Tag Archives: PTSD

20% of Iraq, Afghanistan Soldiers Have Depression or PTSD

Veteranstoday.com

Half of Depression and PTSD affected troops untreated

A study published by the Rand Corporation shows that of the 300,000 troops affected by mental disorders of depression or PTSDless than half have been treated.   Yes, that is 150,000 untreated heroes on active dury or recently released to the streets without proper treatment according to this independent study.

Picture from Veterans Today site.  Find it Here

The sad news continues…  About one in five, about 20%, of our Iraq and Afghanistan active dury and veterans suffer from depression or PTSD.

The Rand study says that too many soldiers and Marines are still slipping through the cracks since the symptoms of depression and PTSD can appear months after an incident, and many mental problems that appear later may never be caught, the study said.

The RAND study interviewed 1,965 current and former service members and asked them how many had suffered from PTSD within the previous 30 days and suffered from depression within the previous two weeks.

  • “We have tried to generate this estimate across the entire deployed population,” said Terri Tanielian, one of the study’s authors. “We are looking at the scope of the problem now among the population back in the United States.”

The study shows that 19.5% of veterans had received a concussion or other traumatic brain injury during their combat tour.    The study found that some service members actively avoid a diagnosis of a mental health problem due to a fear of negative consequences of such a diagnosis.    The worry is that co-workers would have less confidence in them after a diagnosis and thus impact their career.

  • “When we asked folks what was limiting them from getting the help that they need, among the top barriers that were reported were really negative career repercussions,” Tanielian said.

Please read the rest of this article (paraphrased above) here:  Veterans Today.

You can get a different take at Medical News Today.  They report that 30% of our soldiers that are on their third or fourth tour have expressed emotional illnesses as gleaned from 2295 anonymous responses to the survey (11.9 % first tour soldiers, 18.5% second tour, 27.2% third tour).

And from the Associated Press at the Atlanta Journal Constitution website.

I encourage you to write the candidates at every government level and all of our current congressmen to encourage them to show their support by increasing the help for these wonderful men and women that have served our country.  Let’s serve them now!

Help our Heroes!

The ‘equal opportunity war’ bring equal opportunity trauma

Much of the information below was gleaned from a well written USA Today story entitled Mental toll of war hitting female servicemembers.   Early in the story the writer tells about Master Sgt. Cindy Rathbun who began losing hair in clumps within 3 weeks of arriving in Iraq.   She is now enrolled in the first group of a new Women’s Trauma Recovery Program which is a 60 to 90 day program for female warriors. 

Cindy is suffering from the stress and trauma of war, but also from sexual trauma from prior to her deployment by a military superior.

Some tidbits of information directly from the article cited:

More than 182,000 women have served in Iraq, Afghanistan and the surrounding region — about 11% of U.S. troops deployed, the Pentagon says.

That dwarfs the 7,500 who served mostly as nurses in Vietnam and the nearly 41,000 women deployed during the brief Gulf War.

Although some of those women suffered PTSD, few saw actual fighting or were subjected to the stress of multiple deployments.

In Iraq, “there are no lines, so anybody that deploys is in a war zone,” Rathbun says. “Females are combat veterans as well as guys.”

 To be sure, women are barred from ground jobs, technically assigned to support roles, but guess what?   Those support roles include guarding checkpoints, driving supply convoys and searching women in neighborhood patrols.   Dangerous duty just the same. 

Attacks come from IED’s, mortars, and suicide attacks on checkpoints as well as from enemy fighters.   The stress is there.  The fear is there.  The fatigue is there, the unknown is there, the worry about the home folks is there.  Death and destruction are evident every day.   More than 100 of our female warriors have died and almost 600 wounded.

 More from the article cited:

The ranks of psychologically wounded from this war are far larger. In 2006, nearly 3,800 women diagnosed with PTSD were treated by the VA. They accounted for 14% of a total 27,000 recent veterans treated for PTSD last year.

In June, the Defense Department’s Mental Health Task Force reported that the number of women suffering from combat trauma might be higher than reported. It cited “a potential barrier” for women needing mental-health treatment as “their need to show the emotional strength expected of military members.”

The report also said that after leaving the military, “many women no longer see themselves as veterans” and might not associate psychological symptoms with their time in the war zone.

Did you notice that?  Women represent 11% of the deployed but have 14% of the cases, even though the DoD thinks they are under reported.  Battle lines or not, they are being affected at a much higher rate than men, some possibly due to MST, Military Sexual Trauma that was being diagnosed and treated as PTSD.

Here is a link to Oldtimer’s PTSD Videos which includes a video on MST.

It is about time that this problem is being addressed early in the process for our returning heroes.   Our warriors are the best and deserve the best, black, white, male and female.    

Wear the uniform, deserve the best

Our programs should never be just about the men. 

It should be about our heroes.

Oldtimer

VA Research Factsheet on PTSD

The following is a factsheet from the VA’s Research Advances Series titled Posttraumatic Stress Disorder (PTSD),  published in September, 2007:

Soldier from VA BulletinSoldier from VA Bulletin VA’s Office of Research & Development supports a strong program of research directed to understanding, treating, and preventing Posttraumatic Stress Disorder (PTSD), which is an unrelenting biological reaction to the experience of a traumatic event. In the case of veterans, the trauma may occur from combat duty or other experiences where one’s safety or life is threatened. VA researchers have long been leaders in discovering new advances for treating and understanding PTSD.    The photo came with the article in 2007    I found a larger version here They title it “Prayer”.    I don’t know who the original photographer was.

Examples of VA research advances

Drug already used by millions may be effective in the treatment of PTSD – In an exciting new treatment development, VA researchers found that prazosin, an inexpensive generic drug already used by millions of Americans for high blood pressure and prostate problems, improved sleep and reduced trauma nightmares in a small number of veterans with PTSD.  Plans are under way for a large, multi-site trial to confirm the drug’s effectiveness.

Prolonged-exposure therapy effective in treatment of women veterans with PTSD– VA researchers found that prolonged-exposure therapy – in which therapists helped them recall their trauma memories under safe, controlled conditions-was effective in reducing PTSD symptoms in women veterans who have developed PTSD as the result of sexual trauma in the military, and that such reductions remained stable over time. Women who received prolonged-exposure therapy had greater reductions of PTSD symptoms than women who received only emotional support and counseling focused on current problems. This approach may be tested in, and applied to, other PTSD populations.

First ever clinical trial for the treatment of military service-related chronic PTSD– The largest study of its kind, involving 400 veterans from 20 VA medical centers nationwide, is being conducted to determine if risperidone, a medication already shown to be safe and effective in the treatment of PTSD, is also effective in veterans with chronic PTSD who continue to have symptoms despite receiving standard medications used for this disorder.

