It’s been a little more than four decades since post-traumatic stress disorder (PTSD) was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the official dictionary of known conditions that mental health practitioners use for diagnoses and care. Since then, treatment for PTSD, broadly speaking, has focused on the symptoms and consisted of two modalities: cognitive behavioral therapy and medication
But starting 11 years ago, an organization in San Antonio, Texas, took a different approach. Endeavors, which offers services and support for the unhoused and other vulnerable populations, expanded its scope to reach veterans, too. But in contrast to programs that treat just the symptoms of challenges like PTSD, they decided to take a holistic approach, with wellness as the cornerstone.
To that end, they created the Veteran Wellness Center (VWC). Services include traditional treatments, including therapy, group sessions and sometimes medication. But the methodology also includes a handful of modalities that aren’t medical, per se, but can impact mental and physical health—like life skills and fitness, spirituality and socializing. Endeavors is a faith-based organization (its origin was the union of five churches to help the homeless) yet has a strict no-proselytizing rule; on its website, it emphasizes that its doors are open to people of all faiths and backgrounds. That open-arms philosophy is, arguably, another element that views holistic wellbeing as key.
According to Jon Allman, a veteran of the US Air Force and Endeavors CEO, the center’s philosophy stemmed from a realization that, among their clients, cultivating stable, healthy and happy lives usually necessitated changes in lifestyle. That’s where veteran wellness comes in.
In terms of its program, the VWC works with each veteran and their family to create what they call a wellness profile, based on six principles of wellness:
Mind-body connection: the complete integration of physical fitness, medical care, holistic treatments and mental health care
- Connectedness: this principle fosters a basic human need of togetherness with a targeted focus on decreasing isolation
- Spiritual: embracing spiritual diversity to feed the deepest needs of oneself
- Environmental: this has the overall goal of connecting with the natural world
- Economic: as viewed through the lens of social determinants of health and how finances impact overall wellness
- Knowledge: a common thread that enhances life and strengthens and supports health
While Endeavors’s approach may be non-traditional, the results of its efforts are indeed concrete. Javier Sandoval is both a client and an employee of the organization, which he credits for helping him quite literally turn his life around. A US Marine Corps veteran who did tours in Iraq and Somalia, traumas from his experiences during deployment continued to haunt him after his service. Sandoval struggled with alcohol abuse and wasn’t able to create a stable life.
Finally, when his brother found him asleep on the street clutching a gallon of vodka, came a turning point. He connected Sandoval with Endeavor, where his first stop was therapy.
“I wasn’t the easiest person at first,” he says. “I was angry, mostly at myself,” he says. “It takes strength to ask for help.”
Over time, though, Sandoval began to change. There was more therapy. But also, sessions at the gym. Training in deep breathing and other ways to self-regulate emotions. As veterans learn to manage their own thoughts and fears, they gain the ability to interact with family and friends in new ways.
For Dr. Jill E. Palmer, a US Navy veteran and Endeavors Chief of Behavioral Health, learning to cope in healthier, positive ways is personal. Her father was a veteran of the Vietnam War and when he came home, she says, his way of handling his trauma was ineffective in the long-run. To this day, she believes he would have had a better experience—and, perhaps, a better chance at finding equilibrium—if he’d been in a non-traditional program.
Another important element of Endeavor’s mission is its accessibility. Allman, the CEO, says the goal as an organization is to reduce barriers to care. As one of the first privately-funded veteran centers of its kind, Endeavors strives to get veterans in for appointments quickly. If a veteran needs transportation, Endeavors will arrange a ride. And if childcare is of concern, clients can drop their children at an on-site daycare.
For Sandoval, access to free, ongoing treatment has been fundamental to his ability to get back on his feet. Since walking through the door of Endeavors, he says, he hasn’t spent a dime. But the most meaningful aspect of his experience so far is something else—something that lets all the other components come together and have an impact.
The best thing about Endeavors, says Sandoval: “They didn’t give up on me.”