SHERIDAN — Relationships between the Sheridan community and the Sheridan Veteran’s Affairs Health Care System are constantly improving through events like the annual Mental Health Summit, held this year at Cornerstone Church Aug. 29, Kristina Miller, public affairs officer for the SVAHCS said.

In the two years since she’s been working for the VA, one of Miller’s main goals has been to bridge the gaps between available resources and a veteran’s needs. She said the Sheridan VA can do better with outreach and that’s a big focus of her job.

“How can we reach the people who we aren’t reaching?” she asked. “That’s a struggle for VA across the nation. But I would say in our frontier state it’s even more difficult.”

Miller said Wyoming’s small population, spread out across the state, makes it difficult to reach every veteran.

Virginia Wilder, Sheridan VA associate chief of nursing for mental health, said veterans can suffer from impaired self-awareness as a result of a traumatic brain injury, which impedes one’s ability to reflect on choices and outcomes in day-to-day life.

Self-awareness and reflection happen at a high level of cognitive function and TBIs can leave those parts of the brain vulnerable or damaged, she said.

Social interactions and communication can become challenging, sometimes leading to isolation and depression, she said.


Outreach and suicide prevention

There are more than 6,000 veteran suicides every year in the U.S., about 20 per day, according to the VA.

U.S. Sen. John Barrasso, R-Wyoming, who spoke at the summit, said life expectancy is lower and suicides rates are higher among men, so engaging men with VA services is important, as well as keeping active-duty service members and veterans connected to their communities.

“I think that Wyoming does better than anybody,” he said.

There is no singular way to make outreach tactics more effective. Miller said the Sheridan VA tries to reach veterans in a variety of ways — through billboards, a booth at Third Thursdays, posters, the mental health summit and other events.

Barrasso said the summit is an effective way of sharing services available to veterans to the community and health care providers.

Wyoming’s long history of military service, a tough, independent mentality and resilient spirit can prevent veterans from accessing the care they need, he said.

“For me as a doctor, I want people that have mental health — mental illness issues — I want them to get care, want them to get treatment, want them to get help,” Barrasso said. “That’s what’s best for them, it’s what’s best for our communities, it’s what’s best for their families, it’s what’s best for everybody.”

James McDonald, Sheridan VA physician, said traumatic brain injuries account for 15-30% of all combat injuries, most sustained from improvised explosive devices. Most veterans have sustained at least two TBIs during the course of their military service, he said.

McDonald also said Wyoming and the military share a culture of toughness that leads to stigma about accessing appropriate mental and physical health care.

Rather than taking the appropriate time to rest, relax and allow the brain to heal after an initial brain injury, many active-duty military personnel are prone to “pushing through it” which can lead to more problems later on, he said.

McDonald said there is increasing awareness within the U.S. Department of Defense about the importance of taking care of the brain after a TBI, but it’s an ongoing process.

Miller said the Sheridan VA’s goal is to connect people with appropriate resources from high- to low-level needs, whether that’s mental or physical health.

“By mandate, we’re not going to turn anyone away even if it means we connect them with services in the community,” she said. “For whatever reason, if they’re not eligible for VA care we’re still going to make sure they get connected to community.”

While Miller said some people may fall through the cracks, her goal is to mend those oversights and connect available resources to a veteran’s needs.

“In a perfect world, that’s what we’re trying to fix,” she said.

Barrasso suggested shortening the suicide prevention lifeline number. The National Suicide Prevention Lifeline phone number is 1-800-273-8255, which Barrasso said is too long.

“If you’re in that crisis situation, to try to go and lookup National Suicide Prevention Hotline, how many lives could we save if we could just go to a simple three-digit number,” he said.


One journey through recovery

Tristan Jackson lost a friend and fellow veteran to suicide in April 2019. Today, Jackson works with the Sheridan County Suicide Prevention Coalition. He said the Sheridan VA and Barrasso saved his life.

Jackson is a veteran of the U.S. Navy; one of his deployments was to Somalia from 1993-1994.

Jackson remembers a moment when he stood a few feet from an enemy soldier in Somalia and saw they were just as frightened as he was. It was a life-changing and burdensome moment to recognize the humanity in a person on the “other side,” he said.

Dawn Lacko, director of the Brain Injury Alliance of Wyoming, said finding meaningful work or activities is important for veterans’ mental health. Jackson constantly looks for a hands-on approach to suicide prevention.

“I want to show my gratitude [to the VA] through action,” Jackson said.

In 2014, he had trouble accessing services to address his mental health conditions through the VA in Phoenix, Arizona.

The Phoenix VA faced heavy criticism in 2014 for allegations of falsifying medical records and keeping inaccurate waiting lists that made it appear veterans accessed care more quickly than they did, the Washington Post reported.

Jackson said after the Phoenix VA “dropped the ball,” he contacted Sen. Barrasso’s office and was quickly put in touch with resources in Sheridan. Programs through the Sheridan VA helped him become more aware of his own behaviors, learn coping mechanisms and access appropriate medications.

Jackson said before accessing help, he used drugs and alcohol to self-medicate during his battles with depression, anxiety, fear and shame. Some internal battles can become too great but there are options to regain control, he said.

“Therapy helps give you your choice back,” he said.

Jackson is learning to react calmly to stressful situations and acknowledge the realities of post-traumatic stress disorder without letting them “run the ship.”

Rather than trying to isolate whether a veteran suffers from PTSD, depression, anxiety, a TBI or all of the above, McDonald said he focuses on treatment and wellness.

McDonald said sometimes the burden of a veteran’s mental health falls on the caregiver or spouse who notices changes in their personality or behavior when they return from combat. Cognitive impairments can alter daily roles and relationships, he said.

McDonald said the VA offers support programs for caregivers and partners of veterans to manage the burden.

Jackson said therapy has been immeasurably helpful and today he’s able to comfortably interact with large groups of people while sober, like at the mental health summit where he provided information about the suicide prevention coalition.

“I’m glad to be here, this is a great VA,” he said.