Saturday, March 8, 2008

Staff ready to aid returning troops


TROOPS -- "It's called exhaustion backlash. When they come

home, they're euphoric. It's like being intoxicated. They

don't perceive any more danger. It's all behind them.

That takes about 30 days to wear off."

Story here...

Story below:


Staff ready to aid returning troops

By Jan A. Igoe

The first month home from combat brings such elation to returning warriors that they can be unprepared for a delayed emotional toll that could be simmering beneath the surface, experts in post-war treatment say.

As an increasing number of veterans return from Iraq and Afghanistan to life in the coastal Carolinas, the region's veteran medical community is boosting its staff and outreach.

More than 31,000 service members have been wounded in action since operations in Iraq and Afghanistan began, but assessing the wars' mental toll on combat troops is just beginning. The prevalence of post-traumatic stress disorder, or PTSD, once considered a coward's alibi, has become a top priority for military health experts.

Almost half of a state's National Guard soldiers need mental health treatment after they return from fighting, Pentagon studies show.

That has S.C. officials gearing up for the springtime return of its 1,800 soldiers in Afghanistan.

"They've seen some bad things, and left untreated, that could create some problems down the road," says Lt. Col. Taube Roy, the officer in charge of a new program designed to ease the transition of the members of the 218th Brigade Combat Team from wartime wariness to hometown normality.

The Newberry-based 218th Brigade Brigade Combat Team has lost three soldiers during its Afghanistan deployment, which began last summer, according to Guard spokesman Col. Pete Brooks.

"At 90 days, more than 40 percent of reserve soldiers exhibit some form of combat operational stress issues. Not full-blown PTSD, but some type of mental health issues may need a counselor to just follow up," Roy said.

"It's called exhaustion backlash. When they come home, they're euphoric. It's like being intoxicated. They don't perceive any more danger. It's all behind them. That takes about 30 days to wear off," Roy said.

According to the Department of Veterans Affairs, about 30 percent of troops returning from war zones experience some level of PTSD, a psychiatric disorder more likely to become chronic and disabling without early intervention.

But even among combat veterans exhibiting symptoms of severe depression and PTSD, a Department of Defense study found the majority reluctant to seek mental health help.

"It's unfortunate that there's still a lot of stigma," said Dr. Hugh Myrick, psychiatrist and director of Mental Health Services at the Ralph H. Johnson VA Medical Center in Charleston.

"Often it is difficult for patients to come out in the public eye. It pains me to think we still have that problem."

The center, which operates community-based outpatient clinics in Myrtle Beach, Beaufort, Goose Creek and Savannah, added 29.5 full-time mental health positions in 2007, said Public Affairs Officer Tonya Lobbestael. Those include psychiatrists, psychologists, nurse practitioners and social workers for inpatient and outpatient care, a post traumatic stress disorder team and a new suicide prevention coordinator.

"We handle 40,000 veterans along the coast from all age groups - from veterans in their 80s and 90s to vets barely 20 years old," Lobbestael said. "Our entire population has seen about a 5 percent increase in 2007, and we're expecting another 5 percent jump [in 2008] because South Carolina is such a popular place to move to."

Addressing the need

The S.C. National Guard has also taken a proactive stance on PTSD with frequent mental health screenings and education for families about warning signs of depression and withdrawal in their soldiers.

A certain amount of combat stress is absolutely normal for returning veterans, Myrick said. "You can't expect these people to be exposed and not to have some effects. Some will get better with time alone."

Once separated from active duty, veterans' health issues are handled by the VA. The agency has recently increased guaranteed free health care from two to five years for service-related conditions such as PTSD, which has been linked to domestic violence, chronic disease, divorce, substance abuse, major depression and suicide risk.

"Typically, guys with PTSD have trouble getting close to other people. I put that down to having lost so many people they were close to, possibly in combat," Dr. Richard Fahy, a psychiatrist who retired from the Myrtle Beach Primary Care Clinic in January.

"They'll say they can't go to Wal-Mart except in the middle of the night. They can't go to church. They don't want to be surrounded."

Fahy started a support group that became a lifeline for local combat veterans, many of whom had never confided their war experiences to anyone.

"Many World War II veterans were simply embarrassed to apply to the VA for mental problems associated with the war," said Brent Davidson, Veteran Affairs officer for the American Legion Riders of Murrells Inlet.

"Their code was 'men don't cry' and 'get over it.' It is incorrect to believe a veteran cannot suffer PTSD many years after having been involved with war-related stress," Davidson said.

"Vietnam [veterans], some of them have been through terrible things and don't have PTSD," Fahy said. "I don't think there's a way to predict who will develop this stuff. What we know is that men who appear to be the strongest can succumb to the syndrome just as well as someone who appears to be a weakling."

More combat, more PTSD At least 45,521 of Iraq and Afghanistan veterans were "treated for possible PTSD at a VA hospital or vet center" through September 2006 and "tens of thousands" have been treated for alcohol abuse, according to a report issued by Iraq and Afghanistan Veterans of America.

Younger veterans are more vulnerable to PTSD than their seasoned comrades, but the intensity of combat and multiple deployments are risk factors.

Researchers are examining the roles that marital status, intelligence, hand dexterity, brain chemistry, genetics and previous concussions play in developing PTSD.

"There's a lot of work being done on seeing if there's any genetic influence for those who may develop mental health or substance abuse disorders," said Myrick, a researcher on substance abuse. "We're getting closer and closer to taking a drop of blood and deciding what medications to give. We could predict who will respond to what type of treatment."

In harm's wayThe November 2006 Mental Health Advisory Team IV report, assessing the mental health and well-being of soldiers and Marines in Operation Iraqi Freedom, concluded that more than 62 percent of those surveyed had lost a team member or knew someone who had been seriously injured.

Soldiers and Marines reported seeing legs blown off, being pinned down by rocket and mortar fire, watching friends burn to death and handling the bodies of bomb victims.

Adding to their sense of helplessness, troops reported being betrayed by the Rules of Engagement, which initially precluded them from responding to Iraqis "throwing gasoline-filled bottles," i.e. Molotov cocktails, and dropping "large chunks of concrete blocks from second-story buildings or overpasses" on passing troops.

The VA is urging veterans to seek help at the first sign of a problem. Veterans requiring substance abuse services must be seen within 14 days.

New therapies and delivery methods, such as telemental health, enable experts to assist veterans where they live.

Lobbestael said she'd love to get out this message: "If vets coming back from combat theater are having any issues at all, we want them to contact us to get the services they need and return to the best quality of life as soon as possible."

The Associated Press contributed to this report.

