Mary Lou Brauti-Minkler had two fathers: the caring man who left to serve in World War II and Korea, and the angry, volatile veteran who returned from combat.
Back home, the U.S. Army veteran had anxiety, nightmares and violent outbursts that often were fueled by heavy drinking. When Brauti-Minkler was 4, her father in a drunken fury threatened his daughter and wife with a gun.
As she grew up, Brauti-Minkler says she and her mother were confused and frightened. A loving father and husband had been replaced by a rage-filled, paranoid man – and they had no explanation for the changes. They later would understand his behaviors were the result of post-traumatic stress disorder. He died 25 years ago.
Her father’s PTSD left more than the veteran damaged, Brauti-Minkler says. She and her mother experienced trauma themselves, and she still bears emotional scars. Her father needed treatment, she says, but she and her mother needed help, too.
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“Pretty much all my life, I lived with the consequences,” says Brauti-Minkler, now 72, of Fresno.
Pretty much all my life, I lived with the consequences.
Mary Lou Brauti-Minkler, NAMI Homefront teacher and daughter of a combat veteran
It’s not uncommon for spouses and children of service members and veterans to experience psychological distress themselves. A 2014 study of military caregivers by the Rand Corp. found they are four times more at risk for depression compared to the general population. And military caregivers need education and training about how to care for someone with PTSD, traumatic brain injuries and other war wounds.
“We know from other caregivers that structured social support interventions can improve their health by reducing depression,” says Terri Tanielian, senior behavioral scientist at Rand, a research organization based in Santa Monica.
A new program for military and veteran families in Fresno could provide that education and support.
The Fresno chapter of the National Alliance on Mental Illness is offering a NAMI Homefront education and support program designed for family members, friends and significant others of service members and veterans who have PTSD, depression, anxiety and other mental health conditions. NAMI is the largest nonprofit grass-roots mental health organization in the United States.
NAMI created the program two years ago, and 25 states have trained teachers, but not all are offering classes. This year, California NAMI got $25,000 in funding from the California Mental Health Services Authority for a one-year pilot project to train teachers in Fresno, Sonoma, Santa Clara and San Diego for classes to begin this fall.
Military and veteran families taking NAMI Homefront will be provided information and resources to help them understand and support their service member or veteran while maintaining their own well-being. The sessions will be taught by people who have had personal experiences as family members of someone who is in the military or is a veteran.
Brauti-Minkler will be one of the teachers at the first NAMI Homefront class in Fresno that starts Oct. 5.
“I really wanted to help get it started,” she says. “Military families need something more tailored to their experience.”
Teachers have experience
Brauti-Minkler, who has an adult son with mental illness, is a member of the NAMI Fresno board of directors. She has experience teaching NAMI’s peer-led Family-to-Family Education Program, which is a 12-session educational program for family, significant others and friends of people living with mental illness. Brauti-Minkler and two other Family-to-Family teachers have been trained to lead the NAMI Homefront sessions in Fresno.
NAMI Homefront incorporates many of the lessons from the Family-to-Family program, but it also offers specific information about PTSD, traumatic brain injuries, sexual trauma, combat stress and substance abuse disorders, among other mental health conditions that military members and veterans can experience. The sessions also include information to help family members weave through the bureaucracy to get health care and other needed services for their loved ones.
Participants in the NAMI Homefront program will attend six sessions instead of the 12 offered in the Family-to-Family program. The program was shortened to accommodate post-9/11 military and veteran family members who often are working full time and raising children, says Suzanne Robinson, a NAMI senior manager for education programs who helped develop the special program.
NAMI Homefront is independent of services offered to veterans and their families through the Department of Veterans Affairs, but the agency is supportive. In February, the VA signed a three-year agreement with NAMI to expand a partnership to offer the peer-led family education programs. As part of the collaboration, each VA facility must let veterans know about NAMI Homefront and help enroll family members in the program.
The program will be taught at the nonprofit organization’s office in northwest Fresno. “We want people to know NAMI as a resource to them and also want to get them into a safe place, out of the veterans’ atmosphere and environment,” says Christina Roup, executive director of NAMI Fresno.
Also, contrary to VA requirements for the agency’s programs, family members can participate in NAMI Homefront if their loved ones were less-than-honorably discharged from military service. And families do not have to have an official mental health diagnosis to attend.
NAMI Homefront purposely will not include the service members and veterans in the six sessions, Roup says.
Groups that combine veterans and their family members can be effective, but there is a need for separate sessions, she says. “The intent is to provide that family member a short period of respite and safe place to share their emotional journey of living with someone with mental health challenges,” Roup says.
