Veterans for Common Sense

May 23, 2008, Washington, DC – Secretary of Veterans Affairs Dr. James B. Peake today announced the names of members appointed to two special panels that will make recommendations on ways the Department of Veterans Affairs (VA) can improve its programs in suicide prevention, suicide research and suicide education.

“There is nothing more tragic than the death by suicide of even one of the great men or women who have served this nation,” Peake said. “VA is committed to doing all we can to improve our understanding of a complicated issue that is also a national concern.”

Membership in the first group, the “Blue Ribbon Work Group on Suicide Prevention in the Veterans Population,” will be comprised of government experts in various suicide prevention and education programs.  Those experts will come from agencies including the Department of Defense, the Centers for Disease Control, the National Institute of Health, and the Substance Abuse and Mental Health Services Administration.

The five-member work group is expected to meet from June 11-13, and will develop a report with recommendations for the Secretary within 15 days of meeting. 

The second group is a nine-member expert panel, made up of nationally renowned experts in public health suicide programs, suicide research and clinical treatment programs, that will provide professional opinion, interpretation, and conclusions on information and data to the work group.  It will also make recommendations to the work group on opportunities for improvement in VA’s programs. 

Secretary Peake initially announced the formation of the work group during testimony to the House Veterans Affairs Committee on May 6.

Members of the “Blue Ribbon Work Group on Suicide Prevention in the Veterans Population” include:

Cmdr. Alex E. Crosby, M.D., medical epidemiologist with the Centers for Disease Control and Prevention;
Colonel Charles W. Hoge, M.D., director of the division of psychiatry and behavior services at Walter Reed Army Institute of Research;
Colonel Robert Roy Ireland, M.D., program director for mental health policy, Office of the Assistant Secretary of Defense for Health Affairs;
Richard McKeon, Ph.D., special advisor for suicide prevention with the Substance Abuse and Mental Health Services Administration; and
Jane Pearson, Ph.D., associate director for preventive interventions, National Institute of Mental Health.

Appointees to the expert panel include:

Dr. Dan Blazer II, professor of psychology at Catholic University of America;
Greg Brown, Ph.D., University of Pennsylvania;
Martha Livingston Bruce, Ph.D., professor in clinical epidemiology and health services research at Weill Medical College of Cornell University;
Dr. Eric D. Caine, chair of the department of psychiatry at the University of Rochester;
Dr. Jan Fawcett, professor of psychiatry at the University of New Mexico School of Medicine;
Robert D. Gibbons, director of the Center for Health Statistics, University of Illinois at Chicago;
David Alan Jobes, Ph.D., professor of psychology at Catholic University of America;
Mark S. Kaplan, Ph.D., from Portland State University.  Member of the Suicide Prevention Action Network-USA National Scientific Advisory Council; and
Thomas R. Ten Have, director of the Biostatistics Analysis Center at the University of Pennsylvania School of Medicine.

May 22, 2008 – Memorial Day is upon us again, and the more traditional towns will be flying flags and hosting parades and holding ceremonies to honor the million American soldiers, sailors, airmen, Marines and Coast Guardsmen who’ve fallen in the wars of history and in the wars of today.

It is good to honor the fallen and to comfort the families and friends who mourn one among them whose death broke their hearts.

This year, however, I’ll depart from tradition and ask that we reflect less on our fallen comrades who are at peace, and more on those veterans – especially those from our wars in Iraq and Afghanistan – who are alive and need our help.

How strange that today in our country, in a time of war, battles are raging over the need for medical care, educational benefits, employment opportunities and assistance for those who’ve served honorably and come home to begin new lives in a nation they risked their lives to defend.

The shameful thing is that most of those battles are being waged against the very government, the very bureaucracies, the very politicians who sent those young men and women to war in Iraq and Afghanistan.

Maybe the right word here isn’t shameful, but criminal.

On Capitol Hill, our lawmakers debate the pros and cons of a new GI Bill that would provide our latest combat veterans with education benefits at least equal to those that their grandfathers received when they came home from winning World War II.

Our president has threatened to veto that bill if Congress passes it. The Republican candidate to succeed him, Sen. John McCain, a veteran and former prisoner of war himself, refuses to support that GI Bill and offers a watered down, cheaper substitute.

The Pentagon and the Secretary of Defense, Robert Gates, a former university president, oppose better educational benefits for veterans, for fear that offering them might entice more young troops to leave the service for the campus.

This is odd, coming as it does from a president who talks a lot about supporting our troops, from a senator who draws a 100 percent military disability pension and from a former college president who surely knows the value of higher education.

Others among us wage endless battles and rage against the very agency charged with providing medical care, disability pensions, mental health care and counseling and, yes, the parsimonious educational benefits for all who’ve served and sacrificed for our country – the Veterans Administration (VA).

