May 22, Waco (Texas) Tribune Newspaper Editorial About VA E-Mail Scandal: Appalling PTSD Memo

May 20, 2008 – At a time when increasing numbers of veterans suffer from post-traumatic stress disorder, it is outrageous to learn that a Veterans Affairs supervisor suggested that VA caregivers downgrade PTSD findings to “adjustment disorders.”

Congress should launch an investigation to make sure America’s veterans receive the mental health care they deserve.

Rep. Chet Edwards, D-Waco, said he was “appalled” by the VA memo.

Edwards has fought for years to obtain funding for veterans’ health care, especially to treat PTSD at the Waco VA Medical Center.

Edwards helped fund a joint VA research project into PTSD between the Waco VA hospital and the Temple VA Medical Center.

Now comes the memo: A PTSD program coordinator and psychologist at the Olin E. Teague Veterans’ Center in Temple sent an e-mail in March to VA staffers including psychologists, social workers and a psychiatrist that said, “Given that we are having more and more compensation-seeking veterans, I’d like to suggest that you refrain from giving a diagnosis of PTSD straight out.”

The supervisor, identified as Norma J. Perez, went on to recommend that her caregivers instead “consider a diagnosis of Adjustment Disorder .  .  . ”

“Additionally,” Perez wrote, “we really don’t have or (sic) have time to do the extensive testing that should be done to determine PTSD.”

Veterans diagnosed with PTSD can be eligible for up to $2,527 a month in disability compensation, depending on their condition. Those diagnosed with adjustment disorder generally receive no compensation.

Also, treatment for adjustment disorder usually takes no more than six months. PTSD treatment generally takes much longer.

The memo, obtained by VoteVets.org, and Citizens for Responsibility and Ethics in Washington, was called “inappropriate” by VA Secretary James Peake. He said it does not reflect VA policy.

Peake said Perez has been “counseled” and is “extremely apologetic.” She also remains on her job.

Peake recently appeared before the House Veterans Affairs Committee to answer questions about VA e-mails that suggested VA officials were hiding the number of veterans trying to commit suicide.

A Rand Corp. report found that about 300,000 U.S. military personnel who have served in Iraq or Afghanistan are suffering from PTSD or major depression. There are estimates that as many as 18 veterans a day commit suicide.

Peake needs to be called back to Congress to assure lawmakers that the outrageous recommendations in the Temple VA memo are not VA policy. Peake also should send out his own memo instructing that cost-cutting diagnoses will not be allowed.

There are estimates that as many as 18 veterans a day commit suicide.

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May 23: VCS Memorial Day Weekend 2008 – Information to Use and to Share

For Memorial Day 2008, Veterans for Common Sense provides several pieces of information frequently requested by our members.  Here are the latest death counts from the two current wars plus all prior wars.  We also provide the history behind Memorial Day plus a link to our U.S. Constitution that our service members swear an oath to protect and defend.  Finally, we provide the full text of President Lincoln’s poignant Gettysburg Address, where he honored our Civil War dead after the historic battle in 1863.

Memorial Day is set aside so that we may honor our Nation’s fallen service members – fellow Americans who died protecting and defending our U.S. Constitution.

1. U.S. Military Deaths in Iraq War: 4,059, as of May 3, 2008
   – Source: DoD, http://siadapp.dmdc.osd.mil/personnel/CASUALTY/OIF-Total.pdf

2. U.S. Military Deaths in Afghanistan War: 491, as of May 3, 2008
   – Source: DoD, http://siadapp.dmdc.osd.mil/personnel/CASUALTY/WOTSUM.pdf 

3. U.S. Military Deaths 1775 – to 1991:
   – U.S. Military Service during Wartime: 41,891,368
   – Battle Deaths: 651,022
   – Other Deaths (In Theater): 308,797
   – Other Deaths in Service (Non-Theater): 230,279
   – Source: VA, http://www1.va.gov/opa/fact/amwars.asp

4. History of Memorial Day from VA: http://www1.va.gov/opa/speceven/memday/history.asp#hist

5. U.S. Constitution: http://www.archives.gov/exhibits/charters/constitution_transcript.html

6. President Abraham Lincoln’s Gettysburg Address, November 19, 1863:
   – Source: Library of Congress: http://www.loc.gov/exhibits/gadd/images/Gettysburg-2.jpg

Fourscore and seven years ago our fathers brought forth on this continent a new nation, conceived in liberty and dedicated to the proposition that all men are created equal. Now we are engaged in a great civil war, testing whether that nation or any nation so conceived and so dedicated can long endure.