Contact JAN A. IGOE at 626-0366.


posted by Larry Scott
Founder and Editor
VA Watchdog dot Org

Don't forget to read all of
Help for South Carolina combat veterans


My only comments on this article is the part where the story says the veteran has to be service connected for the medical problems in order to be seen at the VA, is NOT accurate, after war time service veterans used to be entitled to two years of "free" medical care, last year Congress changed it to 5 years and none of the medical problems have to be service connected the veterans just need to go to the VA and the medical people will help them for 5 years, if the veterans have a service connnected problem they get taken care of for life for that problem, if they are rated over 50% all medical problems are taken care of service conencted or not for life, with no co pays. To many rules and they take awhile to figure out. Get the manual if you need to, they have it online at the

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Thursday, March 6, 2008

Care for Injured Vets Raises Questions

Care for Injured Vets Raises Questions

By BRADLEY BROOKS – 3 hours ago

BAGHDAD (AP) — The number of wounded soldiers has become a hallmark of the nearly 5-year-old Iraq war, pointing to both the use of roadside bombs as the extremists' weapon of choice and advances in battlefield medicine to save lives.

About 15 soldiers are wounded for every fatality, compared with 2.6 per death in Vietnam and 2.8 in Korea.

But with those saved soldiers comes a financial price — one veterans groups and others claim the government is unwilling to pay.

Those critics also say that the tens of thousands of soldiers wounded in Iraq are part of a political numbers game, one they say undermines the medical system meant to care for them.

The most frequently cited figure is the 29,320 soldiers wounded in action in Iraq as of Thursday. But there have been 31,325 others treated for non-combat injuries and illness as of March 1.

"The Pentagon keeps two sets of books," said Linda Bilmes, a professor at Harvard and an expert on budgeting and public finance whose newly published book, "The Three Trillion Dollar War," was co-authored with Nobel Prize-winning economist Joseph Stiglitz.

"It is important to understand the full number of casualties because the U.S. government is responsible for paying disability compensation and medical care for all our troops, regardless of how they were injured," Bilmes said.

Veterans Affairs predicts it will treat 330,000 veterans from Iraq and Afghanistan in 2009 — a 14 percent increase over the 2008 estimate of 263,000 — at a cost of nearly $1.3 billion.

For the 2009 budget, the White House requested $93.7 billion for the VA, including $41.2 billion for medical care for all veterans — not just those from Iraq and Afghanistan. That's an increase of $2.3 billion over the current budget.

But critics say that is not enough for a system that has a backlog of about 400,000 pending medical claims and complaints, especially in mental health care.

The VA "will not request enough resources to care for the troops — and in fact this is precisely what has happened in the past three years," said Bilmes.

Cynthia Smith, a Pentagon spokeswoman, rejected accusations that the government is trying to hide or obscure the number of wounded soldiers by placing the total in two categories on its Web pages.

"Both of the Web sites have equal importance. They are just counting different things," Smith said. "Neither is more prominent than the other."

James Peake, secretary of the Department of Veterans Affairs, said that funding for VA medical care requested for next year is "more than twice what it was seven years ago" before operations in Afghanistan started.

But Bilmes says the VA is hoping to offset some of the costs through increased fees and co-payments — putting more of the burden for health care costs back on soldiers.

"That is the thing that sticks in the gullet, the fact they're hoping to raise $2 or $3 billion through their fees, which is what we spend in Iraq and Afghanistan in about three days," she said. "For three days of fighting, we could not charge these vets a higher co-payment."

Paul Sullivan, executive director of Veterans for Common Sense, an advocacy group based in Washington, said the VA's budget request for 2009 also does not pay adequate attention to chronic problems facing Iraq and Afghanistan veterans, such as drug and alcohol addictions.

Earlier this week, a federal judge in San Francisco held the first hearing in a class-action lawsuit filed by two vet groups, including Sullivan's, against the VA alleging their neglect in treating suicidal soldiers. The lawsuit asks that the VA immediately screen and treat all potentially suicidal veterans.

According to VA research obtained last month by The Associated Press, 144 veterans from Iraq and Afghanistan committed suicide from the start of the war in Afghanistan in 2001 through the end of 2005. Statistics from 2006 and 2007 were not yet available.

Dr. Gerald Cross, a VA official, said during this week's lawsuit hearings that 120,000 vets from Iraq and Afghanistan using VA care have potential mental health problems, and that nearly 68,000 have potential post-traumatic stress disorder.

In November, President Bush signed legislation directing the VA to improve its mental health training for staff and do a better job of evaluating and treating veterans.

Peake, in a telephone interview, emphasized new efforts in mental health. He said the VA has "changed the access standard. If you present with a mental health issue, you'll be screened within 24 hours."

Peake said he recognized the need to make changes within the VA — particularly in the disability claims system which he said dates back to 1945 — saying that "it is time to review and simplify and modernize our disability system, but that will take work with Congress."

In response to the backlog in pending claims, Peake said, some 3,100 new claims-processing jobs have been opened. He acknowledged, however, that it takes "about two or three years to train somebody to be top notch in terms of being able to develop a claim and adjudicate it."

Not all wounded soldiers leave the battlefield for good.

A roadside bomb that sent shrapnel through Fred White's hands and legs did enough damage to require four operations and six months of physical therapy. White, then an Army specialist who was wounded early in the war while protecting a convoy, is now a chief warrant officer, piloting Black Hawk helicopters.

The wounds that left White missing most of his middle finger on his right hand, nerve damage and broken bones in his left hand and shrapnel that is still lodged in his legs and left wrist were not treated in a VA facility.

Once evacuated from Iraq, he got treatment at the U.S. military hospital in Landsthul, Germany, near the Ramstein air base. He then went to Brooke Army Medical Center on Fort Sam Houston in San Antonio because there was a hand specialist there.

Despite his wounds, White made it through pilot's school and passed a few extra tests to ensure the damage to his hands would not affect his ability to fly a Black Hawk.

White's mother, who made a career of the Army, was disabled in a non-combat accident while serving, and he witnessed her struggles in dealing with the system.

"My biggest thing for the VA is they need to remember what their purpose in service is. These vets, they've already served their country, they've already sacrificed," he said. "There is no reason they should have to fight twice."

The Associated Press News Research Center in New York contributed to this report.

On the Net:
Pentagon site listing those killed and wounded in action in Iraq:
Pentagon site listing all those wounded in Iraq, regardless if in combat:

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Our veterans deserve full commitment to care


Felina Franklin

ARTICLE TOOLS: Email Article | Print-Friendly Format HOUSTON - A 36-year-old male, non-service connected Gulf War era veteran visits the Veterans Administration Medical Center (VAMC) with a toothache. X-rays in the dental clinic determine two teeth need extraction due to infection.
However, he is ineligible at the VAMC; he is not a "service-connected disabled veteran." If the infection was life-threatening, the extraction would cost him $200.00 out of pocket. Since it is not life-threatening he is given pain medicine, antibiotics and referred to the county emergency room.

