Overcoming Ptsd: Assessing Va’S Efforts to Promote Wellness and Healing
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OVERCOMING PTSD: ASSESSING VA’S EFFORTS TO PROMOTE WELLNESS AND HEALING HEARING BEFORE THE COMMITTEE ON VETERANS’ AFFAIRS U.S. HOUSE OF REPRESENTATIVES ONE HUNDRED FIFTEENTH CONGRESS FIRST SESSION WEDNESDAY, JUNE 7, 2017 Serial No. 115–16 Printed for the use of the Committee on Veterans’ Affairs ( Available via the World Wide Web: http://www.fdsys.gov U.S. GOVERNMENT PUBLISHING OFFICE 29–684 WASHINGTON : 2018 VerDate Aug 31 2005 11:44 Jun 07, 2018 Jkt 000000 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 Y:\115TH\FIRST SESSION, 2017\FC\6-7-17\GPO\29684.TXT LHORNE leonard.horne on VACREP0180 with DISTILLER COMMITTEE ON VETERANS’ AFFAIRS DAVID P. ROE, Tennessee, Chairman GUS M. BILIRAKIS, Florida, Vice-Chairman TIM WALZ, Minnesota, Ranking Member MIKE COFFMAN, Colorado MARK TAKANO, California BRAD R. WENSTRUP, Ohio JULIA BROWNLEY, California AMATA COLEMAN RADEWAGEN, American ANN M. KUSTER, New Hampshire Samoa BETO O’ROURKE, Texas MIKE BOST, Illinois KATHLEEN RICE, New York BRUCE POLIQUIN, Maine J. LUIS CORREA, California NEAL DUNN, Florida KILILI SABLAN, Northern Mariana Islands JODEY ARRINGTON, Texas ELIZABETH ESTY, Connecticut JOHN RUTHERFORD, Florida SCOTT PETERS, California CLAY HIGGINS, Louisiana JACK BERGMAN, Michigan JIM BANKS, Indiana JENNIFFER GONZALEZ-COLON, Puerto Rico JON TOWERS, Staff Director RAY KELLEY, Democratic Staff Director Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records of the Committee on Veterans’ Affairs are also published in electronic form. The printed hearing record remains the official version. Because electronic submissions are used to prepare both printed and electronic versions of the hearing record, the process of converting between various electronic formats may introduce unintentional errors or omissions. Such occur- rences are inherent in the current publication process and should diminish as the process is further refined. (II) VerDate Aug 31 2005 11:44 Jun 07, 2018 Jkt 000000 PO 00000 Frm 00002 Fmt 5904 Sfmt 5904 Y:\115TH\FIRST SESSION, 2017\FC\6-7-17\GPO\29684.TXT LHORNE leonard.horne on VACREP0180 with DISTILLER C O N T E N T S Wednesday, June 7, 2017 Page Overcoming PTSD: Assessing VA’s Efforts To Promote Wellness And Healing . 1 OPENING STATEMENTS Honorable David P. Roe, Chairman ....................................................................... 1 Honorable Timothy J. Walz, Ranking Member ..................................................... 3 WITNESSES Brendan O’Byrne, Veteran, United States Army .................................................. 4 Prepared Statement ......................................................................................... 45 Sebastian Junger, Author, Tribe: on Homecoming and Belonging ...................... 6 Prepared Statement ......................................................................................... 46 Zach Iscol, Executive Director, Headstrong Project, Veteran, United States Marine Corps ........................................................................................................ 8 Prepared Statement ......................................................................................... 47 Paul Downs, Staff Member, Boulder Crest Retreat Team, Operation Warrior Wellness, The David Lynch Foundation, Veteran, United States Marine Corps ..................................................................................................................... 11 Prepared Statement ......................................................................................... 50 Dr. Harold Kudler M.D., Acting Assistant Deputy Under Secretary for Patient Care Services, Veterans Health Administration, U.S. Department of Vet- erans Affairs ......................................................................................................... 13 Prepared Statement ......................................................................................... 51 Accompanied by: Brad Flohr, Senior Advisor, Veterans Benefits Administration, U.S. De- partment of Veterans Affairs STATEMENTS FOR THE RECORD Outward Bound Veterans ....................................................................................... 57 The American Legion .............................................................................................. 58 Coalition to Heal Invisible Wounds ........................................................................ 63 Disabled American Veterans (DAV) ....................................................................... 66 Military Order Of The Purple Heart (MOPH) ...................................................... 71 National Alliance on Mental Illness (NAMI) ......................................................... 