Support for Families of Deployed Soldiers Needed, Some Say
SOLDIERS
New London Day
Erin Kutz
Boston University Washington News Service
May 1, 2008
WASHINGTON – When Elizabeth Lilly Rivera’s daughter returned in October from her 15-month deployment in Iraq, she would often wake up in the middle of the night with nightmares and drive off in her car, never saying where she was going or what she was doing. Rivera would wait anxiously by the window until her daughter returned.
During the daytime, her 22-year-old daughter, Celia Crespo, exhibited panic attacks, bouts of extreme sadness and an intense, undecipherable anger, Rivera said. Even though her job at the National Guard’s armory in New London put Rivera in contact with families affected by the wars in Iraq and Afghanistan, it was difficult to understand her daughter’s behavior.
“It’s just a slew of emotions,” said Rivera, a New London resident. “Some of them are hard to ride the wave with.”
Crespo, an Army National Guard specialist, described her emotions as part of the “normal feelings some soldiers go through when they come home.” For a while she sought monthly counseling for posttraumatic stress disorder at one of the U.S. Department of Veterans Affairs’ community-based Vet Centers, but has since elected to stop the formalized treatment.
“Now I control it myself,” she said. “I just want to keep improving on my own. That’s just me and that’s how I am.”
The VA’s protocol does not allow the department to directly counsel the family members of veterans, leaving people like Rivera to draw support from friends, private clinicians or military unit resources.
“The VA is authorized to work with families when it is part of a treatment plan designed to benefit veterans,” said Dr. Ira Katz, director of mental health for the U.S. Department of Veterans Affairs. “People work within those limitations to do as much family work as possible.”
Since Sept. 11, 16,500 Connecticut residents have deployed to Iraq or Afghanistan, 55 percent to 60 percent of whom are National Guard and Reserve members lacking the support system of a military base, said Linda Schwartz, commissioner of the Connecticut Department of Veterans Affairs.
About 60 percent of military personnel serving in Iraq and Afghanistan are married, compared to 4 percent of those who deployed to Vietnam. Fifteen percent of those now deployed are women, Schwartz said.
With the mental, emotional and behavioral fallout of the war spreading far beyond the combat zones and into the homes of the deployed and returning troops, lawmakers, mental health professionals and veterans advocacy organizations say existing mental health services fall short.
Jim Tackett of the Connecticut Department of Mental Health and Addiction Services cited depression, anxiety, sleep disturbance, irritability, anger, substance abuse and hyper-vigilance as “a universal, predictable set of challenges” facing returning service members.
Rep. Joe Courtney, D-2nd District, said veterans’ casework accounts for some of his office’s highest volume of business. Veterans who come to him aren’t aware of the services available to them, a problem further exaggerated with returning soldiers whose posttraumatic stress or traumatic brain injuries complicate even the simplest daily tasks, he observed.
The entirely voluntary force in Iraq and Afghanistan forces many soldiers already with mental health issues to reenter combat and make their problems go from bad to worse, Courtney added. “The system was clearly not prepared to deal with a major long-term conflict like the one our country is experiencing,” he said.
In anticipation of heightened problems among troops returning from service in Iraq and Afghanistan, the Department of Veterans Affairs mental health budget has increased from $2 billion in 2001 to $3.5 billion this year, Katz said. Next year’s mental health budget approaches $4 billion.
The VA’s efforts in increasing its psychological staff is commendable, but may have not come in time, said Ed Burke, Courtney’s field representative and legislative aide on military affairs.
“They’re trying to gear up, but the problem is that the issue is here already,” said Burke, a Vietnam veteran.
Close to 300,000 of the 800,000 men and women who have returned from Iraq and Afghanistan have come to the VA for care and are represented relatively evenly between regular active duty officers and members of the Guard or Reserves, Katz said. About 120,000 of them have been diagnosed with mental health problems, only half of which are posttraumatic stress disorder diagnoses.