Facts About PTSD:

PTSD is a psychiatric disorder that can affect people who have experienced life-threatening events, such as combat, a terrorist attack, or a personal assault. Symptoms include flashbacks, nightmares, depression, and social withdrawal, as well as physical health changes. Treatment often includes anti-anxiety drugs or other medication, as well as exposure therapy, a form of cognitive-behavioral therapy in which patients recall their traumas in a safe setting and gradually learn to adjust their emotional response. VA Research has long been leaders in making new advances for treating and understanding PTSD.

http://www.research.va.gov
Research & Development
Veterans Affairs

Oldtimer’s Comment: There are 17 of these factsheets.  Below is a linked list of them.    You may find something of interest in one or more of them.   For example, PTSD is mentioned in several.

Factsheets

  • Alzheimer’s Disease (193 KB, PDF)
  • Depression (192 KB, PDF)
  • Diabetes (168 KB, PDF)
  • Hearing Loss (194 KB, PDF)
  • Heart Disease and Stroke (223 KB, PDF)
  • Hepatitis C (198 KB, PDF)
  • HIV / AIDS (205 KB, PDF)
  • Iraq / Afghanistan (232 KB, )
  • Low Vision (248 KB, PDF)
  • Mental Health (191 KB, PDF)
  • Obesity (214 KB, PDF)
  • Osteoarthritis (175 KB, PDF)
  • Parkinson’s Disease (179 KB, PDF)
  • Personalized Medicine (208 KB, PDF)
  • Post-Traumatic Stress Disorder (PTSD) (189 KB, PDF)
  • Prosthetics / Amputations (209 KB, PDF)
  • Spinal Cord Injury (205 KB, PDF)
  • Substance Abuse (175 KB, PDF)
  • Womens’ Health (201 KB, PDF)
  • Oldtimer

    VA overrates its success stories

    VA overrates its success stories

    This problem was first brought to light by an article written by Chris Adams that appeared in the Ledger Enquirer in an article printed May 11, 2007.  

    The McClatchy Newspapers study shows that the VA has “habitually exaggerated” its success stories in ways that would assure Congress that the agency is doing a good job of caring for our soldier heroes.   The indented areas below are details taken from the article linked above.  Large portions of the original article are omitted and others paraphrased.  You should take the time to read the original article in its entirety to get all the details.  

    The agency has touted how quickly veterans get in for appointments, but its own inspector general found that scheduling records have been manipulated repeatedly.

    For example, on Oct. 2, 2003, a veteran was referred to an ophthalmology clinic. On May 3, 2004, a scheduler created an appointment, saying the “desired date” was June 21. The appointment was scheduled for June 23, the inspector general said.

    Actual waiting time: 264 days. Reported waiting time: two days. Some schedulers even kept “informal waiting lists” to consult when they were ready to make formal appointments.

    The VA boasted that its customer service ratings are 10 points higher than those of private-sector hospitals, but the survey it cited shows a far smaller gap.

    The article details how that the gap narrows to 3 points (still favorable but not nearly 10 points higher) when adjusted to the same conditions.  

    Regarding the key issue of PTSD treatment, the VA said this about the PTSD treatment teams: “There are over 200 of them,” Dr. Michael Kussman told a congressional subcommittee. He indicated that they were in all of the agency’s roughly 155 hospitals.

    When McClatchy asked for more detail, the VA said that about 40 hospitals didn’t have the specialized units known as “PTSD clinical teams.” Committees in the House of Representatives and the Senate and experts within the VA have encouraged the agency to put those teams into every hospital.  

    Dr. Jonathan Perlin, then the top VA health official, said in a radio interview that RAND “compared VA care to 12 other health-care organizations, some of the best in the country,” and found VA superior. Studies such as RAND’s showed the agency’s care to be “the best that you can get in the country,” he said.

    Kussman wrote in a statement to McClatchy earlier this year that RAND “recently” reported that veterans “receive better health care than any other patients in America.”

    The VA’s public affairs department wrote in a magazine that the study “was conducted by the RAND Corporation, an independent think tank,” as well as researchers from two universities.

    Those are pretty lofty statements, but as it turns out, the RAND study was neither fully independent nor all that recent. A VA grant helped pay for it. Two of its main authors had received VA career-development awards, and four of its nine listed authors were affiliated with the agency, according to the study’s documentation.

    It was published in 2004 but used data from 1997 to 1999, when the system treated far fewer patients than it does now.  In additon, the “12 other health care organization” were not organizations at all but 12 health care regions under many mixed organizational entities.

    Once again, we see some deliberate misleading statements from the VA, often directly to Congress.  Yet they seem to get away with it.  

    Oldtimer

    PTSD Payments Vary State to State

    PTSD Payments Vary State to State

    I’m indebted to the blog at Healing Combat Trauma for alerting me to this information in which they refererence an article published in Military.com with the above title.   You should read the information at Healing Combat Trauma as it is told better there than I can do it.   Below is a summary of information.

    It seems that the McClatchy Newspapers chain did extensive research through the freedom of information act and discovered that there is wide variation in the way disability ratings are given depending on where the veteran lives.   A veteran returning from Iraq that lives in Ohio or Montana for example, is typically given a much lower disability rating on average than one that returns to New Mexico.

    The study involved some 3 million disability claims records.  Consider these quotes from the Military.com article:

    “The VA workers who decide PTSD cases determine whether a veteran’s ability to function at work is limited a little, a lot or somewhere in between. They examine the frequency of panic attacks and the level of memory loss. The process is subjective, and veterans are placed on a scale that gives them scores – or “ratings” – of zero, 10, 30, 50, 70 or 100.

    “McClatchy’s analysis found that some regional offices are far more likely to give veterans scores of 50 or 70 while others are far more likely to stick with scores of 10 or 30.

    “Consider the New Mexico and Montana offices, where there are big differences up and down the scale.

    “In Montana, more than three-quarters of veterans have ratings of zero, 10 or 30. In New Mexico, a majority of the veterans have ratings of 50 or 70.

    “On top of that, 6 percent of New Mexico veterans had the highest rating possible – 100, worth $2,527 a month – compared with just 1 percent of Montana veterans.”

    The initial ratings pretty much stick with a veteran for the rest of their life, and the disparity in how the disability is rated may make a difference of hundreds of thousands over the remaining lifetime of the veteran.   Apparently some offices make a point of being generous in their ratings and some apparently are downright stingy, not giving a proper rating. 

    “Of recent vets processed in Roanoke, Va., 27 percent have high ratings for post-traumatic stress disorder. In Albuquerque, N.M., the number is 56 percent.”

    You need to read the Healing Combat Trauma article for some excellent commentary and also the military.com article for some extra details.   The research suggests that something is wrong with the VA’s rating system when one city rates twice as many of their veterans higher than in another city.   The VA does not treat our heroes fairly if they happen to live in the wrong part of our great country.

    Oldtimer

    Surge Seen in Number of Homeless Veterans

    Surge Seen in Number of Homeless Veterans

     Oldtimer’s Comment:  I’ve seen a number of these types of articles.   Although the estimates vary depending on the subject area from 400 to about 1500, the word on the street is that the returning soldiers from Iraq and Afghanistan are showing up in shelters much faster than in previous wars.  The problem stems from higher rates of PTSD and TBI (traumatic brain injury) which still take too long to diagnose, and which are resulting from the combined effect of IED’s and higher survival rates.    The VA has long under diagnosed these problems and only recently, after much heat, begun to actively pursue it. 