73 Veterans Of Foreign Wars Of The United States (VFW) ..................................... 74 Vietnam Veterans of America (VVA) ..................................................................... 76 Cohen Veterans Network ........................................................................................ 78 MATERIAL SUBMITTED FOR THE RECORD DAVID LYNCH FOUNDATION ATTACHMENT ................................................ 80 (III) VerDate Aug 31 2005 11:44 Jun 07, 2018 Jkt 000000 PO 00000 Frm 00003 Fmt 5904 Sfmt 5904 Y:\115TH\FIRST SESSION, 2017\FC\6-7-17\GPO\29684.TXT LHORNE leonard.horne on VACREP0180 with DISTILLER VerDate Aug 31 2005 11:44 Jun 07, 2018 Jkt 000000 PO 00000 Frm 00004 Fmt 5904 Sfmt 5904 Y:\115TH\FIRST SESSION, 2017\FC\6-7-17\GPO\29684.TXT LHORNE leonard.horne on VACREP0180 with DISTILLER OVERCOMING PTSD: ASSESSING VA’S EF- FORTS TO PROMOTE WELLNESS AND HEAL- ING Wednesday, June 7, 2017 COMMITTEE ON VETERANS’ AFFAIRS, U. S. HOUSE OF REPRESENTATIVES, Washington, D.C. The Committee met, pursuant to notice, at 10:00 a.m., in Room 334, Cannon House Office Building, Hon. David P. Roe [Chairman of the Committee] presiding. Present: Representatives Roe, Coffman, Wenstrup, Bost, Poliquin, Bergman, Banks, Walz, Takano, Brownley, Kuster, O’Rourke, Sablan, and Esty. Also Present: Representative Ryan of Ohio. OPENING STATEMENT OF DAVID P. ROE, CHAIRMAN The CHAIRMAN. Good morning. The Committee will come to order. And before we begin, I would like to ask unanimous consent for our colleague, Representative Tim Ryan from Ohio, to sit on the dais and to participate in today’s hearings. Without objection, so ordered. With that procedural note out of the way, welcome and thank you all for joining us this morning. During the Civil War, it was called Soldier’s Heart; during World War I, it was called shell shock; during World War II, it was called battle fatigue; today we know it as post-traumatic stress and the last fiscal year alone almost 600,000 veterans sought care for it in the Department of Veterans Affairs. At today’s hearing we are going to discuss whether the current system of VA health care services and benefits effectively promotes wellness and supports veterans with PTSD in seeking treatment. VA exists to provide veterans with PTSD or any other condition that may be connected to a veteran’s time in uniform with the care they need to live healthy, whole lives. Accordingly, the array of benefits and services that VA provides to veterans who have been diagnosed with PTSD is most impressive and expanding. And I am encouraged by the plethora of treatment programs, both traditional and nontraditional, that VA offers; by the in- creased number of partnerships with private sector and non-for- profit providers organizations that VA is entering into to better support those with PTSD; and by the innovative research that VA is continually investing in to gain a deeper understanding of how (1) VerDate Aug 31 2005 11:44 Jun 07, 2018 Jkt 000000 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 Y:\115TH\FIRST SESSION, 2017\FC\6-7-17\GPO\29684.TXT LHORNE leonard.horne on VACREP0180 with DISTILLER 2 veterans can overcome PTSD, including one important study that is going on right now to evaluate the use of service dogs for vet- erans with PTSD. I very much support the research and look for- ward to reviewing its results when they become available. I also look forward to holding a separate hearing this Congress to discuss more in depth an issue we will briefly touch on this morning: the benefits of complementary and integrative medicine for veterans, and actions needed to spread both the awareness and the availability of nontraditional techniques that can do a world of good for those struggling. But this morning I want to focus on the perennial problem of PTSD among our Nation’s veterans and what more we as a grateful Nation can be doing to support veterans who may be struggling to seek help and to embrace recovery. Thanks to the quantum leaps in battlefield traumatic medical care, there are fewer casualties as a result of today’s conflicts than there have been in previous wars, yet the mental strain that some, certainly not all, but some of our veterans face seem to be taking a heavier toll than it perhaps has ever before. Since 2010, the number of veterans receiving care for PTSD from the VA health care system has grown by more than 50 percent and despite historic and ever-increasing investments in VA mental health services and supports since the turn of the century, suicide rates among veterans with PTSD are not declining. Despite all the good, well-intentioned work that has been done, clearly we must do more to reduce the stigma against seeking care to break down institutional barriers that prevent veterans from ac- cessing the services they need, to encourage veterans with PTSD