After 22 hours in the emergency waiting room, the veteran is given pain medicine, antibiotics for infection, and an appointment (two weeks later) for tooth extraction. This is only one example of the hundreds of thousands of veterans referred out, given delayed treatment or denied services based on current policy and eligibility for veteran healthcare.

Currently, Title 38 of the U.S. Code states veterans injured or diagnosed while "in line of duty during a period of war" will be paid compensation. Veterans are placed in priority groups based on their level of disability and the Geographic Means Test Threshold. Most disabilities are rated less than 50 percent, making veterans ineligible for VA services. Low-priority veterans are restricted from services based on income and zip code.

Title 38 also promises preventative care, but most provisions treat veterans for service connected disabilities only. Most ailments are hard to prove as service connected and more difficult for veterans with physical or psychological ailments that take months or even years to become symptomatic. The same is true for income-eligible requirements. Many veterans are not working as much as they want or are able to in order to receive benefits. Those who earn above the income limit become ineligible for services and pay out of pocket.

In January 2008, the Department of Veterans Affairs projected there are 23,532,000 veterans; 8 percent of the total U.S. population. Of those veterans, 7.8 million were enrolled in the VA healthcare system in 2007. A 2004 study showed about 1.8 million veterans did not have healthcare coverage and/or were not eligible for VAMC services.

The VA provides healthcare to about 100,000 (25 percent of 400,000) homeless veterans each year and estimates 200,000 veterans are homeless on any given night. The National Coalition of Homeless Veterans reports one of the top three reasons veterans are homeless is inaccessibility to healthcare.

I suggest a Full Coverage Veteran Act (FCVA) to replace Title 38 and establish the use of veterans' DD-214 Form (discharge orders) to guarantee government payment for all services rendered. Veterans will receive treatment for any ailment at any medical facility they choose. Facilities providing treatment to veterans will receive tax cuts for services. Doctors will be able to serve veterans with adequate resources and without cost worries. Rural veterans also will have better access to care.

FCVA will reduce the number of homeless veterans due to lack of healthcare, increase employment for those with treatable health conditions and reduce costs. Preventative care is less expensive than treatment of any condition. A study in the American Journal of Public Health (1988) reported outpatient care cost less than inpatient care. Without limitations to preventative services, veterans are less likely to have severe illnesses and more likely to be treated on an outpatient basis. Therefore, decreasing absenteeism from work. Citizens that make more money, spend more money; stimulating the economy.

A country is only as good as it treats its veterans; those who put their lives on the line for freedom. There are billions of dollars allocated for the war, but limited funds, cut periodically, used for veteran healthcare.

We serve only part of the veteran if we allow this policy to limit healthcare given solely based on disabilities acquired while in service. Do you want less than 50 percent of a soldier standing post tonight?

Felina Franklin is a University of Houston doctoral student. She was reared in Amarillo and is a 2001 Highland Park High School graduate. Franklin currently is a social work intern at the Michael E. DeBakey VA Medical Center in Houston.

opinion article

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Wednesday, March 5, 2008

Sanders: Bush Needs to Help War Veterans

Bernie Sanders stands up for veterans

Vermont Senator Bernie Sanders says President Bush needs to do more to help war veterans.

At a congressional hearing, Sanders told the leadership of Veterans of Foreign Wars, that the U.S. must fulfill its duty to help men and women in uniform. Congress allocated $43 billion dollars in discretionary spending for the Department of Veterans Affairs last year.

The President requested almost $45 billion this year. That's a four percent increase, but Senator Sanders says it's not enough.

"Instead of worrying about some of the wealthiest people in this country who are doing just fine, maybe it's time we changed our national priorities and paid attention to the men and women who have put their lives on the line defending this country, he said.

Congress can allocate more money than requested by the president. That happened last year when Congress gave the department about $3.8 billion more than the President requested.

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U.S. Military Index

U.S. Military Index

This is a nine page article based on a survey conducted with flag officers and career officers in the rank of Major and higher, it is the most detailed article I have read lately that details the current state of affairs of our armed forces.

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Tuesday, March 4, 2008

Rally in LA for Veterans Home

Email from Gene Simes
Gene Simes []



March 9, 2008

1pm to 2:30pm





Enforce the Deed of 1888

“To locate, establish, construct, and permanently maintain

a National Home for Disabled Volunteer Soldiers.”




What: A PUBLIC RALLY – Please Join This Great Patriotic Unification and Noble Gathering to Morally and Responsibly Save the Los Angeles National Veterans Home.

Why: To stop the land grabbing of Veterans hallowed land and to fully implement the Veterans' "Declaration of Enforcement” that will Protect, Preserve and Defend the Deed of 1888.

SAVE THE NATIONAL VETERANS HOME -- This land was specifically Deeded 120 years ago to be permanently maintained as a National Home for America's Military Veterans. There’s absolutely nothing in the Deed of 1888 that allows anyone to designate any land for a public park, open space, commercial use, or any other purpose whatsoever, other than for the direct benefit of America’s Military Veterans. This means to Enforce the Deed just as it was Patriotically Granted in 1888: “To locate, establish, construct, and permanently maintain a National Home for Disabled Volunteer Soldiers.”

When: Sunday, March 9th From 1:00 - 4:00 PM

Where: On the sidewalks at the northeast Corner of Wilshire and San Vicente Boulevards in Brentwood. (Outside and along the fence of the National Veterans Home)

Who: YOU, and fellow American Military Veterans and Loyal Community Supporters.


Please Forward This To Your Fellow Veterans

and Loyal Community Supporters!


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Army struggles with suicides - Chicago Tribune

Army struggles with suicides

PAHRUMP, Nev. - All Spec. Travis Virgadamo ever wanted was to be a soldier.

But two years after his father signed papers for him to enlist at age 17, things went terribly wrong. Last August, three months after arriving in Iraq, he walked outside his barracks and killed himself with his rifle.

When the news crackled over the Bonecrusher Troop's radio, 1st Lt. Kyle Graham knew immediately that it was Virgadamo, the troubled soldier who had been on suicide watch since June, when he threatened to kill himself while on patrol.

"I feel like we all had some responsibility to make sure this didn't happen," Graham said shortly after the incident. "It's our responsibility to make sure we take care of our fellow soldiers."

Virgadamo, whose case has been cited on the Senate floor and in congressional hearings, is a symbol of a growing problem facing the military as soldiers in the Iraq and Afghanistan wars face repeated and extended deployments.

