Social distancing adds stress to veterans with mental health concerns

By Julie Havlak
Carolina Journal News Service

RALEIGH — Unemployment, homelessness, depression, and a host of mental health issues are on the rise for North Carolina’s military veterans.

Veterans face challenges even during prosperous times. But COVID-19’s social distancing mandates and the economic shutdown have taken an outsized toll on those who were teetering before the pandemic hit. Veteran advocates have seen a sharp uptick in homelessness, along with requests from veteran families who can’t afford food. Veterans face higher rates of unemployment and mental health problems than the general population as well. Support networks have dried up. Veterans in trouble can’t reach out to their brothers and sisters in arms.

Almost seven in 10 veterans worried about their mental health because of social distancing, while three in five were concerned about keeping their jobs, according to an America’s Mental Health COVID-19 Survey of veterans who served after 9/11.

If veterans can’t buy food, advocates worry about what else they can’t afford — including medical services if they lack internet access. “With the food, you worry about their medications,” said Diane Krisanda, president of the National Alliance on Mental Illness South Mountains. “We’ve received calls that people are at the ends of their ropes, they don’t know what to do, they want to take their lives. If they have access to phones and computers, that’s great, but, let’s face it, not everyone does.”

In normal times, veteran suicide rates are roughly 1.5 times higher than civilian rates, with 17 veterans dying each day across the nation. No one knows how the coronavirus is affecting that rate, but experts say unemployment and isolation increase suicide risks.

Making matters worse, COVID-19 has made it tougher for charities that serve veterans, including homeless ones.

“It’s difficult, trying to find them a place to go at night,” says veteran Antony Cutler, an Iredell County health care worker. “Housing was bad and tough before. But now, because of COVID-19, people will be reluctant to open their doors to anyone and help them out. They’re afraid, they’re unwilling to take that chance.”

Greenville-area veteran service officer Charles Beddard says some of his clients can’t work. Others are retired and suddenly struggling financially or mentally. Three weeks ago, a veteran called who couldn’t pay his bills. Financial aid covered just one month of expenses.

“Some of them haven’t quite gotten Social Security yet, so they don’t have anything,” Beddard said.  “That was only to pay one month’s bills. If this goes on to August, they can’t help him, and what do you do? … Only thing I can tell them is maybe work construction.”

Surf City veteran Michael Nicolai’s small business is devastated.

“Before the pandemic and the economic crisis, we were just starting out, but I was making sales,” Nicolai said. “But with the immediate stop in the economy, I have not received a single order. Rings by Michael is not making a profit. At all.”

Nicolai had used his business to raise money to combat veteran suicide. He’s now engaged to the wife of his late comrade, who committed suicide after serving in Afghanistan. The couple still focuses on preventing veteran suicide, but they’re worried.

“They’re dealing with their own demons, now they have furloughs and unemployment,” Nicolai said. “It’s hard to put blame on any one thing. The economic crisis is just the tipping point.”

Advocates say veterans are uniquely resilient because of their military experience. Telemedicine has never been so widely available, and the vast majority of mental health providers are now online, offering veterans treatment during the crisis, said Dr. Nicole French, Clinical Director of Veterans Bridge Home, the coordination center of the statewide veteran service network NCServes.

“Right now, everybody is in crisis,” French said. “Communicating is critical. Loneliness can cause greater health concerns than obesity. … In unhealthy lives, there are all these broken connections between ourselves, each other, and our systems.”

But some veterans say virtual treatment doesn’t work as well as face-to-face contact in treating post-traumatic stress disorder and other service-related conditions.

“There’s no connectivity for me. I grew up in an age where looking at you on the screen feels like watching a movie,” said Huntersville veteran Shawn Caldwell. “I don’t want to tell you I feel like I’m broke as hell if we’re on the television.”

The crisis has also crippled veteran support groups’ ability to meet in person. Fears of contagion and a ban on gatherings of more than 10 people indoors largely prevent in-person meetings.

“It’s difficult. When you’re in the service, you’re in close quarters. That’s what gets you through, knowing that the people you’re serving with have your back,” Cutler said. “And now you can’t have intimacy like that, because you’re facing a silent killer.”

For some, physical isolation became social isolation — something that can be toxic for those with severe PTSD, said John Bigger, chief operating officer of Steven A. Cohen Military Family Clinic at Cape Fear Valley Health.

Others find themselves trapped in crowded houses and struggling to fill multiple roles as caregivers.

“Kids aren’t at school, everyone is working,” said A.J. Duff, a veteran with NAMI Lake Norman-Iredell. “How do you maintain a sense of calmness, a little bit of peace, when you have toddlers jumping off of everything?”

Some military spouses have lost their support networks to social distancing. Their children can be more isolated because of frequent moves, and that isolation is now worse for some. There has been a large increase in anxiety, depression, and requests for mental health care, said Sheila Weaver, clinic director of the Cohen Military Clinic in Fayetteville.

“They’re homeschooling the children, working if they’re essential employees, and trying to fill multiple roles,” Weaver said. “It’s taking on a lot, and they’re losing that safety net. As everyone is isolating into their own family units, people feel like they’ve lost that support.”

Worst of all is the uncertainty, said Bigger.

“If you’re active duty and a soldier, you have a mission-readiness mentality. How am I going to take this on, how am I going to deal with this problem?” Bigger said. “With this pandemic, it’s almost impossible to come up with a way to battle this. It can be a real challenge.”