PTSD Combat : Winning the War Within: April 2006

Thursday, April 27, 2006

Thank You For Visiting PTSD Combat

I'll be away from my computer until Monday, soaking up a family event. Back to posting PTSD news early next week.

As long as I'm adding a personal note here, I'd like to thank those of you -- all 4,384! -- who have visited this past 2 1/2 months. The amount of traffic is great, but the type of traffic is even more impressive. We've become quite popular with the educational and government institutions, and it's great to see that. Please continue to share the link with others who may need the information, and let me know if there's anything specifically you'd like me to cover or seek out. I'm more than happy to help in any way I can.

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Bush Budget Fight: Senate Not Likely to Raise Vet Fees

One Senator is reporting some good news re: veteran's health, if it holds. Senator Schumer says the Senate is not likely to back at least one provision of President Bush's 2007 proposed budget: raising veteran's fees for health care and prescription drugs.

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From AP New York:

Lawmakers are gearing up to reject charging higher fees to some military veterans for their health care and prescription drugs, Sen. Charles Schumer said Wednesday.

The Bush administration's proposed budget for the 2007 fiscal year includes a boost in co-pay fees from $8 to $15, and a new $250 user fee to health care enrollment with the Department of Veterans Affairs.

Congress has beaten back similar attempts in the past, and Schumer, D-N.Y., said he would push an amendment to cancel the higher fees when the Senate votes next week on a supplemental war spending measure.

Let's hope we can beat back a few more of the nastier provisions, too.

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Labels: disillusion

Seattle Post-Intelligencer: Support the Troops Just a Slogan?

Wow, the editorial board at the Seattle PI comes out swinging for our troops and the families that have to help them heal as they return home in Thursday's (now online) Opinion: "The slogan adorns bumper stickers and those yellow-ribbon trunk magnets: 'Support Our Troops.' Great slogan. But is it anything more?" Find out what's got them so tweaked, and be sure to take the poll ("Is America doing enough to help severely injured and disabled Iraq war veterans?") at the bottom of the page.

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Continuing from the Post-Intelligencer:

Most Americans have enjoyed a separate peace during the three-years-and-counting war in Iraq. The war has brought no hardships, demanded no sacrifices, except from the soldiers who've been called to fight it and their families, for whom the hardships and sacrifices have been very real.

P-I reporter Mike Barber brought that home Wednesday with the story of Staff Sgt. John Bennett, his wife, Dena, and their four children. Bennett was severely wounded in Iraq. Much of his long recovery and rehabilitation -- including his time at the Seattle VA facility -- was a nightmare for the family. They lived on credit cards and stayed in seedy hotels, far from home.

The war is producing a steady stream of badly wounded and disabled soldiers for which our veterans' facilities are unprepared. Now Seattle has a chance to support our troops with more than a bumper sticker.

The Fisher House philanthropy has helped build 33 wheelchair-friendly centers where families can live and visit wounded soldiers. We need one here. Half of the estimated $4 million to build the Seattle Fisher House must be raised locally. As of this week, the tally stood at about $70,000.

Seattle, home to software billionaires and $1 billion in sports stadia, should do better than that.

I took the liberty of quoting the editorial in full, for educational purposes only.

Please, if you would like:

Thank the Seattle PI for their strong show of support for their local veterans and their families.
Share your comments in their 'Sound Off' area.
Consider donating to the Fisher House (national/international donations welcomed).
And don't forget to take the poll found at the bottom of the editorial page.

Wednesday, April 26, 2006

Veterans Rally: Recap on State Protests

During the past two days, veterans and their supporters arrived in Washington, DC for a number of events geared to petition their government for their grievances. Those who couldn't make it to the national Capitol descended on their own state Capitols. Let's take a quick review of a few of the actions that took place.

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In Montana, from the Billings Gazette:

When Shane Pierson of Seeley Lake came home from the Gulf War, he had to wait six months before a Veterans Affairs doctor had time to see him.

Now, Pierson told a small crowd gathered on the steps of the Capitol, there are 30,000 soldiers waiting for room in the U.S. Department of Veterans Affairs health system. "Our returning veterans can't wait six months," Pierson said. "They need help now."

The Montana rally, which drew almost as many politicians and reporters as veterans and activists, ran in conjunction with a national Washington, D.C., rally held Tuesday called Operation Firing for Effect. ...

Morgana Rhys of Bigfork, the wife and daughter of veterans, organized the Montana event. "(Veterans) are not cannon fodder to be thrown off to the side when we're done with them," she told the small crowd.

Rhys urged people to do something more to support troops than merely putting a yellow magnet on their cars. She said people should write their senators and representatives and urge them to support money for the VA, including a recently defeated provision that would have made full funding for the VA medical system mandatory.

According to information from Disabled American Veterans, funding for the VA is discretionary, which means that Congress must authorize the money every year, and the funding competes against other federal spending. Mandatory VA funding would mean that the full cost of paying for veterans' benefits would be automatically incorporated into the federal budget.

In New Jersey via the Asbury Park Press:

As the U.S. Senate considered a massive new spending bill Tuesday, military veterans gathered in Washington, outside a Veterans Administration clinic in Ocean County and elsewhere across the nation to press their case against health care cuts. "There's demonstrations going on as we speak down in Washington," said James Robinson, commander-elect of the Disabled American Veterans Chapter 20, Brick. "Veterans' benefits are being cut. All of our coverage (costs) are going up. The money isn't being appropriated for us, and for the veterans coming home now."

The "shadow rally" outside the James J. Howard Veterans Clinic in Brick attracted about 60 people in support of Operation Firing for Effect, a national coalition of veteran activists who staged a Washington event Tuesday.

New Jersey organizer and Mantoloking resident Don Scholtes said the group organized in response to last year's VA budget shortfall when Congress had to scare up an additional $1.5 billion for the agency. The group's message to Congress is "mandatory funding, or no vote," said Gary DeRosa of Toms River, a vice commander for DAV Chapter 20.

The demonstrations' title is a play on the military phrase "fire for effect" — a message for artillery gunners to begin bombarding an enemy target once they find the correct ranging. The implied threat is to "fire" members of Congress who don't support more VA funding, organizers say. "They want to change the (medical) definitions for veterans," DeRosa said. "They're proposing changes for post-traumatic stress disorder, head trauma. Everything is under a microscope. Their objective is to cut as much funding as possible."

From Michigan's Daily Mining Gazette:

They were there for the young men and women who are about to become veterans, not for themselves, said Backwoods Vets member Paul Jensen.

About a dozen representatives of local veterans groups, including local Veteran of Foreign Wars (VFW) posts and Backwoods, rallied at Veterans Park Tuesday in support of veteran affairs. “The people from Afghanistan and Iraq are going to have nothing to come home to, this rally is for them and not for us,” he said.

Houghton’s rally was a shadow rally of a bigger rally called “Operation Firing for Effect — Veterans’ March” Tuesday in Washington D.C. Jensen said the rallies are to draw attention to the many veteran issues that are in front of Congress right now. Veterans meet with legislators today. “We face so many things over the years,” he said. “One of the major things is our health care system.”

According to the House Committee on Veterans’ Affairs in the Democratic office, the number of new veterans enrolled in the department’s health care system and waiting for their first clinic appointment to be scheduled has doubled during the year. As of April 2005, 15,211 veterans were waiting. This month, the number increased to 30,475.

Will add more as I come across them. Good going, states!

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Tuesday, April 25, 2006

Mount Vernon, OH: Returning Vet Support Group Organizes

The people in Ohio are doing an outstanding job of standing up in support of our troops in tangible and important ways. This weekend I wrote of a new support program, the Veteran Freedom Fighters of America, starting up in Sebring, OH; and today there's word that the Mental Health Association of Knox County, OH (including Mount Vernon) is hosting an organizational meeting tomorrow to "solicit interest in getting a [PTSD support] group going in the county." The meeting will take place Wednesday, April 26, 2006 at 7 p.m. at the Public Library of Mount Vernon and Knox County, Room A and B. Call 740-397-3088 for more information.

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From the Mount Vernon News:

Many in the community are affected by post-traumatic stress disorder, and the Mental Health Association of Knox County has received many calls expressing an interest in a support group for those who have been diagnosed with this disorder. An organizational meeting will be Wednesday at 7 p.m. at the Public Library of Mount Vernon and Knox County, Room A and B, to solicit interest in getting a group going in the county. Several agencies in the county, such as the Knox County Red Cross, the Knox County Veterans Services and hospice, have been invited to attend and provide information and resources. ...

Despite the very painful and real effects of PTSD, treatment is often successful. Among the treatments is individual psychotherapy, medication, family therapy is sometimes recommended, and peer-counseling groups. A peer-support group encourages survivors of similar traumatic events to share their experiences and reactions to them.

The Mental Health Association of Knox County, 11 W. Gambier St., invites anyone who thinks they may benefit from sharing their feelings and experiences with others to attend the meeting. For more information call 397-3088.

I wish this takes off, and a hat tip to the community for making this happen!

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Labels: reintegration

One Student's Plea: Troops Deserve Our Help

I just came across this article by NIU's Northern Star opinion columnist Henry Kraemer. It describes how his life was personally touched by the Iraq war, as he watched a distant cousin ship off to Iraq -- only to return home suffering with PTSD and eventually giving up on life and choosing suicide. The author's position of writing for a university newspaper provides an excellent opportunity at PTSD education -- and Mr. Kraemer takes it.

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Although I haven't quoted from the entire piece, I've clipped a substantial passage and hope the author agrees it a valid exercise in this case:

Since Jamie died, I've been thinking about the soldiers. According to CNN, there are about 132,000 American soldiers stationed in Iraq right now. That's five times more than the entire student body of NIU. A lot of them are our age. Most of them are willing to lay their lives on the line every day. Many of them do.

The war has been hard on a lot of them. The U.S. Department of Defense reports that 2,384 have died so far, and more than 17,000 have been wounded. Most of us know these figures - the death toll is on the news at least every week - but there is a hidden toll taken on soldiers. It may be the cause of many post-war suicides, and it may have killed Jamie. Post-traumatic stress disorder is affecting soldiers in a tremendous way.

Post-traumatic stress was identified first after the Vietnam War to describe the effects of battle on returning soldiers. The symptoms are seemingly endless: anxiety, depression, nightmares, irritability and flashbacks to name a few.

The American Medical Association surveyed 222,620 Army soldiers and Marines on leave from Iraq and found more than 21,000 of them suffer from post-traumatic stress. The study did not account for the 132,000 serving now, but the percentage is probably the same, if not greater. More soldiers may suffer from the disorder than report it. Many soldiers see it as a sign of weakness and therefore claim to have nothing wrong with them.

The military has tried to identify PTSD sufferers earlier than ever before. Leaders probably learned the lesson after Vietnam, when countless veterans came back emotionally shattered. There are now on-site therapy sessions held in combat zones - but these sessions do little to help the soldiers beyond diagnosing them. The damage has already been done.

PTSD is hitting soldiers in very much the same way it did in Vietnam. Then and now, the soldiers don't know friend from foe. This breeds a great deal of fear and anger. Lt. Col. Alan Peterson, an Air Force psychologist, told the New York Times of the devastation caused by ambiguous urban combat.

"These guys go out in convoys, and boom: the first vehicle gets hit, their best friend dies and now they're seeing life flash before them and get a surge of adrenaline and want to do something," Peterson said. "But often there's nothing they can do. There's no enemy there. ... They wish they could act out on this adrenaline rush and do what they were trained to do but can't."

Post-traumatic stress is ghostly and incessant, much like the soldiers' human enemies. Sufferers are torn apart by it, but military mores keep many of them from getting help. The military is commendably doing much to help them. But the responsibility also falls to us, the families they return to.

Our soldiers come home shaken. They come home hurt and lonely.

We can show them their home is a safe place. We can let them know what they're feeling is perfectly natural and encourage them to get help. If any of your friends or family show signs of PTSD, refer them to local veterans centers or to the National Center for Post-Traumatic Stress Disorder.

We all respect their service. Now they deserve our help.

I'd like to thank the Northern Star's Henry Kraemer (email him if you'd like to as well) for reaching out to do what he can to help educate Northern Illinois University's student body on the plight of our returning soldiers. His effort will make it easier for others to understand they have an important role to play in assisting the returning veteran's reintegration back into civilian life.

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Monday, April 24, 2006

Today's Combat Roles Not Only for Army and Marines

With the military stretched thinner than it's perhaps ever been, service members from all branches are increasingly faced with taking on new roles these days. Combat duty is no longer the sole job of the soldier or the Marine; and so, traditional battlefield fighters may no longer be the only ones asked to bear war's psychological burdens. Let's take a look at how the Air Force and Navy are affected by this broadening of combat roles and responsibilities in their ranks.

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First, let's take a look at the changes taking place in the Air Force via this article in today's Houston Chronicle:

When a group of U.S. Air Force commanders visited Iraq two years ago, they made some disturbing observations as they watched enlisted airmen working in the war zone. Many lacked basic combat skills and instincts. Some didn't know how to handle and load their weapons. A few even had their guns taken away as a safety precaution.

Within months, the high command mandated an overhaul of Air Force basic military training, which has been conducted here since 1942. Officials now say they've imposed the most dramatic changes in 60 years in the training's tone and curriculum.

Chief among them is a new, time-consuming emphasis on "warrior ethos," making every airmen capable of self defense in a service with a reputation for being removed from the front lines. The 38,000 trainees per year now spend less time learning to fold T-shirts so they can spend more time learning to wage war.

With 46 deaths recorded among airmen in Iraq — many of them in ground combat roles — trainees are embracing the new approach as a way of improving their survival chances in their almost-certain deployments to the war zone.

We're introduced to a couple of the newest trainees (classes began in November); after three weeks, one 19-year old airwoman is now confident in firing her M-16A2 training rifle. The only other weapon she'd ever fired up to that point was a BB gun.

That's more exposure to weapons than trainee Amanda Reed of Burlington Township, N.J., had before arriving for basic training, which now features rifle-handling from the outset. "I'm getting used to it. We still haven't fired them — we do that next week," she said. Her family wasn't aware of the new push for combat training, but "when I told them I was learning to use an M-16, my younger brother was very enthusiastic about that."

Like many recruits, Reed joined the Air Force with the notion that it wouldn't be as perilous as other service branches. "I still think that the Air Force isn't as dangerous as the Army or Marines," Reed said.

On his last day in basic, Alex Gaines, 20, of Portage, Ind., said he's ready to move on to training in electronics, but he's prepared to use combat skills if required. The former fast-food worker said he benefited greatly from the grueling training. "I have a lot more confidence, a lot more discipline. We learned how to work as a team," although it was tough initially, he said. "The first couple of weeks, we were like, 'What have we gotten ourselves into?' After that, it didn't get easier, but you adjusted to it," Gaines said. "They (instructors) pretty much want to see if they can break you down."

Trainee Jose Castro, 19, of Little Rock, Ark., agreed. "You try your hardest to do everything right and they just never gave you enough time to actually do it right or finish it. I guess that was the whole point, to stress you out. That's what was hardest for me," he reflected, on the eve of graduation.

As the first in his family to join the military, Castro said his decision wasn't embraced. He portrayed the Air Force as a relatively safe experience to win his family's support. "That's what I actually explained to my mother to make her at least accept it, because she wasn't too happy with it," Castro said.

Trainee Amber Huber, 21, a former waitress and bartender from Alma, Wis., said combat scenarios were among the toughest ordeals. "Once you get used to that, it's not bad," Huber said.

It's a bit of a bait and switch; but, our armed forces being what and who they are rise to the occasion time and again. Some Air Force stats are given:

Women make up 1/4 of the Air Force
Minorities make up 1/3
Average age of new enlistees, 20.2 years
1/4 have some college or a degree
Shortest basic training of all branches (will be increased by 2 weeks next year)
800 new trainees arrive weekly
93% will make it through basic training
84% complete that training in the standard 6 1/2 weeks

Go ahead and read the rest of the article to get a feel for what an average day of this branch's basic training is like; I'll close out our look at the Air Force with this quote:

"Now we're doing war skills training up front. We're prepping to deploy. What we did was shave off as much time as we could from the airmanship skills, and we put that into war skills training," the commander said.

A tad unnerving of a consideration.

Of course, if Air Force service members must be placed into combat roles, they need to get the proper war skills training. But stating it in terms of reducing the airmanship skills of an airman and replacing them with combat skills sounds to be a great loss in many ways.

The blending of the roles of our military branches seems to be a significant marker, a significant change in our modern military. As with traditional Guard and Reserve roles, the Air Force is quickly learning there are no longer clear lines of separation from one branch of service to the next: they're all in the Army now.

But the Air Force isn't the only branch of the military remolding itself -- the Navy is, too. Let's take a glimpse at some of the changes happening in that branch via this weekend's Norfolk Virginian-Pilot:

At 9 a.m. on a normal weekday, Lt. Jon French would be checking his e-mail, refilling his coffee cup and probably offering legal advice to a Norfolk sailor. Instead, the Navy lawyer, 28, spent Thursday morning crowded into the back of a truck with a dozen other Kevlar-clad troops, cradling an M-16, his eyes scanning the woods of this Army training base for "insurgents."

French, who works at Norfolk Naval Station's trial services office, left normal behind in December, when he agreed to go to Iraq so his married colleagues didn't have to leave their families . For the next year, French will work with Task Force 134, helping Iraqi lawyers and judges prosecute insurgents rounded up by U.S. forces. "It never occurred to me that I would ever be in combat boots with a rifle," said French, who joined the Navy while he was at Gonzaga University School of Law. "Anybody who's in uniform has to be ready to answer the call when it comes, and it did this time."

That call is coming for more and more sailors. Adm. Mike Mullen , the chief of naval operations, has told his ranks that the Navy will step up its contribution to the war on terror by increasing the number of "individual augmentees" filling support roles in Iraq and Afghanistan.

Unfortunately, the downside here is that by tapping people not originally intended for these types of deployments creates a problem or two. The work and position they've left behind remains unfilled. More importantly, however, family members of these "individual augmentees" (or IAs) are left to deal with the stress of deployment on their own.

Unlike what's been built up over decades in the Army and the Marines, what's lacking in the other branches is a support structure to help these families navigate smoothly through this unusual -- and generally unplanned for -- event. Air Force, Reserves, Guard, Navy...they're all going to have to find a way to deal with this new reality because it's here, and it doesn't look to be going anywhere anytime soon.

In March, the Navy cut orders for more than 900 sailors to leave their posts for Middle Eastern combat zones. An additional 400 were tapped in April, said Rear Adm. Daniel Holloway , one of the Navy's top personnel officers. Overall, about 11,000 sailors are on the ground in the Middle East, said Navy spokesman Lt. Trey Brown . That includes mobilized reservists, augmentees and Navy units. That number has steadily increased since the United States invaded Afghanistan and Iraq, he said.

The increased commitment to sending individual augmentees into harm's way led the Navy to develop a two-week training program at Fort Jackson. The base in South Carolina's capital also puts Army recruits through basic training and gives refresher training to retired soldiers called back to active duty.

Before the classes began in January, Navy augmentees trained at Fort Bliss, Texas, or Fort Benning, Ga., where some deploying Navy units go to brush up on combat skills. It's like fast-track basic training, without the marching and in-your-face discipline. The sailors here learn to shoot machine guns, clear a building, frisk enemy prisoners of war and toss grenades.

Fast-track training? Although this isn't something I've looked into yet (but, certainly have plans to), I hope our Naval (and Air Force) troops aren't being short-changed along with fast-tracked.

After 25 years on ship and shore duty, Chief Warrant Officer Mark Rees is headed to Afghanistan, where he'll work with an Army unit training Afghan police. It's a big change for someone who specializes in the Aegis weapons system and had been serving aboard the destroyer James E. Williams .

Rees, who lives in Suffolk, said the physical adjustment of operating with a helmet, body armor and rifle has been his biggest challenge. "I don't normally carry an M-16. On a ship, I carry a pen and a notebook, and I write things down," Rees, 42 , said during a break from drills. "Every kid, I think, plays Army," he said. "Doing it this late in life, with real people shooting at you, may not be the smartest thing."

His wife is not enthused about his next tour, but Rees is being a good sport. "In my opinion, if we can help the Afghans, it's a good thing," he said, "if they want the help."

Rees and Chief Warrant Officer Chris Logan of Virginia Beach have had about a month to prepare for their new task.

Logan, a father of three, had been working at the Navy-Marine Corps Warfighting Intelligence Center at the Fleet Combat Training Center at Dam Neck when he got a phone call five weeks ago telling him he was on a short list to go to Afghanistan.

It wasn't a surprise. With his experience in intelligence, Logan figured he'd get tapped. He's happy he'll be working alongside Army personnel and that it's a six-month tour instead of a year. "I'd rather take directions from an Army guy on the ground than a Navy guy," Logan said. "Not that a Navy guy isn't competent, but they're more experienced," he said, referring to the soldiers.

That last quote goes back to the concern I raised earlier -- a solid point that needs to be considered as we continue down this road of expecting all branches to be ground war capable.

Brig. General James H. Schwitters , the commanding general of Fort Jackson, said the most important thing for sailors to learn is "operational awareness" -- knowing what to look for and what not to do if a fight breaks out around them. Schwitters, who last year finished a tour in Iraq helping to set up that country's army, said he worked with individual augmentees from other U.S. military branches and saw for himself they needed more training for emergencies.

He isn't worried about soldiers mistrusting the sailors who serve alongside them. "I'm not naive enough to think there aren't individuals who would feel that way," Schwitters said while at the training site, "but that almost never becomes a problem."

The drill sergeants took a few good-natured jabs at their Navy charges but said they're impressed by the attitude of the sailors, who are about evenly split between active and reserves.