Last year, 121 soldiers in the Army and active-duty National Guard and Reserves committed suicide, the largest number since the military began keeping records in 1980.

That is more than double the 52 suicides reported in 2001, the year the war in Afghanistan began, according to a recent Pentagon report. The report also cited 2,100 attempted suicides or self-inflicted injuries last year -- six times the 350 reported in 2002, prior to the start of the Iraq war.

Efforts fail to stunt rise

The numbers are rising despite efforts by the military to beef up its mental-health programs. Faced with growing scrutiny over those programs in Congress and the news media, the Army has sought to improve services for soldiers, spending more than $1 million last year on additional counselors, training and screening, Army officials said.

"We are concerned," said Col. Elspeth Ritchie, the Army's chief psychiatrist. "We are doing a lot already to assist in suicide prevention, but clearly we need to do more."

It is not uncommon to see an increase in suicides during war, said Coleen Boyle, an epidemiologist for the Centers for Disease Control and Prevention and co-author of a mortality study on Vietnam veterans.

The current suicides, one-quarter of which occurred in Iraq and Afghanistan, are due primarily to strained personal relationships exacerbated by repeated deployments that last up to 15 months, Ritchie said. That, coupled with the ready availability of firearms, often can become a deadly combination.

Ritchie said there is no indication that the stress of combat plays a major role in the suicides. But 19-year-old Virgadamo, his relatives said, was distressed over what he had seen in Iraq.

There were signs that he was having trouble long before he deployed. According to his grandmother, Katie O'Brien, Virgadamo had been sent to an anger-management program while in boot camp. She said he also was placed on suicide watch at the Army's Ft. Stewart in Georgia and prescribed the antidepressant Prozac shortly before he deployed. Last June, officials in Iraq placed him on suicide watch again.

Informed of Virgadamo's death, "I asked, 'How many others lost their life with him?'" said O'Brien, 65. "They stood there for a minute and took a deep breath and said, 'No others. It was self-inflicted.' I went ballistic, and I screamed, 'No, no no!'"

Rep. Shelley Berkley (D-Nev.) said Virgadamo's death and the growing number of suicides could signal that the Army is overlooking mental-health problems because it is overstretched by repeated deployments.

"This young man should not have gone back to Iraq," Berkley said.

'Deployed on Prozac'

While Ritchie would not specifically address Virgadamo's case, which is under investigation, she said it is not uncommon for soldiers to return to active duty while prescribed mild antidepressants such as Prozac or Paxil. She estimated 5 percent fit in that category.

"If soldiers are treated and their symptoms are in remission and they are not having side effects, they can be deployed on Prozac," said Ritchie, who compiled the Army's suicide data.

David Rudd, head of the psychology department at Texas Tech University, said soldiers diagnosed with a psychiatric illness are vulnerable going back into a combat zone.

"Today, most people need medication and therapy," said Rudd, a former Army psychologist. "My concern is about the availability of therapy in those combat zones."

Shortly after arriving in Iraq, Virgadamo asked Graham and Sgt. 1st Class Chhay Mao if he could join their platoon. Mao said Virgadamo was a hard worker, but he worried that they would have to expend too much energy keeping an eye on the troubled young man. So Virgadamo transferred to another platoon.

After he threatened to kill himself, he was excused from patrol duty and given a desk job. The trigger bolt was removed from his weapon, making it useless, and he was ordered to undergo counseling.

On Aug. 30 he was cleared for duty and given back the bolt. About 10:30 that night, he shot himself.

The previous month, Virgadamo had been so depressed, his grandmother said, that the Army sent him home on leave for two weeks.

"It was my understanding from him that it was a leave to kind of see if he could be with his family and regroup," she said. "Maybe it would be beneficial to him, but I don't think 15 days was long enough."

O'Brien's daughter, Jacque Juliano, 46, and her husband, Travis Virgadamo Sr. adopted their son at birth. They divorced when he was 4.

Two days before his death, Virgadamo called his grandmother.

"I said, 'Are you doing OK?' He said, 'Yeah Grandma, just keep praying for me.'"

"I just said, 'Sweetheart, I'm praying for you and all of you over there.' I said, 'It's going to be OK, Travis. It's going to be OK, baby.'"


IN THE WEB EDITION: In a video, the family of Spec. Travis Virgadamo has questions about the military's response to mental illness:


you need to go to the link and see the video and the graphs outstanding work by these writers

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VA to Train More Psychologists

Peake: Expansion Meets Current and Future Needs
WASHINGTON (March 4, 2008) - To meet increased needs for mental health
services for veterans, especially those returning from the Global War on
Terror, the Department of Veterans Affairs (VA) is expanding its
training programs for psychologists.

"Not all the wounds of war are visible," said Secretary of Veterans
Affairs Dr. James B. Peake. "VA is committed to ensuring veterans
receive world-class care for mental health services. This initiative
meets our short-term needs, but it will also guarantee we have a pool of
well-trained psychologists in the future."

VA, which has more than 11,000 mental health professionals to care for
veterans, has hired more than 800 psychologists in the last three years.
Because psychology is a key part of comprehensive health care, the
Department anticipates an ongoing need to employ additional

The best resource for VA recruitment of psychologists has been the
Department's own training programs. Seventy-three percent of
psychologists hired in the past two years have had VA training.

As a result, VA has worked with its partners among professional schools
and universities to increase the number of psychologists who receive
training through VA programs each year, beginning with the 2008-2009
training year.

The new positions will include 61 internship and 98 post-doctoral
fellowship positions, bringing the national number of training positions
in psychology to 620 per year.

The recently awarded positions include four new internship training
programs and 26 new post-doctoral fellowship programs. In addition, 31
existing internship programs and 17 existing postdoctoral fellowship
programs have been expanded.

The new internship programs are at the following locations: Anchorage,
Alaska; Asheville, N.C.; Iowa City, Iowa; and Richmond, Va.

The new post-doctoral fellowship programs are located at: Albany, N.Y.;
Albuquerque, N.M.; Ann Arbor, Mich.; Baltimore; Bay Pines, Fla.;
Buffalo, N.Y.; Columbia, Mo.; Detroit; Durham, N.C.; Los Angeles; Hines,
Ill.; Honolulu; Jackson, Miss.; Little Rock, Ark.; Loma Linda, Calif.;
Long Beach, Calif.; Manhattan, N.Y.; Providence, R.I.; Salem, Va.; Salt
Lake City; San Diego; St. Louis; Tampa, Fla.; Washington, D.C.; West
Haven, Conn.; and White River Junction, Vt.