But a study released by the RAND Corporation found 18.5 percent of the nearly 2,000 veterans surveyed exhibited signs of posttraumatic stress disorder or depression and 19.5 percent could have a traumatic brain injury, which effects mood and behavioral functions. The study estimates that if these numbers are proportionate for the 1.64 million deployed soldiers, 300,000 veterans are suffering from PTSD or major depression and 320,000 are facing a traumatic brain injury.
Matthew Cary, president of the advocacy organization Veterans and Military Families for Progress, noted the ability of state governments to step in when the federal system is overburdened.
“The VA doesn’t have the personnel to address all of these mental health issues,” Cary said. “But governors have moved rather quickly through their state veterans offices in putting their state money towards veterans services.”
In 2007, Connecticut used the profits from the sale of a state-owned hospital to establish the Military Support Program, which funds at least a dozen private counseling sessions for members of the Reserves and National Guard and their families, during and after deployment.
The program, run by the Connecticut Department of Mental Health and Addiction Services, features a 24-hour hotline that provides emergency counseling or referrals to its more than 225 specially trained mental health professionals.
A measure before the Connecticut general assembly now seeks to expand the services to all active duty military forces, said Tackett, who directs the Military Support Program.
By February 2008, the hotline had received more than 300 calls and helped more than 180 families, Schwartz said.
Rivera said she has not used the Military Support Program herself, but recommends it to her clients as the family services center coordinator for the New London armory.
Rivera leads family programs for units deploying out of New London’s armory, which brief soldiers and families on the roller coaster of emotions to expect.
She also facilitates support groups for family members left at home, where she said she grew close with a member whose husband and daughter were deployed in Iraq.
It was in this friendship that Rivera said she could be honest about her own feelings and gain solace.
“We were able to break down in front of each other,” she said. “We got through it together.”
Rivera said she’s also drawn strength and support in her church, especially since Crespo’s return. Her daughter’s turbulent emotional displays have subsided and Rivera has learned how to anticipate coming storms.
“I get a sense of when she’s going to have a bad day,” Rivera said. “I kind of know when she’s OK and when she’s not.”
Crespo, who lives with her mother, noted the role her family has played in her improvement. “We clashed a couple of times but my family has been a big help,” she said. “They were mainly my help more than I was.”
For many returning service members, the inability to admit to any struggle can be the biggest roadblock to accessing the necessary care. According to 2007 study by an American Psychological Association task force on military deployment, returning service members cited embarrassment, fear of a damaged career and concern that their leaders and units would lose confidence in them as major barriers for seeking mental health services.
Schwartz said the Military Support Program’s family counseling services could directly aid veterans who are otherwise reluctant to ask for help.
“Many military members who might not go into treatment will go with their families to help work things out,” Schwartz said. “It’s not like they have the problem, they’re doing this for their family.”
Some legislators have argued that the U.S. Department of Veterans Affairs has exhibited similar hesitation in admitting to struggles. In mid-April CBS News reported intercepting emails Dr. Katz sent to a colleague that indicated that suicide attempts among veterans were much higher than what the department reported publicly.
The VA did not release the suicide rate mentioned in Katz’s emails because it was unsure of the accuracy of the numbers, Katz told CBS in response to its reports.
Katz did not further comment on the numbers’ discrepancy, but is set to testify at a House Committee on Veterans’ Affairs hearing May 6.
At a Senate Veterans’ Affairs Committee hearing April 23, U.S. Sen. Patty Murray (D-Wash.) questioned whether lawmakers could trust the VA. She said getting veterans the help they need, not public relations, should be the department’s priority.
“We are not your enemy, we are your support system,” Murray told witnesses from the VA and Department of Defense. “Unless we get accurate information, we cannot do our job.”
Increased transparency may help alleviate mental health epidemics among veterans. The RAND study showed that if 100 percent of returning service members exhibiting PTSD symptoms received treatment, $1.7 billion could be saved, through increased job productivity and decreased suicides. The costs of treating posttraumatic stress disorder and depression in the two years after deployment are estimated to be as much as $6.2 billion.
Rivera said she encourages all returning troops to meet with counselors immediately, even if they’re not yet feeling the weight of these mental health conditions.
“With them, it’s always ‘I don’t need that,’ ” she said. “But the bottom line is you need to take care of yourself to be there for your family.”
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