Vet63 published a compelling diary in which he describes a friend of his who is an older Veteran still suffering from the psychological pain inflicted during the War in Viet Nam.
Over the last 3 decades I lost count of the number of Veterans I've encountered who had PTSD. Usually I had no prior contact. Sometimes a family member or friend would contact me through a mutual friend. A couple of times I met the Veteran in a store, a restaurant, a bar, or at an airport. The Veterans Administration Hospitals to which I've taken these Veterans include Jesse Brown and Hines in Chicago, The Madison VA Hospital in Wisconsin, The Iowa City VA Hospital in Iowa, The Westside Los Angeles VA Hospital in California, and the Portland VA Hospital in Oregon.
As many of us who are Daily Kos Veterans or spouses of Veterans have stressed there are 153 VA medical centers (hospitals) and approaching 2,000 Community Based Out Patient Clinics. Emergency Mental Health is offered only at VA Hospitals. The VA covers WHERE to get help. This diary covers each step in HOW you can get Veterans help.
Many currently are being run like individual fiefdoms with their own rules and regulations - some of which conflict with laws governing their operation. When you are trying to help a Veteran in the middle of a mental health crisis ignore all that.
You have to deal with the reality you face to get the Veteran the care they need. The following has worked at all of those hospitals mentioned above.
To get immediate help for a Veteran fighting PTSD, call the following number:
1-800-273-8255 then press #1
How to Get Help for a Veteran You Think or Know Has PTSD
Step-by-Step Instructions
1. If the Veteran is combative call 911 and request immediate help from the police.
Get far enough away from the Veteran to protect yourself, but keep the Veteran within your range of vision. If you know or believe that she/he has a weapon let 911 know and just get out of there. Do not hang up on 911 until the police arrive.
When the police arrive, stay out of their way, and call 1-800-273-8255 then press #1. Brief the Crisis Counselor about what has happened. Find out where the Veteran should be taken. Ask the Crisis Counselor if they can alert the VA Hospital. Let Police know that the VA is expecting him/her, and you have promised to stay with him/her. Follow the police car containing the Veteran. If they don't go to the hospital, go with them to the police station. Call back 1-800-273-8255 [then press #1] and update them. Ask them what more you can do - the answer varies widely and you just have to accept it.
2. If the Veteran is calm or non-communicative call 1-800-273-8255 then press #1
Remember: You aren't a pro in dealing with PTSD. They are. Take written notes if possible. Keep the Veteran involved by repeating every question the Crisis Counselor asks so the Veteran feels she/he still has some control. If the Veteran disagrees with what you are saying, let the Crisis Counselor know. Do the best you can and ask every question you have. There are no dumb questions. Everything you say is confidential.
3. If the Veteran is calm or non-communicative, CAN walk on his/her own, and agrees to go to the VA Hospital:
Do not let him/her leave your sight.
You stay with him/her every single minute. Don't drop him/her off. The Vet stays in your car until you park it legally - in a parking lot. The two of you go to the
Emergency Room and no where else. Emphasize the fact that you are taking him/her to the
ER and that you will stay with him/her to take him/her home if that is what needs to be done.
4. If the Veteran is calm or non-communicative, CANNOT walk unaided, and agrees to go to the VA Hospital:
Pull up to the Emergency Room ambulance entrance. Honk your horn once. Wave your arm outside your window. Stay in the car. Wait 30 seconds. Honk the horn twice. Yell, "I need help. Bring a gurney." Stay put with the Vet until someone shows up.
When someone does show up, get out of the car. Explain what caused you to bring him in. While you can assist the hospital employee, they are responsible for moving the Vet from the car to the gurney. Then, you will be asked to move your vehicle. Tell them that you will as soon as he is safely in an exam room. If they insist that you move your vehicle tell the Vet that you will join him in 2 minutes - you have to park the car. You will be right back.
5. In either case here is what you do next:
You stay with the Veteran through the check-in procedure, and you let him talk if he wants to. If he won't, you have to do it for him.
At the check-in desk the Vet will be asked for his full name "and last four" [the last 4 numbers of her/his Social Security Number]. YOU should add, "I think this Vet is having some problems with PTSD." (At some VA hospitals that statement will bring in a mental health employee immediately).
If she/he starts lying, do not raise your voice and call her/him on it. Indicate through a gesture to the person checking in the Vet "can we talk? privately?".
The next step is an interview with the Triage Nurse. The Veteran should be answering all of the nurse's questions. If she/he can't or won't you can answer for the Veteran but only to the extent that you are certain the answer is correct. The whole interview comes down to this question:
The million dollar question: Do you believe this Veteran may cause harm to himself/herself or others?
You cannot say no.
You cannot imply nor should you lie.
You cannot avoid answering that question.
You do need to convince the triage nurse that the Veteran needs the VA's help right now. Here are the ways I have answered that question in the past:
His/Her friends think so, but I don't know him/her well enough to predict what he/she may do.
She/He owns a gun - or guns - or hunting knives - or an axe - and her/his family or friends are really, really worried and scared.
People who know her/him better than I do think she/he is on the edge of totally losing it. That's why she/he wanted to come in. She/He was in no shape to drive.
He/she told me that he/she knows he/she needs help but doesn't know how to get it or exactly where to go. I called the Veterans Emergency Hotline and the counselor asked me to bring him/her here right now.
[ And once when I was getting both push-back and attitude from a triage nurse I actually said this: Miss X, look, if you don't admit him and agree to hold him for 72 hours, I will take him to Congressman Denny Hastert's farm and leave him with the caretaker. That caretaker knows me, and while he doesn't much like me, he will call Denny in DC before bringing him back here to you, Miss X. ] Would I have actually done it? Yep. Never threat, only promise.
The Final Step for you, the First Step for the Veteran:
Stay with the Veteran until someone from Mental Health has shown up, briefed you to the extent possible (
HIPPA laws now make that nearly impossible) and taken the Veteran up to Mental Health. Stay with both of them right up until the Veteran is about to walk into Mental Health's secure area. At that point, shake the Veteran's hand, give him your e-mail and first name only [
unless you know the Veteran limit your contact information. The Veteran may have other issues you don't know anything about. ], and I traditionally say,
"Make every minute count."
If you are not a Veteran but you find one needing help, follow those steps above. Remember, there was a time that Vet caught your back.
Now it's your turn to catch hers or his.
4:51 PM PT: I know comments #2 & #3 don't have reply boxes. That's because I added the comments prior to publishing.
I didn't expect many comments to this diary. I just hope you make a copy of Comment #3 "How ANYONE can get PTSD help for a Vet - Summary:" and put it in your wallet.
Thanks
Please feel free to copy this [without attribution is fine by me] and post it anywhere you like.
10:27 PM PT: I will check back in the AM - bear time - and answer additional questions. I believe that if you care enough to comment, you have earned an answer.