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VA failing Iraq war vets


STRESS -- "Within the next three to five years, the flood of

vets seeking help is probably going to overwhelm the VA."

Iraq War veteran Christopher M. Kreiger — at home since Thursday with wife, Melissa, and sons C.J., 6, left, and Cole, 4 — suffers from seizures and hallucinations and has been in and out of VA hospital seven times. (photo: Bill Wippert / Buffalo News)

For a previous story about Christopher Kreiger, click here...

Story here...

Story below:


‘Flood’ coming as soldiers return home needing care

Veterans returning from wars find VA under strain


Another surge is putting pressure on the nation’s military.

It is the surge of veterans from the wars in Iraq and Afghanistan returning home with physical and psychological wounds, and the question is: Are the nation’s veterans hospitals equipped and staffed to handle it?

“The flood is coming,” said Patrick W. Welch, director of veterans services for Erie County. “Within the next three to five years, the flood of vets seeking help is probably going to overwhelm the VA.”

It started with a trickle. Just 61 of these newest war veterans sought help at the local VA hospital in 2003.

But in the years after, nearly 1,800 vets returning from Iraq and Afghanistan went to the Buffalo VA and its seven community clinics.

Local VA officials acknowledge the growing demand, and they say they are keeping up with it and will hire 150 more people to continue what, they insist, is success in providing prompt and comprehensive health care.

The VA’s optimism is not shared by everyone.

Jeremy Lepsch, a Marine who served with an anti-terrorist unit in east Africa, says his most recent admission to the Veterans Affairs Medical Center’s psychiatric unit exposed him to staff shortages and overworked psychiatrists.

Dana Cushing, who served twice in Iraq and once in east Africa, says she has to make a 300-mile round-trip drive to the Syracuse VA because she can’t get timely appointments here with a women’s doctor.

And then there’s Iraq War veteran Christopher M. Kreiger.

He has several physical and psychological problems and has been in and out of the Buffalo VA Medical Center seven times. In the last six months, his condition has worsened as he suffered from mysterious seizures and hallucinations and has been unable to sleep. Kreiger was released Thursday from the hospital and says he still does not know what is ruining his health.

Despite repeated promises by VA doctors to send the Town of Tonawanda father to a facility better equipped to diagnose and possibly cure him, Kreiger remains here.

Even in the face of these criticisms, U.S. Department of Veterans Affairs officials say they provide top-notch care, and veterans, in satisfaction surveys, give the local VA Medical Center an approval rating of 75 percent or better, which is consistent with national ratings.

But in the same breath, the local VA officials say they are looking to hire 150 more staff members this year, from clerical support to medical personnel. That would raise the overall hospital staff here to 2,025.

Over the last five years — since the Iraq War began in 2003 — the hospital has added 86 employees.

The 1,800 new patients who arrived during that same time make up only a fraction of the overall number of veterans receiving VA medical treatment in Western New York. The VA estimates that it assists more than 40,000 local veterans annually.

Michael S. Finegan, the top VA health care administrator in Western New York, says the system is on solid footing with staff and resources. Its 2008 budget, he said, is $200 million, which is $70 million more than the $130 million allocated in 2003.

“If we don’t have the service in the building, we buy it in the community,” Finegan said. “Every two weeks, I get a report on who’s waiting more than 30 days for an appointment. Job number one is to get vets in within 30 days.”

Because of patient confidentiality, Finegan says, he cannot identify veterans who have had successful recoveries at the VA.

But he says they are many, including veterans who have been helped through anger issues and now work full time, as well as vets who have learned how to handle panic attacks and other psychological issues. He also cited a vet who regained his speech after recovering from a traumatic brain injury.

Some veterans, nevertheless,

tell a different story of waiting months for care when it comes to appointments with specialists and getting diagnostic tests.

Funding falls short

When Kreiger began having seizures, doctors ordered an MRI on his brain, but because the machine was broken, he said he waited about a month before a portable machine was brought in to do the scan.

Even with the results, doctors were unable to diagnose his problem, Kreiger said, and they took him off most of his medications and sent him home with a supply of morphine.

At 8 p.m. last Monday , he was rushed to the VA Medical Center on Bailey Avenue suffering from hallucinations, double vision, slurred speech, and severe head and neck pains.

A doctor thought blood vessels in his brain had burst, and Kreiger was admitted to the cardiology ward — a move that Kreiger’s relatives said they found baffling.

“Why would he be placed in the cardio ward if he had a brain injury?” asked Melissa Kreiger, his wife. “We later found out he was overmedicated and it was poisoning his liver. Every time he goes there, they either give him medicine or increase it.”

She said that on Tuesday, she met with Finegan to inform him that his doctors continued to break their promise of sending her husband to a VA hospital better equipped to deal with brain injuries.

She says she’s still waiting to hear back from Finegan.

During his time in Iraq, Kreiger was wounded four times. And he had a close call when a 15-year-old Iraqi boy shot at him and two other soldiers. Kreiger, a medic, shot the boy and then saved his life with first aid.

A big part of the problem for Kreiger and other veterans who say they are not receiving adequate medical treatment is insufficient national funding of the VA, according to Welch, the local veterans services director and a Vietnam War veteran.

“Congress will not fund the VA properly to do the job,” Welch said, in predicting that the VA will be overwhelmed by returning combat veterans. “One of the things we advocate is that Congress has to look at the VA as part of the cost of war.”

At last count, 31,000 members of the armed forces were listed as wounded in Iraq and Afghanistan.

But Finegan says the federal government is aware of the situation and is budgeting for it. Returning troops, he added, have many problems, and that presents greater challenges for the VA.

Welch acknowledges that VA funding has increased nationally but “not at the level that the nine major veterans services organizations feel is appropriate.”

Finegan and his staff cite steps they have taken to meet current and future needs, particularly in the area of hiring mental health workers: three additional psychiatrists, bringing the total to 13; five more psychologists, increasing those ranks to 15; and doubling the number of psychiatric social workers to 32. Also, two care coordinators have been hired to help returning veterans.

Still, some veterans with persistent health problems, including combat-related mental illness, say they feel ignored and betrayed.

Delays breed disgust

Lepsch, the Marine who served with an anti-terrorist unit in east Africa and passed through Iraq, said he suffers from multiple psychological and physical ailments.

When recently admitted to the VA’s psychiatric ward, Lepsch said that he spent most of his time watching television and that after two days, he left in disgust.

“I felt I was doing more harm than good to myself,” said Lepsch, who is currently on “medical hold” awaiting retirement. “They pretty much are treating everybody up there like they are a drug addict or an alcoholic. In my case, I have 300 sheets of paper in my medical records explaining about my [post-traumatic stress disorder] and my back and other ailments.”