Though the sailors are good-natured and interested in succeeding in their changing roles (they're in the 'Narmy' now, they say), their new responsibilities demand an increased awareness and ability to quickly react to situations they have until recently not been physically and mentally trained for.

For Cmdr. Bill Kern, the training and his upcoming tour in Iraq are a chance to combine academics and life experience. Kern teaches military strategic studies at the Air Force Academy in Colorado.

Thursday, Kern learned the hard way that teaching tactics and carrying them out are two different things. Acting as leader of a group of 15 sailors on a convoy exercise, Kern ran into all sorts of trouble when the "fog of war" descended in the form of a simulated attack.

His sailors were supposed to dismount and take cover in the woods, but instead of fanning out as they'd practiced, they clumped too close together. Half the group abandoned the right side of the truck and traipsed to the left, leaving the vehicle open to attack. Kern lost track of the radio operator who was supposed to stay by his side.

Through it all, the drill instructors quietly prodded Kern and his team: "Where's your radio?" "Leapfrog back and maintain security." "Get behind a tree. Not a skinny tree. Something that's going to stop a bullet."

When the exercise ended, Kern and at least seven of his team members had their helmets off -- a signal that the insurgents had "killed" them. Kern was brutally honest when the drill instructors asked him during a debriefing what his team did well. "It's a short list," he said, blaming himself for many of the lapses. "All the things we were taught, we weren't employing," he said. "We just kind of ran around willy-nilly."

French, the lawyer, was one of the bareheaded sailors. He and four teammates were ambushed as they rushed around a building. It was just a drill, and he hopes he won't see anything close to combat when he's in Iraq. Still, the experience left him with a sinking feeling. "When you come around the corner and see a guy standing there and you try to raise your weapon and you don't and your whole team dies, ..." French said, his voice drifting off. "There's so much to pay attention to."

My hopes are that both the Navy and the Air Force -- if they absolutely must place their service members into on-the-ground combat roles -- will continue to test and strengthen their training for these service members. It will ensure their own safety, as well as the safety of those they serve with.

Please consider thanking the Houston Chronicle and Norfolk's Virginian-Pilot for their coverage of this important development in the way our modern military is undergoing such a breathtaking metamorphosis.

Related
PTSD Statistics, WWII to Iraq

Labels: afghanistan, airmen, combat, deployment, iraq, military, navy, shortfalls, stats, tempo, training

Military Chaplain: Different War, Different Stress

What are some of the differences between this war and others that have been fought in the past, and how do those differences add to or subtract from the possible after effect known as posttraumatic stress disorder? One military chaplain answered these questions recently. Although the report is a few months old, the information is still timely and relevant.

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From the American Forces Press Service:

Chaplain: Different War Imposes Different Stresses
By Jim Garamone

FORWARD OPERATING BASE LOYALTY, Iraq, Dec. 18, 2005 – A different kind of war produces different kind of stresses on the servicemembers fighting it, said the 2nd Brigade Combat Team chaplain here. But recognizing those stresses enables the soldiers of this 3rd Infantry Division unit to begin to deal with them, said Chaplain (Maj.) Peter Brzezinski.

Brzezinski, a Presbyterian minister, called uncertainty the greatest stress to the brigade's troops. "Every time you go out the gate, there is the chance that something will happen," he said.

Brigade soldiers work with Iraqi security forces but also patrol East Baghdad on their own. Soldiers moving off the FOB stand the chance of being engaged by suicide bombers, suicide car bombers and small-arms fire. Improvised explosive devices are the big killers in this war, and enemy fighters are constantly changing their tactics and procedures. A route near the FOB has a reputation for being laced with IEDs. "I know it's stupid, but every time I go on (the route), I keep wondering if this is the last thing I'll see," said one soldier.

Soldiers here operate far differently than in 2003, during their initial run up to Baghdad at the beginning of Operation Iraqi Freedom. The rules of engagement are far more restrictive, as troops recognize they need to be. In many cases, the soldiers are working in jobs they never received formal school training to carry out. For example, field artillerymen work as infantrymen and air defense artillery soldiers, as military police. "They've done very well in these new jobs," Brzezinski said. "This is a great, flexible force, but it does provide stress."

Even soldiers on the FOB have combat stress uncertainty. Rocket and mortar attacks, while rare, are a possibility. On the FOB, people don't even look up when they hear the occasional rifle or machine gun fire off base.

Uncertainty in an institutional sense also contributes to the problem, the chaplain said. Army researchers who did a survey at the FOB found the lack of predictability in deployments to be the greatest concern to soldiers. "If the Army could say, 'you will be home for this period and then on this date you will deploy,' the soldiers would be much happier," Brzezinski said. "Not knowing is a stressor on the troops."

Access to the Internet and efforts at Fort Stewart, Ga., the brigade's home, help reduce concerns about family, the chaplain said. The FOB's Internet Café, which enables soldiers to stay in touch via e-mail, Web cams and instant messaging, is packed at all hours. "Of course, if there is an incident here, then the infrastructure here is quickly overloaded," he said.

Also helping reduce stress is a sense of accomplishment. Brigade soldiers feel they are doing a good job with the Iraqi security forces and see daily progress in the region around their base, the chaplain said. "And everyone here is very proud of the way the elections went," he said. "When you feel good about your mission, you can put up with a lot."

The brigade's year-long deployment is drawing to a close. The 506th Brigade Combat Team from Fort Campbell, Ky., is replacing the 2nd Brigade. While the 506th is part of the 101st Airborne Division-remembered as the "Band of Brothers" of World War II and for operations at Hamburger Hill in Vietnam--it will serve as part of the 4th Infantry Division.

As the brigade goes home, the chaplain will work with unit commanders and top NCOs to make sure the soldier's reintegration with their families goes smoothly. The unit will arrive back in Georgia, reunite with their families, go through a week-long decompression routine, then start a month of block leave. "Then we will come back and begin the process all over again," Brzezinski said.

Posted in its entirety for educational purposes.

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Sunday, April 23, 2006

The Fighting Never Ends: One Returning Veteran's PTSD Saga

Today's Fort Worth Star-Telegram reports on one recently returned Iraq veteran's struggle with posttraumatic stress disorder. After serving a 14-month tour in Iraq, Jacob Hounshell ("a private first class in a scout platoon who was cited for his quick thinking during battle") went AWOL as he struggled to fight suicidal demons and nightmares; his parents stepped in to stem their son's downward spiral. Living in a small town, their personal struggle became political as they went public with their problems.

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From the Fort Worth Star-Telegram:

"I have a few bad days, but I take them as they come, and I've learned to deal with it," he said. [Jacob] Hounshell, 21, who went AWOL from the Army after a 14-month tour in Iraq, is trying to start over, free from the military service that he said was a constant reminder of his one-time mental problems and fractious run-ins with his Army command.

The Army discharged him this month, 14 months early from his four-year enlistment, after he finished a monthlong jail sentence. "I'm happy as hell," the Brownwood man said. "I can go on with my life." ...

[T]he military has started a number of programs to help soldiers adapt to life back home after being in a war zone for a year at a time.

Rare, though, is the family that opens the door to its life the way the Hounshells did last May, when Bobbie and Larry Hounshell called the Star-Telegram because they didn't know anyone else to call. The Star-Telegram profiled them in a front-page story in June.

Jacob Hounshell, a private first class in a scout platoon who was cited for his quick thinking during battle, had gone AWOL from his unit at Fort Hood with his parents' help. He was suicidal, angry and emotional, and he couldn't sleep.

He and his family said that his commanders were indifferent to his problems and that the highly touted mental-health programs were not helpful. The Army denied both accusations. "We're not trying to hurt our soldiers overseas, and we didn't want this fight with the Army," his mother said at the time. "But my son had problems when he came home, and all he was told was, 'Drive on.'"

In a small town, the Hounshells paid a price for going public. They said many people shunned them, made hateful phone calls and were quick to judge.

Eventually Bobbie Hounshell wrote a letter to the editor of the local newspaper, asking for understanding from a mother who couldn't say "that we were right or we were wrong. It is a decision based on love and emotion."

Where to begin with this?

Why exactly would this family have to be on the receiving end of this type of public backlash? Ah, the Politics of PTSD which says that our soldiers should be silent and problem-free lest their cries for help provide aid and comfort to the enemy. Could that be part of it?

For nine months, Jacob Hounshell stayed at his house in Brownwood, eventually finding a steady job. In February, he learned that a federal warrant was about to be issued.

That day he drove to Fort Hood and surrendered. Reassigned to his old unit, he reported for duty to a different commander and first sergeant, who he said treated him respectfully. He said that he was offered counseling by Army psychologists but that he declined because he had already soured on the system. "I just wanted to deal with it like I had been," he said.

In a summary court-martial in early March, an officer found Hounshell guilty of being absent without leave. The officer sentenced him to 30 days, to be served in the Bell County Jail.

It was the maximum punishment for a private first class.

Please read the rest of the article; and feel free to contact the Star-Telegram to let them know you appreciate their coverage of this issue.

[Jacob's story previously covered in 20 Years Old and Destroyed By War and PTSD.]

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Labels: disillusion, incidents

Sebring, OH: Community Returning Veteran PTSD Program

Little Sebring, OH is gearing up to offer its returning veterans a program of great importance. Robert Roerich, MD and Darla Hough have received approval from the local American Legion to use their space and resources for the first veteran and veteran family support group, tentatively called Veteran Freedom Fighters of America. Kick-off meeting is on Wednesday, May 10, 2006 from 7-9 p.m. All veterans and military family members are encouraged to participate in this program which will meet the 2nd Monday of every month (with an option to have additional meeting and support groups to be determined by its members). Contact 'Doc' Roerich if you have any questions.

Click on 'Article Link' below tags for map and directions, agenda, etc...

Sebring is a village of approximately 5,000 people in Mahoning County of northeastern Ohio. It is 5 miles east of Alliance, Ohio and 10 miles west of Salem, Ohio. I'm pleased to share preliminary details of their inspiring Veteran Freedom Fighters of America program (please check back for any additional updates as I receive them):

WHEN?

Kick-off meeting is on Wednesday, May 10, 2006 from 7-9 p.m. All veterans and military family members are encouraged to participate in this program which will meet the 2nd Monday of every month (with an option to have additional meeting and support groups to be determined by its members).

WHERE?

American Legion Post #76
395 W California Ave
Sebring, OH 44672

Click on above image for GoogleMaps directions. Or phone the American Legion at (330) 938-9082.

MISSION STATEMENT?

The Veteran Freedom Fighters of America (VFFA) support network was founded by a veteran’s wife and a psychiatrist who saw a growing need to provide a community based support network for our returning military back from Iraq and their families. With many veterans experiencing increased stress in the aftermath of war, a critical need was identified to help heal the unseen wounds of war by providing timely support. It takes a village to help our warriors transition from military to civilian life free of the social stigma of suffering from mental health problems such as anxiety, depression, Post Traumatic Stress Disorder (PTSD) and suicidal or homicidal acts.

A key component of fighting for mental peace of mind is knowing when there is a problem in relationships with friends and family. VFFA will help veterans and families fight for themselves, armed with knowledge of what problems can occur. The support group will not judge or stigmatize anyone but provide a nurturing, healing environment in order to truly return home.

AGENDA?

I. Welcome by Darla Hough and Robert Roerich. Introductions among attendees of the meeting.

II. Informal discussion and timeline of what problems can occur with returning military and their families. Feedback of what members have experienced if they wish to share with the group.

III. Survey of what resources group members would want in the group, which may include:

Printed and digital information handouts on depression, PTSD, and suicide for personal use.
Distribution of a support group work book for member’s use.
Information on problems with spouse or significant other and children affected by a veteran with PTSD.
Stress management
Anger management
Resource manual for families on financial assistance, filing disability claims from the VA, health care and referrals to outpatient, hospital and crisis hotlines.
Setting up peer and family support groups with group facilitator.
Social activities and group functions, fund raisers, grant applications.
Outreach and networking with others at the local, regional, state and national level to set up veteran and veteran family support networks.
CONTACT?

American Legion Post #76 will send out an invitation to their members in their newsletter informing them of their support in setting this veteran and veteran family community support network. A Salem, Ohio newspaper and others may also run a news story about this.

It is not necessary to contact anyone before coming, but if there are questions about the support network, 'Doc' Roerich will post about it on www.roadmind.com which has an announcement about this meeting. Additionally, you may contact the American Legion at (330) 938-9082 for directions or email 'Doc' at Roadmind University if you have any questions.

As the VA struggles to meet the increasing needs of our returning troops (alongside taking care of the those who've served in prior eras) more and more local and state efforts are being made to reach out and offer assistance. Programs like the one started up in Sebring, OH are vital to augment programs offered by the VA, providing yet another option and safety net for our returning troops and their families.

As Dr. Roerich says, "With the VA overwhelmed, understaffed and underfunded, getting the word out on the grass roots effort of concerned citizens and families to set up community based support networks in every hometown in America."

Other local communities are pitching in to help their returning troops in targeted and unique ways including those found in Minnesota, Oregon, and New Jersey and Philadelphia to name a few.

Kudos to them all. And here's to seeing more of this kind of thing pick up steam!

Labels: anger, community, counseling, events, family, homecoming, local, reintegration, society

Saturday, April 22, 2006

Army: 83 suicides in 2005, 67 in 2004

The news splashed across our television screens and our newspapers today: the Army reported its suicide rate figures yesterday. Although our armed forces have been increasingly working to ensure their troops receive mental health/stress support, the rate has still inched upwards to levels not seen since 1993. The data is heartrending.

If you're having trouble coping and are contemplating suicide, please get help.

Click on 'Article Link' below tags for more...

From the Associated Press:

In 2005, a total of 83 soldiers committed suicide, compared with 67 in 2004, and 60 in 2003 — the year U.S.-led forces invaded Iraq. Four other deaths in 2005 are being investigated as possible suicides but have not yet been confirmed. The totals include active duty Army soldiers and deployed National Guard and Reserve troops.

“Although we are not alarmed by the slight increase, we do take suicide prevention very seriously,” said Army spokesman Col. Joseph Curtin. “We have increased the number of combat stress teams, increased suicide prevention and training, and we are working very aggressively to change the culture so that soldiers feel comfortable coming forward with their personal problems in a culture where historically admitting mental health issues was frowned upon.”

Although the Army may not be alarmed, any military family member who has to go through this certainly is. Even one loss is too many. Although the suicide rate is not at an all-time high, the fact that it's creeping up even in the face of targeted measures implemented to stem the tide should be alarming -- even to the Army.

The suicide rate for the Army has fluctuated over the past 25 years, from a high of 15.8 per 100,000 in 1985 to a low of 9.1 per 100,000 in 2001. Last year it was nearly 13 per 100,000.

The Army recorded 90 suicides in 1993, with a suicide rate of 14.2 per 100,000. The Army rate is higher than the civilian suicide rate for 2003, which was 10.8 per 100,000, according to the National Centers for Disease Control and Prevention. But the Army number tracked closely with the rate for civilians aged 18-34, which was 12.19 per 100,000 in 2003.

In the summer of 2002 a series of murder-suicides took place in quick succession at Fort Bragg after the base returned from Afghanistan; the incidents received much publicity at the time (and can be found as the first entries in the PTSD Timeline). Then, in the summer of 2003, there was an alarming increase in suicides in Iraq.

Since then, the Army has increased the number of mental health professionals and placed combat stress teams with units. According to the Army, there are more than 230 mental health practitioners working in Iraq and Afghanistan, compared with “about a handful” when the war began, Curtin said. Soldiers also get cards and booklets that outline suicide warning signs and how to get help.

But at least one veterans group says it’s not enough.

“These numbers should be a wake-up call on the mental health impact of this war,” said Paul Rieckhoff, executive director of the Iraq and Afghanistan Veterans of America. “One in three soldiers will come back with post traumatic stress disorder or comparable mental health issues, or depression and severe anxiety.”

Rieckhoff, who was a platoon leader in Iraq, said soldiers there face increased stress because they are often deployed to the warfront several times, they are fighting urban combat and their enemy blends in with the population, making it more difficult to tell friend from foe. “You don’t get much time to rest and with the increased insurgency, your chances of getting killed or wounded are growing,” he said. “The Army is trying harder, but they’ve got an incredibly long way to go.”

He added that while there are more psychiatrists, the soldiers are still in a war zone, “so you’re just putting your finger in the dam.”

If you'd like to learn more about suicide, take a look at the Center for Disease Control's Suicide: Fact Sheet.

Important info from the American Association of Suiciology:

UNDERSTANDING AND HELPING THE SUICIDAL PERSON

Be Aware of the Warning Signs

Are you or someone you love at risk of suicide? Get the facts and take appropriate action. Get help immediately by contacting a mental health professional or calling 1-800-273-8255 for a referral should you witness, hear, or see anyone exhibiting any one or more of the following:

Someone threatening to hurt or kill him/herself, or talking of wanting to hurt or kill him/herself.
Someone looking for ways to kill him/herself by seeking access to firearms, available pills, or other means.
Someone talking or writing about death, dying or suicide, when these actions are out of the ordinary for the person.
Seek help as soon as possible by contacting a mental health professional or calling 1-800-273-8255 for a referral should you witness, hear, or see someone you know exhibiting any one or more of the following:

Hopelessness
Rage, uncontrolled anger, seeking revenge
Acting reckless or engaging in risky activities, seemingly without thinking
Feeling trapped - like there's no way out
Increased alcohol or drug use
Withdrawing from friends, family and society
Anxiety, agitation, unable to sleep or sleeping all the time
Dramatic mood changes
No reason for living; no sense of purpose in life
What To Do

Here are some ways to be helpful to someone who is threatening suicide:

Be direct. Talk openly and matter-of-factly about suicide.
Be willing to listen. Allow expressions of feelings. Accept the feelings.
Be non-judgmental. Don’t debate whether suicide is right or wrong, or whether feelings are good or bad. Don’t lecture on the value of life.
Get involved. Become available. Show interest and support.
Don’t dare him or her to do it.
Don’t act shocked. This will put distance between you.
Don’t be sworn to secrecy. Seek support.
Offer hope that alternatives are available but do not offer glib reassurance.
Take action. Remove means, such as guns or stockpiled pills.
Get help from persons or agencies specializing in crisis intervention and suicide prevention.
Be Aware of Feelings

Many people at some time in their lives think about completing suicide. Most decide to live because they eventually come to realize that the crisis is temporary and death is permanent. On other hand, people having a crisis sometimes perceive their dilemma as inescapable and feel an utter loss of control. These are some of the feelings and thoughts they experience:

Can’t stop the pain
Can’t think clearly
Can’t make decisions
Can’t sleep, eat or work
Can’t get out of depression
Can’t see a future without pain
Can’t see themselves as worthwhile
Can’t get someone’s attention
Can’t seem to get control
If you experience these feelings, get help!
If someone you know exhibits these symptoms, offer help!

Contact:

A community mental health agency
A private therapist or counselor
A school counselor or psychologist
A family physician
A suicide prevention or crisis center

If you need immediate help, please get it:

Nat'l Veterans Foundation Help Line
1-888-777-4443 (M-F 9-9 Pacific)
Email help also available from NVF

Military OneSource - DOD contracted
1-800-342-9647 in USA (24/7)
1-800-3429-6477 outside of USA

NY/NJ Veterans VA Nurses Helpline
1-800-877-6976

Gulf Coast VA Medical Center Hot Line
1-800-507-4571

Suicide Hotlines
1-888-649-1366
1-800-SUICIDE
1-800-784-2433

Suicide Help Online
http://www.hopeline.com
http://www.spanusa.org

Miles Foundation - Domestic Violence
1-877-570-0688

National Coalition for Homeless Vets
1-800-VET-HELP

Veterans of the Vietnam War
1-800-843-8626

Labels: army, stats, suicidal

Storming Washington: Veterans March to the Capitol

As veterans from across the country descend upon Washington, D.C. next week and take part in Veterans March 2006, I thought I'd share a quick story with you today on a few who are taking part (click on 'Article Link' below for that).

If you're going to the event (taking place April 24-26), you can find all the information you need (including program itinerary, guest speakers, lodging help, maps and directions, etc.) online at www.vetmarch2006.net. Resources for those of us who unfortunately can't be a part of this: Catch streaming online coverage beginning at 0900 on Tuesday morning; or tune in to Stardust Radio's coverage. Go, vets, go!

Click on 'Article Link' below tags for more...

From the Times (out of Northwest Indiana). Reprinted in its entirety for educational purposes:

One bishop is headed to Washington D.C., where he will join thousands of veterans lobbying for veterans' rights. James Wilkowski, Evangelical Catholic Bishop for the Diocese of the Northwest, said social justice is a moral obligation. He wants to encourage the government to take better care of those who have served. Wilkowski represents Indiana, Illinois, Wisconsin and Michigan. Wilkowski, whose home church is Holy Family Church in Chicago, will be one of many keynote speakers at the march. He will also serve as the chaplain for the event.

Veterans March 2006 will be April 24, 25 and 26. Wilkowski said about 10,000 will march. Dale Peters, Republican head of the Veterans of Progress in Illinois, also will participate in the march. "We have served and we are treated like second class citizens," said Peters, Darien, Ill., resident. "Every veteran is my brother."

Peters said he will march with thousands of other veterans to support those who have served and experienced what conflict is like firsthand. "(Post Traumatic Stress Disorder) is a real disease. American children are taught not to kill and then they see this stuff," Peters said. "Our health care has dropped. Our wounded troops are not being taken care of."

Wilkowski said his intent is to do what is necessary to help veterans. He is asking the community to send him letters that he hopes to present to government officials in Washington. "I want to personally present these letters to the Secretary of Veteran Affairs," Wilkowski said. "There is sort of an indifference within the American public regarding the needs of veterans. It's really time for us to defend the defenders."

