House Veterans Affairs Health Subcommittee Explores How Best to Support Military Families

Yesterday, another important hearing, Mental Health Treatment for Families: Supporting Those Who Support Our Veterans, was convened on Capitol Hill by the House Veterans Affairs health subcommittee. [Audio now online; video link not presently available]

Rick Maze, Army Times:

A House subcommittee was urged Thursday to expand the Veterans Affairs Department’s authority to provide mental health counseling for the families of veterans, including National Guard and reserve members who have returned from combat.

Current law restricts VA to providing “limited services to immediate family members,” said Kristin Day, VA’s chief consultant for care management and social work service.

“The law provides, in general, that the immediate family members of a veteran being treated for a service-connected disability may receive counseling, education and training services,” Day told the House Veterans’ Affairs health subcommittee.

That leaves a lot of gaps for people who fall outside the military health care system, some critics say.

Illinois Action: Sauk Valley Veteran Feedback Sought Regarding New Area Medical Clinic

For many veterans, in rural areas especially, a trip to the local VA can be an irritating if not daunting, all-day affair.

As younger Afghanistan and Iraq vets stream home in need of -- at times specialized -- health care services in greater numbers, they join those in their area who've served in previous conflicts and continue to draw on their health care benefits.

Not surprisingly, the need for local VA medical clinics has grown by leaps and bounds. Veterans in my area of Illinois are no different, and they've been advocating for more easily accessible options closer to home.

Experts, Advocacy Groups, Officials: VA Disability System Fixable

From Kelly Kennedy via Navy Times:

Medical experts, advocacy groups and Veterans Affairs Department officials say VA’s disability rating schedule needs to be updated — continually — but they denied the system is so bad that it needs to be dumped completely.

A Tuesday hearing of the House Veterans’ Affairs subcommittee on disability assistance and memorial affairs also focused on studies conducted over the past year that point toward needed improvements not only in the ratings schedule, but in VA’s disability retirement system itself.

Rep. John Hall, D-N.Y., chairman of the subcommittee, said VA needs to remove “archaic” criteria from the rating schedule; update psychiatric criteria to better reflect symptoms of troops diagnosed with post-traumatic stress disorder; find out why so many veterans with PTSD have been rated fully disabled; and update neurological criteria to include new research on traumatic brain injuries.

“The VA needs the right tools to do the right thing,” Hall said.

VA argued that it is already doing the right thing and has been updating the rating schedule, though officials acknowledged they could do better. From 1990 through 2007, VA had updated 47 percent of the ratings schedule, but 35 percent of the codes had not been touched since 1945. However, VA said it updated the codes for TBI in January and is working on an update for PTSD.

Sunday's NIU Memorial to be Simulcast at Iraq's Camp Victory; Remembering Another Lost Huskie

On January 31, 2008, indirect fire ended the life of 1st Lt. David Schultz serving in Iraq with the 82nd Airbone Division.

Two short weeks later, on February 14, the 2005 NIU alum was joined by five other Huskies -- one of them a 12-year Army veteran herself -- after the senseless events that unfolded in Cole Hall that day.

This coming Sunday, NIU and its supporters will draw together throughout the community, throughout the state, throughout the country -- their embrace even extending as far as the sands of Iraq -- to honor those lost.

Amidst Warrrior Transition Unit Overdoses, Army Surgeon General Schoomaker Blasts Streamlined Disability Pilot Project as 'Fast Bad Process'

From Kelly Kennedy, Army Times:

A pilot project intended to speed the process of evaluating and rating service members’ disabilities will do little more than turn a bad process into “a fast bad process,” the Army’s top medical official said Friday.

Army Surgeon General Lt. Gen. Eric Schoomaker’s comments came at a hearing at which the services’ surgeons general had their chance to brag about what they have done in the year since the outpatient scandal at Walter Reed broke — standing up units specially designed to take care of wounded troops, asking for and receiving money to house those service members, ombudsmen, internal checks and toll-free numbers for reporting problems – before the House Armed Services Subcommittee.

