Healing Invisible Wounds: A Look at a Major Push on Veterans’ Mental Health

"Soldiers and veterans are undeniably resilient, both by selection and by training. But they are not superhuman,” states a January report from the Veterans Administration. The report concludes that roughly half of veterans surveyed who showed a need for mental healthcare said they do not currently receive any such care, either through the VA or private physicians. Changing that unacceptable statistic is a major goal of the Warrior Care Network of the Wounded Warriors Project (WWP).

WWP launched Warrior Care Network in January 2016 to address the “invisible wounds of war”—including post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI). Last fall, it made a big investment of $160 million to expand this effort.

With the help of its four academic medical center partner programs—UCLA, Emory Healthcare, Massachusetts General Hospital and Rush University Medical Center—Warrior Care Network provides a year's worth of mental healthcare in intensive two- to three-week programs. Each of these programs is receiving a chunk of the $160 million, funds raised from the wide range of institutional and individual donors that support WWP. (The group reported $211 million in contributions for fiscal year 2017.)

WWP’s stepped-up push here came after years of relatively low philanthropic funding for veterans’ mental health needs. While we have recently reported on several funders who have shown an interest in helping veterans complete an education or develop job skills, it has been several years since there was a significant infusion of private funds in the area of mental health—most notably Steve Cohen’s major gift to this cause in 2016.

Doubling the Number of Veterans Treated

Among the centers working with WWP on its initiative is UCLA Health’s Operation Mend, which received a five-year, $20.1 million grant to expand its intensive treatment program serving veterans with post-traumatic stress and mild traumatic brain injuries, and their caregivers. The funding will more than double the number of mental health patients and caregivers treated by the program. It’s a significant advance: In its first three years at UCLA, Operation Mend had outcomes showing all participants experiencing statistically significant reductions in all symptoms and a program completion rate of 97 percent.

The contribution is the largest ever to Operation Mend, which is part of the Semel Institute for Neuroscience and Human Behavior at UCLA. The six-week program is designed for patients who require more than standard outpatient care. Prior to enrolling in Operation Mend, potential participants spend two to five days at UCLA consulting with specialists from various disciplines to ensure that the program will address their needs.

Once the program begins, veterans and families spend three weeks at UCLA receiving cognitive training for challenges related to symptoms of mild traumatic brain injury. The patient also undergoes one-on-one cognitive processing therapy sessions for post-traumatic stress that address war-related psychological trauma and symptoms related to challenges with memory and concentration.

In addition, the patient and family take wellness programs including psychotherapy in which people interact with horses, practice qi gong (an ancient Chinese form of exercise focused on breathing and movement), acupuncture, acupressure and meditation. They also participate in healing arts therapy, life tools sessions, social activities and more.

The Rest of the Network

Each center within the Warrior Care Network shares information intended to improve the program and establish best practices.

“By bringing together four major academic medical centers willing to pool their innovation, passion, research and clinical experience to improve evidence-based treatment models, Warrior Care Network is creating best practices for our nation to treat the invisible wounds of war,” said Jo Sornborger, director of Operation Mend’s psychological health programs, in a press release.

The three other programs of the Warrior Care Network—the Veterans Program at Emory Healthcare in Atlanta, the Red Sox Foundation and Massachusetts General Hospital Home Base Program in Boston, and the Road Home Program at Rush University Medical Center in Chicago—also received substantial funding.

In September, Emory University received $29.2 million to add space to and build the capacity of its Woodruff Health Science Center.

The five-year grant will support expansion of the Emory Healthcare Veterans Program, which operates a two-week outpatient treatment program designed to help veterans “re-engage in daily life while promoting their physical and mental health and wellness.”

In June, Rush University Medical Center was granted $45 million to significantly expand its Road Home Program, allowing an expected 5,000 military veterans or their family members to receive mental healthcare services without cost to them over the next five years. The grant is the largest single donation to Rush since its founding in 1837.

The Road Home Program is a three-week intensive outpatient program designed for veterans from across the country whose PTSD has not responded to standard treatment. Patients receive more than 100 hours of treatment, which includes cognitive processing therapy and wellness interventions such as mindfulness, yoga, art therapy and acupuncture.

More than 260 veterans have completed the program to date, and the new funding will make the three-week program available to more than 1,500 veterans over the next five years. In addition, the new funding will also enable Road Home Program clinicians and therapists to provide outpatient therapy, counseling and other services to an additional 3,500 veterans and their family members from the Chicago area and elsewhere.

Also in June, Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, became the recipient of a multiyear $65 million grant. The gift includes $3 million toward Home Base’s Capital Campaign to establish a new National Center of Excellence in the Charlestown Navy Yard, while $62 million will expand clinical services, making it the second-largest gift in the history of Massachusetts General Hospital.

Home Base is the first private-sector program in the nation focused on healing the invisible wounds that war inflicts on both veterans and their families. Its services include wrap-around, individualized care, combining evidence-based behavioral treatment, rehabilitative medicine, wellness, complementary alternative medicine, nutrition, mindfulness training and family support.

The WWP gift will not only allow Home Base to increase the number of veterans and families served, but it will also accelerate the establishment of new models of care. These include a dual-diagnosis intensive outpatient clinic for veterans struggling with opioid and addiction challenges and a weekend intensive clinical program to allow better access to care.

Philanthropy Steps Up

The WWP grants are part of a broader push by philanthropy to engage the unique mental health issues veterans face. For example, the America’s Warrior Partnership recently announced it is accepting proposals from local nonprofits and government groups to participate in Operation Deep Dive, a community-based veteran suicide prevention study led by America’s Warrior Partnership and University of Alabama researchers, with $2,961,536 in support from the Bristol-Myers Squibb Foundation. The four-year study is currently being conducted in seven U.S. communities, and this request for proposals seeks to expand the project to seven more communities.

Steve Cohen has said he plans to expand his Cohen Veterans Network (CVN) to 25 mental health clinics by 2020 to better serve veterans and their family members in an effort to create what it called the "mental and brain health care system of the future." (The network attracted some criticism last year for how it operated.) Cohen, the controversial hedge fund manager who reportedly has an estimated net worth of $14 billion, initially pledged $275 million to CVN.

A Desperate Need

The Department of Defense's own Defense and Veterans Brain Injury Center reports that more 380,000 service people have sustained traumatic brain injuries. Statistics from the Department of Veterans Affairs reveal that 20 veterans die by suicide every day.

In 2008, RAND estimated that nearly 20 percent of military service members who have returned from Iraq and Afghanistan reported symptoms of post-traumatic stress disorder or major depression. “The need for services and support continues to grow exponentially, even as the numbers of killed and wounded decline, and the public's interest and involvement wanes,” WWP said at the time.

Yet 10 years later, the Veterans Administration is falling short when it comes to addressing such issues as brain injuries, stress disorders, depression and suicide. Far too many vets survive battle overseas only to lose battles with their inner demons back at home.

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