To prevent veteran suicides, wounded warrior presses for holistic care

Improving VA health care becomes injured veteran's new cause

"If you look at me, you would see just a normal young guy who is pretty big, but I am pretty limited in what I can do, and the pain that keeps me from enjoying life is pretty frustrating," explains retired Army Sgt. Josh Renschler, who suffered a severe back and brain injury in Iraq during his first tour. It happened on Valentines Day in 2004, catapulting Renschler away from the frontlines and onto a new battlefield: advocating for veterans' care.

On Thursday, Renschler went to Capitol Hill to testify at a House Veterans' Affairs Committee hearing alongside the parents of three veterans who committed suicide. When his testimony began, tears and emotions blistered Renschler's calm voice, but he was able to move on and express a clear message.

"We need a system that serves the veteran, not one that requires the veteran to accommodate to the system," Renschler said.

Innately stubborn, Renschler spent the first few years after his injury rejecting the idea that he would never go back to Iraq. "My goal for treatment was patch me up and send me back," he told CBS News. As Renschler waited for appointments at the VA, he and his wife Nikki paid out of their own pocket for Renschler to get the medical help he needed. They eventually lost their home and relied on family to help them care for their children.

As mounting obstacles overwhelmed Renschler at home, he found out that the squad he had served with in Iraq was blown up by an IED. He felt like he lost 10 members of his own family. Fuming with anger, Renschler came close to committing suicide.

"There was a day when I thought that I could stop the pain by just shooting myself, and I remember lying in bed and envisioning picking up a gun and putting it to my head and pulling the trigger," Renschler recalls.

But the idea of Nikki having to tell his parents and his children forced Renschler to push aside those thoughts. Nikki was just 17 years old when she became Renschler's primary caretaker, and he describes her love as the anchor in his life.

Renschler is now a veterans' advocate and mentor. He travels the country meeting with veterans, speaking with government officials and working with multiple veterans' groups, including the Wounded Warrior Project and Men of Valor International. Renschler said he's worn "many hats in this life."

"It is a life that I wouldn't necessarily have dreamed for myself, but I am definitely happy to be serving the guys that I served with," Resnchler explains, adding that if he could do it all over again, he still would have joined the military.

But with about 18 to 22 veterans committing suicide every day, and recent revelations of incompetence at the VA, Renschler says that "suicide is winning."

According to a recently released report from the Institute of Medicine (IOM) on PTSD treatment at the VA and DoD, the percentage of patients at the Veterans Health Administration being treated for PTSD has doubled between 2004 and 2012, yet the VA PTSD research budget has remained static over the last five years.

As Renschler sat down at the Wounded Warrior office in Washington, D.C. to prepare for his Capitol Hill testimony on veteran suicide, he asserted that care for veterans must be holistic.

"Seriously," he said, "you can't focus on the veterans' treatment if their relationship is spiraling out of control."

In June the House and the Senate passed legislation to expand veterans' access to non-VA mental health care providers, but in Renschler's view this won't entirely solve the problem, given the national shortage of mental health care providers.

There are no "silver bullets," Renschler said, but from 2008 to 2009, he experienced a model that worked. It was a trial VA program placing all of Renschler's doctors -- including his primary care physician, psychologist, psychiatrist and social worker -- into one wing of the VA hospital. The medical professionals met together to talk about their patients, providing an interdisciplinary understanding of the mental and physical challenges facing Renschler and the other veterans in the program. The doctors agreed on the best solutions together.

Would this model drive down the suicide rate among veterans? Renschler believes it would.

"A team-based model would definitely prevent many more suicides than any other programs we have seen," he said.

Along with Renschler, the Veterans' Affairs Committee on Thursday heard from Susan Selke, whose son Clay Hunt committed suicide in March 2011 after serving in the Marine Corps.

"Clay's story details the urgency needed in addressing this issue," Selke said in her prepared statement. "Despite his proactive and open approach to seeking care to address his injuries, the VA system did not adequately address his needs. Even today, we continue to hear about both individual and systemic failures by the VA to provide adequate care and address the needs of veterans."

After the hearing, a bipartisan group of congressmen -- Committee Chairman Jeff Miller, R-Fla.; Rep. Tim Walz, D-Minn.; and Rep. Tammy Duckworth, D-Ill. -- introduced a bill to help address the problem, named for Selke's son. The Clay Hunt Suicide Prevention for American Veterans Act would attempt to create greater continuity of care between the National Guard and the VA. It would also require annual evaluations of all mental health care and suicide prevention practices and programs at the DoD and VA, and it would reform the review process for troops who received unfavorable discharges potentially because of mental health problems.

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