In recent months, VA officials have been caught providing false statistics that far understate the true number of veterans, old and young, who commit suicide. They’ve ordered doctors to diagnose fewer cases of post-traumatic stress disorder (PTSD) and to substitute a diagnosis of a lesser, temporary stress disorder.

The young people marching home from war and trying to rejoin civilian society, get a job and start a life aren’t having much luck, either. The government’s own statistics show that fully a quarter of returning veterans are employed in jobs that pay wages that put them below the poverty line, or less than $21,000 a year if they’re single.

Marine Maj. Gen. (ret.) Matt Caulfield of Oceanside, Calif., knows that the young men and women leaving military service today are the finest he’s ever known in a long career in uniform – yet they’re having a hard time finding good jobs.

“The CEO’s and chairmen in industry all say how their companies want to hire veterans,” Caulfield told me. “But this is simply not translating downward to the people who do the interviews and make the hiring decisions. A veteran is someone alien to your average corporate hiring manager, who is a 28-year-old woman with a college degree.”

Caulfield, a veteran of two combat tours in Vietnam, said that government and industry are both failing miserably in providing job opportunities for this new generation of veterans. He called it a scandal when some of the best and brightest and most motivated of their generation are consigned to jobs flipping burgers or, worse, to the street corners in big cities where they hold up cardboard signs that advertise: “Homeless Veteran – Will Work for Food.”

So let’s review the bidding here this Memorial Day.

Let’s all pay lip service to Support Our Troops. But if we want to be honest, we should edit those yellow-ribbon bumper stickers to say Support Our Troops – As Long As It Doesn’t Cost Anything.

Let’s acknowledge that this new generation of soldiers and Marines is amazingly motivated and talented. They’re expected to be good killers, good diplomats and ambassadors of American goodwill who operate under impossibly complex rules of engagement in impossibly dangerous and deadly environments.

But if they come home wounded, their brains rattled by the huge IED’s of the new way of war, and if they suffer the horrors of PTSD nightmares and flashbacks, let’s dump them on the streets with the least amount of help and benefits possible, as cheaply as possible.

For sure we don’t want to improve their chances, better their future prospects, by offering them the same college benefits we gave their grandfathers six decades ago. God help us if they all get college degrees and figure out what we’ve done to them.

In April, lawyers for a veterans’ advocacy group released e-mails written by Dr. Ira Katz, chief of mental health at the VA. Under a subject line of “Shhh,” Dr. Katz revealed that the number of suicides by returning veterans was far higher than the VA publicly had acknowledged. He fretted about the implications if the real numbers — 1,000 suicide attempts a month — got out. 

May 22, 2008 – Disturbing new evidence emerged last week that the Department of Veterans Affairs continues to provide shoddy mental health care for soldiers and Marines returning from Iraq and Afghanistan.

Lack of effective screening, delayed care and denied diagnoses add up to a new kind of “don’t ask, don’t tell” policy that is completely unacceptable.

• A federal report released last September criticized the VA for a “lack of early identification techniques” to detect veterans’ mental health problems.

• VA facilities around the country are short about 3,800 mental health workers, including 1,400 doctors. Professionals at many facilities are working overtime, yet returning veterans continue to face long waits for services and even longer waits for diagnosis and benefits.

According to documents filed in a federal suit in San Francisco, more than 85,000 veterans faced a wait of longer than 30 days for mental health care as of April. Waiting times for decisions relating to service-connected disability compensation stretch into years.

• Repeated deployments to a war zone where there are no front lines have led to an overwhelming need for care. A RAND Corp. report released this month estimates that as many as one in five servicemen and women returning from Iraq and Afghanistan suffer from post-traumatic stress disorder or major depression. With 1.64 million deployed so far, that puts the number of veterans in need of care at about 300,000.

The latest evidence that they’re not getting the care they need came in an e-mail released last week. It was written by Norma J. Perez, the PTSD coordinator at a VA facility in Texas.

Because the facility is seeing more of what Ms. Perez described as “compensation-seeking veterans,” she urged mental health professionals there to “refrain from giving a diagnosis of PTSD (Post Traumatic Stress Disorder) straight out.”

A diagnosis of PTSD would qualify veterans for lifetime medical care, instead of the five years made available to all combat veterans. And it would make them eligible for at least some disability compensation.
Instead of diagnosing PTSD, Ms. Perez asked that therapists “consider a diagnosis of Adjustment Disorder, R/O (ruling out) PTSD.” Veterans with adjustment disorder generally are not eligible for disability payments.

That callous disregard of veterans’ rights is of a piece with the administration’s entire approach to war. It sent troops into combat with inadequate body and vehicle armor, issued so-called stop-loss orders that forced them to serve beyond the expiration dates of their contracts and repeatedly sent them to combat zones.