    Photo by Jeff Swensen for The New York Times
    Frederick Johnson, a veteran of the Iraq war, lives in temporary housing provided by the V.A. after spending a year on the streets.

    By ERIK ECKHOLM

    WASHINGTON, Nov. 7 – More than 400 veterans of the Iraq and Afghanistan wars have turned up homeless, and the Veterans Affairs Department and aid groups say they are bracing for a new surge in homeless veterans in the years ahead.

     

    Photo by Brendan Smialowski for The New York Times
    Joe Williams lives in a homeless shelter in Washington.

    Experts who work with veterans say it often takes several years after leaving military service for veterans’ accumulating problems to push them into the streets. But some aid workers say the Iraq and Afghanistan veterans appear to be turning up sooner than the Vietnam veterans did.

    “We’re beginning to see, across the country, the first trickle of this generation of warriors in homeless shelters,” said Phil Landis, chairman of Veterans Village of San Diego, a residence and counseling center. “But we anticipate that it’s going to be a tsunami.”

    With more women serving in combat zones, the current wars are already resulting in a higher share of homeless women as well. They have an added risk factor: roughly 40 percent of the hundreds of homeless female veterans of recent wars have said they were sexually assaulted by American soldiers while in the military, officials said.

    “Sexual abuse is a risk factor for homelessness,” Pete Dougherty, the V.A.’s director of homeless programs, said.

    Special traits of the current wars may contribute to homelessness, including high rates of post-traumatic stress disorder, or PTSD, and traumatic brain injury, which can cause unstable behavior and substance abuse, and the long and repeated tours of duty, which can make the reintegration into families and work all the harder.

    Frederick Johnson, 37, an Army reservist, slept in abandoned houses shortly after returning to Chester, Pa., from a year in Iraq, where he experienced daily mortar attacks and saw mangled bodies of soldiers and children. He started using crack cocaine and drinking, burning through $6,000 in savings.

    “I cut myself off from my family and went from being a pleasant guy to wanting to rip your head off if you looked at me wrong,” Mr. Johnson said.

    (…)  Read more about Fredrick at the link above

    Poverty and high housing costs also contribute. The National Alliance to End Homelessness in Washington will release a report on Thursday saying that among one million veterans who served after the Sept. 11 attacks, 72,000 are paying more than half their incomes for rent, leaving them highly vulnerable.

    Mr. Dougherty of the V.A. said outreach officers, who visit shelters, soup kitchens and parks, had located about 1,500 returnees from Iraq or Afghanistan who seemed at high risk, though many had jobs. More than 400 have entered agency-supported residential programs around the country. No one knows how many others have not made contact with aid agencies.

    More than 11 percent of the newly homeless veterans are women, Mr. Dougherty said, compared with 4 percent enrolled in such programs over all.

    Veterans have long accounted for a high share of the nation’s homeless. Although they make up 11 percent of the adult population, they make up 26 percent of the homeless on any given day, the National Alliance report calculated.

    Oldtimer’s comment:   My studies show that homeless male veterans make up 43% of the homeless male population, far in excess of what would be expected.

    According to the V.A., some 196,000 veterans of all ages were homeless on any given night in 2006. That represents a decline from about 250,000 a decade back, Mr. Dougherty said, as housing and medical programs grew and older veterans died.

    Oldtimer’s comment:  Oops!  That is a deliberately misleading statement.   A GAO report states that the drop from 250,000 a decade ago was due to a major change in how homeless veterans are counted.   While it is true that our older veterans are dieing off, many more veterans are joining the ranks of the homeless and make up for it.  There has been no real decline, and actually there has been a steady increase in the percentage of homeless veterans vs the overall population of veterans.

    The most troubling face of homelessness has been the chronic cases, those who live in the streets or shelters for more than year. Some 44,000 to 64,000 veterans fit that category, according to the National Alliance study.

    On Wednesday, the Bush administration announced what it described as “remarkable progress” for the chronic homeless. Alphonso R. Jackson, the secretary of housing and urban development, said a new policy of bringing the long-term homeless directly into housing, backed by supporting services, had put more than 20,000, or about 12 percent, into permanent or transitional homes.

    Oldtimer’s comment:  I’m not sure where these numbers come from.  It appears the HUD secretary is talking about all chronic homeless, not just veterans.   20,000 is 12% of 166,000, which is about right for the chronic homeless for the entire homeless population. To get a feel for progress among veterans, see the following two paragraphs.

    Veterans have been among the beneficiaries, but Mary Cunningham, director of the research institute of the National Alliance and chief author of their report, said the share of supported housing marked for veterans was low.

    A collaborative program of the Department of Housing and Urban Development and the V.A. has developed 1,780 such units. The National Alliance said the number needed to grow by 25,000.

    Mr. Dougherty described the large and growing efforts the V.A. was making to prevent homelessness including offering two years of free medical care and identifying psychological and substance abuse problems early.

    Oldtimer’s Comment:  ‘Bout Time!

    (…)

    PTSD vets soon coming like tsunami

    There is a scary article in the San Francisco Chronicle.  The article predicts a flood of new stressed out veterans as they return form Iraq and Afghanistan, many of whom are on the fast track to PTSD, depression, and other mental health disorders compared to previous wars.   I’ve reprinted a little of it below, but you can find the rest at this link where it is reproduced in SGate.com.   

    A flood of stressed vets is expected

    C.W. Nevius

    Sunday, December 9, 2007

    (…) omitted illustrative story about a vet (Tim Chapman) contemplating suicide, find it at the link. 

    First a few facts. Bobby Rosenthal, regional manager for homeless programs at the Department of Veterans Affairs, estimates that one third of the more than 6,000 homeless people – about 2,100 – in San Francisco are veterans.

    And no wonder the number is so high. California leads the nation in homeless veterans by a mile, according to the National Coalition for Homeless Veterans. The 2006 numbers showed 49,724 homeless vets in California. The next nearest state was New York with 21,147.

    Now here’s the scary part. Compared with what’s coming, that’s nothing.

    Roughly 750,000 troops served in the wars in Iraq and Afghanistan, often with multiple tours of duty. Many are only now returning home. But unlike Vietnam veterans, who didn’t begin to demonstrate post-war trauma until five or 10 years after they left the war, this group seems to be on a fast track.

    “Everything is speeded up,” said Michael Blecker, executive director of San Francisco’s Swords to Ploughshares program. “What we’re seeing in San Francisco is guys in their 20s with the kind of stress and trauma that makes it impossible to go on with their lives.”

    It’s been called a health care tsunami. Because not only are the Iraq vets prone to post-traumatic stress disorder (something Chapman has battled) but with improved battlefield health care, far more are surviving traumatic injury. On one hand, that’s good news, but it also means many more vets who are severely disabled, having lost arms and legs. Both factors increase the chances that the returning troops will join the sad ranks of homeless veterans.

