Veterans face another barrier to mental health care: Finding a therapist who gets their trauma

Culturally competent mental health care for veterans — when the therapist truly understands their unique type of trauma — can be the difference between life and death.

Brady Oberg felt the counselors trying to help him who had never been in combat could not understand his trauma.Courtesy Tracy Dunham
SHARE THIS —

Veterans who are in crisis or having thoughts of suicide and those who know a veteran in crisis should call the Veterans Crisis Line for confidential crisis intervention and support 24 hours a day, seven days a week, 365 days a year at 1-800-273-8255 and press 1, chat online at VeteransCrisisLine.net/Chat, or text 838255. 

Tracy Dunham kept her cell phone by her bedside while her brother, Brady Oberg, was deployed to Afghanistan. She never wanted to miss a call from her little brother, regardless of time of day.

"We would talk or text at least every day," Dunham told TODAY. "We were very close, always communicating with each other, or if I had a problem or something, he'd be the one I would call and consult with."

Tracy (left) pictured with her brothers Brady (center) and Bradley Oberg.Courtesy Tracy Dunham

Remembering Brady

Oberg was a sniper on the front lines of Operation Enduring Freedom with the U.S. Army's 10th Mountain Division 4th Brigade out of Fort Polk, Louisiana. During his time in Afghanistan, Oberg earned the Army Commendation Medal for saving four fellow soldiers.

"He was always very proud of his missions and their success. He knew why he was there fighting," Dunham said, adding her brother came home after 12 months of deployment.

Upon his return, Oberg began to transition out of the military. He married his wife, Katie, and began coursework to finish his college degree. But his time in combat haunted him.

"Brady tried counseling, but he felt like those helping him didn't really get it," Dunham said. Despite being a "really close" family, no one realized how deeply Brady was struggling, she added.

Brady Oberg deployed to Afghanistan with the U.S. Army's 10th Mountain Division 4th Brigade.Courtesy Tracy Dunham

On Aug. 6, 2015, the same day Oberg purchased a lake lot to build a home with Katie, he took his own life.

"That night I got up around 10:45, and went and got my cell phone and brought it into my room," Dunham said. To this day, she does not know why she woke up at that time and instinctively went to get her phone.

"(Brady) never called, but my mom and dad, of course, did call that night. ... I'm a pretty hard sleeper, so I've always wondered, 'Why did I wake up?' A part of me thinks that's the time I lost Brady. I woke up and knew something was different in the world."

After Oberg's death, his family realized there were signs of post-traumatic stress disorder that went unrecognized. He believed that counselors trying to help him who had never been in combat could not understand his trauma.

Since her brother’s passing, Dunham and her family have created the Brady Oberg Legacy Foundation, to help serve combat veterans through retreats, scholarships and PTSD awareness.

A system you can trust

In 2019, the most recent year for which data was available, 6,261 veterans died by suicide, a suicide rate 52.3% higher than non-veterans in the U.S., according to the annual report from the U.S. Department of Veterans Affairs.

"The danger of veterans not having a doctor or system they can trust is high, especially those who need mental services," Andrew Anderson, Ph.D., assistant professor at the Tulane School of Public & Tropical Medicine, told TODAY. "The period between suicide ideation and an actual attempt is short, so if veterans don’t trust doctors or the systems they have access to, they are even less likely to seek help."

Anderson noted that the suicide rate among veterans, consistently higher than the general population's, has been increasing for decades.

“The U.S. government has been slow to acknowledge the various negative exposures veterans have faced psychologically and physically,” Anderson said. “And despite having what some would consider equal access to care, there are noteworthy racial and ethnic disparities in the quality of care among veterans.”

The United States Department of Veterans Affairs, a branch of the federal government dedicated to providing vets lifelong health care, told TODAY in a statement that its mental health services are "based on a recovery-oriented model of care that offers rehabilitation to improve functioning, as well as treatment of symptoms. In VA, the Veteran and provider collaborate in developing the treatment plan to ensure that care is responsive to the individual Veteran’s needs."