Schoomaker also spent some time talking about continued problems, including his view that the pilot project designed to streamline the disability system will not prove to be the answer. Under the test, taking place at three military medical facilities and one VA medical center in the Washington, D.C., area, service members will receive a single medical examination and a single disability rating issued by VA, an effort to eliminate duplication in the separate military and VA systems and speed up the process.

But Schoomaker said both the military and VA systems for dealing with service members’ disabilities is based on an “outdated” model from the 1940s, when most of the force consisted of single soldiers with no health care. “When you speed up a bad process, all you have is a fast bad process,” Schoomaker said of the ongoing pilot project.

On other issues, Schoomaker said mental health descriptors used by military medical professionals need to be updated to fit today’s ideas about post-traumatic brain injury and depression.

He also said the Army found a new “trend” as it grouped all of its wounded soldiers into one system where they could be carefully monitored: 11 deaths in that population due to suicide, accidental overdose by prescription medications, and in motor vehicle accidents. Schoomaker said the combination of multiple prescription drugs — usually pain medication — mental health issues, alcohol and no supervision on the weekends are contributing to the problem.

War-Related Mental Health Problems of Today's Veterans: New Clinical Awareness

This one is an oldie, but still a goodie.

Appearing in the July 2005 issue of the Journal of Psychological Nursing, this 11-page article is a good all-purpose clinical guide that can help us all better understand the diagnosis and treatment of combat PTSD. Download your own pdf copy to learn more about the following issues and more:

• War-related Emotional Responses
• Screening Questions for PTSD
• Stressors Faced by Today's Soldiers
• Medications Used to Treat PTSD

Illinois Veteran PTSD Screening, Reintegration Program Gets Underway

From the Quad City Times:

Barely off the ground, Illinois' first-in-the-nation program to help returning Iraq and Afghanistan veterans deal with mental health issues is drawing intense interest from legislators who would like to see the country as a whole take similar steps.

In late January, Illinois began using state money to set up mandatory screening of all returning National Guard and Reserve troops for post-traumatic stress disorder and traumatic brain injury, and also established a 24-hour hot line for veterans having trouble readjusting.

"We should be doing it nationwide, and we should be paying for it at the federal level," says Rep. Shelley Berkley, D-Nev., who is exploring what aspects of the $8 million Illinois program can be implemented at the federal level. "These are ticking time bombs. We've got suicides, homicides, domestic violence."

Last week, Rep. Phil Hare, D-Ill., called on Congress to adopt full mandatory funding for veterans' health care - making it a legal requirement in the federal budget, like Social Security and Medicare. In so doing, Hare cited Illinois' efforts at the state level as showing the unmet needs among veterans, and as pointing the way toward the type of programs that can succeed.

Since the program was started two weeks ago, 860 veterans and family members have come forward to get help, says Jessica Woodward, spokeswoman for the Illinois Department of Veterans' Affairs.

Comforting, Yet Discomfiting, New Clue Found in Florida Missing Iraq Veteran Case

From ABC News:

The discovery of a military-style "spider hole" that may have been used by a missing ex-Marine who is likely suffering from post-traumatic stress disorder has restored hope for the combat veteran's family that he is alive.

Eric Hall, 24, disappeared on Feb. 3 in Port Charlotte, Fla. He was staying with his grandmother when he experienced what his family and authorities have described as a "combat flashback." The Marine, who was left with a permanent limp from a 2005 bomb blast in Iraq, began walking around the house shooting an imaginary gun at imaginary enemies.

Hall then took off on his motorcycle, which later was found with engine running lying in the middle of a road in Deep Creek, near Fort Myers, on Florida's west coast.

