Problems Too Big for Local Centers

Veterans Returning From Iraq With Problems
Too Serious For Local Help
Need for counseling after Iraq, Afghan service expected to rise
Des Moines Register, August 11 Edition

The good news is that local Veteran centers are meeting or beating budget. The not-so-good news is that they are saving money because they are ill-equipped to address the serious nature of the problems they are facing and passing the problem up to larger centers.

This article reiterates and supports the observation of many others that 1) the problem is bigger than we have prepared for and 2) things are going to get worse.

" 'Almost every single Iraq vet who walks into our office has some kind of serious problem, many with mental health problems. So we just have to refer them on,' said David DeBolt, director of the Polk County Commission on Veteran Affairs . 'We're here to help with basic needs - some rent money, help with the bills, prescriptions, transportation around town.'

"Of the 208 Iraq war veterans the county commission has seen over the past two years, 59 received help from the county. Many of the rest were sent to federal Veterans Affairs hospitals in Des Moines and Knoxville, or to the Vet Center, an outpatient counseling facility in Des Moines."

The article continues: "The two Veterans Affairs hospitals have treated 333 veterans of the Iraq and Afghanistan wars since September 2003. The Vet Center saw dozens more. Less than 10 percent sought treatment for severe mental health problems, but doctors and veterans advocates say that figure could triple in years ahead....

" 'Just the things they've seen in combat, that's a big thing,' Jackson said. 'For others, they get caught up in a firefight, it's ugly, and they make it out. Then they struggle with survivor's guilt - you know, 'Why did I make it out and my buddy didn't?'

" 'We'd like to spend every dime we get helping veterans,' DeBolt said. 'But the fact is, they're coming in with serious problems - post-traumatic stress, you name it.

" 'And they are problems that are getting bigger and bigger.' "

The Unseen Cost of War

The Unseen Cost of War: American Minds
SeattlePI, August 27 edition

This is a really good and comprehensive article that covers the spectrum of responses, problems and barriers to treatment. It also points out the rarely mentioned difference in reaction between the reservist serving in the war-zone and the career, volunteer soldier:

"But PTSD specialists say reservists and National Guard soldiers appear particularly vulnerable. War is not the full-time job of the estimated 160,000 'weekend warriors' now in Iraq -- civilian soldiers who have been called up in the largest numbers since World War II. They have off-duty lives, careers and demands back home that increase stress."

And there is the Nam Factor: "Anger and insomnia are common symptoms of PTSD. So is the numbness one counselor calls "a freezing of the heart. A hardened heart may serve in battle. Back home, still numb, it creates its own kind of pain....

"Comparisons between Iraq and Vietnam are frequent in counseling circles. While an estimated 2 percent to 10 percent of veterans exposed to combat in the brief 1991 Gulf War developed combat-related PTSD, in Vietnam it was an estimated 30 percent."

The similarities pointed out in the article are troubling and belie those who say the Vietnam experience is irrelevant. From the article:

* In Iraq, as in Vietnam, it's not always clear who the enemy is. Iraqi fighters don't wear uniforms, they fade in and out of crowds. And in the pressure cooker of urban warfare, it may be a grandparent or grandchild waving hello with one hand and holding a crudely improvised bomb with the other. "You find yourself asking, 'Is that a toy gun or a real gun?' " said one returning soldier.

* Soldiers in Iraq, like those in Vietnam, face danger 24 hours a day, seven days a week, from a 360-degree sweep around them. The study in the New England Journal of Medicine indicates 95 percent of Marines and Army soldiers in Iraq have been shot at, 56.5 percent have killed an enemy combatant and 94.5 percent have seen bodies or human remains. Ambushes, sneak attacks, random mortar fire and roadside bombings are standard enemy operations. But fighting can get up close and personal in patrols and raids. "Everyone is vulnerable most all of the time," said Steve Hunt, director of the deployment health clinic at the VA Medical Center in Seattle.

* As in Vietnam, some soldiers in Iraq find the mission confusing. Are they putting their lives on the line for a war, an occupation, a liberation? "We never really knew what was going on. We were told, 'We're here to do good, to help Iraqis, they want us here.' And we know that's just pep talk from politicians -- a bunch of professional liars," said an Army infantryman recently home on leave from Iraq and counting the days till he leaves the service."

While there are many expressions of personal experiences now available on the Internet via Weblogs and other sources, the story of the Marine reservist near the end of the article is compellingly touching. His story alone is worth the read.

Stigma Remains Difficult to Overcome

European and Pacific Stars & Stripes
Friday, August 12 Edition

Previous articles addressed the issue of a significant barrier that soldiers experience or perceive when considering seeking treatment for symptoms of PTSD. This article further examines the issue, and points out that the military needs to do a better job in helping with the problem.

"The barrier, according to a study of more than 6,100 soldiers and Marines who'd deployed to Iraq and Afghanistan, was the belief that seeking counseling would harm military careers and stigmatize armed forces members as weak. Fifty percent of troops in that study showing symptoms of mental-health problems said it would be bad for their career to see a counselor; 65 percent said they'd be perceived as weak; and 63 percent said commanders would treat them differently."

The article concludes:

"According to Trylch and two soldiers under his command, all who saw difficult duty, the absolute worst experience is easy to identify and very hard to forget: the deaths of three soldiers in their unit killed in action — among 10 soldiers and one civilian the squadron lost in its year in Iraq.

"Trylch credits his equanimity to the support of family and friends, and time spent thinking.

"'Introspection - who I am and what I've seen and how I want to deal with that,' Trylch said. 'I've tried to reconcile them the best that I can so that I can live with it.

"'But do I look at the world through a little different set of eyes? Yeah, I do.'"