    Cities all over the country are bracing themselves, although some, like San Francisco, are bound to be hit harder. Mayor Gavin Newsom says that at a recent conference of mayors, the group passed a resolution asking the VA “to tell us what you are going to do.”   “It’s great lip service,” Newsom said, “but show me the money.”

    If history holds, the mayors shouldn’t hold their breath. If anything, benefits for veterans have been restricted. To take one example, many of us think of the World War II G.I. Bill as a shining example of a reward for service, paying for college for vets. But Blecker, of Swords for Ploughshares, says the current version “is in no way, shape, or form near enough” to pay for a degree.

    As Newsom says, “Yeah, support the troops – as long as they are young, healthy and a great photo op.”

    For San Francisco, the potential impact could be huge. An influx of traumatized, battle-scarred veterans presents a scary future. Consider the case of Scott Kehler, a veteran of the first Gulf War, who needed years to work through his demons. He recalls passing burned bodies and the constant fear that an explosion would suddenly erupt in the street.

    “It was the things I didn’t want to see at night when I closed my eyes,” Kehler said. “I didn’t know what PTSD was. I only knew my dreams, my shame, my guilt, was all coming together.”

    (…) omitted a few details, go to link to get the rest.

    Kehler, who is mentoring Chapman, is testimony to the effectiveness of the Ploughshares slogan – “veterans helping veterans.”

    “Especially now that we’ve got our veterans coming home from Iraq,” said Ploughshares counselor Tyrone Boyd, “we’re going to need people that have been in combat so they know what they are talking about.”

    The challenges are unique. Wanda Heffernon, a program and clinical counselor for Ploughshares, said they had a new inductee who slept in the closet. It was the only place he felt safe.

    It’s the sudden transition that gets them.  “One day they are fighting in a war,” said Kehler. “The next day they are sitting at their mother’s kitchen table.”

    Is it any wonder they end up on the street? Kehler battled alcohol abuse, but Chapman is part of the new breed, who turn to methamphetamine. Married when he returned, he lost his wife and all contact with his parents. Eventually he ended up sleeping in an alley.Now drug-free, living at Treasure Island housing, holding down a full-time job, and reconnected with his mother, he is testimony to the idea that peer counseling seems to work. Ploughshares has earned support from Sens. Dianne Feinstein and Barbara Boxer and House Speaker Nancy Pelosi.

    Imagine the impact it would have on the San Francisco homeless problem if one third of those on street were able to get help and housing.

    But what the vets don’t have is funding.

    “Why isn’t the federal government doing something about this? Why isn’t the Veterans Administration doing something?” Blecker asks. “The irresponsibility of our leaders, not to address this, makes me want to tear my hair out.”

    The VA’s Rosenthal – who gets high marks from local leaders – says the problem is not being ignored.

    “It’s a whole new set of challenges,” she said. “The VA is looking at it. Let’s hope we’ve learned our lesson from Vietnam.”

    We can only hope.

    “You know what scares me?” asks Boyd. “I haven’t heard a plan (from the federal government) about what they are going to do when the troops come home. What’s the plan?”

    Well?

    C.W. Nevius’ column appears Tuesday, Thursday, and Sunday. His blog C.W. Nevius.blog can be found at SFGate.com. E-mail him at cwnevius@sfchronicle.com.

    Oldtimer’s comment:  This story illustrates what I’ve said all along.  PTSD and TBI are leading causes of homelessness among veterans.  It is a rapidly growing problem, approaching flash flood conditions for our heroes returning from Iraq and Afghanistan.   A tsunamis of real people, not just numbers, real people with real names.  Somebody’s sons and daughters, husbands and wives, fathers and mothers, brothers and sisters.  Real people, all in serious trouble, heroes in despair  … we should be crying.  We should be helping, we should be calling on congress, questioning our candidates. 

    Where is your voice, America?

    Oldtimer  

    Vital Mission: Ending Homelessness Among Veterans

    New Report –

    Vital Mission:

    Ending Homelessness

    Among Veterans

    Homeless Veteran

    Photo by  |Shrued (creative commons licensed)  Find it Here

    This 36 page report released by the National Alliance to End Homelessness details the following highlights:

    In 2006, approximately 195,827 veterans were homeless on a given night-an increase of 0.8 percent from 194,254 in 2005. More veterans experience homeless over the course of the year.  They  estimate that 336,627 were homeless in 2006.

    Veterans make up a disproportionate share of homeless people. They represent roughly 26 percent of homeless people, but only 11 percent of the civilian population 18 years and older.  (Please see Oldtimer’s comment on these numbers below before you repeat them.) This is true despite the fact that veterans are better educated, more likely to be employed, and have a lower poverty rate than the general population.

    A number of states, including Louisiana and California, had high rates of homeless veterans. In addition, the District of Columbia had a high rate of homelessness among veterans with approximately 7.5 percent of veterans experiencing homelessness.

    They estimate that in 2005 approximately 44,000 to 64,000 veterans were chronically homeless (i.e., homeless for long periods or repeatedly and with a disability).

    Oldtimer’s comment on the numbers:  My own studies show that  the real numbers are more like 43% of the male homeless are veterans. Here is an interesting footnote to the numbers reported above:

    This estimate was calculated with 2005 veterans data from the CHALENG data set and 2005 tabulations of Continuum of Care (CoC) point-in-time counts.The CoC counts do not differentiate between adults and children, so in the number provided here-percent of homeless people who are veterans-the denominator includes some people under 18. If children were taken out of the 744,313 total, veterans would make up a larger percentage of the homeless population. This suggests that 26 percent is a conservative estimate. Either way, this estimate falls within the bounds of past research.Rosenheck (1994) reviewed research studies and found that between 29 and 49 percent of homeless men are veterans. HUD’s recent Annual Homelessness Assessment report (2007) puts the percentage of homeless veterans at 18 percent; however, 35 percent of the cases in this data source were missing, making the estimate highly unreliable.

    The Rosenheck estimate  range includes the 43% that I had independently found.  The basis data for my findings are here.

    The National Alliance to End Homelessness has an interactive map that show veteran homelessness by state.  Click on the map to activate it, then your cursor will bring up data for each state as you hover over it.

    It is interesting to note that Washington DC has the highest percentage of veterans that are homeless, more than double the rate of any other state at a whopping 7.51%.  Other high percentage states are Louisiana, California, Oregon, Nevada, Connecticut and  North Dakota in that order.   The highest number of homeless veterans are in California with more than 49,000 homeless, followed by New York, Florida and Texas in that order.

    The following comes directly from the report:

    Lack of affordable housing is the primary driver of homelessness. The 23.4 million U.S. veterans generally do not have trouble affording housing costs; veterans have high rates of home ownership and appear generally well housed. However, there is a subset of veterans who have severe housing cost burden.

    ■ We estimate that nearly half a million (467,877) veterans were severely rent burdened and were paying more than 50 percent of their income for rent.