The local sheriff's office called off its search more than a week ago, but Hall's mother, Becky, and a cadre of volunteers led in part by retired members of the military continue to look for the former Marine in an area densely covered with trees and shrubs. [pictures of the search and the spider hole they found]

Military PTSD Diagnosis Now Proof Enough for VA -- For Some

Kelly Kennedy, Air Force Times:

The Department of Veterans Affairs has scrapped a policy requiring combat veterans to verify in writing that they have witnessed or experienced a traumatic event before they can file a claim for post-traumatic stress disorder — but only if the military has already diagnosed them with PTSD.

“This change provides a fairer process for veterans with service-connected PTSD,” Sen. Daniel Akaka, D-Hawaii, said in a written statement. “[It] leaves claim adjudicators more time to devote to reducing the staggering backlog of veterans’ claims.”

In the past, a veteran has needed written verification — a statement from a commander or doctor, or testimony from co-workers — that he or she was involved in a traumatic situation to receive disability compensation from VA if they had not already been diagnosed by the military during a disability retirement process. But PTSD is the only condition that a veteran must “reprove” to receive disability benefits from VA.

“They don’t have to reprove their diabetes,” said Mary Ellen McCarthy, special projects counsel for the Senate Veterans’ Affairs Committee. “They don’t have to reprove a leg injury. I have never seen any other condition diagnosed in service [for which] people had to reprove their injury.”

A Tribute to the Life of Army Veteran and NIU Student Julianna Gehant

"God seemed to have made her just what she was that she might be a blessing to others, and when the influence of her character and abilities began to be felt, removed her. These are the Mysteries, my Dear, that we cannot contemplate without astonishment, but which will nevertheless be explained hereafter, and must in the mean time be revered in silence."

-- William Cowper

In a few hours, my husband and I along with a veteran friend are attending slain NIU student and 12-year Army veteran Julianna Gehant's visitation. While I don't wish to overstate this, I was near her and the others when the incident occurred and will carry them in my heart forever.

I did not personally know Julianna, but it's been my pleasure to have met a time or two with a few of the fine members of the NIU Veterans Club (images and words from last November's NIU Veteran's Day ceremony); a few of them even helped with a class paper of mine written last semester on returning veterans seeking college degrees following service to their country.

Returning veterans are among a community's greatest assets, among their greatest citizens. In times of crises and dark and violent circumstances on our soil or abroad, they step up to defend us; it's a shame that more in our society don't realize the strong leaders our returning veterans are.

Julianna was clearly one of these.

VFA Issues Report on Fort Drum, Site of Much Post-Combat Distress

Last November, eight-year Army veteran Sgt. Brad Gaskins was arrested for going AWOL from Fort Drum, New York. He'd served one peacekeeping tour in Kosovo and two tours in Iraq, having problems with flashbacks, nightmares, headaches, sleeplessness, weight loss and aggressive mood swings after returning from the second Iraq tour.

At the time of his arrest, AP reported:

...Gaskins said he left the base in August 2006 because the Army wasn't providing effective treatment after he was diagnosed with PTSD and severe depression. "They just don't have the resources to handle it, but that's not my fault," Gaskins said.

Navy, Marines May Send Psychologists to the Front

During the Russo-Japanese War (1904-1906), the first organized military system for treating combat fatigue occurred when physicians were placed close to the front ("forward treatment"). They were sent to perform evaluations of and administer care to traumatized soldiers.

The lessons of forward treatment, that soldiers receiving immediate care close to the action and their battle buddies were more resilient, is still relevant today. From the Associated Press:

Navy Chaplain Dick Pusateri has witnessed the stress of war on the faces of troops put in harm's way daily, in the strained relationships of families facing long deployments and the confessions of men shaken by the human cost of war.

For too long, chaplains were among the few people combat Marines felt they could turn to in a crisis. The Navy and Marine Corps aim to change that by sending teams of mental health professionals to the front lines after studies showed a jump in the past five years in cases of combat-related mental health disorders, primarily post-traumatic stress disorder.

