The Military Mental Health Crisis, A National Tragedy: Part II

• Over 1 million veterans of recent U.S. wars have suffered from or are currently suffering from PTSD
• Only about 1 in 3 veterans derives any benefit from the mental health care supplied by the VA
• Over the past 20 years, more than 115,000 veterans have committed suicide due to the failure of the U.S. government to provide adequate care
• In addition to their PTSD, many of these veterans are also grappling with poverty, substance abuse and even homelessness

Part I of this series laid out the Big Picture on the horrific (and deadly) mental health crisis within the U.S. military.

Over the past 20 years, over 115,000 U.S. veterans have committed suicide. That’s an average of nearly 6,000 per year. And the crisis continues to worsen.

Currently, suicides among veterans are at a record rate. An average of 22 veterans per day (nearly one every hour) are committing suicide. Overall, somewhere in excess of 1 million veterans of recent U.S. wars have suffered from or are currently suffering from PTSD.

They served their country. But upon returning home, they discovered that their country wasn’t serving them.

Conventional therapies for PTSD provided by the Department of Veterans Affairs have delivered dismal results. Only about 1 in 3 patients obtain any benefit at all. Worse still, most veterans in need of care receive no therapy at all, and (as Part I reported) only about 15% receive “evidence-based care”.

That’s the overview of this crisis and tragedy. However, it fails to capture the living nightmare of a journey through moderate-to-severe PTSD. To provide a closer focus on this crisis, Psychedelic Stock Watch will tell the story of one returning veteran.

[Kevin Martin, May 2011 — Shah Wali Kowt district, Kandahar, Afghanistan.]

Today, Kevin Martin is a steadily-employed construction inspector living and working in Hawaii. The future looks bright.

But that’s not what Kevin’s life looked like when he was honorably discharged from the U.S. Army in May 2013, after being twice wounded by dreaded “roadside bombs”. At his discharge, Kevin was diagnosed with 30% disability from PTSD.

[August 17th 2011: the armored vehicle Kevin had been traveling in after it was hit by an IED. The 2nd time he was injured in an IED attack.]

Kevin enrolled in college in September 2013, looking to build a new future following his tour of duty. But his PTSD did not cooperate.
By his graduation (June 2016), Kevin had been “reevaluated” as 70% disabled from PTSD.

The cause of PTSD can be a single severe or catastrophic trauma, but more often than not it is a cumulative effect of a series of larger and smaller traumas, occurring in a high-stress environment.

Kevin’s own condition came from an environment that people who have not been in a war zone can even comprehend. Physically stressful, but often mentally debilitating. After returning home, Kevin’s own mental health steadily deteriorated.

Kevin’s continued deterioration is (unfortunately) typical of PTSD sufferers who do not obtain adequate treatment for their condition. And as Part I illustrated (in stark terms), few veterans do receive adequate care for PTSD today.

Kevin described his battle with PTSD, a battle that he was forced to fight largely alone.
 

Kevin moved to Hawaii after graduation looking for a fresh start. But by then, he had also started developing serious substance abuse issues: primarily alcohol, but also Xanax.

Kevin had been one of “the lucky ones” in that he actually obtained treatment from the VA. But he described that experience as running a bureaucratic gauntlet. Minimally-effective conventional therapies had to be tried first – and fail – before any thought was given to newer/alternative therapies.

His symptoms worsened, and the suicide attempts began.

By February 2019, Kevin had been hospitalized for the third time. He had twice attempted suicide (in May and September 2018), and at that point the VA abandoned him – with his therapist concluding that Kevin had chosen “to drink himself to death”.

The Department of Defense (and his government) gave Kevin an honorable discharge and a Purple Heart. But when he needed it most, he received very little support or compassion, and zero gratitude.

Though Kevin obtained very little benefit from his VA treatments, they weren’t cheap. Kevin presented Psychedelic Stock Watch with documentation showing outlays of ~$14,500. It was not an experience that he recalls fondly.

One of the few new therapies being rolled out by the VA involves Johnson&Johnson’s Spravato. This is a non-psychedelic derivative of ketamine, paired up with conventional antidepressants and psychotherapy.

Kevin never advanced far enough along the VA’s bureaucratic obstacle course to even get put onto Spravato therapy. But he’s skeptical it would have made a difference. Another returning Vet (and PTSD sufferer) whom Kevin talked to had tried Spravato-based therapy. He called it “a joke”.

He’s not alone. A small minority of veterans had been fortunate enough to be put on ketamine-based psychotherapy, something that was actually working. Not a true “psychedelic”, ketamine does produce psychedelic effects – and unlike other psychedelic drugs, ketamine is already legal.

The VA began taking patients off of this ketamine-based therapy, without consulting either the patients or their physicians, and forcing them onto Spravato therapy.

Veterans were despondent. Their therapists were outraged. At least one suicide has already been attributed to this forced transition.
By now, Kevin himself was running out of time.
 

Ultimately, he would make three (unsuccessful) suicide attempts. However, finally, Kevin came across some positive options to fight his PTSD – and save his life: psychedelic drugs. In Part III, Psychedelic Stock Watch will chronicle his journey back from PTSD Hell.

Unfortunately, that’s a journey for which the vast majority of veterans continue to have no access. For many (as already noted) their downward spiral is terminal, ending in suicide. However, for the 100s of thousands of surviving veterans trying to cope with PTSD, they often face a number of additional problems.

Substance abuse is the biggest problem, for obvious reasons. But untreated or unsuccessfully treated veterans have to deal with other serious issues as well – in addition to the PTSD itself.

Veterans are victims of poverty and even homelessness, in enormous numbers. Almost 40,000 veterans are “without shelter in the US on any given night.”

As horrific as that figure is (representing ~11% of all homeless people in the United States), it’s actually an improvement. During the peak of the homelessness crisis among veterans (2011), over 60,000 were without shelter each night.

Obviously, the issue of veteran homelessness is part of an even larger issue: veteran poverty. According to Statista, 1.14 million veterans currently live below the poverty line in the U.S., which (as of the 2017 census) was a meager $12,488 per year for a single individual.

Try paying for shelter in any major U.S. city with a total income of only ~$1,000 per month.

Substance abuse is the most serious additional complication of PTSD. Roughly 20% of veterans with PTSD also have substance abuse issues, and 30% of veteran suicides are related to substance abuse.

Not all substance “issues” for veterans are the result of recreational drug use. Kevin was prescribed Xanax (a powerful and very addictive sedative) because the VA was otherwise unable to provide him with relief from his symptoms. The VA’s failed therapies often leave PTSD sufferers with additional medical baggage.

In Part III, Psychedelic Stock Watch will lay out the hope for Kevin (and other Vets) in their battle against PTSD: psychedelic medicine. We will also examine why access to these life-saving therapies is still extremely restricted – despite truly revolutionary clinical results.