State VA treating more PTSD in women

System seeking to remove barriers to care

The top diagnosis of female veterans treated in the VA Connecticut Healthcare System is posttraumatic stress disorder and it is usually accompanied by other mental health illnesses, according to VA officials.

Most female veterans suffer from a mental illness, studies show, and the VA is taking steps to focus more on female-specific mental health care.

A national study commissioned by the VA, Barriers to Care for Women Veterans, found that 52 percent of female veterans said they needed mental health care, but only 24 percent sought treatment. A survey by the nonprofit Service Women’s Action Network, or SWAN, showed that female veterans consider mental health to be their biggest challenge.

At Connecticut VA facilities, 1,404 women had at least one mental health visit last year, representing 45 percent of women who use the VA. This is an increase from 1,023 in 2012. Lynette Adams, a psychologist and program manager for female veterans, attributed the increase in part to added mental health services. Hypertension is the second most frequent diagnosis for women at the Connecticut VA. Unspecified PTSD is the third, which the VA defines as having symptoms that don’t meet the “full criteria for PTSD” but cause significant distress or impairment in functioning.

The VA is seeking to ensure that at least one expert in women’s mental health is in each VA system nationally to consult other providers who treat women. The Women’s Clinic at the West Haven VA hospital added a staff psychiatrist in 2015 after a patient survey showed a need for it, Adams said. The psychiatrist, Dr. Margaret Altemus, is one of three experts designated as a women’s mental health champion at the Connecticut VA.

Adams explained that the champions are resources for VA providers on issues that affect a woman’s mental health, such as military sexual trauma, domestic violence, eating disorders and re-

productive health.

Altemus holds monthly “tele-psychiatry” video conferences with providers at outpatient clinics throughout New England. One video conference, for instance, addressed the symptoms of menopause and how menopause can affect the course of mental health treatments.

Altemus, a specialist in reproductive psychiatry, said she is working with a VA psychiatrist in Chicago on a template for VA providers that will include questions they should ask female patients about reproductive issues, such as pregnancy, birth control and menopause, that could help provide clues about an underlying mental illness.

“If you don’t see women a lot, you might not ask” these questions, she said.

In the national Barriers to Care study, female veterans who didn’t receive mental health care expressed fear that the stigma of mental illness would hurt their jobs and relationships. They also cited lack of transportation and child care, discomfort in the male-dominated VA culture, and concerns about taking psychiatric medications. Some said they lacked knowledge about VA services. The Connecticut VA does not have child care, but does provide some transportation. Statewide, 186 mental health care providers offer services at VA hospitals, clinics and veterans’ centers.

Altemus said she is “on the phone regularly” at the Connecticut VA urging women to keep their mental health appointments.

Melissa Piercy, an East Windsor veteran, takes her 3-year-old daughter with her when she goes to at least three medical appointments weekly at the VA hospitals in Newington and West Haven. Piercy has PTSD, anxiety and depression triggered by a botched bunion operation performed by an Air Force surgeon in 2003.

Her foot has required continuous care. She has had five repair and reconstructive surgeries and a sixth is scheduled for April. She was forced to leave the Air Force after one year.

Piercy, 31, said that because of her mental illnesses, “I go through days I don’t want to talk to anyone.” Among her symptoms are panic attacks and a recurring nightmare that she is missing a toe. Anxious about her upcoming surgery, she increased visits to her VA psychiatrist from once a month to twice. She recently joined a VA therapy group to learn coping skills.

The VA has a variety of support groups for women with behavioral health issues. The West Haven hospital has two co-ed PTSD groups and two female-only groups for victims of military sexual trauma, and the VA’s Errera Community Care Center in West Haven has a group for women with serious psychiatric illnesses. At the Hartford Vet Center in Rocky Hill, a women’s support group focuses on combat experiences, MST and PTSD.

One group at the Errera Center has turned isolated mentally ill women, who have faced homelessness, into friends who meet weekly, celebrate birthdays, check up on each other and go on outings.

Friendships help “reduce the stress” from mental illness, said Dr. Stephanie Lynman, a clinical supervisor. “The fact that they keep coming back,” she said, “shows the impact on their lives.”

For information about VA women’s health care, call Adams at 203-932-5711, ext. 5402. The national Women Veterans Hotline is 1-855-VA-WOMEN (855-8296636). The website is www.va.gov/WOMENVET.