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Saturday, June 13, 2009

An Interview with John Mikelson

I am on the NAMI Veteran's Council, (among other things) and received an email that puzzled me. There was a quote in it about getting veterans into in-patient treatment and that it had a 60% rate. I've heard of all kinds of treatments the DOD and the VA are doing as well as not doing, and I wondered what else this man had to say.

I asked him if he'd be willing to answer a few questions. He responded right away. Behind all the problems posted on this blog, what I fail to do as often as I should, is to show a part we don't see too often. Men and women working with our veterans and our troops, trying to make a difference and hear what they have to say.

Thank you John for taking the time to answer these questions for my readers.



Please tell us about yourself.

Please see attached …I am 49. Have an MA in Higher Education. Spent 25 years in the Army (Active Guard & Active Reserve) My wife and I rescue Greyhounds and 8 of our sixteen dogs are Greyhounds. Small acreage south of Iowa City



This is part of what was attached.
John Mikelson

Army medic became an undergrad at 45, and now helps veterans of all ages make the college transition.

Be Remarkable

During his 26 years in the military, John Mikelson served as a medic for more than 800 soldiers, was cited for recruiting 450 people into the U.S. Army Reserve, and managed supplies, arms, food, fuel, and personnel on a highly regimented schedule.

Regional Director for Distance Education Student Veterans of America Washington, DC
University of Iowa Veterans Center


(Now that you know more about him, read the rest of what he had to say)

How long have you been doing what you do?


The University of Iowa reorganized its Veterans Association in 2005 and we opened the door of the Veterans Center in December 2005




How did you get involved with PTSD veterans?


Many of my peers have had multiple deployments. Returning Veterans tend not to join the traditional Veteran Service Organizations like the American Legion or VFW but; they are going to school…the campus is the place we came reach out to the 526,000 Student Veterans. This led to the founding of the Student Veterans of America in 2008. PTSD is not just a combat related problem…. Any life changing event can trigger this in anybody






There have been many reports over the years about soldier suicides and the claim the DOD is taking all of this seriously. With the report coming out yesterday about the increase in soldier suicides, what is your impression of what the Army has been doing wrong?


Not enough attention is being given to basic NCO Business….Taking care of the troops. Squad leaders should be able to tell when something isn’t right with a squad member. Platoon Sergeants should have visibility on all members of a platoon….no Soldier (Sailor, Marine or Airmen) should have to deal with their problems alone….whatever happened to battle-buddies?




While they have been trying, what do you think they have gotten right and should it be replicated throughout the military?


The Military has recognized the problem….always a good start. Steps are being taken to de-stigmafy Mental Health related treatments…..people are finally allowed to ask for help without jeopardizing their careers. They are also stepping up awareness and prevention of Military Sexual Trauma(MST).




The Montana National Guard came out with a program to address suicides and encourage Guardsmen to seek mental health help. A member of NAMI, Matt Kuntz has been on the forefront of this program. His step-brother, Spc. Chris Dana, committed suicide. Do you know about this program and what is your impression of it?


While I am not aware of the specifics of the Montana program I have seen the evolution of “Enduring Families” and the “Yellow Ribbon” program in Iowa and am pleased with the direction the state has taken with mental health overall




You stated in a recent communication with NAMI Veteran's Council members that;


Now saying that, this gets me to the heart of the reason why I communicated with you originally via phone. We are trying to save the Knoxville VA and there is more than enough capacity to develop programs for female veterans. This is very true when it comes to mental health programs. Female veterans are suffering from PTSD at a substantially higher rate than their male counterparts. Best practices show that for PTSD treatment to be successful the patient must be treated inpatient using a combination of psychotherapy and medication and then the chances of going into full remission rise to around the 60% rate.




Alas, this was not my quote. It was forwarded in a message from Des Moines to friends with NAMI in Iowa City. The Hospital in Knoxville is being closed because it represents excess capitcy in Internal Medicine….but the VA report fails to show the number of Mental Health beds that would be lost and Des Moines, Iowa City and Omaha would have to make up the shortage and do not have the current bed space to do so




What do you think has kept this out of reporting on treating PTSD veterans?

No idea


Why do you think the DOD and the VA has been simply providing medication and very little therapy instead of putting them in for treatment as you stated works best?

My limited experience with the VAMC in Iowa City is that they are doing everything they can and are also reaching into the community for a holistic inpatient/outpatient balance


I do presentations to veterans groups to help them understand what PTSD is and make them more aware of the tragedy we are facing the newer veterans. After the presentation, I hold a question and answer series. The number one question I've been getting has been about this Act and the concern of PTSD veterans regarding gun ownership. Some of the veterans are rated with mild PTSD and are in law enforcement. They are worried about their jobs. Other veterans fear their right to have a gun will be jeopardized. This is keeping them from seeking help.

Are their fears well founded? If so, what can be done to correct this?

Taking away firearms on the grounds of having PTSD would eventually disarm the entire military and law enforcement community. (in my opinion… giving PTSD a stigma) i.e. if I were told that seeking treatment for PTSD would remove me from employment I would refuse to seek treatment or even acknowledge a problem. As stated before…anyone can have a degree of Post Traumatic Stress from any major traumatic event. It only becomes a disorder when we cannot overcome the effects on our own… and it can be treated successfully.