Wilkowski said he wants to provide a voice for those who have died serving their country. He said cutbacks on veteran benefits impact everyone who has served, particularly the aging population. "Sadly, I think our veterans are always on the bottom of the priority list. What we are finding is that the VA and the government is cutting back," Wilkowski said. "I think we need to start getting our priorities realigned."

Wilkowski encouraged all community members, whether they are veterans or not, to write letters regarding the importance of providing health care to veterans. "Please take ownership of the issue of veterans in our country," Wilkowski said. "Please embrace the needs of our veterans because we have what we have thanks to them."

Although I can't be there physically, I'm there in spirit with you all. All of my best for a successful petitioning of our government!

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Thursday, April 20, 2006

Madison, WI: Combat PTSD Art Therapy Program

If you're in the Madison, WI area, you're invited to a limited engagement exhibit, The Art of War: Trauma, Healing & the Vietnam Veteran through July 10, 2006. The exhibit features artwork loaned to the Wisconsin Veterans Museum by the National Vietnam Veterans Art Museum of Chicago which "highlight not only the Vietnam experience, but also how veterans have dealt with the trauma of war." A free PTSD art therapy program is also scheduled for May 2, 2006.

Click on 'Article Link' below tags for details and directions...

First, the art therapy program details:

In conjunction with the "The Art of War: Trauma, Healing and the Vietnam Veteran," the Wisconsin Veterans Museum will offer a program on the use of art therapy to assist with post-traumatic stress disorder on Tuesday, May 2, at 7 p.m. in the museum's education center on the second floor. Dr. Dean Krahn from the Middleton Memorial Veterans Hospital will discuss the topic. The program will include art from current hospital patients.

The museum, an educational activity of the Wisconsin Department of Veterans Affairs, is at 30 W. Mifflin St. on the Square. Hours are 9 a.m. to 4:30 p.m. Monday through Saturday and noon to 4 p.m. Sundays. For information, call 608-264-6086.

Some more Art of War event information and details:

A war veteran once said, "If you don't know any history it's as though you're born yesterday." And today the quote's scariest implications, being a naked babe in battle, unarmed with experience, are compounded by Vietnam veterans' reality: Their experience-weighted voices, and art, may be their most important weapons today.

We need such weapons because these survivors understand what it was like and how to fight a guerrilla war such as Iraq. Part of the problem may be a repressive psychosis -- it's all too easy to dismiss the Vietnam War as a national nightmare. "Were it not for my pictures, I could easily have convinced myself I was never there," marvels Army still photographer James McJunkin, in an artist's statement from a new show of almost hallucinatory potency, "The Art of War: Trauma, Healing and the Vietnam Veteran," at the Wisconsin Veterans Museum through July 10.

Location: 30 W. Mifflin Street (on the Square), Madison, WI
Museum hours: 9 a.m. to 4:30 p.m. Monday through Saturday, noon to 4 p.m. Sundays.
More information: 608-264-6086.

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Wednesday, April 19, 2006

Outstretched Hands: Organizations Helping Our Veterans

Yesterday, I received this email:

The father of a good friend just died, and a group of us would like
to make a donation in his memory. My friend says he was active in
veteran's affairs (American Legion I think), so I thought that an
organization helping returning Iraq vets would be a good place to
start. Any suggestions?

I've been meaning to get a post up on just this topic for some time. What better time than now?

Click on 'Article Link' below tags for some of my favorite charities...

We're all interested in making sure that the funds we decide to donate get the most bang for their buck. The following organizations directly help our veterans -- each in their own way -- with very little waste. Your support goes directly where it's needed: to our troops/veterans and their families.

Without further delay, here are a few of my favorites:

Gift from Within
A non-profit organization dedicated to those who suffer post-traumatic stress disorder (PTSD), those at risk for PTSD, and those who care for traumatized individuals; develops and disseminates educational material, including videotapes, articles, books, and other resources through its website; maintains a roster of survivors who are willing to participate in an international network of peer support; is designated by the Internal Revenue Service as 501(c)(3) public charity, eligible to receive tax-exempt grants, gifts, and donations.

Donate online via PayPal button, or send a check by mail:

Gift from Within
16 Cobb Hill Rd.
Camden, Maine 04843

Fisher House
Because members of the military and their families are stationed worldwide and must often travel great distances for specialized medical care, Fisher House™ Foundation donates “comfort homes,” built on the grounds of major military and VA medical centers. These homes enable family members to be close to a loved one at the most stressful times - during the hospitalization for an unexpected illness, disease, or injury.

There is at least one Fisher House™ at every major military medical center to assist families in need and to ensure that they are provided with the comforts of home in a supportive environment. Annually, the Fisher House™ program serves more than 8,500 families, and have made available more than two million days of lodging to family members since the program originated in 1990. Based on a comparison of fees at a Fisher House™ (the average charge is less than $10 per family per day, with many locations offering rooms at no cost) with commercial lodging facilities in the same area, it is estimated that families have saved more than $60 million by staying at a Fisher House™ since the program began.

Contribute online or send your contribution to:

Fisher House™ Foundation, Inc.
1401 Rockville Pike, Suite 600
Rockville, MD 20852

Operation Homefront
A nonprofit committed to helping to ease the burden of military families left behind during times of war, Operation Homefront makes it easy to help in a real and tangible way by purchasing groceries for our military families who have members actively serving overseas. Buy a bag or groceries for them by purchasing commissary gift certificates in denominations of $10 or $25.

Purchase online or mail a check off to:

Operation Homefront
South Coast Plaza Village
1631 W. Sunflower Ave. Suite C-34
Santa Ana, CA 92704

Angel Flight for Veterans
This nonprofit works to provide long distance transportation for Veterans in need of Medical care. Their aim is to ensure that no financially-needy veteran / active duty military person or their family member(s) is denied access to distant specialized medical evaluation, diagnosis, treatment, or rehabilitation for lack of a means of long-distance medical air transportation. Patients needing help call the National Patient Travel HELPLINE at 1-800-296-1217.

Donate online or mail a check to:

Angel Flight for Veterans
4620 Haygood Road, Ste. 1
Virginia Beach, VA 23455

Homes For Our Troops
Provides handicap accessible homes for our severely wounded Veterans. Homes for Our Troops is a 501 (c)(3) nonprofit organization strongly committed to helping those who have selflessly given to their country and have returned home with serious disabilities and injuries. They assist injured service men and women and their immediate families by raising donations of money, building materials and professional labor and coordinating the process of building a new home or adapting an existing home for handicapped accessibility. With the growing network of professionals in the building industry, building material manufacturers, and generous donors from across the USA, Homes for Our Troops is able to provide this service at little or no cost to the veteran.

Donate online or send your contribution by printing this mail-in form.

Quilts of Valor
The mission of the QOV Foundation is to cover ALL combat wounded servicemembers whether physical or psychological with wartime quilts called Quilts of Valor (QOVs). The wounded servicemembers from the War on Terror or Long War are to be considered first and foremost. The second mission is to teach our children how to sew QOVs. This skill will teach sewing skills in addition to becoming civically involved and volunteering for the betterment of our nation. A natural extension of our mission will be to link up with our coalition countries and see that their combat wounded are also covered. When all is said and done what we are doing is providing a means by which our combat wounded can have a better life. This foundation will do whatever it takes to reach this goal. Tax deductible donations via their site or by mail in the forms of cash, fabric, supplies and other needed items. Email or phone Catherine at cc.roberts@comcast.net or via phone at 302.236.0230 for more information on how you can help.

Donate online via PayPal Button.

Well, there are a lot more doing outstanding work for our veterans; so, I invite you to add any of your favorites in comments.

And a thank you goes out to the person who emailed me yesterday with the question which inspired this post. The thanks is not only for getting me motivated, but for the actions your social circle is taking. What better way to honor this man's life and work with the American Legion, than by carrying onward his life's mission beyond the time that he had with us on earth?

My condolences to your friend's family. And thanks for writing...

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Tuesday, April 18, 2006

County Veterans Service Offices Swamped

We hear a lot about the influx of veterans seeking out health care from the VA; but, what about other organizations set up to provide assistance to our vets? How are they dealing with the crunch? Today's Minneapolis-St. Paul Pioneer Press tells us how things are going in our county veterans service offices -- both in Minnesota and in neighboring Wisconsin (and we can imagine the same can be seen across other states as well). A few stats, a few explanations, and a few stories in this informative piece.

Click on 'Article Link' below tags for more...

From the MSP Pioneer Press:

Artillery fire continues to reverberate for the former [Vietnam-era] Army specialist: [Dennis] Molick has tinnitus, or ringing of the ears, a common affliction of veterans. The condition prompted Molick to visit his local Veterans Service Office in Anoka County — one of several Twin Cities offices handling a burgeoning number of veteran requests for everything from health problems to burial arrangements to vocational help. "We're seeing record numbers of people coming in to access these types of things," said Duane Krueger, director of the Veterans Service Office in Anoka.

Since 1999, the number of client visits to Krueger's office has almost tripled, and the two-person staff saw 31 people on March 31, a one-day record. Late last month, Krueger asked for and received from the County Board the OK to hire another person. Other counties report similar increases. "There shouldn't be an office that isn't busy right now, especially in the metro area," because of the large population of veterans here, said Jon Larson of the Washington County Veterans Service Office. "We never get caught up here."

Provided and paid for by each individual Minnesota county, these Veterans Service Offices fulfill an important role in a local community.

[T]hey assist veterans and their survivors in applying for medical benefits, filing claims for service-related conditions, burials, home loans and education benefits. Neighboring Pierce, Polk and St. Croix counties in Wisconsin also have veterans service offices. Most offices do not track their clients by age or war period. But directors from around the Twin Cities agree on several reasons for the increases.

The Iraq war is creating a new tide of veterans. Vietnam veterans are aging into their 60s, some with conditions related to war injuries or post-traumatic stress renewed by seeing Iraq coverage in the news. World War II and Korean War veterans are even older, and their deaths are leaving survivors with questions about government benefits. And rising health care costs, along with the tendency for employers to offer less insurance coverage, have prompted more veterans to consider treatment at a VA hospital.

In addition, the offices are seeing more veterans who are suffering the effects of Agent Orange exposure.

Anoka County has about 28,000 veterans, Krueger said. Last year, his office logged 3,559 visits from clients. In 2006, the office is on track to see 4,000.

In the light of this increasing need, it's obvious that more money and manpower will need to be devoted to these services; unfortunately, budgets are bursting on just about every level of government these days. Not all offices have the opportunity to hire another employee to meet the rising needs. Not all offices are having an easy time of even remaining open.

From the Quay County [NM] Sun:

Joe Valverde, a veteran of the Korean War and the Vietnam War, told [county] commissioners he was concerned about the scheduled July 1 closing of the veteran’s service office in Tucumcari. “We need all the help we can get and we need it locally,” Valverde said. If the office is closed, Valverde said Clovis is the next closest office. Between Quay, DeBaca and Guadalupe counties, the Tucumcari office serves more than 2,100 veterans -- 1,319 of them in Quay County.

A trip to Clovis isn’t easy for veterans, Valverde said, because of health problems and rising fuel prices. “I’m not primarily looking at myself,” Valverde said. “We have other veterans who do need help.”

The representative of the office, Albert Trujillo, said the cut would be made because the office doesn’t serve as many veterans as other offices around the state. However, Trujillo felt having the local office was the best scenario for veterans. “We have one-on-one contact,” Trujillo said. “They (other offices) have bigger workloads, but I don’t see that as a reason to close our office down.”

Commissioners said they would send letters of support to U.S. Rep. Tom Udall, D-N.M., a member of the House of Representatives’ Veterans Affairs Committee, along with Gov. Bill Richardson and state legislators Clint Harden and Brian K. Moore. Additionally, commissioners said they would do whatever else they could to help prevent the office’s closure [names linked to official contact page if you'd like to send a note, too].

A hat tip to all the hard-working people in our county veterans service offices all around the country -- you're doing important work for our society. Please read the entire piece (local office #s provided), and then join me in thanking the Pioneer Press for their coverage of this issue.

Track down your own state's veterans benefit services from this National Association of County Veteran Services page.

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Near Buffalo, NY? Catch Former Vietnam POW Talk on PTSD

If you're in the Buffalo, NY area next Wednesday (April 26th), you may want to mark you calendar for a thought-provoking and rich evening of posttraumatic stress disorder eduction and discussion. St. Joseph University Parish Church and Compeer of Greater Buffalo welcome Captain Dick Stratton USN (Retired) to discuss his intimate experience with PTSD following 2,251 days in the Hanoi prison system as a POW during the Vietnam war.

Click on 'Article Link' below tags for more details...

From the press release:

Mr. Stratton's appearance is particularly timely in light of the ongoing war in Iraq and the recent hardship that Hurricane Katrina has brought to so many. We encourage the entire community and, in particular, veterans and their loved ones, social workers, educators, psychologists and psychiatrists to attend this valuable conference that is free to the community. ...

For information on attending this special program, contact Annette Pinder at 883-3331, Ext. 18. St. Joseph University Parish is located at 3269 Main Street, Buffalo, New York 14214, next to the University at Buffalo. Parking is available behind the church.

Plan to attend on Wednesday, April 26, 2006 at 7:00 p.m.

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Reconnecting with Your Kids After Deployment

The DOD has once more christened April the Month of the Military Child. Since 1986, this month is set aside to focus on honoring the littlest member of the military family. I'll share resources and family transition tips for those returning home from a long deployment overseas.

Click on 'Article Link' below tags for more...

First, some military resources you might want to make use of:

Explore Grand Forks [ND] Air Force Base's Escape Zone, a new interactive learning center opened just yesterday at 410 Seventh Ave., Building 320, on base. Open for all active-duty military families (Reserve and Guard included), the Escape Zone offers a place for parents to join their kids in a number of hands-on activities and programs aimed at helping with their pre- and post-deployment bonding. Phone (701) 747-5608 for more details.

Don't miss these two great clearinghouses of family info: DeploymentLINK and the valuable Blue Box of resources.

Highly recommended -- lots of Blue Box family reintegration guides, including the following must-haves workbooks:

Deployment and Reunion Guide for Children, Ages 3-6 [60-page pdf]
Deployment and Reunion Guide for Children, Ages 7-12 [58-page pdf]
The Army Brat Pack, Ages 13+ [45-page pdf]

Access the DOD's Military Child in Transition website, brimming with great information for both parent and 'military brat' (said lovingly, of course :o). Some of the gems you'll find here are the 85-page Military Students on the Move Toolkit for Parents [pdf]; the 29-page Parent's Guide to the Military Child During Deployment and Reunion [pdf]; and the 12-page How Communities Can Support the Children and Families of Those Serving in the National Guard or Reserves [pdf].

Check out the DOD's Military Homefront website. Take a special look at the resources collected on their Children & Teens page.

Have your kids explore Kids Information on Deployment Stuff (KIDS), a website made especially for them. Click on their grade level (grouped into three categories), and away they go!

View the Army Reserve Family Programs Readiness Video, Dealing with the Emotional Side of Deployment, that explores what to expect during your soldier's deployment. You'll also learn to handle the stress and emotions that you'll be feeling during this anxious time. Although the video is geared toward the couple's relationship, kids will benefit, too.

Take a look at the Deployment Health Clinical Center Family & Friends page. It has a lot of resources waiting for you including links to the following videos: Making Your Reunion Work, Family Readiness Groups, and Family Assistance Center.

A few other resources:

Give Zero to Three a quick look; they're a nonprofit whose mission is to "support the healthy development and well-being of infants, toddlers and their families." They have some veteran-specific resources including the 8-page booklet Little Listeners in an Uncertain World: Coping strategies for you and your child during deployment or when a crisis occurs [pdf].

Read WNBC's great article which provides a list of things parents and teachers can do to support military children. A few tips include:

Keep in touch. Help kids find ways to keep in touch with their parents overseas. E-mail and/or phone calls can be helpful, when available. Kids can also send letters and/or packages.

Build a scrapbook. If a parent will or may be out of contact for an extended period of time, help kids keep a journal, scrapbook or photo album of daily events to share with their mom or dad when they return. Pay particular attention to holidays and special occasions like birthdays, school plays or graduations. Kids will want to help parents "catch up" on these events when they return.

Leave comforting reminders. Some parents record themselves reading a familiar and soothing story before they leave. Others write notes or leave photographs to be opened each day or week.

Kids need predictability. Be careful about promises to call at a certain time or come home on a specific date.

Schoolwork issues. Children may experience a slight decline in classroom performance while a parent is on active military duty. Children may have difficulty studying with so many other things on their mind. Other children may actually focus on schoolwork as a way to deal with their anxieties. In general, teachers should be told that a parent is on active military duty. It may help them understand any academic or behavioral changes they may see in the classroom.

Get in touch with other military families. Help kids make contact with other kids whose parents are on active military duty. In some areas, school guidance counselors or local therapists are organizing informal groups to give kids a chance to talk about their thoughts and fears.

Limit TV. Many children in military families are riveted to the details of daily media coverage. In part, this may be an effort to master the situation by gathering as much information as possible. This can be an important and healthy reaction. Young children (preschool and school age) should not watch war-related coverage unattended. It's best done with a parent or other adult who can provide reassurance and/or help answer questions. Even adolescents should be encouraged to limit TV viewing. Research clearly indicates that constant exposure to war related coverage may heighten anxiety. Read more on kids' viewing of TV war coverage.

These are only a few of the suggestions, so I'd highly recommend taking a look at the entire article.

Military.com's Your Children and Separation page offers solid advice and links to more solid resources for military parents. A few suggestions:

Be Truthful. Children are very perceptive! As soon as the servicemember starts planning and preparing for a drill or deployment, the child will catch on that something is up. Do not lie to your child in an attempt to shield him or her from the truth or they may assume something worse. Talk to your child openly and honestly.

Share Feelings. Children often lack the vocabulary to share their feelings. It will help if parents talk about their own feelings which will help children communicate their feelings. Let your child know that even negative thoughts and feelings are OK and normal.

Explore Destination. Using a map or globe, show your child where you are going and chart your route. Using books or encyclopedias, explore weather conditions, cultural norms, or products produced in that region.

Communicate with Teachers. If your child is school-age, let the teacher know what is going on at home. The teacher may use maps and chart your travels with the class!

Design an Activity to Pass Time. With your child, design or create an activity to help mark time. For younger children, make a paper chain with a link for each day you will be gone that the child can use to measure time (the child will break a link each day). For an older child, choose a book that you both would enjoy and each read a pre-assigned passage everyday.

Show Your Workspace. If possible, set aside time to show your child the ship and where you will be eating, sleeping, and working. Or, take your child to the armory prior to departure and show him or her the artillery guns or weapons that you might be working with while away.

Let Your Child Help You Pack. Letting your child help you pack will allow him or her to be more involved in the process and also allow them to "care" for you. If possible, let them decorate the inside of your footlocker. Not only will they have great fun but you will enjoy their artwork for days and months to come.

Read to learn to identify signs of possible distress in your child.

Finally, the following helpful tips come from the Blue Box's A Soldier and Family Guide to Redeploying:

Deployment Reunions and Children

Deployment reunions and reintegration are a process, not an event. The process requires time and effort. Stress levels may remain high up to seven months post deployment. School is a setting that remains the same for the child of a deployed parent[; t]herefore, it's an important part of their life. Families and schools working together help children adjust to the changes inherent in deployment reunions and reintegration.

Tips for Parents:

Talk with you children before the service member comes home much as you did when the parent was preparing to leave.
Tell your child's teacher about the return of the military parent from deployment.
Use the services of the Family Support Center and Army Community Service to help address the special challenges of wartime deployment reunions and reintegration.
Know that children's behavior will greatly depend on how their parents renegotiate, compromise, and communicate.
Take care to avoid abruptly shifting love and attention from the children to the returning spouse.
Help children understand that they have changed while the parent was away, AND that the parent has changed, too. Assure them that even though the parent may look or act differently than the child remembers, the returning parent is their same father or mother that left and that loves them.
Understand that children may experience a variety of feelings:

Happy that they will see the parent again.
Afraid that the parent will not like the way they have changed, or that the parent will leave again.
Excited about being able to share some of their favorite activities again.
Proud that their parent is doing an important job for our country.
Jealous of the time and attention taken from them and now given to the returning parent.
Worried that all these feelings are not normal.
Know that the children may not respond to discipline from the returning parent because of the loyalty to the parent that remained behind. Children may test the limits of the family rules to find out how things may have changed with the return of the deployed parent.

Go slowly and let the children set the pace in accepting the parent back. Plan some special time for just the child and the returning parent to get reacquainted.

And finally, just go easy on yourself. Take things one step at a time. And seek out outside help in all of its forms to help support your transition back into the family you so missed -- and so missed you -- while you were away.

Labels: deployment, family, homecoming, pdf, reading, reintegration, resources, video

Chronogram Magazine Reprints 'Blaming the Veteran' Piece

Chronogram Magazine's April issue carries a partial reprint of ePluribus Media Journal's Blaming the Veteran: The Politics of Post-Traumatic Stress Disorder [entire three-part series]. As a co-author of the piece, along with D. E. Ford and Commander Jeff Huber, I'm thrilled to see another market's readership have the opportunity to learn more on this important topic. Thanks, Chronogram!

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Labels: disillusion

Sunday, April 16, 2006

Hilton Hotel Decision Angers Wounded Veterans

Yesterday the Washington Post reported that Fran O'Brien's Stadium Steakhouse, a restaurant beloved by our on-the-mend combat vets at Walter Reed Medical Center, has been refused a lease renewal by landlord Hilton Hotels. The restaurant's basement location in the Capitol Hilton will have to be vacated by May 1, 2006. [See this heart-tugging WUSA Channel 9 video report.]

Click on 'Article Link' below tags for all the maddening details...