We are met on a great battlefield of that war. We have come to dedicate a portion of that field as a final resting-place for those who here gave their lives that that nation might live. It is altogether fitting and proper that we should do this. But in a larger sense, we cannot dedicate, we cannot consecrate, we cannot hallow this ground. The brave men, living and dead who struggled here have consecrated it far above our poor power to add or detract.

The world will little note nor long remember what we say here, but it can never forget what they did here. It is for us the living rather to be dedicated here to the unfinished work which they who fought here have thus far so nobly advanced.

It is rather for us to be here dedicated to the great task remaining before us – that from these honored dead we take increased devotion to that cause for which they gave the last full measure of devotion – that we here highly resolve that these dead shall not have died in vain, that this nation under God shall have a new birth of freedom, and that government of the people, by the people, for the people shall not perish from the earth.

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VA Inspector General Report Finds VA Continues to Inaccurately Report Patient Wait Times

Press Release: Senator Akaka concerned by apparent lack of commitment to accurate assessment  

May 19, 2008, Washington, DC – Responding to a report by the Department of Veterans Affairs Inspector General (IG) on VA patients’ waiting times today, U.S. Senator Daniel K. Akaka (D-HI), Chairman of the Veterans’ Affairs Committee, expressed concern that VA continues to report inaccurate data on wait times for health care appointments.  The IG audit, which focused one VA health care network, VISN 3, found that VA under-reported patient wait times, and that staff there failed to follow recommendations made by the IG in previous reports on the issue.  Some VISN 3 employees reported to the IG that their superiors directed them to violate existing guidelines and directives, and deliberately manipulate data.

“VA’s neglect of patient wait times is a breach of the faith that servicemembers put in the system.  This audit indicates that the Veterans Health Administration is not committed to reducing unacceptable wait times.   I am concerned that this problem exists throughout the VA system,” said Akaka.

The IG report, released today, is titled “Audit of Alleged Manipulation of Waiting Times in Veterans Integrated Service Network 3.”  For the third time in three years, the IG found that VA is not producing accurate wait time records nor following proper scheduling procedures.  As a result, wait times are dramatically under-reported.  Further IG comments note that VA as a whole still has not implemented the majority of recommendations made in the July 2005 and September 2007 wait time reports, which contained similar conclusions.

Akaka continued, “This deception must end.  Veterans are not receiving the services they need, and inaccurate data prevents VA from fixing the problems.  This failure is inexcusable, especially given the unprecedented funding increases VA has received in recent years.”

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Editorial Column: When it Costs Too Much to Support Our Troops

May 19, 2008, Washington, DC – The comment was outrageous, but it was not the least bit surprising. A psychologist responsible for assessing returning war veterans for post-traumatic stress disorder — a psychological ailment that could entitle them to monthly disability payments — told staff members not to diagnose the illness because to do so would increase the government’s costs.

“Given that we are having more and more compensation-seeking veterans, I’d like to suggest that you refrain from giving a diagnosis of PTSD straight out,” the psychologist at a Department of Veterans Affairs center in Texas wrote in an e-mail. She suggested diagnosing a less severe disorder that would not carry the greater long-term disability costs.

The correspondence was made public by VoteVets.org and Citizens for Responsibility and Ethics in Washington, two groups that have dogged the Bush administration about our latest national disgrace: the shoddy care and bureaucratic callousness shown toward the warriors who are returning from Iraq and Afghanistan with life-altering wounds of the body and spirit.

Of course, the morally indefensible missive was repudiated by higher-ups in the Department of Veterans Affairs as soon as it was revealed last week. And, of course, the persistent congressional outcry over the treatment of veterans—not to mention the onrushing election season—makes it more likely than not that some temporary alleviation of the pain and suffering vets endure in a system that is supposed to be serving them will be addressed. Somehow, some day, that is.

That bit of politically induced relief for vets, should it come, does not change the underlying sentiment of the message. Because at bottom, it is a demoralizing reminder of the way the U.S. health care system works for just about everyone.

Certainly, the government agency in charge of caring for veterans is not supposed to behave this way, under the law or any standard of conscience.

In truth, the mind-set mirrors the unconscionable standard of the health insurance industry’s thinking that the rest of us must endure—and from which neither leading candidate for president promises much relief.