    ■ More than half (55 percent) of veterans with severe housing cost burden fell below the poverty level and 43 percent were receiving foods stamps.

    4■ Rhode Island, California, Nevada, and Hawaii were the states with the highest percentage of veterans with severe housing cost burden. The District of Columbia had the highest rate, with 6.4 percent of veterans paying more than 50 percent of their income toward rent.

    ■ Female veterans, those with a disability, and unmarried or separated veterans were more likely to experience severe housing cost burden. There are also differences by period of service, with those serving during the Korean War and WWII more likely to have severe housing cost burden.

    ■ We estimate that approximately 89,553 to 467,877 veterans were at risk of homelessness.  At risk is defined as being below the poverty level and paying more than 50 percent of household income on rent. It also includes households with a member who has a disability, a person living alone, and those who are not in the labor force.

    However, the report body shows a laundry list of causes:

    Lack of Income: Veterans who experience homelessness, like most homeless people, typically have very low incomes, and research suggests that extreme poverty predisposes veterans to homelessness. For this reason, veterans who joined the service after 1973 through the all-volunteer force are more likely to come from poverty and have lower rates of educational attainment.  (…) The unemployment rate for veterans aged 20 to 24 is 15 percent,

    Physical Health and Disability: One out of 10 veterans is disabled and many suffer from physical disabilities, oftentimes caused by injuries in combat. (…)  The number of disabled veterans is increasing with more than 20,000 veterans suffering from wounds in Iraq and Afghanistan.

    Mental Health and Disability: Mental health issues are also prevalent among veterans. The VA reports that 45 percent of homeless veterans suffer from mental illness, including many who report high rates of post-traumatic stress disorder (PTSD).  (…)

    Substance Abuse: According to the Department of Veterans Affairs,  approximately 70 percent of homeless veterans suffer from substance abuse problems (…)

    Weak Social Networks: (…) Veterans have low marriage rates and high divorce rates and, currently, one in five veterans is living alone.  (…) Social networks are particularly important forthose who have a crisis or need temporary help. Without this assistance, they are at high risk for homelessness.

    Lack of Services to Meet Current Need: The VA has over 19,000 transitional housing beds for homeless veterans (10,000 through partnerships with local community agencies) with 460 FTEE in homeless program staffing.  (Oldtimer’s comment:  19,000 beds to serve over 300,000 veterans that are homeless during at least part of the year of which 44,000 to 64,000 are chronically homeless and 195,000 are homeless on any one night!)

    I hope you can sleep well tonight after reading these statistics and findings. I know that I won’t.  I also know the homeless heroes sleeping in the bushes, alleys, behind dumpsters, in doorways, and in the woods or on mountain sides are not going to sleep as well as they could if we could only get our government to respect and support our troops when they come home.

    Our Heroes

    are out there tonight

    and it is so very cold!

    Oldtimer

    News Flash! Army Reports on Delayed PTSD

    Delayed PTSD, Depression,

    Family Conflict Data Revealed

    Picture by AlyssaAS

    Picture by icolman (Creative Commons License – Find it Here)

    This study reported in Army.Mil/News found that out of 88,000 returning Iraq war soldiers given Post-Deployment Health Assessments (PDHA), only 4 to 5% of the soldiers assessed in the 18 months prior to Dec 2006 were found to have PTSD, but 3 to 6 months later that number jumped to 20.3 % for active duty soldiers and to an alarming 42.4% for reserve-component soldiers.

    We are talking about the same soldiers, delayed PTSD symptoms.   There were other delayed complications/symptoms.  Reported depression symptoms doubled and family conflicts rose from 3.5 to 14 % active duty and from 4.2 to 21.2 % for reserve-component soldiers.

    Here is the report:

    Army Study Finds Delayed Combat Stress Reporting

    Nov 14, 2007
    BY Elizabeth M. Lorge

    WASHINGTON (Army News Service, Nov. 14, 2007) – In a study that will appear in the “Journal of the American Medical Association” Wednesday, Army medical officials examined increased Soldier-reported mental-health concerns in mandatory post-deployment health screenings.

    Cols. Charles Milliken, M.D. and Charles W. Hoge, M.D., two of the study’s authors, found that between the initial Post-Deployment Health Assessment and the Post-Deployment Health Re-assessment three to six months later, Soldiers are more likely to report signs of post-combat stress and Post Traumatic Stress Disorder.

    “These efforts are about taking better care of Soldiers,”said Col. Milliken, the principal investigator at Walter Reed Army Institute of Research’s Division of Psychiatry and Neuroscience during a media roundtable at the Pentagon Friday. “What we’re hoping to do with the screenings is detect mental health problems while they are still small, simple and temporary. When these problems get bigger and more complicated, they are much harder to treat and it increases the likelihood that they will become a chronic, long-term problem.”

    The study examined the assessments of 88,235 Iraq veterans completed between June 1, 2005 and December 31, 2006, and found that while only 4 to 5 percent of Soldiers were referred for mental healthcare on the PDHA, three to six months later that number jumped to 20.3 percent for active-duty Soldiers and 42.4 percent for reserve-component Soldiers.

    The second set of numbers encompasses the PDHA, PDHRA and Soldiers who were under mental-health care because of self-referral or employee-assistance referrals. According to Col. Milliken, these Soldiers were not necessarily diagnosed with PTSD, but they were exhibiting symptoms that were serious enough that a medical provider wanted to have them evaluated.

    Similarly, symptoms of depression reported on the PDHA rose from 5 percent to 10 percent on the PDHRA.

    The highest jump the study found between the PDHA and PDHRA were reports of conflict with family and friends. This rose from 3.5 to 14 percent for active-duty Soldiers and 4.2 to 21.1 percent for reserve-component Soldiers.

    Although the study didn’t examine causes and effects, Brig. Gen. Stephen L. Jones, assistant surgeon general for force protection, who has deployed twice, suggested Friday that the PDHA numbers may simply be skewed because Soldiers are so happy to go home and haven’t yet interacted with their families.

    “When you come back, you’re feeling great, almost euphoric. You don’t have any problems in the world. You’re just glad to be home. And then over the next three-four weeks, you re-establish relationships with your family and the normal stress everybody feels when they return home starts to surface. This is a normal, adaptive response and we would expect the stress levels at home to go up,” he said.

    The disparity between active and Army Reserve and National Guard Soldiers was a bit more challenging for the study’s authors, especially because they determined that combat exposure for Reserve and National Guard Soldiers was virtually identical to that of active-duty Soldiers, and they reported more physical health concerns as well.

    Col. Milliken believes this may be due to the differences in health coverage for reserve-component and active-duty Soldiers. Active-duty Soldiers can go to sick call any time, so he said they may not feel as pressed to report every little concern, but Reserve and National Guard Soldiers only have six months of TRICARE coverage when they return and two years of Department of Veterans Affairs benefits. After that, the VA will pay for service-related injuries or illnesses, if they are documented on forms like the PDHRA.