The decision has created an understandable uproar in the veteran's community: Fran O'Brien's has been treating our severly wounded veterans to complimentary Friday night steak dinners for the past 2 1/2 years. Their generosity has become legendary, and going out for dinner at Fran O'Brien's has become a "rite of passage" after difficult months spent recovering from serious injuries in a sterile hospital bed. Veteran's families have begun asking Hilton Hotels to re-think their decision. To help them to do that, a petition has gone up.

Please consider signing the petition and passing the link along to others who might join us if you're so inclined. As many of us celebrate a holiday today with loved ones at our side and good food passed all around, I don't think there's a more appropriate advocacy action worth your time and effort than this one.

From the Washington Post:

The steaks are great, of course.

But it isn't the T-bones, the porterhouses or the rib-eyes that will be sorely, even painfully, missed when Fran O'Brien's Stadium Steakhouse loses its lease and closes its doors this month.

The downtown D.C. restaurant, which has hosted a decade's worth of power lunches, political dinners and salacious hookups, is more poignantly known for its Friday night steak dinners for severely wounded soldiers recovering at Walter Reed Army Medical Center. "It looks like they're kicking us out," sighed Marty O'Brien, son of the late Redskins offensive lineman Fran O'Brien, before closing the restaurant yesterday afternoon for the Easter weekend.

For the past 2 1/2 years, O'Brien and business partner Hal Koster have made their thick steak dinners and a night of bottomless drinks one of the rites of passage for the soldiers who are steeling themselves for their postwar lives in wheelchairs or with prosthetic limbs.

They come to the subterranean restaurant, at the corner of 16th and L streets NW in the basement of the Capital Hilton, in volunteer's vans and trucks. They're carefully wheeled down the stairs or slowly negotiate the steps on crutches. It has become a tradition so beloved among veterans that Garry Trudeau featured the dinners in his Doonesbury comic strip.

Jim Mayer, a veteran who works at the Department of Veterans Affairs and who helped start the steak dinner tradition, is concerned that the hotel wants to eliminate the spectacle of hundreds of severely disabled soldiers coming in and out of its building or that the restaurant's repeated requests for a new elevator or escalator to accommodate them was too much.

Hilton Hotels says the decision is strictly a 'business decision.' After many months of negotiations with the O'Brien owners, they advised the restaurant this week they would not to renew their lease.

The Hilton has offered to help take over the Friday night dinner tradition. Management has suggested the dinners could move to a ballroom or the hotel's other restaurant, Twigs. "Twigs? Nah, . . . they don't get it. It's not just about a place and some food," he said. "I have these guys' numbers in my cellphone. I talk to them. We check on them. Hal picks them up. . . . He brings them milkshakes."

Of course, atmosphere might have something to do with the appeal to veterans. O'Brien's is a virile place, with deep red booths and a long, polished bar [take a look at these photos of the place and the food!]. Sports memorabilia everywhere. A longtime hangout for Redskins players. The pool tournament on television. American flags on the walls. Some veterans have called it the first place where they've felt at home since they left the battlefield and months of sterile hospitals.

The veterans are outraged that O'Brien's is being forced to move out. So Mayer and other veterans have begun a campaign. They're calling Hilton's New York headquarters and flooding its e-mail boxes. "I've got a whole bunch of guys, big groups of people, the service members, who are coming to me and asking: 'Who do we go give static to? What can we do about this?' "Mayer said. "I'm holding them back. I'm telling them: 'Look, we know how you feel, but you're on active duty, so just stay cool for awhile. We'll work on it.' "

O'Brien's intends to hold two more Friday night dinners. In the meantime, the Italian Embassy has called O'Brien, offering its digs for the dinners until he comes up with another plan.

Retired Army Staff Sgt. Michael Cain will never forget the porterhouse he had on his first night at O'Brien's, in 2003 after five months in the hospital. "It beat the hell out of hospital food," said Cain, who lost part of a leg in an explosion in Tikrit. He spent many nights at O'Brien's regaining his appetite, his humor and his dignity. "I really hope they don't end this," Cain said. "It's a great thing that a lot of guys look forward to."

Check out Fran O'Brien's super hip website. Get a feel for the place; then sign the petition if you'd like to chime in. You may also wish to contact Hilton Hotels management, but PLEASE be very respectful if you choose to do so; let them know how much the troops value their Fran O'Brien's experience and that you wish they could re-think their decision:

Online contact form [see this post for a sample letter]

There's other contact information floating around out there, but I hesitate to add it here. It does appear that a number of groups have been working on this problem for the past week, with the consensus being that Hilton Hotels won't budge on the decision. Rather than inundate the Capitol Hilton's management with calls and emails, it may be better to just sign the petition; if you want to go one step further, register your complaint using the company's online contact form. Then, hope for the best...

Update, 5/1/06

Sad news.

The pressure -- and there was a lot of it from many, many groups -- to get Hilton Hotels to reconsider their decision apparently just wasn't enough. Last Friday, April 28th, was the final complimentary Friday steak dinner night for our recovering veterans hosted at Fran O'Brien's. The Washington Post covered the event; and we get some additional details from Scripps Howard News Service:

Despite a tsunami of protest that stretched from Kuwait to London to Hawaii, a Washington restaurant that served solace and support with its free steak dinners for wounded troops was evicted Monday. Hilton Hotel Corp. refused to budge from its intent to shut down Fran O'Brien's Stadium Steak House, where hundreds of the worst-wounded U.S. troops from the wars in Iraq and Afghanistan were feted almost every Friday night for more than two and a half years. "This is a tenant and a business owner that couldn't come to terms," Lisa Cole, a spokeswoman for Hilton, said about the dispute between the Capital Hilton Hotel and Fran's, which rented a subterranean space there.

The disagreement began when Fran's owners Hal Koster and Marty O'Brien asked Hilton to install an elevator or escalator from the street to the restaurant so the troops, many in wheelchairs or walking with prosthetic limbs, would not have to negotiate two-dozen steps or use a service elevator. Hilton responded with its own demands for cosmetic improvements to the decidedly untrendy establishment, which the owners agreed to perform once a new lease was signed. Other issues surfaced, and Hilton stopped communicating with the owners. Once the old lease expired in December, the hotel doubled Fran's rent. ...

The prospect of Fran's eviction galvanized a small army of volunteers who took to the Internet to try to change Hilton's mind. In an effort dubbed "Operation Perish Hilton," veterans and other supporters across the globe flooded Hilton with protest e-mails and telephone calls, and groups across the country canceled reservations. Conservative and liberal radio talk shows took up the cause.

High-powered fans of Fran's, such as World Bank President Paul Wolfowitz, weighed in. The American Legion, the nation's largest veterans organization, offered to pay for half the cost of the elevator. In a letter, national commander Thomas Bock invoked the memory of hotel founder Conrad Hilton, who was a charter member of Legion Post 58 in El Paso, Texas. "This venue has become an important element to their long recovery," Bock wrote. "This environment has provided mental and emotional healing we can't see or put a price tag on."

Under assault, Hilton offered an upstairs restaurant for the dinners, a location Fran's owners deemed unsuitable because it does not offer the requisite privacy, where those uncomfortable about their missing limbs, clumsy prosthetics and disfigured faces can feel at home. ...

Friday evening, during the last meal for the troops at Fran's, anger mixed with sadness. Several patrons wore T-shirts protesting that "Hilton Dishonors Veterans." Army Staff Sgt. Chris Bain, 35, whose left arm was nearly destroyed by a 2004 mortar blast in Iraq, credited Koster, O'Brien, the volunteers and the dinners with helping him put his life back together. Fran's "means the world to us soldiers," Bain said. "Shame on Hilton."

Sad, sad state of affairs that this issue couldn't have been resolved. A great loss...

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Labels: disillusion

Saturday, April 15, 2006

CNN: Local VA Hospitals Increase PTSD Outreach and Care

More signs that the national media is finally waking from its PTSD slumber. CNN carried a piece this week showcasing a unique PTSD screening program and clinic currently offered at Hines VA Hospital in the Chicago area. "Every veteran who comes in for treatment, no matter the reason, is checked out for post-traumatic stress disorder. And they all have access both to individual therapy and a support group with fellow veterans."

Click on 'Article Link' below tags for more...

From CNN Health:

Josh Dobbelstein drives as close to the middle of the road as he can. Over on the side, in a plastic bag or stuffed in the carcass of a dead dog, that's where he knows the enemy intent on killing him hides bombs. Just the other day he dove to the floor of a vehicle he was riding in when he mistook the sound of a trucker hitting his brakes for a machine gun.

They are the kinds of precautions that keep soldiers at war alive. But Dobbelstein left Iraq more than 16 months ago, and for him they are vestiges of a war he can't seem to shake. He's trying, though. The 23-year-old is getting help from a clinic at Hines VA Hospital just outside Chicago set up to help veterans of Iraq and Afghanistan with post-traumatic stress disorder. ...

Dr. Chirag Raval, a psychiatrist at Hines...has treated about 150 veterans at the clinic he established after serving three months in Iraq. The effort [to screen every patient for PTSD, no matter what they initially come in for], which Hines officials say is unlike any in the nation, is evidence that VA hospitals and military leaders are finding new ways to locate and help veterans returning Iraq in Afghanistan.

In Florida, for example, the Pensacola Naval Hospital has placed advertisements in civilian newspaper to make families -- not just veterans themselves -- aware of its counseling program. Navy hospitals are also reaching families through a series of online videos about post-traumatic stress syndrome. "They are a different breed and they need to be handled differently," Raval said of the Iraq and Afghanistan veterans.

A cornerstone of the treatment is the recognition that while these veterans share experiences familiar to anyone who has seen combat, their war was different. "You never really knew the enemy," said Dobbelstein, whose job included scouring roadways for explosive devices. "It could be the guy standing next to you who detonated the bomb, for all you knew."

That meant never dropping your guard. "It's like you're driving down the highway, and you're like, 'Just let me see it, let me see it, don't let me miss something that could get us killed,"' Dobbelstein said.

It becomes obvious, as you read this article, that having a doctor who's served in Iraq on the rolls offers a great benefit to its patients. Dr. Raval punctuates the fact of no one -- in or out of a combat role -- in Iraq is ever safe: the psychiatrist he went to replace had been injured by a mortar.

One recent study found a third of U.S. soldiers who served in Iraq the first year of the war later sought mental health treatment -- a statistic that suggests thousands of veterans might need help.

The Department of Veterans Affairs says it is stepping up its efforts to offer psychological help -- pointing out that besides readjustment counseling at more than 200 community-based Vet Centers established after Vietnam, 44 Returning Veterans Outreach and Care programs were established last year and more than 40 more are scheduled to open.

But there is concern that many of today's veterans aren't getting the help they need. One reason is that they aren't asking for it out of fear they could derail their military careers. "A lot of guys, they see it as a nick in their armor: 'If want to do 20 (years) or more, I don't want to be seen as a nut case,"' said Capt. Jeffrey Weyeneth, a psychiatrist at Pensacola Naval Hospital, who estimates that continued counseling programs reach only about a tenth of the troops returning from Iraq and Afghanistan.

Steve Robinson, director of the National Gulf War [Resource] Center, a veterans advocacy group, says the bigger problem is that there aren't enough places for veterans to get help. As a result, Robinson said it's unclear how many veterans didn't get help because it wasn't available when they asked for it.

One soldier who'd gone to Hines before the new program's start says that the help he was offered at the time (pills that knocked him out for 12 hours) wasn't what he wanted -- or needed.

"I didn't want that," said Adams. "I wanted a group of other veterans I could talk to or maybe a military doctor who was there (Iraq) who can help me out or something."

Such stories are even more significant in light of what Dobbelstein's life has been like since going to Hines. "I still have flashbacks but they're more manageable," he said. "I don't feel as turbulent any more. I don't sleep with weapons now. "I lock my doors, but I don't barricade them."

Further evidence for how far the VA generally and Hines Hospital specifically have come in helping our returning veterans shows up in a sister piece carried in this weekend's Rockford Register Star (Rockford is approx. 75 miles west of Chicago):

When 23-year-old Michael Torok returned home to DeKalb County in September 2004 after serving in the U.S. Army in Afghanistan, he had more health issues than anyone had suspected.

Michael’s father, Roland, recalled recently that his son visited a veterans hospital Sept. 4 in Chicago. “He had back pains and blood in his urine,” the elder Torok said.

Michael’s mother, Barbara, said the hospital did not screen Michael for post-traumatic stress disorder or for suicidal tendencies. The oversight, her husband speculates, might have been attributable to — but not ex-cused by — the fact that it was Labor Day weekend. The next day, Michael left his Kingston home ostensibly to visit a friend in Shabbona in southern DeKalb County.

He never got there.

A 19-day search for Michael uncovered evidence that he had used a credit card at a Menards store in Cherry Valley and that a call to his cell phone had been picked up by a Verizon tower near Illinois 72.

On Sept. 24, Michael was found dead in his pickup truck in a rural area of Ogle County near Monroe Center, the victim of a self-inflicted stab wound. His parents were left to wonder whether his suicide might have been prevented by the kind of outreach and therapy options that have since been adopted at veterans hospitals.

At Hines VA Hospital near Chicago, all patients are now checked for PTSD, no matter how minor the other ailments for which they are seeking treatment. “They should have been doing that a long time ago,” Roland said. “That should have been going on ever since the war (in Afghanistan and Iraq) started. They should have been doing it in Vietnam, too.”

Nick Parnello, a Rockford-area Vietnam veteran and co-founder of VietNow, a national veterans organization, says the VA wasn't prepared for the psychological problems of that era's veteran.

“The hospitals weren’t prepared for it,” Parnello said. “We had guys who were all screwed up because of what they had seen or what they had done. We had thousands of guys committing suicide.”

Parnello said VietNow...began organizing informal discussions among combat veterans about 25 years ago. “The worst cases,” he said, “usually were with guys who wanted to bury their pain. It was just too much for them to deal with. But when we got them talking and listening with their brother vets, they usually were able to begin to heal."

He recalled the case of one vet who was ashamed for years afterward for having been frozen with fear in a combat situation. “His outfit was under fire, and he just laid there with his machine gun and didn’t move,” said Parnello. “He felt so guilty about the fact that he had been afraid. But when he talked to other vets in one of our groups, he got better.”

Parnello said some of the people coming home from military duty in Iraq and Afghanistan are facing psychological problems unique to the conflicts in which they’ve participated. “Every war is different,” he said, “and the problems the veterans face are different.”

Please thank CNN and the Rockford Register Star for their PTSD coverage. Then contact your elected officials, letting them know you support real, tangible efforts to care for our troops as they return home to us.

Related

Listen to a recent interview given to the Chicago Tribune by Hines Hospital's PTSD program director.

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Labels: reintegration

Veteran Filing a PTSD Claim? Here's Help...

The veterans benefits claims process is a grueling one from what I've heard. Not only is having to revisit experiences of combat trauma difficult, trying to document each and every incident on the many claim forms you'll need to fill out for the VA to get your benefits to kick in is anything but easy. What follows are a few tips and resources that I've come across. I hope they help you as you move forward in completing your paperwork.

Click on 'Article Link' below tags for more...

First, a few tips from VVAW's Military and Veteran's Counseling Handbook [pdf]. Of special importance to you as you begin the claims process is the information on page 8. Please take a look at that page, if you read only one from this handbook. The most important thing to do first is to file your claim immediately if you believe you have combat service-related PTSD:

[After a claim is accepted ], the VA will pay starting the first of the month following the month in which a claim is filed. The "claim" need only be a letter giving your name and address, listing the problems and saying that they are service connected or that they have made you totally disabled. You can submit the completed application within a month of that first "claim."

Please read the rest of the information on page 8, noting:

The VA handles most claims "routinely" that is, slowly, no matter how anxious you may feel. The VA will "expedite" a claim only if you submit evidence of financial crisis, and a letter of support from Congress will help. ... If you do nothing else, file the claim, always reply to letters from the VA and don't miss any appeal deadlines.

Important resources to use once you're ready to begin:

Print up a copy of PTSD Help Network's PTSD Worksheet. Filling this out ASAP will make completing the necessary claims forms a lot easier in the long run.
Download Developing Claims for Service Connection for PTSD Based on Personal Trauma [MS Word document] from the VA.
Sign up for an account at the American Gulfwar Veterans Association's bulletin board. This group has been wonderful in answering these types of questions. Even if you don't sign up, take a look at their excellent PTSD Claims FAQ (from A to Z) page and the incredible links here.
The National Gulf War Resource Center has a nicely organized ptsd claims process page.
Check out VA Watchdog's How to File a Claim Page. Easy-to-understand steps to help you get through the mountain of paperwork.
Highly, highly recommend Infinity Publishing's Military Veterans PTSD Reference Manual. It's available online for free. Chapters 7-10 are especially important to take a look at for help in filing your PTSD benefits claims forms.
Another solid recommend: Vietnam Veterans of America's PTSD Benefits Guide.
A must-read Google knol: A Military Veterans Guide To Disability Compensation and Pension Benefits.
Download "The American Veterans’ and Servicemembers’ Survival Guide" by Veterans for America -- all 599 pages available as a PDF, or skip directly to Chapter 5: Explaining the VA Claims and Appeals Process [pdf].

Fortunately, you don't have to reinvent the wheel. Since many others have gone before you and probably had a lot of the same questions, you don't need to be alone on this.

A quick look at the official steps you need to take to get the claims process going from the VA's National Center for PTSD:

How can I establish that I am disabled due to PTSD caused by military service?

A determination of service-connected disability for PTSD is made by the Compensation and Pension Service, an arm of VA's Veterans Benefits Administration. The clinicians who provide care for veterans in VA's specialized PTSD clinics and Vet Centers do not make this decision. A formal request (claim) must be filed by the veteran using forms provided by the VA's Veterans Benefits Administration. After all the forms are submitted, the veteran must complete interviews concerning her or his social history (a review of family, work, and educational experiences before, during, and after military service) and psychiatric status (a review of past and current psychological symptoms and of traumatic experiences during military service). The forms and information about the application process can be obtained by Benefits Officers at any VA Medical Center, Outpatient Clinic, or Regional Office.

The process of applying for a VA disability for PTSD can take several months and can be both complicated and quite stressful. The Veterans Service Organizations provide Service Officers at no cost to help veterans and family members pursue VA disability claims. Service Officers are familiar with every step in the application and interview process and can provide both technical guidance and moral support. In addition, some Service Officers particularly specialize in assisting veterans with PTSD disability claims. Even if a veteran has not been a member of a specific Veterans Service Organization, the veteran still can request the assistance of a Service Officer working for that organization. In order to get representation by a qualified and helpful Service Officer, you can directly contact the local office of any Veterans Service Organization. You may also wish to ask for recommendations from other veterans who have applied for VA disability or from a PTSD specialist at a VA PTSD clinic or a Vet Center.
My claim for a VA PTSD disability has been turned down by the Benefits Office, but I believe I have PTSD due to military service. What can I do?

Contact a Veterans Service Officer who can explain how to file an appeal and who can help you gather the information necessary to make a successful appeal. You may want to contact a Service Officer who has extensive experience in helping veterans file and appeal claims specifically for PTSD.

I can't get records from the military that I need for my disability claim. What can I do?

Veterans Service Officers can help you file the specific paperwork required to obtain your military records. If your Service Officer is not able to help you get necessary records, ask him or her to refer you to another Service Officer who has more experience in getting records.

If you have any helpful resources of your own to share, please add them in comments. And good luck with your claim. You deserve the very best care for your service to our country -- make use of all of the resources that are due you!

[UPDATE Aug 14 2008]: From WikiHow:

How to Understand and Request Veterans' Benefits

You have just gotten out of the service, or you have been out a while. You have medical problems that you feel may be related to your time in service. You could also be a child or widow of a veteran that needs some help. You would be amazed at what types of benefits are out there. What do you do? What are your options? All you have to do is look and ask.
Steps
Understand your benefits. Depending on your percentage of disability and whether or not you have retired, your benefits will vary. The different types of benefits include:
Educational benefits
Retirement pension
Medical care
Psychiatric care
Housing benefits
Financial assistance benefits
Employment Benefits
Veterans Business Benefits
Find your state Department of Veterans Affairs (DVA) webpage.[1]
Know what you have and what you need.
Inventory' all of the records and official documents that you have. Do you have your military records; most especially, your medical records?
You can request them from the military archives.[2][3] When you request the records, there is a certain procedure that needs to be followed, that can be found here.
Find your service officer. A service officer has been trained to help you with your disability claims. VA.gov[4] has a way to find them. Some organizations are the American Legion (AL), Disabled American Vets (DAV), Veterans of Foreign Wars (VFW). Once you decide which one will suit you best, you can contact the individual office to start your claim.
Get the facts. Have you checked out IRIS[5] (Inquiry Routing & Information System)? This site has information about applying for benefits and general FAQs. Some of the information that you can find here is:
Where to find your nearby Veterans' facility
Educational Benefit inquiries
The Board of Veterans Appeals
Toll free numbers to contact the VA
Learn what your benefits are in your state.[6]
Check on the GI Bill/MGIB. Have you checked your schooling options[7]? If you are over a certain percentage of disability, the VA will fund most, if not all, of your schooling to help you retrain so that you can be retrained in another career.
Tips
Be patient. This process takes a while and aggravating the officers that are working on your behalf will not help anything.
There is nothing wrong with requesting your benefits or an increase to your benefits.
Veterans without representation receive fewer benefits than those with representation.[8]
Be patient. This can't be stated enough.
Warnings
Make copies of everything. Never send original documents. You will want to keep those for yourself.
Don't expect anything to happen overnight.
Just because your claim is denied, doesn't mean that you won't get it. You will have to request an appeal. You have to do this within a year of your denial, in order to get the retro-active pay from the date of your original claim. Otherwise, the date will be when you file again.
Sources and Citations
↑ nasdva.com
↑ archives.gov
↑ archives.gov
↑ va.gov
↑ iris.va.gov
↑ military.com
↑ gibill2.va.gov
↑ ptsdcombat.blogspot.com

Article provided by wikiHow, a collaborative writing project to build the world's largest, highest quality how-to manual. Please edit this article and find author credits at the original wikiHow article on How to Understand and Request Veterans' Benefits. All content on wikiHow can be shared under a Creative Commons license.