Short staffing while he was at the ward, he said, resulted in psychiatric patients not being taken outside to a courtyard for fresh air each day.

“Psychiatrists just basically give you a medication and you see the doctor once a day. The doctor asks if your medication is working and that’s it,” said Lepsch, 24, of North Tonawanda.

Cushing, a former Marine, described her efforts to get comprehensive treatment from the VA as a major challenge, since she received a medical retirement two years ago.

“They’re supposed to have four women’s doctors at the VA hospital here, but my VA social worker told me two quit because of the big workload and a third got tired of working here and one doctor is left,” Cushing said of why she now travels to the Syracuse VA for care.

VA officials offered a clarification, explaining that while there might have been more than one women’s doctor, they were part time and equaled one full-time position only. As for the long trips to Syracuse, Dr. Thomas Mahl, a 17-year VA employee and administrator, acknowledged that this some- times happens but noted that 90 percent of veterans receive medical care locally.

“The big problem with the VA is they don’t have the doctors. They keep giving you to physician assistants, and that’s even if you can get an appointment,” Cushing said.

The VA says veterans do have the option of seeing a medical doctor. The ratio between primary-care physicians and local VA patients is 1 doctor to every 1,200 patients, according to the VA. That number is close to the statewide ratio of primary-care physicians to patients.

Sharon M. McGrath, a longtime veterans’ advocate, said that other veterans do have “good experiences,” though she believes that the VA has lost ground since she worked for it in the mid-1980s.

And newer combat veterans such as Cushing and Kreiger by no means have the market cornered when it comes to concerns over VA health care.

A psychiatric nurse who left the VA in 1985 to open C.O.P.I.N. House in Niagara Falls for troubled Vietnam veterans, McGrath says she has to take an aggressive stand every time she sends a veteran to the VA.

Staff ‘being mobbed’

“I know it’s staffing, and I know they’re being mobbed,” McGrath said. “They’ll placate me because I have a big mouth, and I’m not afraid to pick up the phone, but I feel for the staff. I see the staff is working itself to death.”

VA staff members, in fact, told The Buffalo News that they often work beyond their normal workday to assist veterans and do not seek extra compensation.

That, however, does not lessen McGrath’s frustration with how veterans are sometimes released before receiving proper care.

“We just had one of our vets picked up the other day from the VA hospital; he had not shaved,” McGrath said. “When questioned, he said he wasn’t even offered a razor. He wasn’t suicidal. He was in because he’s an alcoholic.”

Finegan said that there are plans to expand the Buffalo VA Medical Center’s psychiatric ward and noted that the VA’s overall national budget for mental health spending increased by $300 million last year.

Dr. Sudha Krishnaswamy, the local VA’s chief of psychiatry, said other steps are being taken to make psychiatric care more accessible.

“We have telepsychiatry, where the patient and psychiatrist are hooked up live [on closed-circuit television] at our community clinics,” she said.

That same type of technology is used to conduct dermatologic and diabetic eye exams at the clinics, making it more convenient for patients, according to Finegan and his staff.

But McGrath says there are shortcomings in talking with a mental health expert over closed-circuit TV.

“How would you like to talk to a psychiatrist by television? This is more convenient for the staff,” said McGrath, who has worked with vets who have complained about having to see a psychiatrist by way of TV.

And while the VA defends its practices, noting that capital improvements are modernizing its facilities, including a state-of- art dental clinic, other veterans advocates are less enthusiastic and say problems here mirror those in other VA regions across the country.

“After monitoring the VA for 30-plus years, it seems they treat the symptom, not the root problem. They will push as much medication as they can on you and then tell you get in line and wait for an appointment,” said Russell K. Terry, cofounder and chief executive officer of the California-based Ira q War Veterans Organization.

Terry, who served two tours of duty in Vietnam, says he is disturbed by what he hears from veterans and those who know of their plight.

“I have talked to many many coroners who have gone into the homes of veterans after their death, either from natural causes or by suicide, and they were absolutely stunned at how much medication the veteran had in his or her bathroom.”

He is quick to say that the VA often succeeds at its job.

“But when it fails,” he said, “it can cost a human life.”


posted by Larry Scott
Founder and Editor
VA Watchdog dot Org

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Monday, March 3, 2008

MSG Woodrow Wilson Keeble awarded Medal of Honor 1st Sioux ever awarded MOH

President Bush Attends Medal of Honor Ceremony for Woodrow Wilson Keeble
East Room
2:35 P.M. EST

THE PRESIDENT: Welcome. Thanks for coming. Mr. Vice President, Mr. Secretary, members of the Dakotan Congressional Delegations, Senator from Alaska, other members of Congress, Members of my Cabinet, members of the administration, members of the United States Armed Forces, distinguished guests: Welcome to the White House.

The Medal of Honor is the highest award for valor a President can bestow, and I'm honored recipients of the Medal of Honor have joined us. Thank you for coming. During my time in office, I've had the privilege of performing this duty on nine separate occasions. Every ceremony has been inspiring. Many have been joyful. Some have been poignant. But I'm not sure I can remember many ceremonies quite like this one.

It's taken nearly 60 years for Master Sergeant Woodrow Wilson Keeble to be awarded the medal he earned on the battlefield in Korea. His nominating paperwork was lost, and then it was resubmitted, and then it was lost again. Then the deadline passed, and Woody and his family were told it was too late. Some blamed the bureaucracy for a shameful blunder. Others suspected racism: Woody was a full-blooded Sioux Indian. Whatever the reason, the first Sioux to ever receive the Medal of Honor died without knowing it was his. A terrible injustice was done to a good man, to his family, and to history. And today we're going to try to set things right.

Few people worked harder for this day than Woody's family. I thank the members who are with us, including his son, Russell, who is accepting this award on their behalf, along with his cousin -- a cousin.


THE PRESIDENT: Along with his nephew. I want to welcome you here. Thank you for supporting Woody. Thank you for your understanding, your patience and, most of all, your persistence.

I also offer special thanks to the determined delegations of North and South Dakota, including the Governor of North Dakota and the former Governor of South Dakota. Woody had ties to both Dakotas. Each state claims him as its own. (Laughter.) I think I'm going to stay out of the argument. I want to thank you for carrying Woody's banner to the Pentagon, and to the halls of Congress. You did the right thing.

It's easy to understand why so many people argued so passionately for the Medal once you hear the story of what Woody Keeble did. This story unfolded at an important time in our history. The year was 1951. The world was divided by a Cold War. America was under threat and -- some believed -- overmatched and out of heart. The great evil of communism was said to be the future of the world. It was on the advance in Europe, and in China, and on the Asian peninsula of Korea.