“We don’t want any damage done to that relationship when some of those feelings are shared, and we know they’re difficult sometimes. We do want to protect the loved ones at all cost.”
The program is designed to be informational and educational and not a support group, but time will be set aside for family members to share their experiences. Roup expects bonds to form between participants and informal support groups to be created, as has happened with the Family-to-Family program.
Herman Barretto, a clinical social worker at the Fresno Vet Center, says military and veteran families need support, and NAMI Homefront will be another place they can turn for help. “No one can do this work alone.”
Fresno Vet Center offers free PTSD education classes that are open to combat veterans and their families. It also has couples classes and classes for spouses of combat veterans. Therapists typically suggest classes that could be beneficial to the veteran and loved ones.
At least I know what’s going on with him.
Amorica Torres, wife of Vietnam War veteran
Amorica Torres, 65, of Fresno, has attended PTSD and couples classes at the center.
She is married to a Vietnam War veteran who can still hear gunshots ringing in his ears from his combat duty as a U.S. Marine. Without the information about PTSD she gained from the classes, Torres says she likely would have divorced her husband. “He was physical with me, verbally abusive with me, and the tension with me was like walking on eggshells.”
The classes have helped her husband manage his PTSD, Torres says, and the information about combat trauma she learned was an eye-opener. She now understands about medications that can help, what can trigger PTSD, and about brain chemistry. “At least I know what’s going on with him.”
She also found support from other spouses who shared their experiences. “You’re not by yourself. There are other people there feeling the same way you are and we can discuss those things.”
As the wives would speak, Torres says: “It was like a tape recorder type of thing. ‘That’s me.’ Every time they would say something, ‘that’s me.’ ”
Getting people to enroll
Torres hopes people will enroll in NAMI Homefront to get the help that she has found at the Fresno Vet Center. “You will be surprised at what you are going to learn,” she says. “One of the best things I can say is that it does open your eyes. It does serve you well.”
NAMI Fresno expects spouses of service members and veterans will be most of the participants in the NAMI Homefront program, but adult children of veterans, grandparents and siblings will find places there, too.
Roup sees the program serving a diverse group. She expects family members will have loved ones who served in World War II, the Korean and Vietnam wars, as well as in the Gulf War and the more recent wars in Iraq and Afghanistan. “Regardless of which tour you were on, which war you served in, the impact it may have on the individual may be the same, as far as needing support,” she says.
Roberta Lerch, 40, will be teaching NAMI Homefront sessions in Fresno. Her husband is the adult child of a Vietnam War veteran. Her father-in-law, who died last year, returned home damaged from combat duty as a Marine gunnery sergeant. He would have nightmares and would think his children were the enemy, she says.
Family members of veterans need a place where they can vent their emotions, Lerch says. “We can share experiences together and cope with this together, and know that there is help out there and we don’t have to keep it a secret.”
Robinson, the NAMI senior manager, hopes family members will enroll in the program. But there is an extra layer of stigma attached to mental health conditions for people on active duty and veterans that can discourage family members from seeking help and support, she says. They can worry about jeopardizing the military career of a loved one, for example, she says.
Brauti-Minkler will be there to welcome Fresno’s first NAMI Homefront class.
“Taking that first step is the hardest for most people,” she says. “Admitting there is a problem is hard. But we offer information and understanding and a safe place to share how they’re really feeling.”
Military caregivers and recipients
Caregivers for Pre-9/11 and Post-9/11 veterans
Pre-9/11: 47 percent employed
Post-9/11: 63 percent employed
Pre-9/11: 71 percent have a support network
Post-9/11: 47 percent have a support network
Pre-9/11: 11 percent are age 30 or younger
Post-9/11: 37 percent are age 30 or younger
Recipients of military caregiver help
Pre-9/11: 36 percent have a behavioral health condition
Post-9/11: 64 percent have a behavioral health condition
Pre-9/11: 30 percent have a VA disability
Post-9/11: 58 percent have a VA disability
Source: RAND Corporation
NAMI Homefront, Fresno: 559-224-2469
Fresno Vet Center: 559-487-5660
San Joaquin Valley Veterans: 559-255-8838
VA Caregiver Support Line: 855-260-3274
VA Central California Health Care System: 559-225-6100, ext. 5468
Give An Hour: www.giveanhour.org
PTSD and the Military
Vietnam War veterans: 30 percent have had post-traumatic stress disorder at some point.
Gulf War veterans: 12 percent have PTSD in a given year.
Iraq and Afghanistan veterans: 11-20 percent have PTSD in a given year.
Source: PTSD: National Center for PTSD