    The PDHRA adds a question about alcohol use, and while 11.8 percent of Soldiers admitted that they might be misusing it, only 0.2 percent of these were referred for a treatment program and still fewer were seen within 90 days.

    While acknowledging the Army has a long way to go when it comes to alcohol treatment, and sight the lack of confidentiality as a real roadblock, both Brig. Gen. Jones and Col. Milliken said they were encouraged that so many Soldiers were even willing to report that they had a problem, because the PDHRA becomes part of a Soldier’s permanent medical record.

    They also believe that the Army’s efforts to reduce the stigma around PTSD and seeking mental-health assistance, including the chain-teaching and Battlemind programs, are working.

    “I think this study shows that we’ve done a pretty good job of reducing the stigma,” said Brig. Gen. Jones. “There’s several factors. Number one: the fact that over half the Soldiers who seek behavioral-health counseling do so within 30 days of the survey and do so on their own. They go in on their own and ask for the counseling. I think the response we’ve gotten to our Soldiers stepping up and saying yeah, I’d like some help is another indication that we’ve helped reduce that stigma.”

    Oldtimer’s note:  The picture above is not part of the article.  Taken at the Korean War Memorial, it was released under creative commons license by icolman

    Barack Obama: Veterans/Poverty Headlines and Video

    Barack and Veterans Issues

    Ok, I’m not trying to influence any votes here, nor run off any readers.  It’s just that I’m impressed with what I’ve heard said by Senator Obama regarding homelessness and veterans and what the press and veterans advocates have said.  I don’t know if you have seen them.   He does have the advantage of being a member of the Senate Veterans’ Affairs Committe.   I acknowledge that there are other important issues than veterans and homelessness to consider in a campaign, but that is what we are about here, so that is my focus.

    I do have an couple of links to the Clinton side.  There is an equal-time segment at the bottom that will give you a look see between the top two Democratic candidates on veterans issues.   I may come back with more of this and feature a Republican or two later.  We will see how this plays out with my readers first.  Are you interested in politics?

    BarackObamadotcom  (Video) Dinner with Barack Obama:  Four grassroots donors talk to Barack Obama about veterans and poverty during dinner.

    I’ve mentioned Obama and Veterans in a previous post where he discusses his plan to improve veterans care and help get the homeless veterans off the streets as reported by a wire service.

    Here are a few more headlines and links on this subject:

    SEN. OBAMA: VETERANS ADMINISTRATION DENIED HEALTH CARE SERVICES TO NEARLY 9,000 ILLINOIS VETERANS IN 2005

    Sen. Barack Obama (D-IL) today announced that the Department of Veterans Affairs (VA) denied health care to 8,944 Illinois veterans last year as part of a Bush Administration cost-cutting policy begun in 2003. Nationally, more than 260,000 veterans were denied access to VA hospitals, clinics and medications in Fiscal
    Year 2005

    Clinton v. Obama, Veterans Version

    The tit-for-tat between Sens. Hillary Rodham Clinton and Barack Obama has expanded to new territory:   veterans benefits.

    This week, the “Commission on Care of America’s Wounded Warriors” issued recommendations for improving treatment for veterans who return injured from the front. Clinton and Obama responded the way members of Congress often do to government reports – with legislative language.  

    (…)  explains different positions

    Obama, McCaskill sponsor bill on care for veterans

    Sens. Barack Obama (D-Ill.) and Claire McCaskill (D-Mo.) are sponsoring legislation to improve the lives of recovering veterans at Walter Reed, while Sen. John Kerry (D-Mass.), a cosponsor of the Obama-McCaskill legislation, said that he would explore ways to direct new funds to Walter Reed and make immediate improvements to its veteran housing.

    Barack Obama Honors Sacrifice of America’s Veterans

    Barack Obama has a record of helping the heroes who defend our nation today and the veterans who fought in years past. As a grandson of a World War II veteran who went to college on the G.I. Bill and a member of the Senate Committee on Veterans Affairs, Obama has successfully reached out to Republicans and Democrats to pass laws to combat homelessness among veterans, improve care for troops recovering from injuries, ease the transition of new veterans into society, and make the disability benefits process more equitable.

    Veterans Issues  From Obama’s website

    Homeless Veterans

    Every year, 400,000 veterans across the country, including an estimated 38,000 in Chicago, spend some time living on the streets. Senator Obama has been a leader in fighting homelessness among veterans. He authored the Sheltering All Veterans Everywhere Act (SAVE Act) to strengthen and expand federal homeless veteran programs that serve over 100,000 homeless veterans annually. During the debate on the Fiscal Year 2007 budget, Senator Obama passed an amendment to increase funding for homeless veterans programs by $40 million. These funds would benefit programs that provide food, clothing, mental health and substance abuse counseling, and employment and housing assistance to homeless veterans.

    Working with Senators Akaka and Craig, Senator Obama passed legislation in December 2006 to provide comprehensive services and affordable housing options to veterans through the Department of Veterans Affairs, Department of Housing and Urban Development and nonprofit organizations. This legislation was signed into law and is modeled on parts of the SAVE Act and the Homes for Heroes Act, a measure that Senator Obama had previously authored.

    Benefits Disparities

    The Bush Administration’s approach to handling veterans’ health care ignores the reality of increasing demands on the VA, and the additional burden placed on veterans. The Administration has established a means test for VA health care eligibility, and it has banned hundreds of thousands of veterans – some who make as little as $30,000 a year – from enrolling in the system. These changes affect both older and younger veterans, and Senator Obama has opposed them, fighting instead for greater funding for veterans’ health care.

    Greater Funding for Veterans Health Care

    In January 2007, Senator Obama reintroduced the Lane Evans Veterans Health and Benefits Improvement Act to improve the VA’s planning process to avoid budget shortfalls in the future. The bill requires the VA and the Department of Defense to work together and share data so that we know precisely how many troops will be returning home and entering the VA system.

    Food for Recovering Soldiers

    Senator Obama introduced an amendment that became law providing food services to wounded veterans receiving physical therapy or rehabilitation services at military hospitals. Previously, service members receiving physical therapy or rehabilitation services in a medical hospital for more than 90 days were required to pay for their meals.

    Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI)
     

    Senator Obama fought a VA proposal that would have required a reexamination of all Post Traumatic Stress Disorder (PTSD) cases in which full benefits were granted. He and Senator Durbin passed an amendment that became law preventing the VA from conducting a review of cases, without first providing Congress with a complete report regarding the implementation of such review. In November 2005, the VA announced that it was abandoning its planned review.

    Senator Obama passed an amendment to ensure that all service members returning from Iraq are properly screened for Traumatic Brain Injury (TBI). TBI is being called the signature injury of the Iraq war. The blast from improvised explosive devices can jar the brain, causing bruising or permanent damage. Concussions can have huge health effects including slowed thinking, headaches, memory loss, sleep disturbance, attention and concentration deficits, and irritability.