Labels: benefits, claims, disabled, resources, va

Friday, April 14, 2006

ePluribus Media Interview with PTSD Combat Editor

You're invited to be one of the first to listen in on an interview I gave to ePluribus Media's Kay Shepherd. We discussed all things combat PTSD: How the PTSD Timeline came to be. My work with D.E. Ford and Commander Jeff Huber on the 3-part series, Blaming the Veteran: The Politics of Post Traumatic Stress Disorder. Fox News and Playboy, too (that should get you interested...). But, more importantly, I did my humble best to advocate for our wonderful returning veterans and their families.

Please give it a listen, or take a look at the commentary thread -- and feel free to let me and ePluribus Media know what you think. Consider supporting their fine organization's work, as they support ours. And have a Good Friday...

Click on 'Article Link' below tags for full interview transcript...

Thank you to Kay Shepherd and ePluribus Media for giving me permission to reprint and share the entire transcript with you:

Kay Shepherd for ePMedia: Greeting Citizens, Welcome to another edition of ePluribus Media podcast and I am your host Kay Shepherd. Our topic today is Post Traumatic Stress Disorder. Not a new phenomenon, certainly. It’s been known as shell shock, combat fatigue, any number of other names, but the facts and figures coming out of the Iraq war are fairly startling to say the least. One in six soldiers returning from Iraq is suffering from PTSD according to a 2003 study published by the New England Journal of Medicine. A Defense Department study says that six in ten of these same veterans are unlikely to seek help due to the extreme social stigma attached to this disorder.

With me today is Ilona Meagher, who came to this issue as a concerned citizen and who is now well known to ePMedia readers for her PTSD diaries. She is also the editor of the online Journal PTSD Combat: Winning the War Within which provides resources for returning veterans and their families. Ilona, thanks so much for your time. I appreciate your being with us today. I wanted to ask how you got involved with the issue of Post Traumatic Stress Disorder. Do you have personal experience within your family with PSTD?

Ilona Meagher: I don’t have any specific experience that is very close personally as far as combat experience. I don’t have anyone in my family at the moment that is serving, though I do have some extended family. But I was drawn to this topic due to about 5 and a half years ago I lost a sister to suicide and that experience. After reading a report of a decorated soldier who had returned from Iraq, shortly he killed himself after returning, it touched me personally in that way. Once you have lost someone in your family to suicide, you’re uniquely aware of that darkness and that stigma that still exists in our society. So I had a very deep empathy for those military families who are having to deal with that.

And as a researcher of course I became interested even more so in this topic because I hadn’t really seen much being reported in our national media on this issue of reintegration of our soldiers after they have been returning. How are they are doing? Really, if you look around, you still even today don’t see much reporting. You don’t see the faces of our soldiers. You don’t really hear much about how they are doing, how they are adapting; and so I began to wonder why and I started to do a little bit of online research to see what was going on to see how the troops were faring.

Initially, it was more of just a personal quest. But the more that I dug in deeper, I really realized that this issue isn’t just an individual issue that only military families should have to worry or deal with, because, of course, the veteran returns from combat and he has to fold back into his own family life, but he also has to fold back into his community’s life and he also folds back into our society, the fabric of society. And so it’s imperative for all of us to, I think, follow this issue, be interested in it, and advocate for it.

So as a researcher that’s what I began to do. I decided that that was one way that I could help to bring this issue a little bit more focus. So I began googling and searching for data on suicides, yes, but other types of combat post traumatic stress-related incidents. Generally police blotter incidents; the smaller incidents of personal struggles with Post Traumatic Stress Disorder aren’t often reported so you aren’t going to find those.

I began recording this data and began posting it online in different community areas for review and for people to look over if the data was significant. If there was any need for it. And there was a need for it. People, certainly, they were drawn to this topic because it was something that hadn't been getting covered.

So I began to compile this information and ePluribus Media spotted my work. And that kind of started the whole thing as far as really increasing the spotlight on this issue. They have been really trail blazers, I think, in this. They offered to house the data I had began collecting into a database and that’s now become the PTSD Timeline; you can find that online and it gets quite a number of hits from veterans and their families. We’ve received email from them thanking them, rather thanking us for our work on this as well as the VA, the DOD, house staffers, news organizations, reporters, educational institutions are using this data and it’s a really good feeling to know that at least there’s one place that everyone can go to to take a look at some of the incidents.

The incidents -- we really aren’t able to make an analysis of the data, of what can be conjectured from it or extrapolated from it because we don’t have full figures of what is going on with every single soldier. But it is a good example of some of the events that are happening as our soldiers return home to us.

KS for ePMedia: You mentioned that as a researcher you became interested in this. I think it bears mentioning that this is not your full time job, working with veterans or working with these issues. You are pretty much self-taught on this. You have put together this research yourself and now other people are referencing it and it’s become something of a mecca online for people who need to know more or want to know more about this issue. I guess my next question is: Are vets experiencing PTSD at a higher rate or of greater severity than in previous wars. Is there any data on that? And if it is true, does any one have any idea why?

IM: That’s a great question. The specific numbers are actually difficult at this point to nail down because, frankly, it’s a little too early to tell and to be able to compare it to previous wars. Often, PTSD doesn’t even reveal itself for a number of months or even a few years after a solder returns home, so that’s one issue.

Generally, in the early months the soldier returns home, is excited to be home, and they have local events that welcome them home. The family members get together; there are reunions. There are a lot of exciting things that happen when the soldier first returns home to delay that return-to-normal routine. But once that normal routine is what the veteran has to be faced with, that’s generally when they begin to -- those who are predisposed or those who had certain combat experiences that lead them to having Post Traumatic Stress Disorder -- a number of months after they return, that’s when they begin to see some of the signs of Post Traumatic Stress Disorder.

One quick explanation of Post Traumatic Stress Disorder. The soldier or veteran does have experience, they experience both biological and psychological symptoms. They have nightmares and flashbacks. They might have difficulty sleeping. They may feel detached or estranged from society, from family members. What complicates the diagnosis and treatment of Post Traumatic Stress Disorder is that it frequently is bundled together with a whole host of other related disorders, depression, and substance abuse. And usually the substance abuse is done to self-medicate and to dull the pain. They have problems with memory and cognition and all of these things work together to make it really difficult for the returning soldier to function in social and family life without adequate help, without counseling, without a good support network.

And this is where, of course, we come in and I know we will talk about that a little later, but this is where our advocacy and shining a light on this condition helps. Because that will ensure that they are going to get the help and the counseling, and the funding will be there to help support them during their transition.

Getting back to the statistics: One of the things. If you look at what I just explained, what some of the examples of what a person dealing with Post Traumatic Stress Disorder has to deal with, you can see it would be difficult for them to hold down employment; it would be difficult for them to maybe maintain a stable marital relationship; they might have problems with child rearing. And unfortunately often what many of our soldiers, and the Vietnam War is a perfect example of what happened, they kind of just checked out of society and became homeless. They couldn’t deal with society and family and those pressures.

One horrible statistic, if you ask me, is that the National Coalition for Homeless Veterans are already conservatively estimating that we already have five hundred Operation Enduring Freedom, those who served in Afghanistan, and Operation Iraqi Freedom veterans who already confirmed homeless. And that is a conservative estimate. So we can already tell just from that -- we have about five hundred thousand homeless American veterans, half of those from Vietnam, and now we have five hundred at least that are from the current wars. So this is definitely a serious topic. And as far as the specifics as to whether Post Traumatic Stress Disorder is different today than it was in the past; of course it is. Every war’s battles are different. There are unique similarities between the Post Traumatic Stress Disorder of Iraq and Vietnam versus that of World War II.

Although World War II veterans did have shell shock, they didn’t experience the really intense type of Post Traumatic Stress Disorder that the modern combat veteran from Iraq is experiencing because of the type of battle: guerrilla warfare, going house to house, insurgent warfare where our veterans really don't have any safe place. I have seen this in many reports where people more intimate with the details and more intimate, have a higher rank and definitely have their fingers on the facts, say that there is no safe place for our veterans to go to. And that, in combination with many redeployments -- they are serving two, three, four times, returned back into the combat zone -- that cumulative introduction of their body into the battlefield is what increases the incidences as well as exacerbates, makes more intense, the Post Traumatic Stress Disorder. So those are some of the statistics that we can look at.

KS for ePMedia: Partly because of the culture of the military, partly because of the nature of the illness, there’s a big shame factor attached to this disorder. How does that affect the reporting? Do we even know if we are capturing all the incidences that are coming in? Are the available statistics reliable?

IM: That’s another excellent point. We, again, don’t know if the statistics are reliable. We do know from a FOX News article -- which I was very, very pleased to have been involved with -- that it offers us a little bit of...some more glimpse on, on some of the statistics. The VA currently says approximately 14% of the soldiers who have left, who have returned home from combat and have left service, have already have been confirmed with Post Traumatic Stress Disorder. And the figure is 20,638. Of course they are saying this is conservative, this is just a small glimpse at, at what the statistics currently are.

The Veterans Administration and the Department of Defense, they obviously...well the Department of Defense I can say. Now the VA, they have actually been wonderful and I think that they try to do the best that they can do. They don't have the funds to be doing a lot of study I think in this matter and this is where the Department of Defense probably should. But they, they really aren't doing any publishing, for example, of the number of suicides that occur both in the combat zone -- because we have had a number of those cases -- and they don't do any reporting of how many soldiers have committed suicide once they've returned home. How many soldiers have committed murder-suicide once they've returned home? There have been cases of that. How many have returned home and are committing other types of violent crime, either harming themselves or others?

So they're not reporting these cases. I'm assuming that they may be collecting the data but they really are not. Politically it's not advantageous for them to realease that data. And we can understand why: it's not in their favor to, to show that face of combat. In fact, one thing that is interesting that has happened here is that, that those soldiers who have returned from combat and commit suicide, of course they're not on the KIA casualty list. They are not included in that list. And there are families who are trying to change that, saying that of course they are directly -- their injury, mental injury is directly -- related to the combat experience; so, certainly that would not have happened had they not gone to war. And there is my understanding, I have seen one report of one family who actually was victorious in receiving a KIA casualty count where their soldier, the troop, was included. He was actually physically airlifted from Iraq and later committed suicide at Walter Reed Hospital in Washington, D.C. So, other families have not been sucessful at doing that.

And so, we'll get back to the issue of, you know, the politics of Post Traumatic Stress Disorder. It's not anything new. You know, we've seen this in other wars and its understandable how there are powerful forces that collide here. We have those people who need, who can benefit from a broader public discussion on this issue. And those people are the military families, the troops themselves. The more people who understand and know this issue will all the more advocate for proper funding, for proper care for our veterans.

But, of course, we've got the other side. Of course, this information is inconvenient. It's inconvenient because our budgets are busted. It's inconvenient because, of course, it's not a good topic for them to continue to try to reclaim public support for the war once people see it can have a very negative effect in society.

There's a lot more of this and I'm certainly not the expert at this. I was fortunate enough to include my name along with Commander Jeff Huber to a recent ePluribus Media Journal piece which I would recommend everybody to read if they have not already. D.E. Ford definately did the heavy lifting on that one and the article's name is Blaming the Veteran: The Politics of Post Traumatic Stress Disorder. It's a three part series that explores this tension between the needs of our veterans and the desires of those who wish to cast the war in a more favorable light. It's an excellent piece. And it has been receiving some wonderful attention which has us all thrilled, of course, because the more that we can talk about this with other groups, with people perhaps that aren't generally finding this information easily themselves...

For example, Chronogram Magazine is just going to be reprinting a large part of the piece for its readership. And Playboy magazine has recently contacted us. They are also going to be writing a piece on the politics of Post Traumatic Stress Disorder and really, really thought that this, this work that we did with Ms. Ford and Commander Huber is a really good place for them to start. So we're excited about that, to see that happening.

KS for ePMedia: Nice plug by the way, very really well done. I wanted to ask you, you have been doing a lot of mainstream media lately. The Fox News story, the Playboy story. Media seems to have discovered this issue in the past few weeks. We've seen it on Hardball. We've seen it on MSNBC on some of the other shows. We've seen it on Fox News. And you've been doing a lot of media. How can decent coverage of this issue help the individuals and families effected by it?

IM: Well, I think that number one first and foremost, since this is a mental health issue -- we all know as people we really don't even have to debate this -- that mental health issues have a stigma in society. Not just Post Traumatic Stress, but every type of depression. We're supposed to be happy. Everything's supposed to be great. We're supposed to always look at the bright side. And those are all wonderful things; but, the reality is that life is not always just one extreme. We also have the other things. We have all of the different colors of the rainbow and shades of gray out there. And certain issues, mental health issues, have a stigma attached to them that people don't want to discuss.

Generally, there has been an increase of discussion the last few decades which is wonderful. Because the more that we highlight this issue, discuss it, the more that we see that others also struggle with this, the less that we condemn ourselves that we're the only ones who deal with this. That we are the only family that has you know, that has this, this whatever it is.

And so for the soldier that's returning first and foremost, or the Marine, the veteran who returns to us. First and foremost, they have a big battle to wage against the typical military indoctrination which I'm not putting down. You know, we need to have strong fighting forces. And everybody knows that and I applaud them. When they return home, though, they are not attached to that strong fighting machine anymore. They are individuals again who return to their families and their lives. And I've seen many veterans say that, you know, that is one of the difficult -- that decompression -- that complete change in what their life is like, they were attached to this greater cause and now they're just dealing with their own lives. And if they don't know that other veterans are also having difficulty with this issue then they may feel "oh it's just me." I'm quote unquote, I guess I'm the crazy one or something. Well they're not. They're, they're very normal. They are dealing with intense situations of combat. Some deal better with it. They come home, perhaps they have a better, stronger support network in their family and their friends, in their community.

There are differences in support even in the military roles of the different...for example, the Reserve and the Guard have less of a military support and are having a more difficult time with dealing with this Post Traumatic Stress issue and counseling and giving them the support that they need verses the traditional Army base, the troops that return home together and they still have that community. They can still talk with their battle buddies. They can kind of, you know, get the other person's back. So that, that's one of the main reasons why talking about this issue, why myself just as a citizen, a concerned citizen, I don't want to see these people falling through the cracks. I think we should have learned something.

We are a giving society. We are a society who supports our troops. And so, I think that, for example, one of the biggest things I would love to see more people advocate for: Many veteran's groups, veteran's families have said that one of the biggest obstacles is of course getting their veteran to accept that maybe they need the help of somebody else and to get them into the VA center for counseling. Or to get them to any other type of perhaps private counseling.

And so, I think one thing that we could do that would really show our support for the troops, in a tangible way as citizens and as the military, is that once they return home, why don't we have a program set up that they automatically have to attend a three month counseling program? Probably a group program with other combat veterans. If they didn't want to attend something like that, individual counseling. Whatever the soldier, however, he is going to be able to deal with that, great. But I really think that rather than the soldier having to be the one to get up the courage to say "I'm floundering, I'm not dealing well with this, I'm hurting," why not just make that counseling available to them? If they personally don't need it, I bet you there is another veteran that he could help, he or she could help.

So, in that situation if they were all going to counseling for three months after they return, they'd still have that kind of a battle buddy group that they could talk about their experiences with. They could decompress. And they could check out each other's progress to make sure that nobody falls through the cracks. So, I think that's why I'm heartened to see the uptick in the national media's coverage. I think it's, it's going in a really good direction. More people know about this I think the more that we'll be able to help the soldiers returning.

KS for ePMedia: Now of course you've done a lot of great work at ePluribus Media on this issue. You have also begun editing an online journal about PTSD called PTSD Combat: Winning the War Within. What's the next facet of the story that you're working on? Where, where does this story go from here?

IM: Well, and thank you for the plug for that too. You know the, the blog started up mainly because I had so much material that I couldn't just put you know as a blog entry, post it. I wanted to have one area to be able to have the veterans, their families to be able to go to so thank you for that. I'm also working on a wonderful local angle. I think that this problem is probably very big for most people and you, you don't know how can you help. I mean certainly, write your Congressman, your Senators. Get them on the ball with this.

Just this past week we did have some legislation that was introduced by Senators Kerry, Akaka, Clinton -- oh I'm missing a few of them -- who for Post Traumatic Stress Disorder, to put some more money into it to get some of that counseling available to them that I was just talking about. So, those types of things we can all do. Advocate for change in that way. But, then we can also do things locally. You can inquire if you have a local VA center. You can inquire to see if perhaps a group, you can get together with a group to ask your local officials "What are we doing to make sure that our veterans are getting the counseling and care that they need?"

And that's what I've been involved with, with a group out here in Dixon, Illinois that I've been honored to be a part of. I'm certainly just one small person in the cog here; but, we are hoping to get some more funding from the State of Illinois to get a program up and running that is based on peer counseling methods both that we have here at home and in Australia. So that's exciting to be involved in. And, of course, continue my writing and my advocacy. And doing whatever I can to help in whatever way that I'm necessary, whatever I can do to help.

So, I'm really very pleased to see what we've managed to accomplish up to this point. We can't do it alone. I certainly can't do it alone and we all need each other. I can honestly say, again, a big plug for ePluribus Media because I know I would not have stuck with the issue myself personally. As you mentioned, I don't do this full time. I have my own small business that I run. I'm just a concerned citizen who was interested in the topic. Had ePluribus Media and others from around the blogosphere not supported the work, then I probably would have slowly fallen away from it because it's such a big issue that without the help of other organizations you quickly would probably drown in it. But, that's not going to happen. We're definately well on the way towards some good things happening. I think the veterans are, are going to a see some better positive change coming up here so it's, it's been a great experience.

KS for ePMedia: And if you're interested in this issue at all I strongly suggest you follow up with a visit to www.epluribusmedia.org which is the ePluribus Media Journal site. You can find all of Ilona's diaries including those she has written with D.E. Ford and Commander Jeff Huber and they really give a great deal of deep background on the PTSD issue with a special emphasis on Iraq War Veterans. You can also visit PTSD Combat, Ilona's online journal, at PTSDCombat.blogspot.com and the links as always will be in the show notes. And while you're linking, I'll let myself out. This has been the ePluribus Media podcast for April 11, 2006. I'm your host Kay Shepherd, thanks for listening, stay subscribed and remember "it's not them, it's us." See you soon.

Podcast available from the ePluribus Media Podcasts page.

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Thursday, April 13, 2006

Do's and Don'ts List for Interactions with Returning Troops

Advice from Jennifer Iveland of the VA Vet Center and a member of the Army Reserve's 785th Combat Stress Control Company, as listed in Rochester, MN's Post-Bulletin:

Let them know you are glad they are back.
Make use of their newly acquired experience, maturity and responsibility.
Encourage their input.
Don't isolate them.
Don't force them to talk about their experience.
Don't offer your opinion about the war unless you were there.

Family members and close friends may need more detailed tips on opening lines of communication with their returning troop.

Click on 'Article Link' below tags for family resources...

Some further resources to tap into:

National Center for PTSD: Returning from the War Zone: A Guide for Families [pdf]
Turning Your Heart Toward Home Workbook [pdf]
Journal of Clinical Psychology Expert Clinical Guidelines Series: Guide for Patients and Families [pdf]
Navy's Lifelines Services Network: Combat Stress Reactions Online Video Series for Families
THRIVEnet: Guide to Listening to War Veterans for Family Members
Recommended Reading List for Military Families
Get specific questions answered via an online community.

If you know of a resource that's been a great help to you, please drop those in comments.

Labels: civilian, family, reading, reintegration

Update on VA's Centers of Excellence Plans

Good news for Rochester/Canandaigua, New York veterans: a Veterans Administration Medical Center which appeared on the VA's 2003 closure list is now set to focus on posttraumatic stress disorder treatment. When its new mission (to "become a model for post-traumatic stress disorder programs") is realized it will join VA Medical Centers in Waco, TX (which is slated to "develop national models for psychiatric rehabilitation and treatment") and San Diego, CA (which will "focus prominently on bolstering treatment for veterans just returning from war") as three 'centers of excellence' in delivering premiere medical care to our veterans.

WHAM Channel 13 (Rochester, NY) covered it in this video report.

Click on 'Article Link' below tags for more...

From the Rochester Democrat and Chronicle:

Veterans Affairs Secretary Jim Nicholson told a House subcommittee [last] Thursday that the V.A. Medical Center in Canandaigua will focus on ways to treat post-traumatic stress disorder. Testifying before the Appropriations subcommittee on military life and veterans affairs, Nicholson disclosed only limited information about the Canandaigua facility's future. He said that as one of three mental health "centers of excellence," it will develop PTSD treatment models, especially for rural settings.

V.A. officials recommended in 2003 that the 72-year-old Canandaigua center be closed in a systemwide cost-cutting effort. But protests, a letter-writing campaign and elected officials' intervention prevented that. Former V.A. Secretary Anthony Principi promised in 2004 that a new nursing home and outpatient clinic would be built in the Canandaigua area, though not necessarily on the current campus.

Then last year, Rep. James Walsh, R-Onondaga, chairman of the subcommittee Nicholson addressed Thursday, included language in an appropriations bill directing the V.A. to establish three centers of excellence in mental health.

From the Waco Tribune-Herald:

The Waco Veterans Affairs Hospital will play an expanded role in helping returning troops transition from combat to civilian life in its new capacity as a center of excellence for mental health. As the facility continues to be considered for downsizing, VA Secretary Jim Nicholson told a congressional panel [last] Thursday that doctors at the Waco hospital will be asked to develop national models for psychiatric rehabilitation and treatment.