They came home to discover that the benefits and care they were promised either were not available or required extended and expensive waits. Even worse, the military and VA have tried to “manage” reality by denying it.

In April, lawyers for a veterans’ advocacy group released e-mails written by Dr. Ira Katz, chief of mental health at the VA. Under a subject line of “Shhh,” Dr. Katz revealed that the number of suicides by returning veterans was far higher than the VA publicly had acknowledged. He fretted about the implications if the real numbers — 1,000 suicide attempts a month — got out.

It’s not the public reaction to 12,000 suicide attempts a year or the cost of compensating servicemen and women for PTSD that should worry VA officials. It’s the fact that veterans, having already risked their lives in combat, are losing their futures to the unseen wounds of battles that ended long ago.

May 22, 2008 – As the debate over supplemental funding for the war in Iraq plays out in Congress, a growing consensus on the need to adopt a policy of “strategic patience” has become accepted wisdom in the national debate. Proponents of this policy argue that solidifying recent security and political gains in Iraq is contingent upon the US military remaining in the country indefinitely. However, in order to truly capitalize on those gains, the United States must begin to withdraw its forces from Iraq.

more stories like thisAn unconditional and open-ended military commitment to a dysfunctional and sectarian Iraqi government will not bring about true national reconciliation, which is necessary to capitalize on what temporary security and political gains have been made.

Rather, this commitment forfeits what little leverage the United States has left: the ability to extract political compromises from a status quo Iraqi government by presenting it with a credible threat of a US withdrawal if concessions are not made and implemented.

Conversely, an indefinite US military presence will reverse the calculations of Iraqi opposition groups – most notably the Sunni Awakening forces and the Sadr movement – that have been critical in bringing about short-term security improvements.

The United States and the Iraqi government share a common interest in a stable Iraq, but further US support must be conditional upon the Iraqi government pursuing political reconciliation. Absent a credible withdrawal plan, the Iraqi government’s sectarian political calculations will remain constant and opposition groups’ recent alliance or patience with the United States will unravel.

First, the Iraqi government. The Bush administration’s open-ended commitment has allowed the government of Prime Minister Nouri al-Maliki to approve only token political benchmarks while core power-sharing legislation remains unaddressed. Unqualified US support has also given Maliki’s Dawa party and his Shi’a allies in the Islamic Supreme Council of Iraq a free hand to take on their political rivals militarily.

Perhaps the only remaining leverage the United States holds over Iraqi lawmakers, regardless of their ethnic or sectarian identity, is the latter’s need of a sustained US military presence that ensures their political and physical survival.

Faced with the potential loss of their American backers, the predominantly Shi’a Iraqi government will have an incentive to integrate its Sunni Awakening and Shi’a rivals into the Iraqi government and security forces on their terms while the balance of power is in their favor. While there is no guarantee that key power sharing legislation – an oil sharing law, a constitutional review, and the implementation of provincial elections – will be undertaken, the current dynamic has not achieved a resolution of these issues and does not appear to be able to do so in the near future.

Second, Sunni Awakening groups and “Sons of Iraq” militias. Despite their cooperation with US forces and recent efforts to form political parties in anticipation of the proposed provincial elections, these Sunni forces still demand a US withdrawal and have predicated their political participation on a US departure.

Indeed, the United States must begin to withdraw in order to capitalize on this development.

The perception that we will maintain a large military presence in Iraq indefinitely will endanger this cooperation and ultimately undermine the security progress that has been made. As one Awakening commander put it in February, “If nothing changes, then we’ll suspend and quit. Then we’ll go back to fighting the Americans.”

Finally, the Sadr movement. Sadr’s August 2007 cease-fire restored his once damaged credibility and allowed him to reorganize his forces and wait out the US presence. However, recent confrontations with US and Iraqi forces are changing Sadr’s calculations. Fighting in Basra and Baghdad have resulted in a loss of the movement’s power and influence and have convinced Sadr rank and file that the United States and other Shi’a groups are conspiring against them. As long as open confrontation with US forces persists, Sadr’s patience will continue to wane.

In order for the United States to regain control of its security interests in Iraq and the greater Middle East, it must use its only remaining leverage with major Iraqi groups: a credible military withdrawal.

“Senator McCain clearly needs to be recognized for his military service and in some respects that will play to his advantage, but when it actually comes to delivering health care and benefits during war, Senator McCain’s going to have some explaining to do,” said Paul Sullivan, director of the nonpartisan Veterans for Common Sense.  

May 20, 2008 – Of all the voting groups John McCain will target this fall, none would seem like more of a sure thing than this country’s war veterans. So why is the celebrated Vietnam War hero and POW bracing for a potentially bad week with so many men and women who have served in uniform?