Vietnam veterans were the first veterans to demand PTSD be treated. Their wives have been involved with learning about PTSD and living with them. Many of us have successful marriages and long histories with our husbands. We've made all the mistakes already and found what works along the way. I believe we have a lot to offer the spouses of the Iraq and Afghanistan veterans and their families. Many of us have offered our thoughts and living expert testimonies to congress but they will not listen to us. Why do you think congress has not been interested in hearing from any of us when we've already been where they are and can get them to where we are a lot easier than we did with trial and errors?

I do not understand why Congress listens to Celebrities but not the people with boot on the ground.




I participated in many groups for the newer veterans wives. Troubling I discovered they were not interested in learning about PTSD. They said they had enough to worry about with their husbands being deployed and having to be a single parent. Since we know that early intervention is best and the families are usually the first to notice drastic changes, how can we get them to want to learn about it so that vital time is not wasted?

By reducing the Stigma of Mental illness in general and PTSD in particular




Veterans Courts are being set up across the nation due to the efforts of NAMI. Considering the unique issues combat veterans face, why do you think so many counties are not setting up Veteran's Courts to get them treated instead of incarcerated?

It varies from financial constraints to ignorance of military or mental health awareness. Not everybody gets it. Not every county can afford it.




Domestic violence can often be avoided if a wife is aware of PTSD. Something as simple as waking up a husband in the middle of a nightmare can produce a fist, black eyes and bloody noses. If a wife is aware of what the nightmare is all about and removes herself from arms reach, domestic violence can be prevented just as when they are having a flashback. What can be done when police respond following something like this if the wife is not aware?

Awareness training in the Family Readiness groups, Awareness training for the peace officers. Again local concern and monetary levels with drive some of this training or prevent it from occurring




When Vietnam veterans began to be treated for PTSD, especially in the 90's, the VA provided support groups for the spouse. Why hasn't this been repeated across the nation?

We have a spouse Support group at the VA’s Cedar Rapids Veteran Center




How do you think we can get communities involved in helping the National Guardsmen and Reservist's when they are presenting at higher rates for PTSD but do not have the same support as regular military?

The Community VetCens are presenting the programs to those who chose to utilize them. The National Guard is standardizing their Yellow Ribbon Program and sharing with the reserves through Military OneSorce (at least here in Iowa where we have no active military installation)




The backlog of VA claims has reached over 900,000. Within those numbers are many PTSD veterans that can no longer work. Is the stress of this financial burden increasing their PTSD?

Lots of different stressors can aggravate PTSD or Depression . Financial stress has always been a key factor.




Would fast tracking PTSD claims, the way congress has been discussing, renew their faith in the country and the credo "grateful nation" ease PTSD symptoms?

It would help but the VA is simply overworked and underfunded to do everything it is taxed with. Mental Health in general is underfunded nationally




What do you think is the reason behind not doing it?

Increased incidents of fraud waste and abuse




In a perfect world, if you could wave a hand and get it done, what would you do get our troops and veterans the best care possible?

In a perfect world we would not have to place the troops in harm’s way.. but since that is unlikely to happen I think we could do a better job of recognizing that mental illness and brain injuries are part and parcel with all the other types of combat injuries and the stigma of treatment would cease to exist


In a perfect world to me, the men and women working with our veterans everyday would be fully involved with coming up with programs for them. Finding what is best for them would come a lot faster if they actually know them and understand them. If the developers of programs are just using some case studies or reading about PTSD in research papers, they will never really understand them.

It's also the most important reason for Congress listening to the families who have been there and done that. Older veterans and their families have been through the fire, made their mistakes and learned from them. So why are they making the same mistakes over and over again? It's one more answer that has eluded me for years. I don't think I'd ever be able to understand how Congress can avoid us. I've written to Senators and Congressmen for years. Either I get back a form letter or no response at all. Why? I'm not alone with this type of response.

The wives of Vietnam veterans live with them everyday and most of us have been married to them for over 20 years. Considering that too many "normal" marriages don't make it that long, you'd think they'd be more than willing to give us the opportunity to discuss how we did it. They don't. PTSD in marriages is complicated, but not impossible to find what works and how to make them successful. As I wrote in my book, For the Love of Jack, His War/My Battle, you can find your own kind of normal with all of this. The point is, too many families can't because they don't understand what PTSD is, what it's doing to their veteran spouse or what they can do to help them. It took me years of research, trial and error to learn what I know and I share it because I remember what it was like when no one was talking about PTSD and feeling totally alone.

Families are falling apart, veterans are committing suicide, soldiers and Marines are committing suicide and young widows wonder what could have prevented all this heartache. Knowledge could have but they just didn't know where to find it. It's also one of the reasons why I started these blogs so they could find the most information in one area instead of all over the place. It's the reason I created videos so they could learn easier than I did. It is also what's behind the videos for the veterans so they can learn just how normal they are. This all began because of Vietnam veterans and now it includes our newer generation of veterans coming home from Iraq and Afghanistan. They are where my heart is tugged to. They are where you heart is calling you as well or you wouldn't be reading a blog like this. You'd be looking for different information. You also take the words "grateful nation" a lot further than most Americans do. I don't say it often enough but thank you from the bottom of my heart for taking the time to read the posts here. We may be living with the problem but because we're fully involved with them, we're going to end up being part of the solution to getting them able to enjoy life again.

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