On that peninsula, a battle raged between communist forces in the North and the forces of freedom in the South. And Woody Keeble, a decorated veteran of Guadalcanal, raised his hand to serve his country once again. Woody said he volunteered for Korea because, "somebody has to teach those kids how to fight." And that's exactly what he did. In George Company, he quickly became a mentor, a teacher, and a legend. He was so strong that he could lift the back of a jeep and spin it around.

Some people knew he had been scouted by the Chicago White Sox. He had a heck of an arm, and he threw grenades like a baseball. One soldier remembered the time Woody walked through a mine field, leaving tracks for his men to follow. Another recalled the time Woody was shot twice in the arm and he kept fighting, without seeming to notice.

That fall, Woody's courage was on full display during a major offensive called Operation No Man [sic]. His company was ordered to take a series of hills protecting a major enemy supply line. High up in those hills and manning machine guns were Chinese communist forces. After days of fighting, the officers in Woody's company had fallen. Woody assumed command of one platoon, then a second, and then a third, until one of the hills was taken, and the enemy fled in wild retreat.

That first advance nearly killed him. By the end of the day, Woody had more than 83 grenade fragments in his body. He had bleeding wounds in his arms, chest, and thighs. And yet he still wanted to fight. So after a day with the medics, he defied the doctor's orders and returned to the battlefield. And that is where, on October 20, 1951, Master Sergeant Woodrow Wilson Keeble made history.

Communist forces still held a crucial hill that was the "pearl" of their defenses. They had pinned down U.S. forces with a furious assault. One soldier said the enemy lobbed so many grenades on American troops that they looked like a flock of blackbirds in the sky. Allied forces had tried heavy artillery to dislodge the enemy, and nothing seemed to be working. The offensive was failing, and American boys were dying. But our forces had one advantage: Woody was back, and Woody was some kind of mad.

He grabbed grenades and his weapon and climbed that crucial hill alone. Woody climbed hundreds of yards through dirt and rock, with his wounds aching, bullets flying, and grenades falling all around him. As Woody first started off, someone saw him and remarked: "Either he's the bravest soldier I have ever met, or he's crazy." Soldiers watched in awe as Woody single-handedly took out one machine gun nest, and then another. When Woody was through, all 16 enemy soldiers were dead, the hill was taken, and the Allies won the day.

Woody Keeble's act of heroism saved many American lives, and earned him a permanent place in his fellow soldiers' hearts. Years later, some of those tough soldiers' eyes would fill with tears when they saw Woody again. One said: "He was the most respected person I ever knew in my life." Another said: "I would have followed him anywhere." A third said: "He was awesome." Those brave boys battled tyranny, held the line against a communist menace, and kept a nation free. And some of them are with us today. We are honored to host you at the White House. We thank you for your courage. We thank you for honoring your comrade in arms. And we thank you for your service to the United States.

As the war ended, Woody went back to North Dakota. In some ways, his return was a sad one. Within a few years, his first wife died. He would suffer from numerous affects of the war. A series of strokes paralyzed his right side and robbed him of his ability to speak. And the wounds he sustained in service to his country would haunt him for the rest of his life.

Yet Woody was not a bitter man. As a member of his family put it: "Woody loved his country, loved his tribe, and loved God." Woody even found love again with a woman named Blossom. Woody may not have been able to speak, but he could still get a message across. He wrote a note asking Blossom to marry him. She told him she needed some time to think about it. So while she was deliberating, Woody put their engagement announcement in the newspaper. (Laughter.) This is a man who was relentless in love as well as war. (Laughter.)

In his community he was an everyday hero. Even in poor health, he would mow lawns for seniors in the summers and help cars out of the snow banks in the winters. He once picked up a hitchhiker who was down on his luck and looking for work. Woody wasn't a rich man, but he gave the man $50. Those who knew Woody can tell countless stories like this -- one of a great soldier who became a Good Samaritan.

To his last days, he was a devoted veteran. He proudly wore his uniform at local events and parades. Sometimes folks who loved him would see that uniform and ask him about his missing medal. They felt he was cheated, yet Woddy never complained. See, he believed America was the greatest nation on Earth, even when it made mistakes. And there was never a single day he wasn't proud to have served our country.

Woody suffered his eighth -- and final -- stroke in 1982. His son, Russell, took him to the hospital and prayed it wasn't the end. But Woody knew, and he wasn't afraid. Woodrow Wilson Keeble died in graceful anonymity, unknown except to the fortunate souls who loved him, and those who learned from him. Russell put it this way: "Woody met death with a smile. He taught me how to live, and he taught me how to die."

I am pleased that this good and honorable man is finally getting the recognition he deserves. But on behalf of our grateful nation, I deeply regret that this tribute comes decades too late. Woody will never hold this Medal in his hands or wear it on his uniform. He will never hear a President thank him for his heroism. He will never stand here to see the pride of his friends and loved ones, as I see in their eyes now.

But there are some things we can still do for him. We can tell his story. We can honor his memory. And we can follow his lead -- by showing all those who have followed him on the battlefield the same love and generosity of spirit that Woody showed his country everyday.

At the request of the Keeble family and in accordance with the Sioux tradition, two empty chairs have been placed on this stage to represent Woody and Blossom and to acknowledge their passing into the spiritual world. The Sioux have a saying: "The life of a man is a circle." Well, today, we complete Woody Keeble's circle -- from an example to his men to an example for the ages. And if we honor his life and take lessons from his good and noble service, then Master Sergeant Woody Keeble will serve his country once again.

I want to thank you all for coming. May I ask for God's blessings on you and Woody Keeble and the Keeble family. May God continue to bless our country. And now I ask Mr. Hawkins and Mr. Bluedog to join me. Commander Thompson will read the citation.

COMMANDER THOMPSON: The President of the United States of America, in the name of Congress, takes pride in presenting the Medal of Honor to Master Sergeant Woodrow W. Keeble, United States Army, for conspicuous gallantry and intrepidity, at the risk of his life, above and beyond the call of duty:

In action with an armed enemy near Sangsan-ni, Korea, on 20 October, 1951. On that day, Master Sergeant Keeble was an acting platoon leader for the support platoon in Company G, 19th Infantry, in the attack on Hill 765, a steep and rugged position that was well defended by the enemy. Leading the support platoon, Master Sergeant Keeble saw that the attacking elements had become pinned down on the slope by heavy enemy fire from three well-fortified and strategically placed enemy positions. With complete disregard for his personal safety, Master Sergeant Keeble dashed forward and joined the pinned-down platoon. Then, hugging the ground, Master Sergeant Keeble crawled forward alone until he was in close proximity to one of the hostile machine-gun emplacements. Ignoring the heavy fire that the crew trained on him, Master Sergeant Keeble activated a grenade and threw it with great accuracy, successfully destroying the position. Continuing his one-man assault, he moved to the second enemy position and destroyed it with another grenade. Despite the fact that the enemy troops were now directing their firepower against him and unleashing a shower of grenades in a frantic attempt to stop his advance, he moved forward against the third hostile emplacement, and skillfully neutralized the remaining enemy position. As his comrades moved forward to join him, Master Sergeant Keeble continued to direct accurate fire against nearby trenches, inflicting heavy casualties on the enemy. Inspired by his courage, Company G successfully moved forward and seized its important objective. The extraordinary courage, selfless service, and devotion to duty displayed that day by Master Sergeant Keeble was an inspiration to all around him and reflected great credit upon himself, his unit, and the United States Army.