The industry’s term for paying a claim is “medical loss.” This is a disturbingly blunt but perfectly accurate reflection of reality: To make a profit, an insurer must take in more money than it pays out in claims. Denying payment on claims, or strictly limiting payments even for the most obvious or debilitating medical conditions, is how the industry stays financially viable. 

“I was told repeatedly that I was not denying care, I was simply denying payment,” Linda Peeno, a doctor and former managed-care medical claims officer testified before Congress in 1996. A video clip of her testimony was included in Michael Moore’s 2007 documentary “Sicko,” the story of how the American health insurance system really works—or rather, doesn’t—for most people.

The slip-up at the veterans’ health agency comes at a propitious time, because neither of the two men who could become president next year would do anything to change the type of thinking it revealed. Democrat Barack Obama relies on the current, if uneasy—and increasingly unworkable—partnership between the insurance industry and employers to expand coverage. But Obama would not make universal coverage mandatory, and so insurers would still be able to cherry-pick among those it really wants to insure (the healthiest, and therefore the cheapest) and those it doesn’t (the sickest and most expensive).

Republican John McCain’s answer is far worse. He would effectively break the link between employers and the insurance industry and give individuals a tax credit with which to buy a policy on their own—a purchase they would make at the mercy of insurers. If you liked President Bush’s plan to privatize Social Security and move toward a do-it-yourself retirement system, you’ll love McCain’s do-it-yourself answer to the insurance crisis.

But, of course, no one can really do it himself because the whole idea of private insurance is to spread risk broadly. That’s why employers are able to purchase policies more cheaply than can individuals: The expensive employee whose child has cancer is offset by the cheaper employee who is as fit as a marathon runner.

The psychology of the cost-conscious official at the Texas veterans medical facility is the psychology that controls the health care system for all of us. If we are outraged at the hint that it might be applied to wounded servicemen and -women, we should also be angry that it is applied every day to the rest of us.

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Veterans Peace Group Blocked from D.C. Parade

May 21, 2008, Washington, DC – A veterans group that opposes the war in Iraq has been blocked from marching in a Memorial Day parade in Washington after being told its plans, which once included a casket representing war dead, would be too political for the event.

Veterans for Peace was initially granted a spot in the Monday parade that is scheduled to travel down Constitution Avenue, past landmarks that include the Washington Monument and the White House.

But the American Veterans Center, a nonprofit that organizes the parade, has pulled that approval, saying it does not allow the expression of political viewpoints.

Anthony Teolis, treasurer of the Washington-area chapter of Veterans for Peace, said that as veterans, the group should be able to take part in the parade. He said it was being singled out because of its anti-war views.

“We are a veterans group like any other except we have the word ‘peace’ in our name,” Teolis said.

Jim Roberts, president of the Arlington, Va.-based American Veterans Center, said the group strives to keep political statements out of the parade. Last year, two groups that supported the wars in Iraq and Afghanistan were turned down. The Veterans for Peace program initially was approved by a contractor handling parade planning, but it was revoked when the center saw its plans for the march.

“We don’t allow groups in the parade that are projecting an opinion. That goes for pro-mission as well as anti-war,” Roberts said.

The parade, now in its fifth year, includes marchers that span the military history of America, from Revolutionary War re-enactors to active-duty military units. Other marchers scheduled for this year include 20 high school bands, a military high school and actor Gary Sinise. Last year, roughly 250,000 people attended.

The Washington-area chapter of Veterans for Peace submitted an application outlining plans to include a “miniature hand drawn funeral casket with U.S. flag symbolizing fallen troops,” according to a copy of their proposal. A convertible carrying three World War II veterans also was planned.

Teolis said the group dropped the casket plan when the producers of the parade objected. But he said the Veterans Center still barred the group from the parade.

Made up of military veterans dating back to before World War II, Veterans for Peace opposes the use of war to meet national objectives and wants American troops in Iraq to be brought home. It has roughly 7,500 members in 122 chapters nationwide.

It has sought to march in other parades honoring veterans with mixed results. Michael McPhearson, national executive director of Veterans for Peace, said the group took part in Veterans Day parades in New York and marched in other events nationwide. But it was blocked from taking part in events in cities such as Boston.

McPhearson said the group does not dishonor veterans. The parades, which highlight wars waged for political ends, are inherently political, he said.

“It is ridiculous to say we have this political objective when the whole thing is about politics,” McPhearson said.

