At West Point, the Future Health of Veterans Seems Bright

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Director of Medicine Dr. Jamie Wells attended the annual Yale-West Point Civil-Military Service Symposium, where issues of veterans health policy were extensively discussed.

I was fortunate to attend and discuss health policy for veterans at the 2017 Yale-West Point Civil-Military Service Symposium. With the theme “In Service to the Nation: Yesterday, Today, and Beyond,” the goal of pairing these prominent institutions— The U.S. Military Academy at West Point and Yale University— for this endeavor was to promote “a commitment to civil-military relations and a dedication to…a broad and inclusive interpretation of national service.”

The mission of the weekend was the following:  “Coinciding with the 100th Anniversary of America’s entry into WWI, the Symposium seeks to expound upon the ongoing national dialogue surrounding such topics as U.S. civil-military relations; salient issues, challenges and opportunities concerning veterans and actively-serving members of the Armed Forces; domestic and international social policy; and the effectiveness and interoperability of our nation’s military in future conflicts as well as in international peacekeeping and regional security operations.”

Subject matter experts abounded to cover a wide array of topics that ranged from Sustainability and Environmentalism as National Security Imperatives, Veterans in the Arts and Service through Business and Entrepreneurship to Veterans in Criminal Justice as well as Life After War touching upon resiliency, reintegration and redemption. 

The end result: The future appears bright for military health and well-being. 

General Loree Sutton, MD gave the keynote address that kicked off the weekend. BG (Ret.) Loree Sutton, MD is now the Commissioner for the New York City Department of Veterans Services (DVS). Among her many accomplishments, Gen. Sutton served as Founding Director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE, TBI). She co-founded Threshold GlobalWorks “to accelerate leading-edge initiatives, informed by neuroscience, that amplify social resilience and human potential.” 

Her bio is quite extensive in honors and achievements, culminating in her motivating theme for her efforts: “Sutton's interest in resilience extends from individuals and families to enterprises, organizations and communities. She is devoted to the public health imperative of designing "working community" approaches that harness the strengths of veterans and their loved ones while promoting healing from the wounds of war, seen and unseen. Proud to serve as the DVS Commissioner, she believes New York City is an ideal place for veterans -- our nation's leading renewable resource -- to live, lead, serve and flourish.”

In our conversations, she seemed particularly enthusiastic about recent advances in our understanding of TBI and neuroscience. Her keynote emphasized the work of the newly established DVS she now leads. As a new city agency, she considers it a privilege to set up an enduring infrastructure that is and will be implementing programs the first of their kind in the country. Her goal is to make NYC the flagship upon which other regions replicate. Identifying that the biggest problem veterans have is navigating their resources, she and DVS are developing the nation’s leading coordinated service delivery platform soon to be rebranded VetConnectNYC (that already has about 80 vetted network service providers). Often veterans do not know where to start, so she underscores that coordination and an ability to customize is essential to wounded warriors and their families.

Over 210,000 veterans are in NYC that are diverse in age, experience, you-name-it. In what she refers to as a holistic approach to veteran health and well-being, DVS is implementing a coordinated model called “Core 4” (aka VetsThriveNYC Core4 Whole Health Model). When referencing the pyramid graphic, you will note C4 at the top reflecting clinical treatment. Recognizing its importance, Sutton believes this level is not the best place for hope and healing and it is time to build out the bottom 90% by going to the front lines. 

As it stands, only 1/2 of veterans go to the clinic and only 1/2 of those go to a second visit. About 10% will possibly experience a reduction in symptoms. It is Sutton’s contention that the answer is not to throw money at programs called “suicide prevention" as we have tried that, but to build out the foundation of that pyramid which is about relationships and communal bonds. While focusing on mental health and trauma is important, it is her desire to end this current narrative on veterans by instead leading with their strengths of values and service. This values-based leadership reflects her training and military background of prioritizing honor, integrity, sacrifice and service, to name a few. She proclaims “Service is our North Star.”

Moving down the pyramid, C3 places an importance on community, holistic services like recreation. She spoke at length about the benefits of equine therapy and its capacity to restore safe and trusting relationships since the horse mirrors an imbalanced inside. The C2 level is about connection, peer-to-peer support. The bottom C1 is focused on culture, education, engagement and the arts. Named GRIT, this model highlights a strength-based foundation of Growth, Resilience, Integrity and Trust.

The Commissioner reveals a sense of urgency about prevention and making up for lost time. With her 3 lines of action being housing and support services, CE5 (city employment, education, entrepreneurship, engagement and events) and whole health and community resilience, she plans to launch a global communication outreach campaign later this year for veterans to “find your next mission” in NY. Sutton’s ultimate plan is to use the communal bonds we experience through service to allow our veterans and their families to come together and in so doing bring our nation together.

The weekend continued with panels and longer form keynote addresses. GEN (Ret.) Gordon Sullivan, the 32nd Chief of Staff—the senior general officer in the US Army—and a member of the Joint Chiefs of Staff, spoke extensively of the role of the citizen soldier and the continued duty to serve after retirement from being active military. He spoke of the innumerable ways to do so and the importance of communication and interaction between those in their final stretch and those who have reintegrated into the civilian community. 

Additionally, I was fortunate to discuss resilience and giving back at length with the closing keynote speaker, LTG (Ret.) Guy Swan III, Vice-President of the Association of the US Army who was a Commanding General and is a member of the Council on Foreign Relations. We talked about the importance of social connectedness in staving off depression and the roles integrated communities play in promoting health and well-being.

It was an honor to continue conversations about the multifaceted topic of veteran health and well-being with The Honorable Linda Spooner Schwartz, RN, MSN, DrPH FAAN (served in the Obama Administration in Department of Veterans Affairs as Assistant Secretary for Policy and Planning), Archie Elam (Director, West Point Association of Graduates (Board of Directors)), and Associate Professor Susan Sheehy, PhD, RN, FAEN, FAAN (Daniel K. Inouye Graduate School of Nursing at Uniformed Services University of the Health Sciences) among many, many others. (They are pictured below with me in the group photo and Linda Spooner Schwartz again with me in the second one).