Although the plan does not have any direct bearing on the massive federal review of the hospital’s future, supporters cheered the development. “It’s good news for all of us who want to keep the Waco VA Hospital campus open because it shows the VA recognizes Waco’s unique strength,” said U.S. Rep. Chet Edwards, D-Waco.

Under Nicholson’s plan, the hospital will:

Collaborate with Department of Defense medical personnel at Fort Hood to provide additional outreach services to soldiers returning from Iraq.

Build on existing programs designed to help troops transition from battle to home.

Develop a structured approach to rehabilitating mentally ill veterans that gives patients a larger share of responsibility over their recovery program.
Congress recognized the Waco VA Hospital and two other hospitals in New York and California as centers of excellence in mental health last year, and VA administrators have been trying to decide how best to use the hospital’s new designation. “This is the first official statement from the leader of the VA saying we have specific, tangible plans for the center of excellence,” Edwards said. “It is no longer a center of excellence in name only.”

Recognizing expertise

“(Nicholson) was acknowledging our expertise in the mental health field and the programs we already have,” she said.

The center of excellence designation comes with $4 million to $6 million in new funding for the three hospitals combined, Edwards said. The resources may be an indication Nicholson isn’t ready to close the hospital, Edwards said. “This new plan that was laid out today for the first time doesn’t guarantee that the Waco hospital will remain open, but it would be awfully unusual for the VA to be committing millions of dollars in resources to Waco’s role in mental health research and services if it had a plan to shut down the entire campus,” Edwards said.

CARES study

The Waco and Canandaigua hospitals are among 18 nationwide being reviewed by federal consultants under the Capital Asset Realignment for Enhanced Services study, which means they could see downsizing or changes in their mission.

Coke Mills, a leader in the effort to keep the hospital open, said the new proposals will benefit veterans, and he implored VA officials to scrap plans to review the hospital when it has new responsibilities during the wars. “If that’s what you’re going to do, then stop this whole CARES business,” Mills said. “It’s silly to go on with it.”

Hopefully, last Thursday's comments by the VA head assures that these facilities will grow into true 'centers of excellence' in mental health. Contact your elected leaders, and let them know you're interested in seeing these plans move forward.

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Wednesday, April 12, 2006

Free, Anonymous Online Mental Health Screening

Screening for Mental Health, a nonprofit organization, offers military troops and family members a free, anonymous online mental health and alcohol self-assessment. Funded by the U.S. Department of Defense Office of Health Affairs, the screening lets you check yourself for depression, bipolar disorder, generalized anxiety disorder, post-traumatic stress disorder, and alcohol abuse from the comfort of your own home. This same screening is also available by calling 1-877-877-3647.

Click on 'Article Link' below tags for related posts...

Labels: anxiety, depression, diagnosis, freebies, nonprofits, online, psychology, resources, screening, self medication

Tuesday, April 11, 2006

America, We Must Embrace and Heal Our Veterans

An important event took place in Kalamazoo, MI yesterday evening. Author and psychotherapist Dr. Ed Tick headed a unique discussion on the "moral, spiritual, and cultural dimensions of war trauma" at this year's Reading Together series. He advocates that all citizens work together towards the return to health of soldier and society alike following the upheaval of war.

Click on 'Article Link' below tags for more...

From the Kalamazoo Gazette:

The transition from war zone back into society extends beyond the soldier, an author and psychotherapist who specializes in post-traumatic-stress disorder told a Kalamazoo audience Monday.

Members of society must also take an active role in healing veterans from the trauma of war, Dr. Edward Tick said in a speech at Kalamazoo Valley Community College. "We are in sacred territory here when we're considering war and its wounds," said Tick, author of "War and the Soul: Healing Our Nation's Veterans from Post-traumatic Stress Disorder."

Because of "difficult experiences and wisdom that veteran's carry," Tick said war stories should be shared as a healing process for soldiers and society and as a way to keep in mind the brutality of battle.

The sooner society begins the work of understanding the traumatic experiences of war, the sooner healing can begin. The work is done by listening to the stories of the returning combat veteran.

Tick said the long-lasting pain of war stems from trauma -- including rape, accidents, crime and illness -- that needs to be understood by society. "And when we don't let them tell their story in their community ... they lock the war inside," he said, urging a "holistic, spiritual, moral and communal" approach to healing such trauma.

Tick called PTSD an identity disorder because people who suffer such trauma lose part of who they were and need to rediscover themselves. He urged members of society to warmly welcome soldiers back from current wars, and to begin to embrace all veterans. Tick talked of creating a way of honoring "warriors," similar to how other cultures do. He said that veterans are more wise for having seen war's literal power over life and death.

After Tick's speech, Vince Rampollo said he sees the same thing today as when he returned home from serving a year in the Korean War. "People are living their life like there's no war," said Rampollo, 73, an Army veteran from Kalamazoo. "Don't they know there's a war?"

Dr. Karen Blaisure, 45, of Kalamazoo, said Tick's speech "provides an insight into some people's reality and those of us who don't go to war can be part of a solution and help."

Contact the Kalamazoo Gazette if you wish to thank them for their fine coverage of this event.

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Helpful Stress Reduction Information

Social Workers offers their visitors useful information and resources for stress management that may be invaluable for those coping with PTSD -- or caring for them. Great pages to check out:

They also explore mind & spirit, suicide prevention, and living with illness topics among many others. A sample of their offerings below the fold.

Click on 'Article Link' below tags for more...

In educational interest, article(s) quoted from extensively.

Continuing:

The Impact of Stress on the Body

* Cardiovascular system – High levels of cortisol can raise your heart rate, increase blood pressure and blood lipid levels. These are risk factors in heart attack and strokes.

* Immune system – Did you ever wonder why you appear to catch more colds and come down with other infections when you’re stressed? Chronic stress tends to weaken you immune system making you more susceptible to whatever is “going around.”

* Nervous system – If your flight-or fight response system never shuts down, stress hormones can produce constant feeling of helplessness, anxiety and impending doom.

* Digestive system – Is it any surprise that you you’ll be stricken with a bout of diarrhea or a queasy stomach when you’re under stress? This happens because stress hormones slow the release of stomach acid and the emptying of the stomach. The same hormones also stimulate the colon, which speeds the passage of its contents.

Self-Help Strategies

You can do many things to help alleviate or quell stress without medications or intervention, starting simply with breathing.

Close your eyes, breathe deeply, and try to answer this question. When was the last time you felt truly relaxed? What was happening in your life? Very likely you were in a quiet, comfortable place where there was no pressure to do anything, and you could sit back and enjoy the day. You felt peaceful and at one with the world. For most people, that’s the definition of a vacation.

Think of it this way: Your body needs a vacation every day. Here are some ways to achieve that.

* Deep Breathing - When we are stressed, our breathing becomes shortened to the point that we can hyperventilate if we are faced with acute stress. Counter the natural instinct by deliberately taking four deep breaths every time you feel stressed. Slowly breathe in through your nose, hold it for five seconds and then release the air through your mouth.

* Exercise - Ongoing muscular tension goes hand in hand with chronic stress response. Counteract it by taking a brisk walk, playing a round of tennis, swimming a few laps. The goal is to keep your body limber and moving. For a more relaxing form of exercise, consider taking a yoga class or even tai chi.

Many gyms, community centers and adult night schools offer classes in this increasingly popular disciplines.

Set aside at least 10 minutes of your day to simply sit and be. It’s easier said than done, yet the benefits are tremendous. Meditation practices are equally helpful in teaching people how to quiet their thoughts and totally relax.

Keeping Diaries and Journals

Some people find solace in the privacy of their journals or diaries. Studies have shown that writing about stressful events or even huge, traumatic experiences can help to alleviate the stress and even improve the immune system. Again, community colleges, adult night schools and sometimes even hospitals offer classes in “ journaling” or therapeutic writing.

If you find that despite your best efforts to get a handle on things in your life, stress seems to be overtaking you, impeding you from living as you’d like to, making you feel chronically tired, or hopeless, a social worker may be able to help.

The goal of meeting with a skilled social worker would be to guide you to come up with a workable plan to help reduce or alleviate the stress in your life. This may entail psychotherapy to help you determine the source of the stress.

Labels: art, caregivers, mind_and_body, stress, treatment, writing

Combat PTSD Affects Non-Combat Troops, Too

As the Iraq war has moved away from traditional combat into guerilla or insurgent warfare, an increasing amount of non-combat personnel are placed at greater risk. No longer are soldiers and Marines the only ones at risk for posttraumatic stress disorder. Female troops (who are supposedly kept from taking on combat roles), medics, administrators, and a variety of others in a supporting or staff role all are now exposed to traumatic conditions that often trigger PTSD: unexpected attacks, violence, and the feeling that one is never safe. Tacoma's News Tribune introduces us to one nurse's story.

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From the News Tribune:

The hug seemed to go on forever. Neither wanted to let go. Rory Dunn and Tina Sundem hadn’t seen each other since their lives briefly crossed in an Army hospital’s intensive-care unit in the middle of Baghdad’s Green Zone nearly two years ago.

Dunn is a former soldier from Renton who suffered a traumatic brain injury and other wounds near Fallujah, Iraq, in May 2004 when a roadside bomb exploded next to his Humvee. He has no memory of the earlier encounter. He was in a coma and given little chance of survival.

Capt. Sundem, an Army nurse who treated him and now lives in Pierce County, vividly remembers former Spc. Dunn. “He was so severely wounded I never imagined he would live,” she said.

The piece describes their recent meeting in a Tacoma, WA restaurant.

For Dunn, 23, the reunion was a chance to say thank you. But for Sundem, 34, it was another step in her own recovery. Sundem’s experience in Iraq left her so traumatized that she attempted suicide 10 days before her tour was to end. She was diagnosed with post-traumatic stress disorder. She spent time in a psychiatric ward at Walter Reed Army Medical Center in Washington, D.C. She’s found it therapeutic to write about her flashbacks from her home in Roy.

Sundem read about Dunn in The News Tribune last summer. She knew that seeing him would help her confront the darkest memories of her days in Iraq and take some comfort that her nursing skills, at least in Dunn’s case, paid off. “Since I came back from Iraq, I haven’t been able to touch a patient,” she said. “It’s so sad. That’s who I was. I was good at it. Others with PTSD can go on to become bankers or lawyers. But the thing I am, I can’t be anymore.”

Stats on PTSD are given. Then, a closer look at the unique experience of combat-zone medical personnel:

Maj. Gen. George Weightman, who oversees Army medical training, said the Army tries to prepare its medical personnel for what they will face at military hospitals in Iraq. “We call them trauma factories,” Weightman said. “It can be a shock when 12 or 15 wounded arrive all at once. In the states, you see people injured in car accidents or wounded by guns or knives. You don’t see high-velocity or explosion wounds. It can get pretty intense.”

Health care professionals in any setting can suffer from “compassion fatigue,” a form of burnout. PTSD, however, can be far more serious. “We are trained to be objective and not grossed out by the blood and gore,” Weightman said. “But at some point – who knows what will trigger it – the emotional floodgates open. As a civilian you can get away from it. In a combat zone you can’t.”

Dr. Jeffrey Poffenbarger served in Iraq with the 31st Combat Support Hospital along with Tina Sundem.

Though the months he spent in the Baghdad are a blur, Poffenbarger said he remembers Dunn. Medical teams thought they had lost him a couple of times. He’s pleased that Dunn survived and would like to go hunting and fishing with him.

Poffenbarger seemed uncomfortable when asked about Sundem, though he did say he understood the stress she and other nurses were under. In many ways, Poffenbarger said the nurses in the Baghdad ICU had it tougher than the doctors, because they provided care 12 or 16 hours a day for six or seven days at a stretch. “It was very hard on some,” he said.

Others who served with the 31st Combat Support Hospital in Baghdad say that since returning they are a little edgier, a little angrier and a little less tolerant. “Everyone who goes there comes backed changed,” said Maj. Nancy Parson, an ICU nurse who was in Baghdad for a year. “You would do everything you could, and they would still die. Sometimes it felt like no matter what you did it wasn’t enough.”

Maj. Mark Brown, a psychiatrist who served in Baghdad and now works with Parson at Fort Bliss in Texas, said the stress came from more than just treating the wounded. Gunfire and mortar attacks caused him to worry about the mental health of those he worked with. “As a psychiatrist, I spent a little part of every day trying to think about what could help them,” he said.

Sundem came out of a military family, so it wasn't a surprise that she enlisted with the Army. Three days after receiving her orders, she was off to Iraq.

Sundem chooses words carefully as she talks about her time in Iraq. Her kids, Hannah, 4, and Bridger, 3, keep popping out of the family room, where they were supposed to be watching a video. She shoos them away as she talks about the carnage she dealt with in Baghdad. “I can’t describe the horror,” she said. “I swiped a wounded soldier’s eyeball into a trash can. At times I would think, ‘This kid isn’t going to make it, this kid will be a vegetable.’ It was never ending. There was no escape.”

Sundem said she worked 14- or 16-hour days, six days a week, and the ICU was always filled to capacity. If it wasn’t U.S. soldiers, it was coalition soldiers, wounded civilians, including children, or enemy combatants. Trash cans overflowed with empty transfusion bags and the wrappers from burn pads. Intercranial pressure monitors and intravenous pumps continually beeped. She recalls soldiers without legs or arms or faces.

One night as she tried to sleep, the blast from a mortar shell shattered the window, spraying her bed with glass shards. But Sundem said it was not the danger of living and working in a war zone that got to her. More than anything, it was the wounded. “I would lean over and whisper in their ears, ‘You aren’t going to die on my watch,’” she said.

With the pressure she placed on herself, and the horrific conditions swirling around her, she began her descent:

She said she began feeling hostile toward her co-workers and, especially, the enemy combatants she treated. At one point, she didn’t sleep for four days. “I called [my husband] Chad, wishing someone could make this stop,” she said.

Sundem did seek help. She was on medication and had been in contact with a psychiatrist. But near the end of her year in Baghdad, she snapped when she heard a doctor had bad-mouthed her care. She tried to commit suicide but survived, and the Army sent her to a hospital in Landstuhl, Germany. “I was a zombie when I got to Germany,” she said. “One doctor said I was the worst case of PTSD he had ever seen.”

While in Germany, Sundem said she couldn’t call home, at first. “I was afraid to come home,” she said. “I had changed. When I went over there I was a successful, happy person. Every premise of my value system was challenged and destroyed. I had lost my faith in God. I had lost my faith in humanity. I felt soiled and impure. I felt like a monster. I didn’t want to poison my children, and I was ashamed of what my family would see in me.”

She's received treatment at Walter Reed. And while she's on the Army’s temporary disability retirement list, she could be redeployed within the next five years. Her husband has already served two tours in Iraq, and one in Afghanistan. She takes each day as it comes, slowly getting her life back in order.

The flashbacks come mostly when her mind is idle. “I can feel them coming,” she said. “It’s like I am there, the smells, the sounds.”

As the flashbacks sweep over her, she retreats to her favorite living room easy chair, pulls out her laptop and writes. She has written a book she titled “Lest They Be Forgotten: An Army Nurse’s Memoirs.” No publisher has shown interest yet. But Sundem said it has been therapeutic and is a story that needs to be told. She will continue seeking a publisher.

Senior Army officials say PTSD and other mental health issues are major concerns with troops returning from Iraq, including medical staff. They have made counseling and treatment a priority. Col. Gregory Gahm, the chief of psychology at Madigan Army Medical Center at Fort Lewis, said his staff works hard to treat Iraq veterans who are facing mental problems. “We are able to help most of them,” he said.

The piece closes back in the restaurant, as she and a soldier she'd treated reunite to help them heal the wounds of their Iraq experience.

Dunn’s mother, Cynthia Lefever, said her son hoped the reunion would help Sundem get on with her life. Lefever hopes the story about her son’s survival would reassure others like Sundem that their efforts were appreciated. “She saw this tall, dark, handsome young man with half his face blown away, and he lived,” she said. “I’m hoping Rory’s story will sent a message for the caregivers to never, ever give up hope and to continue to give the best care possible.”

No one seemed to want the evening to end, but it was time for goodbyes and a final hug. “Rory, you are a miracle,” Sundem said.

“You were a good nurse. You did a good job,” he replied.

Please thank the Tacoma News Tribune for giving coverage to this important issue by publishing such a thoughtful and educational piece. And I'd like to thank the troops and their caregivers for all they do as they wear our nation's uniform.

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Monday, April 10, 2006

Father of Modern Combat PTSD Diagnosis Dies

The man whom I would call the 'Father of Modern Combat PTSD Diagnosis' is dead at the age of 80. Dr. Leonard Neff was a WWII veteran and psychiatrist who'd begun working with Vietnam veterans in the early 1970's. He rose to prominence in dramatic fashion when, in 1974, he persuaded a returning veteran who'd taken hostages to release them following 3 hours of negotiations. The event raised public awareness of the plight of many soldiers returning from Vietnam; it also led Neff to push to include a definition of what today is known as posttraumatic stress disorder to the Diagnostic and Statistical Manual of Mental Disorders.

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From the Los Angeles Times:

What seems commonplace now — the idea that a traumatic experience can cause stress that surfaces later — was not as widely understood or clearly defined more than 30 years ago when Neff began his work with veterans. In previous wars, veterans were described as "shell-shocked" or suffering from "combat fatigue," but these descriptions were not true diagnoses, and they seldom carried the moral issue of blame.

Vietnam veterans — many of whom were young and poor — were often seen as the source of their own postwar problems. Some observers argued that the war itself had little to do with the veterans' mental health issues, said Charles R. Figley, a noted psychologist, author and expert in psychological trauma. But Neff, a veteran of World War II, did not share that view.

"Neff wanted to shift the paradigm," said Figley, who heads the Traumatology Institute at Florida State University. "He said no matter who you are under this kind of circumstance — that being war — it will leave a mark, and that mark is predictable and understandable, and we need to do something about it."

Neff was working at what is now the Veterans Affairs psychiatric hospital in Westwood when a then 22-year-old Johnny Gabron took hostages at Griffith Park, recalled Floyd "Shad" Meshad, a Vietnam veteran who was a psychiatric social worker and with Neff when he negotiated the release of the hostages. "At the time we didn't have a diagnosis for Johnny," Meshad said. "We didn't have the term post-traumatic stress disorder."

Although Gabron's story came to define the Vietnam veteran returning with mental health needs due to combat, conflicting accounts of what his experience truly was didn't deter Dr. Neff.

When Neff spoke on behalf of veterans, he did so carrying the weight of his credentials and an international reputation, Figley said. In those contentious years when veterans returned to a sometimes hostile, sometimes ambivalent public, Neff was a bridge. He had the respect of academics, and because of his work with Meshad, a well-known street counselor, he also had the trust of veterans and their advocates who saw him as an ally.

Neff was an innovator who saw the need not only for better treatment but also for appropriate diagnoses. Clearly defining and acknowledging the disorder in the standard reference guide of mental health conditions would mean better treatment and more benefits for veterans.

In 1976 Neff and other professionals presented a working definition of the phenomenon at the annual meeting of the American Orthopsychiatric Assn. But Neff soon left the VA, Meshad said. Behind the scenes, he continued to support the efforts of Meshad, Figley and many others. "His influence and his work and his testimonial about the real world, especially war veterans, was instrumental in making sure [post-traumatic stress disorder] became an actual diagnosis in 1980," said Figley, who was part of a subcommittee of the American Psychiatric Assn. that examined the issue.

From MSNBC:

Himself a World War II veteran, Neff joined an effort to study the disorder that had described for decades as “shell shock” or “combat fatigue.” He helped officials understand how a traumatic experience in wartime can surface much later, and urged better services for Vietnam veterans.

“He said no matter who you are under this kind of circumstance, that being war it will leave a mark, and that mark is predictable and understandable, and we need to do something about it,” said psychologist Charles R. Figley, who heads the Traumatology Institute at Florida State University.

Dr. Neff passed away on March 26, 2006. Please read his entire obituary to learn more about this remarkable man's life and works.

My condolences go out to the entire Neff family.

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Today's War Can Be Difficult for Prior Veterans

The Lafayette, LA Daily Advertiser explores how some Vietnam veterans are affected by the past years' wars. [By the way, while combing the Internet for combat-related incidents to add to the PTSD Timeline, I found one heartrending example of how today's war can trigger traumatic reactions in veterans of earlier eras.]

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From the Daily Advertiser:

Vietnam veteran Donald Gene Young, 57, has a message for Iraqi war veterans. "I tell them young men, 'Don't go through 30 years and four wives like I did to wait to get help,' " Young said.

Young, of Eunice, said the war in Iraq seems to have triggered stress for many of his fellow Vietnam veterans. "It sparked a lot of them. They started really having problems," Young said. "Me, personally, I'm in a 12-man Vietnam group. Nine of them joined the group within the last two years. I knew what I had, but I wouldn't accept it."

Jody Baudoin, social worker at the Lafayette Veterans Administration clinic, said he often hears reports of events in Iraq triggering trauma for Vietnam veterans. "When they watch the news reports - I've heard this from many, many Vietnam vets - it's such a trigger. For them, it's not like remembering it, it's like re-experiencing it," Baudoin said. "When they see a roadside bomb or a casualty, they relive it. To the extent that they can't watch the news any more, they just turn off the television. Some of them feel so compelled to watch it, they can't help it. In a way, I guess they're still fighting their own war."

One PTSD-diagnosed Vietnam veteran says he escapes by watching movies. All kinds -- except for war movies. Donald Gene Young shares his feelings of guilt he's had to learn to live with all of these years, being the only one of seven battle buddies to make it home alive.

He said there still is a stigma for those in the military who experience emotional struggles triggered by the trauma of war. "The military doesn't want to talk about it. The military's job is to put their troops on the front line and do their job. The only reason I survived or anyone else survives is they teach you not to think, they only teach you to respond," Young said.