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May 21, Torture Lawsuit News: Dept. of Justice Inspector General Report Details How U.S. Torture of Prisoners Began in 2002

May 21, 2008, Washington, DC – F.B.I. agents complained repeatedly, beginning in 2002, about the harsh interrogation tactics that military and C.I.A. interrogators were using in questioning terrorism suspects, like making them do dog tricks and parade in the nude in front of female soldiers, but their complaints appear to have had little effect, according to an exhaustive report released Tuesday by the Justice Department’s inspector general.

The report describes major and repeated clashes between F.B.I. agents and their counterparts over the rough methods being used on detainees in Guantánamo Bay, Afghanistan and Iraq — some of which, according to the inspector general, may have violated the Defense Department’s own policies at the time.

It also provides new insight into the intense debates at senior levels of the Justice Department, the Defense Department and the National Security Council over what should and should not be allowed — a debate in which the Defense Department prevailed.

The inspector general found that in a few instances, F.B.I. agents participated in interrogations using pressure tactics that would not have been permitted inside the United States. But the “vast majority” of agents followed the bureau’s legal guidelines and “separated themselves” from harsh treatment.

For instance, F.B.I. agents expressed “strong concerns” about the abusive treatment by the C.I.A. in 2002 of Abu Zubaydah, a senior Al Qaeda figure, leading to tense discussions between senior officials at the two agencies over how such important prisoners should be handled.

Still, the bureau “had not provided sufficient guidance to its agents on how to respond when confronted with military interrogators who used interrogation techniques that were not permitted by the F.B.I.,” and that fueled confusion and dissension, the report said.

“In sum, while our report concluded that the F.B.I. could have provided clearer guidance earlier, and while the F.B.I. and DoJ could have pressed harder for resolution of F.B.I. concerns about detainee treatment, we believe the F.B.I. should be credited for its conduct and professionalism in detainee interrogations in the military zones in Afghanistan,” in Iraq and at Guantánamo Bay, the report said. DoJ refers to the Justice Department, the bureau’s parent agency.

Jameel Jaffer, who tracks detainee issues for the American Civil Liberties Union, took a more critical stance. “The report confirms that senior F.B.I. officials knew as early as 2002 that other agencies were using abusive interrogation methods,” Mr. Jaffer said. “The report shows unequivocally, however, that the F.B.I.’s leadership failed to act aggressively to end the abuse.”

He said the report documents “a failure of leadership” at the bureau, and “only underscores the pressing need for an independent and comprehensive investigation of prisoner abuse.”

The report said that several senior Justice Department Criminal Division officials raised concerns with the National Security Council in 2003 about the military’s treatment of detainees, but saw no changes as a result of their complaints.

John Ashcroft, the former attorney general, declined to be interviewed by the inspector general’s office of the department he had headed, an unusual refusal and one that hampered investigators’ attempts to learn of discussions inside the council, the report said.

A Pentagon spokesman had no immediate comment on the report.

The inspector general’s office started its investigation in late 2004, following widespread public attention to the question of detainee treatment spurred by graphic photographs of prisoners at the Abu Ghraib prison in Iraq.

The American Civil Liberties Union, through a lawsuit, also unearthed numerous internal e-mail messages from the bureau about agents’ complaints of rough interrogation tactics at Guantánamo Bay, which proved central in the Justice Department’s review.

The investigation examined about a half-million documents and included surveys of 1,000 F.B.I. agents regarding their experiences with interrogation tactics by military and C.I.A. interrogators, as well as interviews with hundreds of other bureau personnel, officials said. The investigation centered on the accounts of what the agents witnessed in the treatment of prisoners at Guantánamo Bay, in Iraq and in Afghanistan, and how those complaints were handled. The Justice Department’s inspector general does not have jurisdiction over the Pentagon.

The bulk of the report was completed last year, but its public release by the inspector general was bottled up for months because of concerns from the Defense Department about the disclosure of sensitive information centering on interrogation tactics. The final report from the inspector general, unlike some earlier terrorism investigations, was released with relatively few blacked-out sections.

The bureau stationed agents at Guantánamo Bay and other military detention sites to assist in the questioning of detainees taken into custody after the terror attacks of Sept. 11, 2001, but the rough tactics by military interrogators soon became a major source of friction between the bureau and sister agencies. Agents complained to superiors beginning in 2002 that the tactics they had seen in use yielded little actual intelligence, prevented them from establishing a rapport with detainees through more traditional means of questioning, and might violate bureau policy or American law.

