As president-elect Trump continues to fill his cabinet and inner circle of advisersbigstock--135338915, it’s not surprising that perhaps the most difficult job – that of Secretary of the Veterans Administration- will be the last to be filled. The next Secretary will inherit myriad challenges; managing an overwhelming staff, bureaucracy, claims backlogs and a negative public perception.  And most importantly, the psychological wounds of combat such as PTSD.

The VA rightly states that there is a national shortage of mental health workers.  Not only are there not enough, but according to Rand, many of these mental health professionals are not trained to deal with and understand the types of trauma that our veterans experience.  This situation is compounded by the fact that for many veterans, seeking “therapy” is inconsistent and counter-culture to the way military veterans are trained.  A concept that veterans do understand is one of “mental health training” especially when the training is provided by a veteran peer who speaks the same language and has lived within the military culture.

The next VA Secretary will not only have to understand the nature of psychological wounds and the magnitude of the problem, but lead an organization that many consider resistant to change to use new and innovative approaches to mental wellness.  The VA estimates that about 700,000 (almost 30 percent) of post 9/11 veterans who deployed to Iraq or Afghanistan are struggling with psychological wounds such at PTSD.

Based upon a VA study, we know that on average, 20 veterans take their own lives every day.  At the same time, there are fears that the current approach of talk therapy and medication attacks symptoms, not core issues of PTSD.  In August of 2015, the Journal of the American Medical Association called for a “new and innovative approach to PTSD among veterans.” Often what is seen as “war trauma” begins at an early age through parental abuse, domestic violence, drug and alcohol abuse or sexual trauma.  Recognizing that those serving in the military have a higher rate of these types of childhood trauma creates a need for health professionals to dig deeper beyond “tell me about the IED attack.”

Posttraumatic Growth

Most importantly, we need to change how we think about and discuss mental health issues such as PTSD.  Retired Navy Captain, Charlie Plumb, was a prisoner of war in Vietnam for nearly six years between 1967-1973.  While Captain Plumb spent years being tortured and held in an 8’ by 8’ cell, an experience that anyone would find traumatic, Charlie will tell you that these were the best growth years of his life.  Charlie came back many pounds lighter, but immeasurably stronger.  He was not suffering from Post-Traumatic Stress Disorder, but benefiting from Posttraumatic Growth (PTG).

While extensive writings of growing stronger from your struggles (PTG) are found in ancient literature and religion, the concept seems to have been forgotten or at least not talked about regarding veterans.  Dr. Rich Tedeschi, a psychologist at the University of North Carolina, Charlotte, has spent the past 30 years researching and documenting PTG and creating a body of evidence that demonstrates the power of times of struggle.

The VA can’t care for our veterans alone. Likewise, no new Secretary, changes in bureaucracy, privatization of services or bags of money will completely heal our veterans of their invisible wounds and reintegrate them into communities.  We need a national dialogue and innovative approaches to reframe the “burden of PTSD” to the “opportunity of PTG.” Through increased understanding of Posttraumatic Growth and the use of military-style training, we can help remove at least one of the issues for the new Secretary of the VA.

* This article is a collaboration between Dr. Moore and Ken Falke.  Mr. Falke is a retired Navy EOD Master Chief Petty Officer, Founder of Boulder Crest Retreat in Bluemont VA and the co-author of the Warrior PATHH Posttraumatic Growth Curriculum.