Finding My Horizon: falling through the cracks of the military mental health care system.

“Never did I dream that my last fight in the military would be fighting for myself.”

By Jessica Ruttenber

Standing by a window trying to get a cellphone signal on the 5th floor of the most inner ring of the Pentagon, I awaited a call from my medical provider. It had been a difficult two years. Three weeks after finishing a deployment I started homeschooling my three children as we quarantined for COVID-19 while my spouse performed shift work at the National Military Command Center. Just like most Americans during the pandemic our family dynamics were strained and I was exhausted. The last six months proved the most difficult after receiving a phone call from my sister shortly after she found her son’s lifeless body, my nephew, on the floor in his bedroom after overdosing on drugs followed by the weight of planning my father’s funeral a couple months after. During this time, I made the decision to retire after serving over 20 years in the Air Force. I knew it was essential to seek support in order to ensure my success and not end up another statistic.

Starting one year out from retirement I planned my transition like a military operation. I joined transition programs, coaching, and mapped out milestones to accomplish. I was extremely proactive but also a little arrogant. What I didn’t plan for was the weight and stress of it all. I found myself dreading getting up everyday and realized I needed to seek mental health to get ahead of this. This was a big pill for me to swallow with my pride and the stigma often associated with mental health.  This was something other people did, not me, but here I was.

The doctor finally called me. I don’t know what I was expecting but I knew how I felt the time I got off the phone with him. He treated me with indifference, seemed annoyed when I asked for a recommendation for a clinic I could be treated at, and even though I didn’t have thoughts of suicide he failed to ask me any questions if I had any thoughts of hurting myself.  In some ways he almost discouraged me since I was a pilot and held a top-secret clearance.  I explained I understood the potential consequences to my future career and he reluctantly put in the referral for care.

It was clear to me early on; the system could not provide me continuity of care. Calling the clinic two days later it took a month for the first open appointment to see a counselor and two months to be seen by a psychiatrist that could evaluate if I would be a good candidate for medication. After being seen I was only able to receive care from a counselor every three weeks and often that appointment was canceled at the last minute.

Eventually my retirement came. I had an amazing week of celebration surrounded by family and friends. We took a quick family vacation and I started my new job. From there began my entry into the retirement system, with the VA, and Tricare as a spouse. As proactive as I was I received one road block after another entering the system. I was turned away for care for an ear infection because the DEERS system wasn’t talking to the Tricare system. I had a series of Veterans Affairs (VA) appointments to access my disability benefits. I often showed up to the appointments the VA sent me to, sometimes an hour away, only to find the facility wasn’t expecting me. It took two months after retirement before I could talk to my new primary care provider after my final out date to ask for another mental health referral.

Unfortunately, even as I actively sought help I didn’t detect I was in a graveyard spiral brought on from exhaustion. For those not familiar with the term a graveyard spiral it is when a pilot mistakenly believes they are flying with the wings level, but in actuality they are slowly losing altitude in an insidious angle of bank and start to descend.  Unless something breaks this chain of events it often results in a crash with loss of life. The solution is for the pilot to consciously override the brain’s imperative to judge physical altitude on the basis of signals from the brain. I knew something wasn’t right but I just couldn’t see my horizon.

Unfortunately, and not uncommon my spouse was in denial of my situation despite several attempts to communicate with him. For me the disrupting factor from this spiral was a breakdown at home.  What saved me was my friends who leapt into action and took me to the closest VA hospital two days later. Even with their support, including a member of the White House staff who had connections inside the VA, I was turned away initially from the mental health desk and by admissions. I honestly can say I would have walked out right there hadn’t been for my friends who were persistent and advocated on my behalf.  

As a woman in the VA I was often mistaken as a nurse or a spouse and not a patient seeking care.  When being accessed in each office the provider would often try to skip over any combat or Post Traumatic Stress Disorder (PTSD) questions even though my record clearly indicated I flew missions in Operation Iraqi Freedom and Operation Enduring Freedom. After initial intake and thanks to my amazing friends I now have consistency of care and my future is looking brighter.

Even the most grounded people can feel hijacked by the winds of unpredictable change. What concerns me the most is if this is happening to me, then how are other service members and veterans that don’t have the advantage of a strong support system navigating through all of it? As I walked out of my final admissions appointment the doctor stated “you dedicated your life defending this country, now it’s our turn to take care of you.” Never did I dream that my last fight in the military would be fighting for myself.

In 2019, 6,261 Veterans died by suicide and reflected a suicide rate 52.3% higher than non-Veterans in the U.S.  Additionally, women are the fastest-growing Veteran group. They constitute approximately 9 percent of the U.S. Veteran population and are projected to account for 15 percent by 2035. Women Veterans are more likely to die by suicide than non-Veteran women: In 2016, the suicide rate of women Veterans was nearly twice the suicide rate of non-Veteran women, after accounting for age differences.

As painful as these statistics are to hear, it is imperative to walk back the outcome of the crisis to an earlier stage of intervention. Ease of access to preventive care is key.  But I challenge the reader to consider an equal model of responsibility. Not only should our government provide necessary resources in a timely manner but the friends and family of the service member or veteran should also have the willingness to have tough and uncomfortable conversations with their loved ones. Often the cry for help is much subtler then an attempted suicide and likely would have been perceived in the conversations that needed to happen but never occurred.

Perhaps you don’t have the social support needed. One of the best ways to find the support you need is to start with yourself. Be your own greatest supporter. Often, we hesitate because we don’t know where to start. I encourage you to take that first step even if you can’t see past tomorrow. At the end of this article are several resources I encourage you to begin with.

In a way I am grateful for having this experience which now gives me an appreciation for over worked mental healthcare providers and challenges they face. I am now more attuned to the weight of the invisible scars our service members, veterans and their families face. Not all experiences were as challenging as mine to receive care.  The system is far from perfect but there is hope. Now with a few repairs to my wings I can see my horizon again and I’m flying wings level.


Substance Abuse and Addiction – The Essentials here.

If you or someone you know is in crisis or thinking about suicide, contact the toll-free, 24/7 Veterans Crisis Line to speak with a trained, caring VA responder. Call 1-800-273-8255 and Press 1, text to 838255, or chat online at

Women Veterans Program Manager: At every VA medical center, there is a designated Women Veterans
Program Manager who acts as an administrative leader for the Women’s Health Program and advocates for women Veterans

Women Veterans Call Center: This service provides women Veterans with information about relevant VA
benefits and services and answers questions women Veterans may have about their benefits. Call 1-855-VA-WOMEN (1-855-829-6636) to contact responders who can make referrals to Women Veterans Program Managers, the Health Eligibility Center, the Veterans Benefits Administration, and suicide and homeless crisis lines as needed.

Military One Source (1-800-342-9647): You can schedule face-to-face non-medical counseling by calling a consultant. Free Expert and Confidential Support & More. Conflict & Stress Management, Marriage & Family Counseling.

Coaching Into Care (1-888-823-7458): A national telephone service of VA, Coaching Into Care aims to
educate, support, and empower family members and friends who are seeking care or services for a Veteran. More information is available at

National Suicide Prevention Lifeline: Hours: Available 24 hours. Languages: English, Spanish. Learn more (1-800-273-8255)

VA Women’s Health Transition Training: The online, self-paced Women’s Health Transition Training is available for servicewomen and women Veterans to take anytime, anyplace at

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