One bureau memorandum spoke of “torture techniques” used by military interrogators. Agents described seeing things like inmates handcuffed in a fetal position for up to 24 hours, left to defecate on themselves, intimidated by dogs, made to wear women’s underwear and subjected to strobe lights and extreme heat and cold.

Ultimately, the bureau ordered its agents not to participate in or remain present when such tactics were used. But that directive was not formalized until May 2004, and it governed only the bureau’s own agents. Robert S. Mueller III, director of the F.B.I., told Congress that he was not made aware of his agents’ concerns until 2004.

Democrats in Congress have been anxiously awaiting the findings from the inspector general as they seek to push for answers from the Bush administration about how interrogation policies were developed. Representative Jerrold Nadler, the New York Democrat who leads a House Judiciary subcommittee on the Constitution and civil right, told reporters on Monday, in advance of the report’s release, that he sensed a “a reluctance to confront senior administration officials” about interrogation policies from the bureau and elsewhere. He said the report should help answer key questions about how policies were executed.

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VA Capacity Crisis Hits California – Older Veterans Feel Forced Out of Counseling by Newer Veterans

May 20, 2008 – A group of older military veterans in the Inland region says the U.S. Department of Veterans Affairs is pushing it out of counseling programs to make room for an expected influx of Afghanistan and Iraq war veterans.

Albert Cruz, 59, of Hesperia, said officials at the Victorville Veterans Center told him and other members of a post-traumatic stress disorder therapy group that “they have to bring (the group) to an end.”

Cruz, a veteran of Vietnam and Desert Storm, and his colleagues are convinced that their government is abandoning them.

“It’s like a slap in the face,” he said.

When he asked the veterans officials what he should do about treatment, he said, “They said, ‘Well, if you flip out again, call 911.’ “

Lois Krawczik, a psychologist who oversees post-traumatic stress programs for the VA Medical Center in Loma Linda, said Cruz is mistaken. She said the VA has no plans to eliminate programs at the Victorville clinic. In fact, the clinic is expanding, she said.

“There may be some changes,” Krawczik said, but “we’re not discontinuing or cutting back services.”

Budget figures provided by the Loma Linda medical center show that funding earmarked for mental health has increased dramatically in recent years, from $70,000 in 2004 to $3.1 million in 2007. During the same period, the number of patients seen each month for mental health went from 6,700 to 9,600.

Cruz, and others, insist they have been told they’ll have to go. Whether it is a misunderstanding or not, there seems to be a pervasive suspicion among older veterans, particularly those with post-traumatic stress disorder, both locally and in other parts of the country, that the VA is interested in pushing them out.

Stories of Cancellations

A dozen of those veterans, including Cruz, stood outside the Victorville clinic on a recent morning. They said they had all been given the same information about the counseling groups being cancelled.

In March, a group of veterans receiving therapy at the San Bernardino Veterans Center picketed the clinic. They said their therapist, Phillip Garcia, had been told to retire because he refused to drop Vietnam-era patients to make room for Iraq war returnees. Garcia is no longer at the center and said he could not be quoted for this article.

Two veterans receiving counseling therapy at the veterans center in Palm Desert said they had not heard of any cutbacks at their clinic.

David Autry is a spokesman for Disabled American Veterans, a Washington-based advocacy group. He hadn’t heard of the situation in Victorville, but said he has seen the same thing elsewhere.

“There was a similar situation in North Carolina not terribly long ago,” Autry said, “where the VA had scaled back its PTSD counseling for Vietnam-era veterans and had cited the need to put more resources into the returning folks from Iraq and Afghanistan.

“In some ways, the VA is pulling all the stops out for the veterans of Iraq and Afghanistan at the expense of the other veterans,” he added.

Cutbacks Denied

Laurie Tranter, spokeswoman for the Department of Veterans Affairs in Washington, D.C., said: “There is no policy on cutting back on services for Vietnam vets.”

Tranter also said she had not heard of any complaints regarding such cutbacks.

Former Inland resident Frank Flores, a founder of a veterans assistance group called Project Guiding Light, now lives in Texas. He said the VA hospital in Temple, Texas, discontinued counseling groups for nearly 150 older veterans.

“This is happening nationwide,” Flores said. “They say, ‘We’re here to take care of our veterans.’ That’s a hell of a way to take care of them if you just show them the door.”

