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A solider returns home. Photo by US Army.

A solider returns home. Photo by US Army.


Veterans' Barriers To Care Are Multifaceted

Patricia Murphy

Washington Senator Patty Murray chairs the Veterans Affairs Committee. In July, she requested data and feedback from VA providers after hearing from vets who were suicidal and could not get appointments. Last week, she got the news.

Murray: "The survey not only showed that our veterans are being forced to wait for care, it provided a glimpse at a VA system that 10 years into war is still not fully equipped for the influx of veterans seeking mental health care."

A recent USA Today analysis showed that more than 200,000 veterans are now seeking care from the VA for post trauma. Many civilian nonprofits are also working to meet the mental health needs of veterans. But as KUOW's Patricia Murphy reports, beyond the system, one of the biggest barriers to care can be the veterans themselves.


It's a clear, crisp Saturday in Woodinville. Brian Dale pauses to look out toward the horizon; 21 acres of farmland surround him.

Dale served 5 years in the Navy. But his reentry to civilian life was difficult. Now through an organization called Vet Corps, he manages a half acre of this property. It's a place for vets to come and work, but it's also a healing exercise.

Dale: "Just coming out here and being out in nature doing gardening work and having the opportunity to have the one–on–one conversation, just kind of chat while you're working and take your mind off other things. It allows people to open up to one another."

Vet Corps can also connect vet with counselors and programs that can help with things like post–traumatic stress (PTSD) and traumatic brain injury.

Dale knows that with help most troubled veterans can rebuild their lives, but getting them out here is tricky. Vets dealing with PTSD tend to isolate themselves. In fact, some researchers believe that less than 40 percent of vets who need help reach out for it.

Randi Jensen: "The pattern is a pattern of avoidance. I hear stories where the individuals who tie themselves to the bed at night so they don't sleepwalk, so they don't hurt anybody. Then all of a sudden they think they're crazy."

Randi Jensen is a counselor and the director of Soldiers Project Northwest, the private nonprofit that provides free counseling and therapy to veterans.

Many see civilian counseling groups like Soldiers Project as a necessary alternative to the VA system which can be backlogged and hard to navigate.

Jensen: "What you need to do is find a way to deal with it on a daily basis. Understand that these are patterns in your brain, neuropathways in your brain that are set, and what you need to do is understand what's going on, forgive yourself because you're not crazy. This is just a normal reaction to an abnormal situation and get some help early.

The sooner the better, says Jensen.

Untreated PTSD can lead to family violence, drug and alcohol abuse, or worse. According to the VA, 18 US veterans commit suicide each day.

The Army is trying to do more to help soldiers deal with combat stress before it becomes a chronic problem. Medics who work on the battlefield are now trained to recognize the early signs of post trauma. There are more deployed therapists. Troops also undergo a series of mental health screenings upon their return from deployment.

There are few people more influential in a soldier's life than their commanding officer.

General Peter Chiarelli is the vice chief of staff of the Army. Chiarelli has called on commanders to use that influence on troop members to send the message that it is OK to ask for help.

During a visit to Seattle this spring, Chiarelli told KUOW he makes a point to speak to troops and National Guard members about the dangers of untreated PTSD.

Chiarelli: "And when they hear that coming from a soldier — not a doctor, but from a soldier — I think we're beginning to chip away at some of that stigma. But this is not this is a long–term problem. This is not something we're going to solve overnight because you're changing people's values, their beliefs."

Many soldiers and Marines wrestle with survivor guilt and moral conflict over the split–second decisions they had to make while in combat.

Thomas (not his real name) deployed to Iraq in January 2004 for 9 months with the Marines. His company played a major role in the taking of the Iraq city of Fallujah. While deployed he discovered the body of a friend who had taken his life. Thomas says his trouble may have started in Iraq, but quickly spiraled after his return home.

Thomas: "They all came out to California — my mom and my dad and my brother — and they're having this party for me in the house, and I was out in the garage crying the whole time. I felt bad; the things I did. I killed seven people that I know of and that never sat right with me."

Randi Jensen says there's no time to process during combat.

Jensen: "You've got 10 minutes to grieve. You've just lost seven of your buddies, you've got 10 minutes to grieve, then we've got to get back out on patrol. So they compact all of those experiences and then when they come back all of those experiences start to expand."

For Thomas, the anguish, isolation and self–medication all culminated one night with a bottle and a gun.

Thomas: "I was going to this lake that I used to go to in high school and I had my Desert Eagle with me. I was going to go shoot myself in the head. I got pulled over; I was drunk. I got pulled over by a state trooper. He probably saved my life."

Thomas got into therapy. It's been seven years, and he still goes weekly.

Thomas still has trouble sleeping and being in large groups.

Thomas: "There's not a day that goes by that I don't think about it. There probably never will be. I mean, it's a scar."

But just being able to talk about what happened to him is progress for Thomas. Like counselor Randi Jensen says, it's learning to live with the new you.

Thomas is in school and pursuing a career with the Forest Service. He grew up in Alaska and feels a sense of peace surrounded by nature. On most days, he feels hopeful about his future.

Jensen says there's a range of treatment options for post trauma that vets can use.

Jensen: "Just get a check up from the neck up. Find out if your reality is the real reality; that's all you have to do. You don't have to commit to years of psychotherapy. You just have to come in and let's see what's going on, see if we can make things better for you."

Along with traditional psychotherapy, the VA in Seattle has a mindfulness meditation group. About two–thirds of patients are helped by a treatment known as prolonged exposure therapy. It helps to disempower painful memories in patients by having them recount the traumatic event over and over in a clinical setting.

For Vet Corps' Brian Dale, it was this half acre in Woodinville that made the difference.

Dale: "I had a very tough transition, and I ended up meeting my boss now who was the Vet Corps member at my school, and we came out here and we were spreading manure and pulling up fence posts and I started getting more involved with it and just coming out here and helping."

Now Dale is the one in charge, using a combination of compassion and peer pressure to get more vets out here to work the land, shovel manure and find their way back from the mental wounds of war.

I'm Patricia Murphy, KUOW News.

© Copyright 2011, KUOW