Gerald De Worth, spokesman for the Alexandria VA Medical Center, said about 608 combat veterans from Operation Enduring Freedom and Operation Iraqi Freedom have enrolled in health care programs. De Worth said the VA is working to streamline the process for recently-returned veterans seeking help. "The Department of Defense understands that it's going to take time to see if they can transform their culture to accept and not stigmatize soldiers who come forward and need help - that's going to take time," De Worth said.

Paul Lamberty, psychologist with the Lafayette Veterans Affairs clinic, agrees. "You still have the soldiers with the macho attitude. You can lead a horse to water, but you can't make him drink," Lamberty said. Both Lamberty and De Worth are pleased with the progress toward more Iraq veterans seeking assistance to adjust to life back at home.

After serving a year in Iraq with the Louisiana National Guard 256th Mechanized Infantry Brigade, Ricky Nicholas, 21, said he "had no clue" there would be any difficulties in readjusting to life at home. "I figured that we're all American citizens. This is the life we know," Nicholas said. "We adjusted to life at Fort Hood, in Kuwait and then Iraq, with no problems. I thought if I could adjust to all of this then I could adjust to what I had been used to, but come to find out that's been the hardest one."

Nicholas doesn't believe he has post-traumatic stress disorder, but he said he and his fiancee attend counseling sessions through the VA to help them readjust to his return. Nicholas' efforts to seek help now could pay off in the future. "At first it kind of starts as an adjustment disorder, then if it's not addressed, it can develop into full-blown PTSD," Baudoin said. "You've got to treat it while it's still manageable. If not, it will also trigger secondary problems like alcoholism and other problems. People will self-medicate when they're in pain. It can create a cascade of secondary problems. It can balloon."

The article closes by reminding us that early intervention and action is the key to staying on top of and containing war's after effects.

[UPDATE June 30 2007] A 10 minute video program produced in England called "Not Forgotten" describes how WWII era veterans and their family members have been affected in the decades following their war experiences:

Labels: family, history, stigma, trauma, triggers, video, vietnam, wwii

Sunday, April 09, 2006

Philadelphia Inquirer Offers Thoughtful Combat PTSD Piece

A solid piece runs in the Philadelphia Inquirer today which takes the reader through the combat-related posttraumatic stress disorder experiences of a handful of returning Iraq veterans, and discusses ways local groups in PA and NJ are joining with the Veterans Administration (VA) to give them the care they need and deserve once they're home.

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The piece opens with the story of Army Sgt. First Class Mark Rizzo. Fighting in Baghdad's Sadr City, four of his fellow National Guard battle buddies were lost in two separate attacks; the events of those days still haunt him.

From the Philadelphia Inquirer:

Rizzo's field-artillery unit, pressed into service as provisional military police, came home last year with 23 Purple Hearts, 17 Bronze Stars - and a lot more "processing" to do. Nearly 40 percent of the 180 members sought counseling, New Jersey officials said.

Nationally, at least 35 percent of Iraq veterans received mental-health care during their first year home, according to a Pentagon survey of more than 222,000 returning Army soldiers and Marines since 2003.

Across New Jersey and Pennsylvania, military, state and federal veterans organizations are aggressively encouraging Iraq and Afghanistan veterans to get help with posttraumatic stress disorder. New Jersey this year has more than doubled the amount to treat the disorder, allocating $800,000, which supplements federal aid. An additional $200,000 is likely to be sought next year as the needs grow, veterans officials said. Calls to the state's 24-hour hotline rose dramatically after 1,700 soldiers returned in November and December. Five hundred calls came in during the first six months of operation last year; more than 400 were logged in just the first three months of this year.

Pennsylvania, though it has no separate fund for posttraumatic stress treatment, is closely tracking returning troops and making them aware of the vast safety net of federal and state veterans programs.

A list of some of the efforts made by the military to educate troops on mental health issues is covered, including teaching soldiers to spot the signs of trauma and depression.

Many requests for counseling come 30 to 90 days after troops return, said Bill Devereaux, director of veterans programs for the New Jersey Department of Military and Veterans Affairs. Soldiers report problems with "nightmares, anxiety, anger, antisocial behavior, adjusting to family, overindulging with drugs," Devereaux said. "They miss the camaraderie of their friends, the rush of adrenaline, the call to arms. They also remember things that happened over there - dead friends, dead children," he added. An improvised explosive device "goes off, wounds two GIs, and blows up seven Iraqis. Now they feel guilty for being safe. The hardest thing they do now is get through traffic on Route 73."

At the same time, memories of combat trauma can be triggered when least expected. "A smell will set you off, a certain song, shadows on a dark night," said Devereaux, a Vietnam veteran who was wounded twice. "You don't get rid of it. You just learn to live with it. "Like physical wounds, you treat it. You continue counseling, group meetings. Talking to peers is the best cathartic medicine."

Another combat experience is shared, one of an attack on a former Iraqi base which left a Marine dead. Mark Rizzo, the soldier whose combat experience opens the piece, relates how he over-reacted to an abandoned car on the side of the street one day as he and his wife were driving along.

"I made my wife get in the passing lane," said Rizzo, a member of the Third Battalion of the 112th Field Artillery with units based in Cherry Hill, Vineland, Morristown, Toms River and Lawrenceville. "I said, 'We need to clear the area.' She kind of understood."

Today's veterans "are better educated about psychological reactions and what to do about it" than troops in past wars, said Steven Silver, director of the Coatesville center's posttraumatic stress disorder program. "Some information has been provided to them during the demobilization process," said Silver, 61, a Vietnam veteran. "They're told, 'If you have problems, get help immediately.' They've heard that message and are acting on it. There wasn't any debriefing or demobilization process at all after Vietnam," he said. The troops "turned in their equipment and were discharged to their homes 24 hours after they left the combat zone."

Rather than set aside funding for posttraumatic stress treatment, Pennsylvania depends on the VA network, said Cecil Hengeveld, deputy adjutant general for veterans affairs in Pennsylvania. "Every state does it slightly different," he said.

New Jersey provides funding so veterans don't have to be on waiting lists for treatment, Devereaux said. They can seek treatment from one of 20 private counselors across the state who are paid a prorated amount for their services.

Brig. Gen. Maria Falca-Dodson, deputy adjutant general of New Jersey's Department of Military and Veterans Affairs, said additional state money was needed because of the influx of returning troops with exposure to combat. "It's better to get care up front and not let it become chronic," she said. Rizzo believes troops suffer posttraumatic stress because, he said, "they have feelings for everybody - Americans and Iraqis. "Is it logical for one person to kill another person?" he asked. "It doesn't make sense, and soldiers struggle with that."

Please read the entire piece; then contact [scroll down] the Philadelphia Inquirer to let them know you appreciate their coverage.

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Friday, April 07, 2006

MA's Pioneer Valley Hosts "Stories of War and Return"

If you live in Massachusetts, you may want to check out some of the many events taking place in Nostio's month-long program, Stories of War and Return. The collection of films, lectures, poetry readings, plays, symposia, photo and art exhibits are "aimed at creating a community of understanding and support for veterans returning from service in Afghanistan and Iraq and for their families, and at encouraging a wider public dialogue and understanding concerning the realities of war."

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An ever so small selection of some of the film offerings:

Achilles in Vietnam
A 90-minute documentary by Charles Berkowitz, based on the book of the same name by Jonathan Shay. The stories of Homer and those of Vietnam veterans are woven together to portray the trauma of combat and survival.

After the Fog
Ten U.S. combat veterans, nearly all from Vermont, tell of their military experience in WWII, Vietnam and Iraq. They provide vivid, poignant, personally charged accounts of their own enlistment, training, combat, and return to civilian life. Their stories, skillfully woven together by the filmmaker, create a compelling and moving portrait of the American veteran across several generations.

All That I Can Be
At once an intimate portrait and an exploration of the promises and realities of the U.S. military in post-9/11 America. This YO-TV (Youth Organizers Television) documentary offers insight into the lives of young people making their way in a society in which joining the military seems to be their best or only option.

Let There Be Light
Filmed in 1946 for the U.S. government by the legendary director, John Huston. Highly controversial in its day for its unguarded depiction of WWII battlefield fatigue, Let There Be Light was suppressed by the government for over thirty years after it was produced.

The Soldier’s Heart
A 60-minute PBS Frontline documentary, telling the stories of soldiers who have come home haunted by their experiences and asking whether the government is doing enough to help them.

Voices in Wartime and Beyond Wartime
Heralded by the New York Times as “an elegant statement not only about the devastation of war, but also about poetry’s power to amaze,” these two films focus on the wounds of war and on the people who are working to heal them.

A few other events (there are more) in the program include:

Art Exhibit • 100 Faces of War Experience: Portraits and Words of Americans Who Have Served in Afghanistan or Iraq
“100 Faces” is a show of portraits, painted by Amherst artist Matt Mitchell, of Americans who have been witness to and part of the current theaters of war. Each portrait is shown next to a statement written by the person pictured in the portrait. The statements are letters, poems, recorded statements or other writings, which illustrate some small part of their personal experience of war. This exhibit will travel to several Valley venues in March and April.

Theater • All My Sons
Arthur Miller's 1946 masterpiece, directed by Rob Freedman. With World War II recently ended, the Keller family is living a prosperous and normal life in middle America. One Keller son is missing-in-action and one son has returned home to restart his life. But the impact of the war and how the family business prospered ultimately shatters the normalcy. This story of love, betrayal, greed, and responsibility won the Best New Play Award of 1947. Although set a half century ago, Miller's work addresses a variety of timeless themes and issues related to war and homecoming. The April 23rd performance will feature a "talkback" about the play with the actors and veterans of different generations, including veterans from the Veterans Education Project.

Although the film showings and art exhibits run through the end of the month, the crowning event is the following symposium scheduled to be held on April 22, 2006:

Rituals of Return and Healing
Featured Speakers: Kristin Henderson, William P. Mahedy, James G. Munroe, Philip G. Salois, Jonathan Shay
On Saturday April 22, 2006 the Nostoi Project, “Stories of War and Return,” will close with a one-day workshop focused on “rituals of return and healing.” This workshop will not be a time for long lectures but rather for deep searching and discussion shared by those most closely involved in the return and healing of soldiers from combat-secular care-givers (psychiatrists, therapists, counselors), religious caregivers (military chaplains and local clergy), veterans, and their families. The aim of this day will be to reach towards a fuller, more holistic understanding of the wounds inflicted by war and of the appropriate therapies for their healing.

Date, time, and place information for all of the above can be found on the Nostoi Calendar of Events page. Simply click on the event you'd like to attend for more details.

Boy, I wish I lived in Massachusetts!

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Psychiatric News: Iraq and Afghanistan Combat Experiences Compared

The American Psychiatric Association's Psychiatric News offers a quick glimpse at the differences found between the OEF and OIF combat arenas. The article also discusses a selection of findings from last month's ground-breaking mental health study published in the Journal of the American Medical Association.

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From Psychiatric News, Volume 41, Number 7, page 1:

Service in Iraq was more hazardous to soldiers' mental health than serving in Afghanistan or elsewhere, wrote the researchers.

"Overall, 19.1 percent of soldiers and Marines who returned from [Iraq] met the risk criteria for a mental health concern, compared with 11.3 percent for [Afghanistan] and 8.5 percent for other locations," they said. The latter rate is close to baseline levels from soldiers surveyed before initial service in Iraq and Afghanistan.

Soldiers and Marines returning from Iraq were twice as likely to screen positive for PTSD as those who had served in Afghanistan (9.8 percent versus 4.7 percent) and were twice as likely to be referred for mental health care (4.3 percent versus 2.0 percent). There were only minor differences in mental health issues when comparing active service troops with National Guard or Reserve members, or women with men. Overall, 28.4 percent of Iraq vets and 16.0 percent of Afghanistan vets were referred for any medical follow-up. Veterans of Iraq were hospitalized more often during deployment (6.6 percent) than Afghanistan vets (3.6 percent), which may serve as a marker for injury.

The need for mental health services is a function of combat experience, and ground service in Iraq entailed a greater exposure to combat, according to the PDHA data. Compared with troops in Afghanistan, troops in Iraq more frequently saw comrades killed or wounded and were three times more likely to fire their weapons. Half the soldiers and Marines in Iraq had felt in great danger of being killed, twice the rate of those who served in Afghanistan.

Both the nature of the war and deployment practices may account for differences in mental health outcomes in the two theaters. There are no safe zones in Iraq, Col. Elspeth Cameron Ritchie, M.C., psychiatry consultant to the U.S. Army surgeon general, told Psychiatric News. "Danger can come from any direction, and it's hard to tell friend from foe."

The multiple, year-long deployments to the war zone are tough on troops and their families. In World War II, soldiers, sailors, and Marines knew they were in for the duration of the war, and troops served only for one year in Vietnam. But those serving today in Iraq or Afghanistan may be there for a year, return, adjust to life back in the States, and then have to ship out again when their units are called up again. They must face the threat of roadside bombs and stresses on family life at the same time.

Please read the rest of the article. Additional information can be found in 2004's Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care study published in JAMA.

Labels: afghanistan, army, combat, guard, iraq, marines, psychology, reintegration, reserve, studies, wwii

Sidran Institute: A PTSD Info, Advocacy, and Counseling Resource

The Sidran Institute is a rich resource you'll want to make use of during your own PTSD research and recovery. They provide:

"Education and resources on traumatic stress.
Training and consulting on treating and managing traumatic stress
Publications on traumatic stress"

They also offer a help desk where you can email away for a listing of recommended PTSD counselors and programs in your area, along with further reading recommendations, etc. Feel free to download your own copy of their complimentary 76 page book, The Essence of Being Real: Relational Peer Support for Men and Women Who Have Experienced Trauma [pdf link].

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Thursday, April 06, 2006

Worries Vets May be Denied Care Due to Deficit Cut Plan

If the President's 2007 budget is to be believed, worries are understandably mounting over the nation's ability to meet the health care needs of our returning troops over the coming years. President Bush would like to cut the federal deficit by half, and his plan to do this includes decreasing veterans healthcare spending in 2008 -- and continue the cutting in successive years. With more severely wounded veterans returning from Iraq in need of care, many are suggesting either the President's budget shouldn't be taken seriously, or the cuts would amount to draconian measures directed at the very troops our President tells us to support.

Click on 'Article Link' below tags for more...

From AP:

At least tens of thousands of veterans with non-critical medical issues could suffer delayed or even denied care in coming years to enable President Bush to meet his promise of cutting the deficit in half - if the White House is serious about its proposed budget.

After an increase for next year, the Bush budget would turn current trends on their head. Even though the cost of providing medical care to veterans has been growing by leaps and bounds, White House budget documents assume a cutback in 2008 and further cuts thereafter. ...

"Either the administration is proposing gutting VA health care over the next five years or it is not serious about its own budget," said Rep. Chet Edwards of Texas, top Democrat on the panel overseeing the VA's budget. "If the proposals aren't serious, then that would undermine the administration's argument that they intend to reduce the deficit in half over the next several years."

In fact, the White House doesn't seem serious about the numbers. It says the long-term budget numbers don't represent actual administration policies. Similar cuts assumed in earlier budgets have been reversed. "Instead, the president's subsequent budgets have increased funding for all of these programs," said White House budget office spokesman Scott Milburn. "The country can meet the goal of cutting the deficit in half and still invest in key programs for vulnerable Americans, and claims to the contrary aren't supported by the facts of recent budget history."

So, while more veterans are returning from combat with "grievous injuries requiring costly care," the budget would reduce funding for just such care?

The administration insists it makes spending policies one year at a time and that the long-term veterans' budget figures are therefore subject to change. "We don't make multiyear discretionary funding requests," said Veterans Administration spokesman Scott Hogenson, who declined to speculate on whether long-term cuts were realistic. "We look at our needs and assess our needs on a year-to-year basis."

The rapidly growing budget for veterans' medical services, funded for the current year at $24.5 billion, would leap to $27.7 billion in 2007 under Bush's budget. But the medical services budget faces a 3 percent cut in 2008 and would hover below $27 billion for the next four years, even as increasing numbers of veterans from the Iraq war claim their benefits and the costs of providing care to elderly World War II and Korean War veterans continue to rise.

Those cuts would prove traumatic to the already troubled VA medical system, and would force staff cuts, delay investment in new medical equipment and deny care to hundreds of thousands of veterans. "The only way you can do what they want to do in terms of actually cutting the budget is to throw a lot of veterans out who are already in the system and/or redefine who is a veteran," said Rick Weidman, director of government relations for the Vietnam Veterans of America.

From the Raleigh-Durham Herald-Sun:

Rep. David Price, D-4th District, accused the Bush administration on Thursday of trying to delay medical and prosthetic research for veterans in its 2007 budget proposal by cutting funding that helps pay for a Durham rehabilitation center.

The proposal, part of President Bush's proposed Veterans Affairs budget of $80.6 billion for 2007, would cut research funding from this year's $412 million allocation to $399 million next year. Price said a $23 million increase from this year's spending is needed just to maintain current programs, according to the biomedical research and development price index, "so that means the administration's proposal is effectively a $36 million cut." ...

The Office of Independent Budget for the Department of Veteran Affairs said on its Web site that the agency would need $460 million for medical and prosthetic research in 2007. "It's really difficult to avoid the conclusion that the VA intends to slow down its research program and certainly halt any program growth in fiscal year 2007," said Price, a member of the subcommittee on Military Quality of Life and Veterans Affairs.

The proposed funding cuts for research could affect the Mental Illness Research, Education and Clinical Center at the Durham VA Medical Center. Harold Kudler, the center's co-director, said he did not want to speculate about what possible cuts might mean, but acknowledged that the center relies entirely on federal funding and hoped it would continue. The center, which opened last year and has been receiving $2.8 million a year in federal funding, focuses on treating and assessing the "post-deployment mental health" of soldiers returning from war.

Experts in the field say a growing number of returning soldiers are suffering from post-traumatic stress disorder. Louis Washington, director of Durham County Veterans Services, said he has seen more veterans, including some who served in the Vietnam War, filing claims for PTSD in the last few years. But Washington said being discharged from the military for PTSD is difficult because the Department of Defense views the disorder as "a way for soldiers to get out" of serving.

Everyone's vigilence on this matter is vitally important as we move forward. We must ensure that our returning troops have access to the recuperative care they deserve and need.

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Labels: disillusion

ABC News: Family Effects of Combat PTSD

ABC News' Sunday Spotlight this past weekend showed their viewers how "the vicarious power of traumatic stress" affects family members of a veteran coping with posttraumatic stress disorder.

Through the experiences of the daughter of a Vietnam veteran, we learn that combat PTSD has a broad reach beyond the battlefield -- scooping up even those who've never seen a day of combat. View the video report, and then thank ABC Weekend News for covering this important issue.

If you're a family coping with PTSD, you might want to check out some of these helpful combat PTSD books.

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PTSD Statistics, WWII to Iraq

See also the comprehensive The War List: OEF/OIF Statistics.

Jack Epstein and Johnny Miller of the San Francisco Chronicle have done a great job of compiling statistics for shell shock, battle fatigue, and today's posttraumatic stress disorder from wars waged from WWII to Iraq.

Click on 'Article Link' below tags for a sample of Iraq stats...

[One note: A few stats are already outdated since this article's publication in June of 2005. Currently, according to the VA, 20,638 OEF/OIF troops have been diagnosed with PTSD.]

From the San Francisco Chronicle:

-- According to a 2005 VA study of 168,528 Iraqi veterans, 20 percent were diagnosed with psychological disorders, including 1,641 with PTSD.

-- In an earlier VA study this year, almost 12,500 of nearly 245,000 veterans visited VA counseling centers for readjustment problems and symptoms of PTSD.

-- The Marines and Army were nearly four times more likely to report PTSD than Navy or Air Force because of their greater exposure to combat situations.

-- Enlisted men were twice as likely as officers to report PTSD.

-- 8 percent to 10 percent of active-duty women and retired military women who served in Iraq suffer from PTSD.

-- Studies show that U.S. women serving in Iraq suffer from more pronounced and debilitating forms of PTSD than their male counterparts.

-- A Defense Department study of combat troops returning from Iraq found 1 in 6 soldiers and Marines acknowledged symptoms of severe depression and PTSD, and 6 in 10 of these same veterans were unlikely to seek help out of fear their commanders and fellow troops would treat them differently.

-- A 2003 study published in the New England Journal of Medicine said about 1 in 6 soldiers returning from Iraq suffered from PTSD. Interviews with those at risk showed that only 23 percent to 40 percent sought professional help, most typically because they feared it would hurt their military careers.

An updated study regarding the mental health of our current combat veterans was published in the Journal of the American Medical Association last month. Additional combat troop data can be found in the March 2006 issue of Esquire magazine, which I summarized here.

[UPDATE May 26, 2006]: The Waterloo/Cedar Falls [IA] Courier does another fine job of reporting on combat PTSD in a companion piece to this weekend's article detailing the unique characteristics of the Iraq war. This latest offering takes us on a quick history tour of PTSD through the years. Although each war has its own flavor, the only thing that's changed as far as the war's emotional aftershocks is what we decide to call the mental burdens placed on its veterans.

From the Courier:

Experts maintain the mental state as it relates to armed conflict likely began when the first human picked up the first stick or stone. Only the name has changed. During the Civil War, soldiers who lost their will or capacity to fight were afflicted with nostalgia, later diagnosed as soldier's heart. The affliction for a time also carried the name Swiss disease, a tribute to soldiers from that country forced into military units.

Society later introduced the concept of railway spine, which evolved from numerous and horrific railroad accidents. The diagnosis was popularized in lawsuits in the 1870s. As the theory evolved, doctors reached a general view that intense fear disturbed a person's nervous system. By the end of the 19th century, traumatic hysteria and traumatic neurasthenia were the accepted terms.