(The Medal is presented.) (Applause.)

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Veteran Bears Scars of Stateside Agent Orange

Fort Gordon Veteran exposed to Agent Orange

When it comes to deadly poisons, few are better known. The military's use of Agent Orange is one of the dark chapters of the Vietnam War.

But NewsChannel 5 investigative reporter Ben Hall has found the military used Agent Orange here in the United States -- and one veteran says he has the health problems to prove it.

Agent Orange was a toxic herbicide used by the military to thin out the jungles of Vietnam. Soldiers sprayed millions of gallons, unaware how poisonous it was.

"There was a problem and the evidence is on my back and my chest and 40 years of my life," says James Cripps, a Vietnam era veteran.

He says he was poisoned by Agent Orange, but he never served in Vietnam.

"When I got wounded I didn't know it I had no reason to suspect there would have been no way to have proved it," Cripps says.

Cripps had what seemed like a dream job as game warden at Fort Gordon in Georgia.

"This is me in 1971 when I got out of the Army you can see all the marks on my face," he says, pointing to photos of himself.

Cripps says when he left the military he had already been exposed. He believes he sprayed Agent Orange in the lakes around Fort Gordon to kill weeds.

"I was ordered to spray that herbicide," Cripps says. And pictures show signs warning people about fishing in the lakes Cripps once cared for. "I know what's in those lakes, I put it there," adds Cripps.

NewsChannel 5 Investigates has uncovered defense department documents that prove the military sprayed Agent Orange at Fort Gordon during the time Cripps was there.

Documents detail more than 30 locations in the United States where Agent Orange was tested.

The documents show helicopters sprayed at least 95 gallons of Agent Orange at Fort Gordon in 1967. Cripps says that alone should prove he was exposed.

"A lot of them cause scars sometimes they go so sore he can't wear his shirt," his wife, Sandra Cripps, says.

But he and his wife say his body offers the greatest proof. The blackheads on his back contain the poisonous residue from Agent Orange which causes acne called ‘chloracne.'

"In some persons the skin legions persist," says Dr. Dewey Dunn, an Agent Orange expert.
He says chloracne is a tell-tale sign of Agent Orange exposure. "It's just sort of a marker so its on the list and probably at the top of the list."

Dr. Dunn examined James Cripps but could not talk specifically about his case. Medical records show Dr. Dunn diagnosed Cripps with Chloracne and type-two diabetes, another sign of exposure.

Despite all the evidence, the VA will not approve James Cripps disability claim. "I'm being denied my medical care to this very day," says Cripps.

"From what I see it strictly gets down to money," says Donald Stephens, who is with the Disabled American Veterans. He's helped hundreds of veterans prepare their VA medical claims.

Ben Hall asks, "How strong is Mr. Cripps claim?"

"A ten," Stephens answers. "I would give it a ten."

He says there's plenty of help for veterans exposed in Vietnam, but he believes Cripps claim would open the floodgates for veterans exposed in the United States.

Meanwhile, James Cripps is on multiple medications and he's struggling to pay his medical bills. And now the VA is actually garnishing his Social Security checks.

"We have discussed of late, even yesterday, the thought of suicide," he confides.

After years of service, Cripps and his wife feel broken and betrayed.

"I can see why some veterans would give up," Sandra Cripps says. "It's not fair."

Back to NewsChannel 5 Investigates

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Invisible injuries

Mental Health of veterans in Canada

Invisible injuries
The Ottawa Citizen
Published: Friday, February 22, 2008
The country mourns and reflects when a Canadian soldier is killed or wounded on duty in Afghanistan - at least if the injuries are visible.

But when soldiers return from combat with invisible injuries - including mental disorders such as post traumatic stress or problems such as alcoholism - they sometimes slide back into society with little help or attention. Until things begin to go wrong.

Until recently, the military was not particularly sensitive to issues of mental illness. Soldiers are supposed to be "tough," and the resulting stigma around mental illness reduced the likelihood of soldiers getting treatment. Thanks to the efforts of a few brave soldiers, chief among them Lt.-Gen. Roméo Dallaire, attitudes have begun to change, but not quickly enough.

A recent survey suggests the Canadian military has plenty to do if it is serious about erasing the shame and ensuring that personnel whose wounds are psychological rather than physical receive proper treatment.

The survey of 8,441 soldiers - the first to look at the use of mental health services in the Canadian Forces - found an astonishing four out of six soldiers in need of psychological help did not get it, even though it was available. Some said they distrusted military management or the military health system. It was unclear if they feared the impact it would have on their careers.

The survey was conducted at the start of Canada's deployment in Afghanistan, at the request of the Department of National Defence.

Since that time, the Department of National Defence has made changes aimed at soldiers suffering what are sometimes called stress injuries. Those include the creation of the Operational Stress Support System, a program of peer support for afflicted soldiers. The military has also begun what it calls "third location decompression" in which soldiers are sent to a peacetime location outside Canada before they come home from combat.

There is more to do, however. Just think: Even in civilian society, despite vigorous public education campaigns, and despite research suggesting that mental illness afflicts virtually every family and workplace, the stigma remains. The challenge is all the greater in a military environment.

In 2002, then military ombudsman André Marin wrote a scathing report about the treatment of soldiers who were diagnosed with post-traumatic stress disorder. Six years later, little or no action has been taken on more than half of the report's 31 recommendations - including creation of a post traumatic stress disorder co-ordinator for the military and the development of databases to track suicides and soldiers with post traumatic stress disorder.

The American experience is sobering. A U.S. study identified more than 120 homicides committed by veterans of the Iraq and Afghanistan wars. The numbers are disputed by the Pentagon, but it's hard to dispute that they point to a significant problem of untreated mental illness among veterans.

Canadians make a lot of noise about supporting our troops who are doing a difficult mission in one of the most dangerous parts of the world. They deserve real support, both on the battlefield and when they return home.

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