But Nelia Schrum, spokeswoman for the VA Medical Center in Temple, said the groups were simply moved to a new VA center 20 minutes away in Killeen.

“They haven’t been discontinued,” Schrum said. She said Flores and other veterans might just be confused about the change.

Loma Linda’s Krawczik said changes are taking place with programs here, too, and veterans may have trouble adjusting to that.

“It’s easy for people, when it’s an emotional issue, for there to be misunderstanding,” Krawczik said.

While some counseling programs at the Loma Linda hospital are being discontinued, she said, others are being added.

“We have national rollouts right now for a variety of evidence-based treatments,” she said. Those include peer counseling and a 12-step oriented protocol.

Veterans’ Fears

Dane Steinberg is another of the veterans at the Victorville clinic. He said he and his colleagues don’t begrudge the newer vets and support the aggressive outreach programs being conducted by veteran agencies. He just doesn’t want to see the door close on him as a result.

“They’re out soliciting the Iraqi vets while on the other hand they’re telling us to go home,” said Steinberg, 61, of Helendale. “Isn’t that strange?”

Steinberg said two different officials at the clinic told him his therapy group was being eliminated by the end of summer. He and others suspect a sinister motive.

Wilfred Abeda, one of Steinberg’s fellow group members, lives in Barstow. He is on 100 percent disability for his post-traumatic stress disorder. To maintain that disability rating, he said, he has to be receiving therapy. Several years ago, when his wife was dying from cancer, Abeda was her primary caregiver and couldn’t travel to his therapy group, which at that time was in Loma Linda. He said the VA cut his disability.

“They said, ‘You’re not going to therapy. You must be cured,’ ” Abeda said. “They rejected me.”

He was able to get his disability reinstated after he appealed and re-entered therapy. But he believes the same thing may happen again if his current group is discontinued. Only this time, he said, he won’t have a group to go back to.

Project Guiding Light’s Flores said such fears are not without merit.

“The VA does use medical treatment as a basis of continuing disability,” Flores said. Veterans such as Abeda, he said, “are worried because if they’re not getting treatment their disability will be reduced.”

Programs ‘Keep Us Alive’

Of even greater concern, Abeda said, is the well-being of his fellow veterans. He worries about possible suicides.

“It’s going to happen,” he said. “A couple of guys said, ‘This is the only thing that keeps us alive.’ It helps us a lot.”

Some might wonder how, 40 years after returning from battle, Vietnam veterans can be so dependent upon group counseling. But Abeda was diagnosed with post-traumatic stress disorder just five years ago. Many veterans have exhibited symptoms for years, such as night terrors, uncontrolled anger and the inability to hold a job, but never knew why.

“We’ve been suffering with this since (Vietnam),” Steinberg said. “I didn’t get diagnosed until three years ago.”

Now, he and others feel, just when they are getting some help, the rug is being pulled out from under them.

“That makes it pretty hard on all the guys,” Abeda said. “You have to fight for everything.”

Reach Mark Muckenfuss at 951-368-9595 or mmuckenfuss@PE.com

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Female Veterans Pose a Challenge for VA

May 19, 2008 – Two nightmares haunt Robin Milonas.

While serving in Afghanistan in 2004 as an Army Reserve civil-affairs officer, the former lieutenant colonel got lost in a minefield while leading a small convoy delivering school supplies to civilians. Even more troubling is the memory of a man who arrived at the main gate of Bagram Air Base carrying a young boy whose leg had been blown off by a land mine.

“I was an outgoing, energetic, determined good soldier who wanted to make the Army a career,” said Milonas of Puyallup, who just turned 50. “Now I am broken.”

Milonas is one of roughly 180,000 women who have been deployed in Afghanistan and Iraq. While they don’t officially serve in combat, they have experienced life in a war zone where there are no front lines.

And, as they return home, they are increasingly turning to an already overtaxed Department of Veterans Affairs for help. Last year, the VA treated more than 255,000 women vets. The number is expected to double within five years.

In some regions, the surge already has arrived. During the past 10 years, the number of women treated at the VA’s hospital at American Lake outside of Tacoma has risen 80 percent, and the Seattle VA hospital has seen a 42 percent increase.

VA officials say they are better prepared to handle women patients than they were several years ago. But they acknowledge “continual challenges” as they move to open the door to a man’s world where pap smears and mammograms could become as common as prostate exams.

And where “military sexual trauma” would be treated as a serious and growing mentalhealth problem, rather than a subject to be avoided.