"We've got a lot of knowledge about the way combat trauma affects people, and having somebody there to guide Marines through it in Iraq means we can respond to it more quickly," Pusateri said.

While psychologists and psychiatrists have long treated military service members on bases and in field hospitals, next month's deployment of teams of psychological professionals - one per regiment - to combat zones marks a new approach in identifying and treating mental health before problems arise.

Emotional Warmth and Sunny Saturday Light Chase Away the Darkness at NIU

I wanted to quickly share a few photos and reflections with you of my return visit to NIU yesterday [see them all at Flickr].

It was a chilly day, in the upper 20's; but, the warm hugs and heartfelt nods among Huskies -- now feeling more related and open to one another than at any time before -- leaning on one another cast a soothing glow in my heart. It was quite a tonic to my soul.

Action: Full Faith in Veterans Act

Editorial from the Bangor Daily News:

The phrase "War is hell," attributed to Union Gen. William Tecumseh Sherman during the Civil War, is perhaps the most succinct and eloquent description of armed conflict. Yet it falls far short of bridging the gulf between those who have experienced war and those who have not, and it fails to impart the indelible impression this particular hell leaves on young hearts and minds.

Almost no one survives war unscathed; whether the scars are physical or psychological, they are there, and remain for decades. The terms used to describe troops who struggle to heal from those wounds have changed, from "shell shocked" in the World War II era, to "flashbacks" from the Vietnam years, to the clinical Post Traumatic Stress Disorder now in vogue. But the condition is the same. After witnessing unspeakable horrors, or having to kill, or simply from the crushing weight of constant fear, our young men and women succumb. It is a reaction that is more normal than not.

Some rebound with rest and connection with family and friends back home. Others need help. Just as the federal government is obligated to treat the physical wounds, so must it treat the psychological wounds. A bill proposed by Reps. Tom Allen and Mike Michaud, the Full Faith in Veterans Act [pdf], goes a long way toward ensuring that PTSD victims get help and compensation.

The bill would change the standard of proof for veterans who don’t have full military records to verify the cause of their PTSD. Under current law, veterans must have a diagnosis of the condition and military documentation or two "buddy statements" to show the stressor event occurred during duty.

A Little Update on Things Here

Thought I would pass along a few quick impressions and thoughts going through my mind the past few days in reaction to the incidents at NIU, as well as share a bit of personal musings.

It has been a very hectic few days; many, many calls and emails of concern have come in and I'd like to thank everyone for caring, for giving of themselves, for listening. It all the more is appreciated because I have not been giving of myself, reaching out to you, in the same measure lately.

It's been a peculiar few months for me.

A Dark Day at NIU with Pockets of Light

More lives dramatically changed by another base act of the type we've become all too familiar with over the past few years.

I'm sure most have by now heard about the events on the Northern Illinois University campus yesterday afternoon. I'm a student at NIU and was seated at a doorway, catching up on reading between classes, in a building immediately next to Cole, the building where the shooting took place. [I shared my experience in a post after returning home.]

Alongside so much mourning that we have before us, we have much to be proud of. I witnessed some really courageous, kind, insightful actions yesterday. I’m proud to be a Huskie, blessed to be a part of the NIU family. Yet even more importantly, I'm keeping those most directly faced with personal losses in my thoughts tonight and in the days and months ahead. We will persevere.

By Abraham Lincoln (who lost three sons during his lifetime):

"In this sad world of ours, sorrow comes to all...
It comes with bitterest agony...
Perfect relief is not possible, except with time."

Upcoming Congressional Hearings on Combat PTSD

Received this head's up on two important upcoming House Veterans Affairs Committee hearings from Mike and Kim Bowman. In December as you may recall, they offered Chairman Bob Filner and the committee heartrending testimony on their son Tim's suicide. Tim was an Illinois National Guard member, one of the OEF/OIF veterans' groups most at risk for taking their own lives after returning home.

