(This story is by Nora Doyle-Burr of the Valley News, in which it first appeared July 29, 2017.)
[W]HITE RIVER JUNCTION — Valerie Pallotta, whose son Joshua died by suicide in 2014, isn’t sure what, if anything, could have prevented her son’s death at the age of 25.
Josh Pallotta, a veteran of the Vermont National Guard, struggled with post-traumatic stress disorder and brain injuries after returning from a tour in Afghanistan, a tour that included the deaths of two members of his unit.
“Little did we know how much (his war experiences) would affect Josh,” said his mother, a Colchester resident, during a community mental health summit Friday at the White River Junction Veterans Affairs Medical Center.
Once home in Vermont, Josh Pallotta struggled with his memories, survivor’s guilt, relationships, money and life in general, Valerie Pallotta said. Her son received counseling, but it was not enough. He died Sept. 23, 2014.
In an emotional speech, Valerie Pallotta told the approximately 100 care providers, veterans and family members gathered at the VA that her son’s death broke her spirit.
“I’ve contemplated suicide myself,” she said. But “I wouldn’t do it to my mother. I wouldn’t put her through the pain that I’ve gone through.”
Instead, Valerie Pallotta is focusing her energy on establishing a place — to be called Josh’s House — where veterans will be able to gather and receive alternative therapies such as massage and aromatherapy to help them heal from their experiences. She also hopes the facility, which she aims to set up in Chittenden County, will include a gym, a kitchen, a video and game room, and a quiet place for veterans to study.
“I’m hoping that Josh’s House … will make a difference,” she said.
Nationally, 20 veterans die by suicide each day, said Brett Rusch, the White River Junction VA’s chief of staff. Because only six of the 20 veterans who die in the U.S. each day are enrolled in the VA, and only three are in active treatment, Rusch said it is important for the VA to collaborate with community partners to prevent such deaths.
“The VA is going through a lot of change right now … but one thing is certain, prevention of suicide is the top clinical priority,” Rusch said.
Overall rates of suicide in the Twin States are increasing and increasingly higher than national rates, said Tom Delaney, a University of Vermont researcher.
In 2015, there were 16.5 deaths by suicide per 100,000 people in New Hampshire and 14.8 deaths by suicide per 100,000 people in Vermont, according to the Centers for Disease Control and Prevention. Both states came in above the national average of 13.3 deaths by suicide per 100,000 people in 2015.
Women tend to be more likely than men to attempt suicide, but men tend to be more likely to die by suicide, Delaney said.
Though each suicide occurs under a unique set of circumstances, Delaney said, the Twin States rank highly in risk factors such as binge drinking and firearm ownership, and they have rural, older and isolated populations.
In a quest to bring the rate of suicide to zero — at least for those who are receiving mental health care — providers at three mental health agencies in Vermont are making changes in the way they screen for those at risk of suicide, the way they assess patients’ suicide risk, the way they target therapy specifically to prevent suicide and the way they follow up with patients after they receive care.
For Steve Broer, director of behavioral health services for Northwestern Counseling and Support Services, which provides care in Vermont’s Franklin and Grand Isle counties, moving toward zero involves discussions with clinicians about the challenges of making these changes in their practices.
It also involves looking back at the few instances where a patient did die by suicide. “What could we have been doing differently?” Broer said.
The VA also is making changes, said Meghan Snitkin, the White River Junction VA’s suicide prevention coordinator. Over the past year, the emergency department has begun screening every veteran who comes in for suicide risk, she said. She aims to expand the screening to other departments as well, she said.
She also hopes to improve follow-up with patients who have demonstrated a risk of suicide and for those who have received care in the past.
“How do we make sure they don’t fall through the cracks?” she said.
During Friday’s event, veterans, family members and mental health providers described ways in which the care and support available to veterans might be improved and barriers to receiving care might be diminished.
Some — like Valerie Pallotta — pointed to a need for expanded access to alternative therapies such as massage, yoga and Reiki.
Kevin Willey, an Army veteran who lives in West Lebanon, New Hampshire, and suffers from social phobias and PTSD, said he has benefited from massage therapy.
“My first massage ever … it was like ‘wow,’ ” he said.
Unfortunately, he said, the costs of massage can add up and he’s on a limited income. “It can get expensive,” he said.
Other issues discussed Friday included continuity of care. Jeffrey Brooks, who served in the Vermont National Guard, said he recently had to switch mental health providers after seeing one person at the VA for 3½ years.
The problem with switching providers is having to tell the whole story again, said Brooks, who is an outreach specialist for Vermont Veterans Outreach, which assists veterans with transportation and directing them to other services they may need.
Access challenges are less significant for Brooks, he said, because he knows what resources are available, but he’s concerned about other veterans who may not be aware of how to get the services they need.
The way veterans transition from war to civilian life could be improved, Valerie Pallotta said in her remarks. Josh Pallotta initially told military officials that he was not suffering from PTSD so that he could return home, rather than receive treatment on a base in another state, his mother said.
Brian Barrows, an Army veteran who served in Iraq and Afghanistan and now works as a social worker in Chittenden County, echoed Valerie Pallotta’s concerns.
He said there is a 90-day gap between when veterans return home and when they meet up with their unit again, which is a long time to go without support.
Unlike Josh Pallotta, Barrows said he was able to get the care he needed to treat his PTSD through the VA. Without a “really good team of providers” at the VA, Barrows said, “I wouldn’t be here today.”