The point of contention between the two seemingly natural allies is a piece of legislation the Senate is expected to vote on this week to update the 1944 G.I. Bill to provide expanded education assistance and opportunities to the armed forces. The bill, co-sponsored by two other Vietnam veterans in the Senate, Republican Chuck Hagel of Nebraska and Democrat Jim Webb of Virginia, would effectively provide full tuition and housing costs at a four-year public university for veterans who have served at least three years of active duty. Given his family’s and his own long and distinguished service career, the bill would seem like a natural fit for the presumptive Republican presidential nominee. But McCain, concerned about the estimated $4 billion annual price tag and the incentive he worries it might give people to leave an already strapped military, has sponsored his own competing proposal. It increases the existing monthly education benefit from around $1,100 to $1,500 a month while adding more generous benefits for those who’ve served more than 12 years.

McCain’s concerns, however, don’t seem to impress the vast majority of veterans’ organizations. They are feverishly lobbying him to support the Webb and Hagel bill, which simply adds the new program’s expense to the $165 billion annual emergency war supplemental, a move President George W. Bush has threatened to veto. (The House version offsets the program by increasing taxes by 0.5{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} on those individuals who earn more than $500,000 a year and couples who earn more than $1 million, a move also under veto threat.) “This isn’t about anything partisan; we are firmly supporting the bill that does right by the veterans, does right by the troops, and that is not McCain’s bill,” said Ramona Joyce, a spokeswoman for the American Legion. “It could do McCain damage with veteran voters if this issue drags out.”

Even with the current dustup, it’s hard to imagine John McCain not winning the majority of the veterans vote in November. But the nation’s 26 million veterans are by no means a monolithic voting bloc, and any level of disappointment with McCain could sway some undecideds. The Democratic National Committee is already gleefully preparing TV spots about McCain’s position on the Senate bill. And, sensing a vulnerability in McCain’s seemingly greatest strength, some Democratic strategists are already contemplating what other veterans votes they can bring up this year.

Obama, who sits on the Senate Veterans Affairs Committee, has already won some support from many Iraq and Afghanistan vets who oppose the war in Iraq, and has been actively trying to expand his appeal to older veterans — though his efforts in that regard didn’t help him in the primaries in veteran-heavy states like Pennsylvania, Ohio and West Virginia. To underline his own family’s military pedigree, Obama plans a trip in coming weeks to the Punchbowl National Cemetery in Hawaii, where his grandfather, who served in World War II, is buried. Obama and McCain’s G.O.P. rival, the antiwar presidential candidate Congressman Ron Paul, actually beat McCain in donations from the four branches of active military this year, according to a study by the Center for Responsive Politics.

This is not the first time McCain, who has a proud history of opposing what he views as excessive government spending, has found himself at odds with his fellow veterans on legislation. He’s voted for veterans funding bills only 30{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of the time, according to a scorecard of roll-call votes put out by the nonpartisan Disabled Americans for America. Under the same system Obama has a 90{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} rating — though, of course, he has spent a much shorter time in Washington.

“Senator McCain clearly needs to be recognized for his military service and in some respects that will play to his advantage, but when it actually comes to delivering health care and benefits during war, Senator McCain’s going to have some explaining to do,” said Paul Sullivan, director of the nonpartisan Veterans for Common Sense.

Supporters of Webb and Hagel’s bill dismiss McCain’s concerns about the retention issue. While the Congressional Budget Office estimates that the bill would cause a 16{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} drop in re-enlistment rates across all four branches of the military, the same study also predicts a 16{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} uptick in new recruits attracted by the benefit. The bill has 58 co-sponsors, including none other than Obama — just two shy of a veto-proof majority. It was passed last week by the House with a comfortable veto-proof majority, but as an amendment to the emergency war supplemental, it could be altered as the two chambers hammer out differences between the two versions. McCain’s office is confident that in the reconciliation process a compromise can be worked out. “We’re negotiating in good faith and we think they are as well. We want to do something for veterans. We’re really working hard to accomplish our goal,” said Mark Buse, McCain’s Senate chief of staff.

Webb, who has yet to endorse a presidential candidate but is rumored to be on Obama’s vice presidential shortlist, might have been more open to talks until last week. After the two camps met but failed to come to a resolution on their differences, McCain’s allies moved to attach his version — which has nine G.O.P. co-sponsors — to an unrelated bill on the Senate floor. The Senate came to a grinding halt for two hours as Senate Majority Leader Harry Reid worked to remove McCain’s amendment; eventually it was tabled by a vote of 56-42. But the tactic created no good will with Webb’s staff. “At this point we were really not in the position to negotiate,” said Jess Smith, a spokeswoman for Webb. “We’re sticking to our guns that our bill will take care of our vets; incentivizing long-term military service is not the top aim of this bill.”