 miles away.

If veterans can't get the help they need, the VA Mission Act says the VA is supposed to pay other health care systems to take over, like community care.

But an investigation from USA Today last year found that in some cases, administrators overrule doctor recommendations to send vets outside the VA to retain patients. And once people are sent to community care, the average wait time is about 42 days.

The VA told USA Today it's following Mission Act requirements. And some doctors say expanded telehealth is easing struggles.

"The way that psychiatrists and psychologists can work with someone in a rural area is very effective as well," Zablocki VA Hospital Mental Health Division Manager Dr. Bert Berger said.

VA data shows the pandemic drove telehealth appointments to unprecedented heights, jumping nearly 2,000% between January 2020 and 2021.

Officials told Congress last year about spending government funds to expand care and improve reach.

Veterans Health Administration Acting Deputy Under Secretary Dr. Steven Lieberman said the VA distributed over 84,000 iPads and 20,000 cell phones. "It helped us accelerate the modernization of bandwidth to reach over 2,100 locations with increased bandwidth on modernized platforms."

Today, the system supports over 100,000 remote users.

Still, some veterans expressed distrust over using online services, telling BMC researchers they think the system will share private information.

One Vietnam veteran confessed he was afraid that sharing about his time overseas would land him in jail.

Other vets said they simply didn't know anything about VA benefits before leaving the military. They struggled to understand how to find or use mental health services as veterans, instead of as active-duty members.

The VA built Make the Connection, a website to link up veterans with resources and solutions for their mental health needs.

There are also free, online tools for veterans to deal with sleep issues or anger management, plus a crisis line with 24/7 support for vets and their families.

But Berger says it's important for veterans to take the difficult first step and seek the support they need.

"Veterans are proud," he said. "They served their country. They don't want to admit they have a problem or admit defeat in any way, so admitting that they have a mental health problem is really difficult."

As for David McDaniel, he just wants to make sure troops know they aren't alone when they come back from a deployment while keeping his son's memory alive along the way.

"I really do strongly feel like if we can make the 'D' disappear from PTSD, and it's not such a stigma, and everybody who's been in combat goes for some mental health, I think it will change things a lot."

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