Dates to make a note of:

2/28/2008 - Mental Health Treatment for Families: Supporting Those Who Support our Veterans

4/01/2008 - Post Traumatic Stress Disorder (PTSD) Treatment and Research: Moving Ahead Toward Recovery

More on these hearings as it becomes available.

AP: Over 50% of VA's OEF/OIF Veteran Suicides from Guard/Reserve

From the Associated Press:

More than half of all veterans who took their own lives after returning from Iraq or Afghanistan were members of the National Guard or Reserves, according to new government data that prompted activists on Tuesday to call for a closer examination of the problem.

A Department of Veterans Affairs analysis of ongoing research of deaths among veterans of both wars — obtained by The Associated Press — found that Guard or Reserve members accounted for 53 percent of the veteran suicides from 2001, when the war in Afghanistan began, through the end of 2005. The research, conducted by the department's Office of Environmental Epidemiology, provides the first demographic look at suicides among veterans from those wars who left the military.

Joe Davis, public affairs director for the Veterans of Foreign Wars, said the Pentagon and VA must combine efforts to track suicides among those who have served in those countries in order to get a clearer picture of the problem.

"To fix a problem, you have to define it first," Davis said.

Bush Admin: Vets Have No Legal Right to Expect Specific Types of Medical Care

Latest updates on this and related VA/Army lawsuits posted in "As Second Legal Attempt Fails to Force VA Hand on Disability Claims Processing, Army Sued Over Discharged Veteran PTSD Disability Ratings." -- Ilona Meagher, 12/17/08

Astounding when you see how our government really feels about caring for its vets. The San Francisco Chronicle:

Veterans have no legal right to specific types of medical care, the Bush administration argues in a lawsuit accusing the government of illegally denying mental health treatment to some troops returning from Iraq and Afghanistan.

The arguments, filed Wednesday in federal court in San Francisco, strike at the heart of a lawsuit filed on behalf of veterans that claims the health care system for returning troops provides little recourse when the government rejects their medical claims.

The Department of Veterans Affairs is making progress in increasing its staffing and screening veterans for combat-related stress, Justice Department lawyers said. But their central argument is that Congress left decisions about who should get health care, and what type of care, to the VA and not to veterans or the courts.

A federal law providing five years of care for veterans from the date of their discharge establishes "veterans' eligibility for health care, but it does not create an entitlement to any particular medical service," government lawyers said. They said the law entitles veterans only to "medical care which the secretary (of Veterans Affairs) determines is needed, and only to the extent funds ... are available."

The argument drew a sharp retort from a lawyer for advocacy groups that sued the government in July. The suit is a proposed class action on behalf of 320,000 to 800,000 veterans or their survivors.

"Veterans need to know in this country that the government thinks all their benefits are mere gratuities," attorney Gordon Erspamer said. "They're saying it's completely discretionary, that even if Congress appropriates money for veterans' health care, we can do anything we want with it."

Chicago Trib Mag Brings the War Home

From Sunday's Chicago Tribune Magazine:

PTSD can make the bravest soldier, police officer or chaplain curl up and cry, explode with rage or drown in drink, remembering something they saw or did when only chance seemed to separate life and death.

It is why [Army medic Eugene] Cherry brought a seething anger home along with his dog tags. They dangle and dance at the end of a chain hanging from the knob of his bedroom door. When he closes the door to the outside world the tags make a sound like the tinkling clatter of wind chimes or an alarm on the perimeter.

Cherry knows that soldiers have a hard time accepting as real a war wound they cannot see. "I was in denial for a long time," he says. "I always thought I was strong enough not to let that stuff get to me." So have thousands of other soldiers returning from combat in Iraq and Afghanistan

"Eugene speaks for many, many people," says Tod Ensign, director of Citizen Soldier, a veterans advocacy group based in New York. "We've only just begun to see the beginning of the PTSD problem. A tsunami is coming."