    Easing the Transition to the VA

    Senator Obama passed an amendment that became law requiring the Department of Defense (DOD) to report to Congress on the delayed development of an electronic medical records system compatible with the VA’s electronic medical records system. DOD’s delay in developing such a system has created obstacles for service members transitioning into the VA health care system.

    Part of the Lane Evans Veterans Health and Benefits Improvement Act, which Senator Obama reintroduced in January 2007, would help veterans transition from the DOD health system to the VA system by extending the window in which new veterans can get mental health care from two years to five years. The Lane Evans bill also would improve transition services for members of the National Guard and Reserves.

    For Equal Time’s sake:

    Compare Senator Obama’s site with Senator Clinton’s site, both on Veterans Issues.

    Oldtimer

    Wounded warriors battle with VA – Story and Videos

    Wounded Warriors Battle With VA

    I watched a horrifying story on CNN last night.  I missed it on regular programming, checked the programming guide and waited for the midnight repeat.   The CNN title of the story was:

    Broken Government: Waging War on the VA

    It repeats tonight, Sunday night (Nov 18) at 8 Eastern, so if you get a chance, please check your schedule.   It is a powerful indictment of the VA’s handling of disability claims.  It is the story of 3 wounded veterans trying to get justice and only able to do it by virtually going to war again to fight for their rights.

    One of the wounded warriors and a really heartbreaking story was Ty Ziegel, 25 years old who had been severely injured by a suicide bomber, “sent back to the states to die”, but lived.  Despite losing nearly half of his skull and a large portion of his brain, penetrating shrapnel and bone fragments in his brain, with both ears, nose and lips burned off and impossible to replace,  loss of an eye and resulting enormous disfiguration, the VA listed him as having “10% head trauma”.  10% head trauma.  In addition the damage to the left lobe of his brain,  loss of an eye and jaw fracture as haveing 0% trauma.  0% for loss of 1/4 of his brain, loss of an eye? He also lost one arm at the elbow, and two fingers and a thumb from his other hand, plus numerous other injuries for which the bulk of his small disability payment was granted.    Far below the poverty line disability for a man disfigured and totally disabled.

    Ty Ziegel before and after

    Ty Ziegel, before and after.   CNN News photo

    (Click on the picture or here to see the video).  These videos are short promo clips about 2 minutes long and I don’t know how long they will keep them up on their site.  Go to  CNN and see the real thing.  Click here for part 2

    Another veteran, Garrett Anderson received a roadside bomb injury that sent shrapanel into his head and body, and he lost an arm while driving a truck in a convoy.  The VA initially rejected his claim, saying that it was “not service connected”.   He was also suffering from what he thought was PTSD.  In Garrett’s case the letter stating that there were “shrapnel wounds all over his body, not service connected” had the signature cut out of the letter with a knife.  Apparently the signer was not proud of his decision and knew it was wrong.  

    Garrett Anderson

    Garrett Anderson.  Click on the picture or here for the video clip.

    In Ziegel’s case, within 48 hours of taping an interview with CNN, the VA changed his disability to 100%.  In Anderson’s case, his wife took a sneak peak at his case file while a nurse was out of he room and she discovered they had  him listed in their files a suffering from Traumatic Brain Injury (TBI), but had failed to tell him or give him any disability credit for it.   He went to Sen. Dick Durbin of Illinois who turned up the pressure on the VA and subsequently has been awarded disability for TBI.

    The third story was about Tammy Duckworth who lost both legs and had severe injuries to one arm and her body.   She later ran for Congress with the hope of improving things for disabled veterans.  She lost but has been appointed by the Governor of Illinois to be the Director of the IL Department of Veterans’ Affairs.

    Click here for the CNN news promo clip for her story.  Go to the link with Tammy’s name above and click on “veteran’s issues” to get a flavor of what she has learned about the Va while she was in their care and her run for Congress.

    Our wounded warriors, our heroes, should not have to fight for our country, then fight for their life and still have to fight for their benefits!

    Oldtimer

     

    GAO Testimony – DOD and VA

    Transition Field Unit staffingGAO Testimony – DOD and VA

    This is a troubling situation.  We have our kids off at war and they become severely injured, physically and mentally.   Our country has pulled out all stops to provide the best possible care for them and still we have problems.  Due to the protective gear and terrific and speedy medical care, thankfully more and more are surviving.  This shift in the severity and long term recovery needs requires major adjustments in our programs for treatment and rehabitation, for our benefits and compensation programs.  The cause and effect has driven the case loads and delays out of sight at the expense of our wounded heroes.

    The good news is that that there is a scramble going on to correct these problems as soon as possible. There are people in high places capable of fixing the problem that have a heart for our heroes and are working very hard to fix the problems.  There are people in our VA and in militray trauma centers that are just as frustrated as we are.  There is a continuum of care mentality for our soldiers starting at the battlefield and continuing through our VA system. There are programs under development to reduce the time required to make determinations before our heroes get the treatment and benefits they need.

    The bad news is there are still more than 150,000 cases more than 6 months old among the pending 600,000 cases in the VBA system, and we have no idea how old these cases really are.  The GAO found that new programs designed to correct the problems are not yet fully off the ground and there are severe staffing problems in key places, both on the active duty side and the veteran side of the picture. It appears to me that some of it is due to needing to move physicians from one program to staff another, leaving both under staffed. 

    (Download Here)

    What the GAO found

    Warrior Transition Unit

    Challenges have emerged for staffing the Warrior Transition Unit in which servicemembers are assigned to three key staff – a physician care manager, a nurse care manager, and a squad leader. For example, as of mid-September 2007, over half the U.S. Warrior Transition Units had significant shortfalls in one or more of these critical positions. In addition the number of recovery coordinators and how many servicemembers each would serve have yet to be determined.

    Transition Field Unit staffing

    This table shows that in actuality we have only 35% perminent staffing for these teams.  More than 450 of the existing staff (19%) have been borrowed from elsewhere, likely reducing the staff, already short, in othere facilities.   The table below shows where those with less than 50% staffing are located. 

     Staffing problem locations

    PTSD and TBI 

    Three independent review groups examining the deficiencies found at Walter Reed identified a range of complex problems associated with DOD and VA’s screening, diagnosis, and treatment of TBI (Traumatic Brain Injury) and PTSD, signature injuries of recent conflicts. Both conditions are sometimes referred to as “invisible injuries” because outwardly the individual’s appearance is just as it was before the injury or onset of symptoms. In terms of mild TBI, there may be no observable head injury and symptoms may overlap with those associated with PTSD. With respect to PTSD, there is no objective diagnostic test and its symptoms can sometimes be associated with other psychological conditions (e.g., depression).

    TBI and PTSD chart
     
    This table outlines what is being implimented (or planned) for handling TBI and PTSD better.   However, according to Army officials and the Independent Review Group report, obtaining qualified health professionals, such as clinical psychologists, is a challenge, which is due to competition with private sector salaries and difficulty recruiting for certain geographical locations. 

    Data Sharing

    In addition, the Dole-Shalala Commission noted that while VA is considered a leader in PTSD research and treatment, knowledge generated through research and clinical experience is not systematically disseminated to all DOD and VA providers of care.