Then came World War I. The global cataclysm advanced the idea of subconscious mental processes, a theory gaining acceptance. During that war, physicians described soldiers as shell shocked. They assigned the diagnosis to those with neurological symptoms but no physical injuries. The term came from the idea exploding shells changed atmospheric pressure near soldiers, harming their nervous systems. Researchers later determined relatively few cases involved exploding ordnance, which only added to the mystery.

World War II provided the concept of combat fatigue. Statistics show one in four casualties in World War II resulted from the mental disorder. In Europe, the U.S. military recorded one combat stress casualty for every three soldiers wounded in action, according to Field Manual FM 6-22.5, which is used and distributed by the U.S. Marine Corps.

But it was the experience of Vietnam which eventually brought about the term posttraumatic stress disorder, recognized in the Diagnostic and Statistical Manual of Mental Disorders in 1980. In 1999, the DOD began to require the use of the term combat stress reaction; later it was changed to combat-operational stress reaction to show how it differed from other forms of trauma-induced PTSD.

Part of the disorder's history includes society's reaction to it. Whether diagnosed with nostalgia, railway spine or shell shock, afflicted soldiers over the years were labeled as malingerers. When he admitted problems about midway through a tour in Iraq, Army veteran Ron DeVoll Jr. of Cedar Falls says supervisors' attitudes changed. "They talked down to me, called me a coward. 'You're supposed to be tough. You're supposed to be a man.' I thought I was," he says.

In the course of seeking help, DeVoll told superiors he was having nightmares. "They said, 'That's normal. You'll get over it.'" The response DeVoll received in 2003 echoes that from earlier eras.

During World War I, Thomas Salmon, a U.S. medical officer, defined the condition as merely an "escape" from intolerable circumstances. At the same time, Fredrick Parsons, commanding officer at a U.S. military hospital, said "a war neurosis which persists is not a creditable disease to have ... as it indicates in practically every case a lack of the soldierly qualities which have distinguished the Allied Armies." He added "no one should be permitted to glorify himself as a case of 'shell shock.'"

During World War I, the British military reportedly executed more than 300 of its own soldiers for cowardice, desertion or insubordination. In today's terms, at least some likely were only demonstrating effects of combat-stress reaction.

In World War II, the British military described some of its soldiers as lacking moral fiber. On the American side, Gen. George Patton severely tarnished his distinguished military career after slapping and yelling at two soldiers. The privates were recuperating in a military hospital in Sicily alongside others with more visible wounds. "Don't admit this yellow bastard," Patton reportedly yelled at a medical officer. "There's nothing the matter with him. I won't have the hospitals cluttered up with these sons of bitches who haven't got the guts to fight."

President Franklin Roosevelt received hundreds of letters about the incident. The majority supported Patton and his actions; some even suggested a promotion was in order. Ultimately, though, Patton was reprimanded, ordered to apologize and relieved of command of the Seventh Army.

One of the best articles I've seen out there on the historical aspect of PTSD. Not surprising that it come from a local media source; they've been cleaning the clocks of the national media coverage on this for quite a while.

Labels: afghanistan, army, history, iraq, kia, malingering, marines, society, stats, studies, va, wounded, wwii

Wednesday, April 05, 2006

MSNBC's Hardball Reports on Combat PTSD

Posttraumatic stress disorder continues to get some much-needed national media attention. Monday's Hardball is the latest example. Host Chris Matthews opened the the segment with the story of Marine Lance Corporal Blake Miller, an Iraq veteran who received international notoriety when a photograph snapped of him in Fallujah was printed far and wide. He's now returned to the states, and is coping with PTSD.

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From the Hardball transcript (scroll down 2/3 of the page):

MATTHEWS: Welcome back to HARDBALL. For many American troops fighting in Iraq and Afghanistan, getting home is only half the battle. Once back with their family and friends, they face the new challenge of coping with their sometimes traumatizing memories of war, the condition known as post traumatic stress disorder or PTSD. MSNBC‘s Norah O‘Donnell has more. (BEGIN VIDEOTAPE)

NORAH O‘DONNELL, MSNBC CHIEF WASHINGTON CORRESPONDENT (voice-over):

Remember this picture? It is one of the most iconic images from the Iraq war. Marine Lance Corporal Blake Miller went from Fallujah to the front pages of newspapers and was called The Marlboro Man. Now, almost two years later, Miller is at home in Kentucky a changed man.

BLAKE MILLER, ‘MARLBORO MARINE‘: You can put something aside, but as far as trying to forget it, it doesn‘t work.

O‘DONNELL: Miller now suffers from post traumatic stress disorder or PTSD.

Miller is 21, honorably discharged, and can't find employment. He's having trouble sleeping, he's bogged down by nervous ticks and an aversion to crowds. The video piece closed with comments made by Charles Engle, a Walter Reed psychiatrist, and Jay Nicholson, Secretary of Veterans Affairs stating that the VA is taking care of the needs of our returning veterans.

Following O'Donnell's opening report, Chris Matthews introduces his guests: Gordon Mansfield, deputy secretary for Veterans Affairs, and General Barry McCaffrey. Before he begins the debate in the studio, he asks O'Donnell the following question:

MATTHEWS: Norah, is there any deniers out there who say there‘s no such thing as PTSD?

O‘DONNELL: I did not speak to any who believe there is, because in every war from the Civil War, it was called soldier‘s heart, after Vietnam, it was called shell shock, and now we have this more clinical term called post traumatic stress disorder. So we know many our soldiers throughout America‘s history have suffered from some sort of mental illness, but of course all mental illness has been difficult to talk about until recently.

Blake Miller spoke to us, this very heroic soldier, because he says that by speaking out he hopes that other troops will feel more comfortable talking about some of the problems they‘re experiencing and there is help available from Veterans Affairs.

He asks the same question of his guests:

MATTHEWS: Mr. Secretary, thank you for joining us. Just to repeat the question, there‘s no doubt this exists?

GORDON MANSFIELD, DEPUTY SECRETARY OF VETERANS AFFAIRS: There‘s no doubt in my mind or in the V.A.‘s mind that it does exist.

Perhaps someone needs to tell Oliver North, or Sally Satel, MD, or Christina Hoff Sommers, or Mackubin T. Owens, or George F. Will, or...oh, you get the picture. PTSD is a political and financial liability, so there are a lot of people who might rather gloss over it.

Back to Hardball:

MATTHEWS: General McCaffrey, I was struck by the difficulty that soldier had, The Marlboro Man they called him, who appeared with the cigarette in that famous picture, talking about the casualties he inflicted. You‘ve been in a lot of combat. Is that something you‘ve seen from your fellow troops?

GEN. BARRY MCCAFFREY, U.S. ARMY (RET): Well, you know, first of all, let me start off by saying, there‘s no question that this PTSD is real. We‘ve always known you can take soldiers, Marines, push them over the edge.

A lot of artillery mortar fire, extreme cold, malnutrition, extreme heat. Don‘t tell them when they‘re going to come home from combat. There‘s all sorts of reasons why any combat soldier can reach his limit.

This young Marine obviously saw a lot of heavy combat. Having said that, Chris, let me just offer a balancing viewpoint. Most young soldiers and Marines that fought in heavy combat like Fallujah, as much fighting as we‘ve done since for God‘s sakes Aurora Pocket. That was high intensity battle. Most of them come home strengthened by it, not weakened. They‘re grateful for the comradeship, the valor of their fellow soldiers and Marines. They are grateful for hot water at night, grateful for freedom and safety here in America. Most of them aren‘t damaged by this experience.

MATTHEWS: Mr. Secretary, can you be that positive?

MANSFIELD: I would...

MATTHEWS: That combat doesn‘t generally hurt a person‘s psyche.

GORDON: Well, combat is not the ordinary way of life. It‘s an uncommon situation. So the question is what happens in that uncommon situation? What happens with the camaraderie of the unit that person serves in? And how that person is returned to the United States and how they can adapt to being back in the United States.

MATTHEWS: But all the guys that came back from World War II—you know, you talk about Tom Brokaw and the greatest generation. All of these guys came back, and I grew up with them as friends of mine—or father‘s of friends of mine. You know, Knights of Columbus guys, regular guys. And only later did I realize that these guys had been to hell and back, so many of them.

And they seem to be totally normal. They had a beer and a cigarette. They raised a family. They seemed to enjoy life, turned on the tube at night, watch Phil Silvers. You know, they seem to enjoy life, so many of them.

MANSFIELD: Your correspondent referred though to the term of shell shock and combat fatigue, and those two terms come out of basically World War I and World War II. And really I think they mean almost the same thing as PTSD means.

MATTHEWS: But they‘re the odd case or the familiar case?

MANSFIELD: Well, right now if you look at the total number of troops that have been in Iraq, that total is around 500,000. Out of that 500,000, we in the V.A. have seen about 145,000.

MATTHEWS: A third.

MANSFIELD: And out of those, 20,638 are being treated right now for PTSD or mental health problems. So that‘s 14 percent or 15 percent of the lesser number.

The Deputy Secretary, who was entirely sympathetic in my view, went on to explain some of what the VA is doing to help these thousands who are in need of help. Mental health assessments of all troops when they return home, as well as 6 months later (this new review, the PDHRA, has only recently been implemented), etc.

Now, it's nitpicking time. The problem I had with the Hardball segment was the choice of guests:

We had an official advocating for the VA.
We had an official advocating the hardline military 'rah-rah' view.
We had the pro-Bush administration host.
Anyone missing from this picture?

Why was there not a chair at the table for a representative from Veterans for Common Sense or any other veterans organization -- even someone from the more traditional/conservative AMVETS or American Legion?

Could the producers of Hardball not find anyone who directly represents and advocates solely for the veterans to sit at the table?

Labels: avoidance, fallujah, history, hypervigilence, incidents, marines, politics, reintegration, sleeplessness, stigma, va, vietnam, wwii

Democrats Present Bill to Raise PTSD Counseling, Care Funding

Great news to report on the PTSD legislation front. Sens. Daniel K. Akaka, Hawaii; John Kerry, Mass.; Frank Lautenberg, N.J.; and Hillary Rodham Clinton, N.Y. yesterday presented legislation to increase funding and provide appropriate counseling and benefits to combat veterans coping with PTSD.

Click on 'Article Link' below tags for more...

From the Army Times:

The bill, S 2500, the Healing the Invisible Wounds Act of 2006, aims to prevent the Bush administration from cutting disability benefits for veterans with combat stress and to improve counseling and readjustment services for National Guard and reserve members, sponsors said. ...

“Many of the men and women who served in Iraq and Afghanistan are suffering from some of the most severe physical injuries. However, even more of these brave service members have invisible wounds — difficulties with adjusting to not being on the battlefield or dealing with long-lasting visions and experiences that they encountered,” said Akaka, ranking Democrat on the Senate Veterans’ Affairs Committee. ...

The bill includes $180 million extra for readjustment counseling and mental health services at Vet Centers, and a promise of one-on-one counseling for returning veterans in addition to group counseling.

Akaka said it’s important to ensure that that counseling and other help is available as soon as combat veterans return because “the transition period for these soldiers is extremely critical, so critical that it can, in some cases, mean the difference between short-term readjustment issues and severely chronic psychological conditions.”

Guard and reserve members can demobilize so rapidly after returning from deployments in Iraq or Afghanistan that “they sometimes do not receive or are overwhelmed by the benefits information they need,” Akaka said. That is why the bill requires counseling to be available within 14 days of returning from combat, and that service members be kept on active duty to receive counseling, he said.

I applaud these Senators and this legislation. If you'd like to join me in thanking them, please feel free to contact them and let them know they're doing a great job for our returning veterans.

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Tuesday, April 04, 2006

Fox News Delivers Strong Combat PTSD Piece

FOX News delivers a great piece of reporting on PTSD this week. I want to thank reporter Kelley Beaucar Vlahos for her efforts in presenting PTSD to the FOX News audience. She wrote a solid piece any veterans health advocate should be glad to be associated with. And she eased my worries (this was the first time I was approached for an interview on the subject).

Click on 'Article Link' below tags for more...

From the article:

Blaming what they say is a shortsighted, under-funded system that does not learn from past mistakes, some advocacy groups say they are concerned that the federal government is unprepared to help the wave of troops returning from Iraq seeking mental health care.

"We should have been ready for this," said Steve Robinson, director of the National Gulf War Resource Center, a veterans advocacy organization. "It's simple math: If there is an increase in demand, and there is not an equal increase in dollars to hire new people to buy more equipment or provide more services, the person who suffers is the returning veteran."

Vlahos goes on to share some veteran mental health stats that come from a study published in the Journal of the American Medical Association in March.

She refreshingly included my main criticism I have with the data: you simply can't use these statistics (which are from the first year of the war) to reliably conclude what the current mental state of our soldiers is. As ground-breaking as this study was (and it honestly deserved the credit and attention it received), today's Iraq battlefield is entirely different than the one that existed in 2003 -- and that difference has a direct bearing on the number and intensity of PTSD cases we're seeing today.

The numbers were based on screening and follow-ups of more than 300,000 troops returning from Iraq, Afghanistan and Bosnia from May 2003 to April 2004, leading many to surmise that the number with mental health problems has increased since then, since the rate of battlefield casualties among U.S. service members has also risen.

"[The study] is only marginally relevant to what condition our troops currently find themselves in," said [the] editor of PTSD Combat: Winning the War Within. "A lot has changed since that time, including increased number of troop deployments ... and an escalation in [improvised explosive device] attacks."

She'd asked me if I believed that the nation is prepared to deal with the needs of our returning veterans coping with PTSD. I was glad to see that she included my response:

[A]n alarming rate of violent incidents, suicide, homelessness and unemployment among recent veterans has been documented, but the issue has not garnered much national attention. "We simply have not been the beneficiaries of that type of substantial coverage by the media these past three years," she said. "So, how exactly would the public be expected to be prepared for what's to come -- in fact, what is already here?"

Vlahos moves on to include a response by the VA, listing some of their efforts in providing the best health care possible to our returning veterans: the record-setting $80 billion set aside in Bush's 2007 VA budget is mentioned as is the addition of PTSD specialists in every VA facility.

The article concluded:

Republican Sen. Larry Craig of Idaho, chairman of the Senate Veterans Affairs Committee, said the government is already meeting the new demands. "The president has always made it clear that military veterans are among his highest priorities, and this budget demonstrates his dedication to all who have worked in uniform," he said.

In any case, advocates ... say they hope the government will stick to its promises. "How loudly we cheered them onward as they laced up their boots has no relevance once they've done their job. It's how well we took care of them when they return that really defines our true moral character."

Can I say that I'm humbled to have been the one whose words closed out this fine piece of reporting (not the least bit impartial at the moment, am I?). Although this one article is but a grain of sand in a sandstorm of spin and analysis in the modern media landscape, I welcome it (and I'll keep fingers crossed for more of its kind).

Bit by bit, hopefully people of all political stripes can come together on this of all issues. Can we all agree that our soldiers should be taken care of -- for their own good, as well as that of the society at large? Again, I'd like to personally thank Ms. Vlahos for writing this piece.

It personally gives me much to be hopeful for: the plight of our soldiers and Marines weighed down by PTSD is reaching a wider national audience, one that probably doesn't hear enough about this issue. Or, what it hears of the issue falls more along the lines of what's found in a recent Oliver North column -- that the mere public discussion of PTSD seems to be causing the high unemployment rates of our returning troops:

According to the U.S. Department of Labor, the national unemployment rate is hovering around 4.8 percent. But for veterans of the Global War on Terror (GWOT), the unemployment rate is more than three times higher -- 15.6 percent. Why?

Part of the answer is found in the fact that so few corporate executives and personnel managers are veterans themselves. Couple that with a drumbeat of adverse publicity about the war, a mainstream media fixation on military "atrocities" and the constant harping about post-traumatic stress disorder -- PTSD -- and one has to wonder how any war veteran gets hired. On a recent flight to Texas, my seatmate, a corporate CEO, asked if "all the troops coming back from 'over there' were 'screwed up.'" He cited a study alleging that, "more than a third of those who served in Iraq and Afghanistan needed psychological treatment." The actual number -- according to the American Medical Association -- is 35 percent -- a figure compiled by psychiatrists who have made diagnosing PTSD a self-employment program.

I have to say, I don't like this type of PTSD bashing attitude. Besides, 35% actually equals "more than a third" the last time I checked. And I've heard there's an organization that goes by the name of the Veterans Administration which has an entire website devoted to combat-related PTSD. An entire website!

Is the VA also merely trying to stay in business with its PTSD conspiracy ploy? What is someone like Oliver North trying to say when he makes light of PTSD, or blames its mere discussion for the woes of our returning troops?

So, I applaud Ms. Vlahos' solid reporting. A larger cross-section of people are learning more about combat-related PTSD tonight -- and, hopefully, a few more will rally around the cause as we have here. As great as it is for us to talk amongst ourselves, sometimes it's even better to have the opportunity to reach a wider audience -- and Ms. Vlahos' excellent piece allows us that opportunity.

And so, please:

Read the entire article.
Email it to those friends and family members who only believe things they hear from FOX News.
And thank FOX News for this effort to educate their readers.

Better late than never, say I! And keep it coming...

Labels: advocacy, craig, deployment, injustice, jobs, media, politics, psychology, shortfalls, society, stats, va

Monday, April 03, 2006

Senators Announce New Bipartisan Mental Health Caucus

Springing from last week's regrouped New Freedom Commission on Mental Health panels on Capitol Hill, U.S. Senators Pete V. Domenici (R-NM), Edward M. Kennedy (D-MA), Gordon H. Smith (R-OR) and Tom Harkin (D-IA) announce today the creation of a Senate Caucus on Mental Health Reform. Its goal is to help Senators better understand mental health issues, including combat-related PTSD.

Click on 'Article Link' below tags for more...

From a Campaign for Mental Health Reform press release:

CMHR Executive Director Charles Konigsberg said, "We are very pleased that the establishment of the new Senate Caucus by Senators Domenici, Kennedy, Smith, and Harkin will give invaluable bipartisan political support to making mental health a national priority." ...

Comments on the Senate Caucus on Mental Health Reform:

Senator Kennedy said, "The Senate Mental Health Caucus will work in a bipartisan way to educate the Congress on the importance of addressing mental health as a national priority. No one is exempt from the human toll of mental illness, and it is time to end the discrimination and stigma that millions of Americans face each day."

In particular, Senator Smith noted that one example of the Caucus' efforts will be to "help those of us who care deeply about mental health to educate our colleagues about the devastating impact of mental illness and the vital importance of access to mental health coverage for all Americans."

Kudos to these Senators for creating this caucus. The mental health education of our elected officials will go far in increasing PTSD awareness across the board.

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Thursday, April 27, 2006

Thank You For Visiting PTSD Combat

Bush Budget Fight: Senate Not Likely to Raise Vet Fees

Seattle Post-Intelligencer: Support the Troops Just a Slogan?

Wednesday, April 26, 2006

Veterans Rally: Recap on State Protests

Tuesday, April 25, 2006

Mount Vernon, OH: Returning Vet Support Group Organizes

One Student's Plea: Troops Deserve Our Help

Monday, April 24, 2006

Today's Combat Roles Not Only for Army and Marines

Military Chaplain: Different War, Different Stress

Sunday, April 23, 2006

The Fighting Never Ends: One Returning Veteran's PTSD Saga

Sebring, OH: Community Returning Veteran PTSD Program

Saturday, April 22, 2006

Army: 83 suicides in 2005, 67 in 2004

Storming Washington: Veterans March to the Capitol

Thursday, April 20, 2006

Madison, WI: Combat PTSD Art Therapy Program

Wednesday, April 19, 2006

Outstretched Hands: Organizations Helping Our Veterans

Tuesday, April 18, 2006

County Veterans Service Offices Swamped

Near Buffalo, NY? Catch Former Vietnam POW Talk on PTSD

Reconnecting with Your Kids After Deployment

Chronogram Magazine Reprints 'Blaming the Veteran' Piece

Sunday, April 16, 2006

Hilton Hotel Decision Angers Wounded Veterans

Saturday, April 15, 2006

CNN: Local VA Hospitals Increase PTSD Outreach and Care

Veteran Filing a PTSD Claim? Here's Help...

Steps

Tips

Warnings

Sources and Citations

Friday, April 14, 2006

ePluribus Media Interview with PTSD Combat Editor

Thursday, April 13, 2006

Do's and Don'ts List for Interactions with Returning Troops

Update on VA's Centers of Excellence Plans

Wednesday, April 12, 2006

Free, Anonymous Online Mental Health Screening

Tuesday, April 11, 2006

America, We Must Embrace and Heal Our Veterans

Helpful Stress Reduction Information

Combat PTSD Affects Non-Combat Troops, Too

Monday, April 10, 2006

Father of Modern Combat PTSD Diagnosis Dies

Today's War Can Be Difficult for Prior Veterans

Sunday, April 09, 2006

Philadelphia Inquirer Offers Thoughtful Combat PTSD Piece

Friday, April 07, 2006

MA's Pioneer Valley Hosts "Stories of War and Return"

Psychiatric News: Iraq and Afghanistan Combat Experiences Compared

Sidran Institute: A PTSD Info, Advocacy, and Counseling Resource

Thursday, April 06, 2006

Worries Vets May be Denied Care Due to Deficit Cut Plan

ABC News: Family Effects of Combat PTSD

PTSD Statistics, WWII to Iraq

Wednesday, April 05, 2006

MSNBC's Hardball Reports on Combat PTSD

Democrats Present Bill to Raise PTSD Counseling, Care Funding

Tuesday, April 04, 2006

Fox News Delivers Strong Combat PTSD Piece

Monday, April 03, 2006

Senators Announce New Bipartisan Mental Health Caucus

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