“It’s not your father’s VA, it really isn’t,” said Patricia Hayes, the VA’s national director of women’s health care issues. “We have geared up and are gearing up. But there are places that may have gaps.”

Others say the agency is far from prepared. And given the VA’s chronic budget shortfalls and increasing demands from the rapidly growing number of male veterans, the task could be even harder than expected.

“They aren’t ready,” U.S. Sen. Patty Murray, D-Wash., said of VA officials. “Absent a proactive, concerted effort and knowing their limited resources, they (the VA) are struggling with so much this might get lost.”

Murray, perhaps the leading VA critic on Capitol Hill, has introduced legislation requiring studies of how serving in Iraq and Afghanistan has affected the physical, mental and reproductive health of women, and how the VA is dealing with their problems.

“It’s a hard issue, and pouring a huge light on this is a risk, as some will say women just shouldn’t be in the military,” Murray said. “But as more women transition home from the physical and mental wounds of war, and step back into lives as mothers, wives and citizens, the VA must be there for them.”

IT’S PTSD, NOT PMS

Milonas says she’s been stopped three times by police for erratic driving. When she sees a dark spot in the road, she thinks it’s a landmine and swerves. Except for her job teaching special education at Lochburn Middle School in the Clover Park School District, she stays home. She constantly checks to see the doors and windows are locked.

Milonas has been diagnosed with PTSD and receives therapy at the Tacoma Veterans Center. But three times she has been denied a disability rating from the VA, which says Milonas hasn’t proven her problems are related to her service in Afghanistan.

Milonas believes the VA has yet to recognize that even though women are barred from combat, it’s hard for them to avoid the trauma associated with serving in a war zone like Afghanistan.

“The battle is everywhere,” she said.

VA officials say there is no double standard when it comes to disability ratings for PTSD.

“This is the first group of women vets we have seen with this intensity of experience,” said Hayes. “We are not sure what the long-term effects will be.”

The VA has begun a longterm study of 12,000 women veterans.

Women veterans have faced a number of problems, ranging from clinics that don’t have fulltime obstetrician/gynecologists to uncomfortable group therapy sessions where men outnumber women and topics can include sexual assault and harassment.

“I don’t want to say this derogatorily, but women view VA hospitals as male domains,” said Chili Perez, a 58-year-old Mount Lake Terrace Army veteran.

MILITARY SEXUAL TRAUMA

Concern is mounting over the numbers of women veterans suffering from military sexual trauma, which can include rape, assault and harassment. According to the VA, nearly one in five women veterans seeking care have been diagnosed as victims of military sexual trauma, though some believe the figure could be nearer to one in three.

“I was raped by a senior officer,” said a 33-year-old former captain in civil affairs who was based in Tikrit, Iraq, who now lives in Olympia. She said she returned home depressed and suicidal. The woman asked that her name not be used.

“I don’t have a harrowing combat story to tell, but it is relevant,” she said. “Some come back and just get on with their day-to-day lives, but believe me, there will be a surge of people 10 to 15 years from now who will have to face it.”

The woman has nothing but praise for her treatment at the VA, though she said the key was being assigned a strong counselor from the start.

“I think they are getting better at dealing with this, but some still want to blame the victim,” she said.

The VA now offers womenonly group therapy sessions, women vets can request women counselors and womenonly entrances to clinics are being provided.

“A lot of women are reluctant to come into a hospital,” said Jan Buchanan, women veterans program manager for the VA’s Puget Sound Region. “It seems too military to them. They fear they might see their perpetrator.”

But they are coming, and it’s the younger veterans in particular. So, far, 41 percent of the women who have served in Iraq and Afghanistan have sought medical help, at least once, at the VA. That compares with 14 percent of older women and 22 percent of male veterans.

They want birth control, infertility and family planning advice, child care for their children when they are being treated and coverage for their newborns, VA officials say.

“The old saying was, ‘If the Army wanted you to have a baby, it would have issued you one,’ ” said Lourdes Alvarado- Ramos, who rose to the rank of sergeant major in the Army Medical Corps and now is deputy director of the Washington state Department of Veterans Affairs. “But that has changed. The system has been geared to males. Bricks and mortar, clinics and hospitals, they were all thought of as a male place. We need to make women veterans more comfortable with the system.”