“The mission of the Veterans Health Administration (VHA) mental health services is to promote, protect and restore Veterans’ mental health and overall well-being, to empower and equip them to achieve their life goals, and to provide quality, state-of-the-art care in a timely manner," the statement read in part.

Anderson emphasized the importance of culturally competent care — "care that is delivered based on a patient's personal circumstances and preferences" — for the veteran community.

"It’s a term that’s been typically used to describe a provider's knowledge of the preferences of patients from historically marginalized groups," he explained. "The lack of knowledge and inability to obtain the required knowledge results in missteps and poor experiences for patients."

Tim Hoyt, Ph.D., a U.S. Army veteran and current deputy director for force resiliency in the Office of the Under Secretary of Defense for Personnel & Readiness, told TODAY one of the ways the military is addressing this barrier to care is by embedding behavioral health teams with military units.

"Participating in these embedded behavioral health teams allows civilian providers to gain a better understanding of the day-to-day battle rhythm of that unit and increase their military cultural competence," Hoyt, who deployed to Afghanistan, said. "These embedded providers build trust by participating in unit ceremonies and certain training events, demonstrating their willingness to work with the military community."

In addition to being skeptical that a therapist will understand their military experience, veterans and service members may also be hesitant to seek mental health care due to stigma and concerns about confidentiality, Hoyt said.

“If our service members and veterans have sought care in the past and didn’t connect well with the therapist, I encourage them to reach out and try again,” he said. “Just like dating, you can’t assume that you will automatically connect with the first person you meet. Despite these barriers, reaching out for help is a sign of strength.”

Advocating for veterans' mental health

Garrett Gunn was progressing quickly in his U.S. Army career, but when he came home from Afghanistan in 2013, things felt different.

"You never really know how bad things are for you, especially with mental illness. A lot of times you don't have that self-awareness," Gunn told TODAY. "I come from a long family of military people. It’s the stigma of, 'Pull yourself up by your bootstraps, and handle your business if things get hard,' and I sort of reached a point where I was like, 'I’m not OK. I really need something because things are getting real dark.'"

Tensions were also rising at home.

"Things just started to slowly get worse, and I was snapping at my wife all the time and snapping at my young kid," he said. "(It) caused me to really do some inner reflection. I realized I was not OK, and it was rough."

Gunn initially spoke with military-appointed mental health counselors, who deemed him medically unfit to continue service and recommended he retire from the military, which he did.

“They were not wildly helpful. I told them confidential things I thought I could discuss,” Gunn said, adding it felt more like the contracted professionals needed to "check a box" than help soldiers.

“The next thing I know, (they were) using those things to try to medically retire me, and I’m like, ‘Whoa, man, I thought I was coming here to get help and get back in the fight. And you’re using me getting help against me.'"

Through his frustration and anger, Gunn sought mental health treatment from a civilian provider whom he felt was familiar with the veteran community.

"A lot of us see right through the typical therapy approach," Gunn explained. "I think there's a big emphasis with veterans and active duty that they want someone that is going to be real with them."

Gunn said he felt his anger turn to compassion, and was able to see life outside his career in the Army.

"I've noticed such an insane difference in the way I approach every aspect of my life — understanding how to recognize my behavior and how to recognize even the behavior in others and how to be more compassionate towards other people because I recognize the behavior in them that I used to display," he said.

Now 33, Gunn uses every opportunity to advocate for veterans' mental health.

"I have so many military buddies that I've turned on to therapy and I'm just like, 'Dude, I'm telling you, it's so great'," Gunn said. It's just a way to get things off your chest. Even if you're not getting out (of the military), having a third party to be like, 'This is pissing me off,' just to have somebody there to absorb that and validate that, it's an incredible feeling. I just wished that more of these people would would do it, because it's just life changing."

Related: