A Mother's Journey: The search for answers after suicide

ALEXANDRIA, La. (KALB) - Vernon Parish resident Nina Todd still relives the day she was told her daughter had committed suicide last December. Amanda Brailer was 35-years-old and a mother of two.

Amanda Brailer was 35 years old when she took her own life. (Credit: Nina Todd)

"When I see a flag, the last flag I saw was on her casket," Todd said.

As Todd sat on a quilt at Hodges Gardens, a place her daughter enjoyed visiting, she looked through a stack of family pictures.

"This is her 8th-grade graduation at Anacoco," the mother said holding a picture of Brailer in a purple cap and gown.

Memories and Brailer's beloved 18-year-old cat Miss Kitty are all Todd has left.

"That cat stayed with Mandi until they cut her down."

Brailer served in the Navy for nearly five years as aviation maintenance administration. She was honorably discharged in 2004 as a Petty Officer Second Class and was a Persian Gulf War veteran. The loss is especially painful because Todd said her daughter never showed signs of suicide and left behind two children who still live in Missouri.

"She was kind and loving," Todd said. "Mandi was the most generous, she danced, she wrote beautiful poetry."

Following her daughter's death, Todd wanted to know what happened. Upon request, she received medical records from the Saint Louis VA facility in Missouri where Brailer spent some time and has contacted several local politicians.

"You have no idea what they're going through until you read it," she said. "So many times I would lay on that floor, rolling, I was in so much emotional and physical pain because she didn't have anybody."

Todd has read through hundreds of pages of her daughter's medical records to piece together what her daughter may have been going through.

"I kind of put the dates of when I talked to her on the phone and how she was doing good and then she began to slip on me again," she said.

But rather than closure, Todd only had more questions. Her main concerns included how Brailer felt harassed by two nurses while in a rehabilitation program for homeless veterans at the St Louis facility or DCHV, the prescription medications she was taking and her daughter's sudden request for discharge from an outpatient recovery program against the VA's advice just weeks before her death.

"This was the most heartbreaking, gut-wrenching thing I have ever read in my life," Todd said. "I had no idea how sick my child was."

By 2016, Brailer was receiving 80-percent disability from the VA, mainly for a "Major Depressive Disorder" and limited motion of the jaw, the result of a metal plate in her mouth after damage from a wisdom tooth surgery around 2003 while in the Navy. Todd said Amanda had issues for the rest of her life and received various dental care from VA and non-VA providers.

"She called me hysterical and said 'Momma pray, just please pray because him trying to get that tooth out, I'm scared that that plate and all those screws are going to come with it.'"

Brailer was in the Domiciliary Care for Homeless Veteran's program from April to October 2016. That May, she sent a letter to then-Congressman John Fleming stating she felt harassed by two VA nurses. Although veterans in the DCHV program were expected to follow certain rules for their well-being and recovery, Brailer wrote that they were 'writing her up for everything.'

"I feel that the staff is nitpicking everything that I do and making it hard for me to focus on myself and my program," reads Todd from a copy of Amanda's letter.

Some examples include notes about Brailer using the wrong exit and improperly signing in and out along with various incidents in which staff reported she wasn't following a certain procedure that Brailer may not have seen as breaking any sort of rule at the time.

"They are creating a negative environment for me that is also affecting my mental health," the letter said.

In a reply to Congressman Fleming's office, the St. Louis VA said they had developed a 'mutually acceptable plan' that would allow Brailer to "add her own written notes to her record explaining write-ups from her perspective." Following the meeting with DCHV staff, there is no record of any further complaints from Amanda.

VA records state that Brailer was recovering and not considered at-risk. But in some of her phone conversations with staff, records show that toward the end of October, Brailer felt stressed trying to balance her life.

She was attending Opiate Addiction Treatment twice a week, an outpatient program at the St. Louis facility. Eventually, she began missing appointments citing conflicts in her work schedule and not having adequate transportation and child care, but records show treatment counselors always followed up with the veteran over the phone.

On Nov. 16, 2016, Brailer discharged upon her own request "against medical advice" and was considered at-risk for relapse. Although a significant other was listed as Amanda's emergency point of contact, Todd said she wishes more attempts had been made to make her aware of what she feels was a red flag.

"If a doctor had called me and said, 'look, Miss Todd, your daughter is in a very dangerous situation, you need to come up here, your support is needed' I would've been there in a heartbeat," she said.

But she never imagined Amanda would take her own life on Dec. 8, 2016.

"No one came and at 7:43 she kicked the stool."

Todd feels over time, things from home life to rehab began adding to Amanda's anxiety and says it broke her spirit. She wonders if more could have been done for her.

But Peter Dancy, Director of the Alexandria, Louisiana Veterans Affairs Health Care System said the VA does its best to be proactive about personalized care for veterans.

"We need to know those veterans, we need to find those triggers that are concerning to them, so we're teaching staff to be cognizant to those types of things that veterans may have," Dancy said. "As opposed to asking a question of the veteran 'what's the matter with you?' We ask 'what matters to you?' You'll get a different answer to that so focusing on what matters to that veteran I think is critical."

Todd questions medications Amanda was prescribed, which were mainly for symptoms of opiate dependence and depression. Dancy said alternatives to medication are just as important and a priority for the VA. Medical records show Brailer enjoyed and responded well to activities like bowling with peers and equine therapy.

"Tai-chi, yoga, acupuncture, aqua therapy, those are some of the alternatives that the veterans can potentially use," Dancy said.

Nina may never get all the answers she's looking for but finds some peace in knowing that despite the bad days, Amanda's medical records show she was focused on her recovery.

"Look how happy," the mother said holding up another picture. Reflecting in Hodges Gardens, Todd hopes that sharing her grief will affect change to the system and save the life of another veteran or anyone else struggling with thoughts of suicide.

"Don't shove that needle in your arm, don't take that bottle of pills, don't tie that rope around your neck," she said. "Listen to me...I care about you, and I don't want you to do that."

(Editor's Note)
The Public Affairs Manager for the Saint Louis VA Health Care System emailed us the following statement:

"Every suicide is a tragic outcome. We are saddened by the loss of this Veteran. We again extend our condolences to the family and friends of Amanda Brailer. It's important that we continue to talk about suicide prevention and bring awareness to this illness...We are committed to providing the highest level of support to Veterans living with mental illness and struggling with these daily challenges. We ask family members and friends to help us, support your loved ones by connecting them to these important VA services."

A spokesperson for U.S. Senator Bill Cassidy's office emailed this statement:

"After her daughter's tragic passing, Nina Todd contacted Senator Cassidy's office seeking assistance in dealing with the VA. Over a period of several months, we were in frequent contact with her and did everything we could to help with her requests."

In September 2017, the St. Louis Va Medical Center Director responded to an inquiry made by Congressman Mike Johnson's office on behalf of Nina Todd. The letter reiterated information found in Amanda's medical records regarding her complaint against two VA nurses while in DCHV, a verbal threat by a peer Amanda alerted staff about but declined to file a formal complaint and attempts to involve family in her care at DCHV.
According to the St. Louis VA, Amanda "repeatedly refused offers to involve Mrs. Todd in her care and identified a significant other as her emergency point of contact."