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Dallas VA Hospital Psychiatric Unit Reopens Its Doors to Veterans

May 20, 2008 – The VA Medical Center in Dallas resumed psychiatric admissions Monday, six weeks after all but shutting down the ward because of a rash of suicides. The 51-bed psychiatric unit serves all of North Texas. The Fort Worth VA clinic handles outpatient care only.

Joe Dalpiaz, director of the North Texas medical system for the Veterans Affairs Department, ordered psychiatric admissions halted April 5 until outside experts could evaluate care.

The VA has been sending patients to a VA medical center in Waco and to area hospitals such as Parkland Memorial, Zale Lipshy, Timberlawn and Trinity Springs Pavilion, which is operated by the JPS Health Network in Fort Worth.  VA officials were not available for comment Monday.

Background

Two North Texas veterans committed suicide in January shortly after their release from the psychiatric unit. Then in early February, Air Force veteran Larry Johnson of Arlington committed suicide in the unit by using a tall-frame wheelchair to hang himself.

The last man to commit suicide hung himself in his hospital room in early April, the day before Dalpiaz’s decision to cease admissions. None of the veterans had served in Iraq or Afghanistan.

Dr. Catherine Orsak, the hospital’s associate chief of staff for mental health, said last month that until this year there had not been an in-patient suicide in the 10 years she has worked at the hospital.

What’s new

Two teams from VA headquarters in Washington, D.C. — the Office of Medical Inspector and the Office of Mental Health Services — visited the hospital in April; both have recommended changes to the unit.

Among the medical inspector’s recommendations: that the unit increase the amount of patient activity on nights and weekends; remove certain doors, metal trash cans and chairs in the showers; and re-evaluate the effectiveness of its suicide risk assessments.

The hospital is adding nurses to the emergency department, increasing the unit’s housekeeping staff, repositioning cameras and monitors and adding another suicide prevention coordinator.

National background

In recent weeks, the VA has been accused of downplaying the number of attempted suicides at its facilities. Its chief mental health officer, Dr. Ira Katz, has been criticized by some members of Congress who believe that he provided them misleading information.

Katz sent an e-mail to the VA’s top communications officer — the subject line read “Shh!” — asking whether the agency should acknowledge that there were 1,000 attempted suicides a month at its facilities. Publicly, the VA said that there were fewer than 800 in all of 2007.

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Jericho Project Adds Site for Vets’ Housing in Bronx

May 20, 2008 – Homeless heroes are getting a second-helping of support in the Bronx.

The Jericho Project, a national group seeking permanent solutions to homelessness, recently purchased a second site in the borough to build another residence for homeless vets.

Jericho launched its Veterans Initiative late last year with the purchase of a vacant lot at 355 E. 194th St. in Fordham, and recently closed the deal on property in Kingsbridge Terrace.

Together, the two planned residences will offer permanent, supportive housing and comprehensive counseling to 130 homeless and low-income veterans.

“We intend for our Veterans Initiative to be scalable – and become a model for helping low-income and homeless veterans nationwide regain their dignity and rightful place in society,” said Jericho Executive Director Tori Lyon.

Veterans advocates say repeated deployments and post-traumatic stress disorder are leading to a cascade of financial dislocation, family estrangement and homelessness.

A recent study by the RAND Corp. found that about 300,000 U.S. combat troops are suffering from major depression and PTSD, while 320,000 have suffered traumatic brain injuries. Most of them, the study concluded, do not get adequate care.

According to The Homelessness Research Institute, veterans make up 26{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of the homeless population nationwide, despite representing only 11{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of the civilian adult population.

Although veterans are disproportionately represented among homeless adults in the New York City shelter system, there are only two supportive housing projects dedicated to veterans in the city.

Vietnam vet Ivery Walker, 57, who does outreach for the Bronx Vet Center on the campus of the Bronx VA Medical Center, was delighted to hear of Jericho’s plans.

“That would be wonderful,” he said, pointing out that the Bronx VA’s homeless services unit offers counseling but not housing.

He said that without a stable address, it’s almost impossible for disabled veterans to receive their rightful benefits.

“Homelessness is a real problem for vets,” Walker said.

At both facilities, 60{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of potential residents will be veterans referred from the city’s homeless shelter system, and 40{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} will be low-income veterans from the community.

The Jericho Project purchased the vacant lots with financing from the New York City Acquisition Loan Fund, and will receive development funding from the city Housing Preservation and Development Department as part of the New York-New York III program, as well as ongoing funding from the city Health Department.

Jericho expects to begin construction on the first residence this year, and open the doors in early 2010.

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