    Data Sharing

    This table shows the efforts being taken to improve the data sharing between organizations. 

    Disability Evaluations

    As GAO and others have previously reported, providing timely and consistent disability decisions is a challenge for both DOD and VA. To address identified concerns, the Army has taken steps to streamline its disability evaluation process and reduce bottlenecks.   To address identified concerns, the Army has taken steps to streamline its disability evaluation process and reduce bottlenecks. The Army has also developed and conducted the first certification training for evaluation board liaisons who help servicemembers navigate the system. To address more systemic concerns, the Senior Oversight Committee is planning to pilot a joint disability evaluation system. Pilot options may incorporate variations of three key elements:

    (1) a single, comprehensive medical examination;

    (2) a single disability rating done by VA; and

    (3) a DOD-level evaluation board for adjudicating servicemembers’ fitness for duty.

    DOD and VA officials hoped to begin the pilot in August 2007, but postponed implementation in order to further review options and address open questions, including those related to proposed legislation.

    Fixing these long-standing and complex problems as expeditiously as possible is critical to ensuring high-quality care for returning servicemembers, and success will ultimately depend on sustained attention, systematic oversight by DOD and VA, and sufficient resources.

    You are invited to download and read the entire report here:  GAO Report (pdf – 32 pages)

    Oldtimer

    Video – The Soldier’s Heart – PTSD a Frontline Video Series

    The Soldier’s Heart is a 60 minute PBS “Frontline” video series in four parts.  It is available for viewing online here on the PBS Frontline web site.

    “Soldier’s heart”  or “nostalgia” are the names given for PTSD after the Cival War.  Later from various wars it became “shell shock”,”battle fatigue”, Post Vietnam Syndrome” and now commonly diagnosed as Post-Tramutic Stress Disorder or PTSD for Combat Trauma and there is a just-as-damaging subset called Military Sexual Trauma or MST. 

    Click on the link above for the full introduction and production information from the PBS Frontline Series.    Click on any of the pictures below to watch any of the 4 segments of the video.  Each is 15 minutes long.  Visit the PBS site anyway to get insight and background.  It is interesting and informative reading.   If you have low speed internet, you will need to go to the PBS site link above.  The links below are all high-speed links.

    PBS Frontline Homecoming

    Homecoming
    For three returning Iraq war veterans, it’s when they got home that the feelings, images, smells and nightmares of war began haunting them

    The Impact of Combat

    The Psychological Impact of Combat
    Decades of records have tracked the psychological toll of war on those who fight it. Today, what happens to a soldier who admits to emotional distress and asks for help?

    Needing Help

    Needing Help
    One young Marine, in a downward spiral, keeps his torment and pain bottled up. Another, showing symptoms of PTSD, joins a Camp Pendleton support group.

    Need for Change

    A Need for Change
    A young Marine takes his own life. In January 2005, the military announces plans for better mental health screening of returning vets. Will it be enough?

    This series from Frontline is astounding.  If you have not seen it before, please take the time to look at it now.  Visit them here for program notes, insights, background. and links to other videos and excellent programming.

    Honor Our Troops

    Honor Our Veterans

    Help our Homeless Veterans

     

    They Are All Heroes!

    Oldtimer

    Video – Soldiers with PTSD

    Soldiers with PTSD

    Video Thanks to AlyssaAS

    (turn up the sound)

    This is powerful!   Watch and decide to help.   Please

    Oldtimer 

     

    PTSD vet ‘chooses’ homelessness

    PTSD vet ‘chooses’ homelessness

    I found this in the Air Force Times

    By Brandon Stahl – The Associated Press
    Posted : Tuesday Oct 16, 2007 11:03:14 EDT

    DULUTH, Minn. – A bowl of corn flakes and room-temperature milk sits in front of Kevan Boman, 52, at a table in the Duluth Union Gospel Mission. His eyes flip down for a second, his lips purse and twist into a slight frown – just another reminder of what his life has become.

    “This is breakfast,” he says as his eyes shift up to the acrid cafeteria, not wanting any of the other sad, tired faces of destitute and homeless people to get too close to him. As he eats, he reminisces about what his life once was. He was a military man for 27 years, a veteran of two wars who retired as a decorated officer. He was a nurse, a proud husband and father of three daughters, once so wealthy that he donated thousands of dollars to the very soup kitchens where he now eats.

    Now, he lives in a car. It was other cars, before those were stolen or repossessed. In between were unlocked garages, tool sheds and apartment building basements, gas station bathrooms, drug houses or the couches of his daughters’ homes. Before all that, before he had to sneak into hospital and gas station bathrooms to bathe and groom himself, before the drugs and the suicide attempts, it was a three-bedroom, two-bath, two-car-garage home in a tree-lined Duluth neighborhood with his family.

    That was his life three years ago, before his mind was overwhelmed by the guilt and shame from post-traumatic stress disorder, and he walked out on it all.

    Since then, he has lived on the streets, but it doesn’t have to be that way. He could take his military disability checks for a tax-free $4,400 a month, get an apartment and start his life over. But he won’t. He says he would rather give his money away, to his kids, to friends, to just about anyone who asks for it. He says he would rather punish himself.

    “I haven’t made peace with myself,” he says, pausing for a moment as his eyes drop again, disappointment stretching across his face. “This is my penance. I don’t let God forgive me. I don’t know why I do this. I have to.”

    On any given night, according to the Department of Veterans Affairs, there are about 200,000 homeless veterans across the country, and about 400,000 veterans experience homelessness over the course of a year. About 97 percent of them are men, and they account for 23 percent of the total homeless population. 

    (Oldtimer’s Note:  Actually male veterans make up 43 percent of the male homeless but only 27% of the male population!)

    There’s no easy answer to why there are so many homeless veterans, though 45 percent suffer from mental health problems and substance abuse.

    “Some people develop alcohol abuse or dependence as they try to treat themselves,” said Dr. Ira Katz, VA’s national chief consultant for mental health. “Then the two conditions together can lead to difficulties with work and social relationships that could lead, in turn, to unemployment, separation or divorce, and homelessness.”

    Still, he said, it seems almost like an alien concept to him to suggest someone would choose to be homeless.

    “I’m not sure that homelessness is a choice,” Katz said. Instead, he suggests that a situation like Boman’s may be a complication of PTSD.

    “People think they are making a choice,” said Phil Ringstrom, a counselor at the Duluth Vet Center. “If they could flip a switch to make themselves better, they’d flip the switch. They’re not choosing this. They’re enduring.”

    So it’s debatable as to whether Boman chooses to live in his car.

    (this is a long article and I encourage you to read the rest of this story at the link above)

    Oldtimer’s comment: Kevan Boman is not alone out there.  PTSD is a common ailment for those who have been in combat, often also for women veterans who have been abused in the service.   See this article for more on PTSD – PTSD – Some Help for Veterans – information fact sheet to help recognize the symptoms, and includes other useful information.

    Oldtimer