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Talk first (continued)


FORCED TO re-enter society without a proper support system, many veterans end up with stories like Carl Miller’s. Miller, a Vietnam veteran whom I met at the Boston Vet Center last month, has been divorced four times; he recalls numbing his pain with alcohol upon his return to the United States. Luckily, Miller’s father and the Boston Vet Center were there to help him. Many men were not as lucky, and their misfortunes and disillusion blight several decades of American political and social history.

Among Vietnam veterans, PTSD will at some point afflict a full 30 percent of males and 25 percent of females. And that’s not all — about half of all Vietnam veterans suffer from some emotional distress that doesn’t necessarily fit a strict PTSD diagnosis.

Experts predict that today’s soldiers are at risk for the same mental-health crisis — or worse. Many experts acknowledge that soldiers fighting the war on terror are welcomed home by a more supportive public than the one that greeted Vietnam veterans. But in July 2004 — just over a year after the war began — the New England Journal of Medicine study showed that after just a few months back in the states, up to 16 percent of those men and women already met the criteria for a PTSD diagnosis, depending on what level of combat they’d seen. Others reported varying degrees of depression and alcohol misuse. As the war rages on, those numbers may climb.

The study "identified a significant number of things that we’re quite concerned with," says Dr. Al Batres, head of readjustment counseling for the VA. "We hope that if we intervene early, you don’t get the number of problems that occurred in the Vietnam era."

That’s just what New Hampshire’s program — the result of a collaboration between the state’s National Guard, Vet Centers, and VA hospitals — aims to do. RSRP seeks to prepare Army National Guard soldiers — who "were never deployed in the proportion that we’re now using them," Batres says — for the emotional difficulties they may experience as they return to their families, jobs, and daily routines. And it tries to make counseling non-threatening and accessible by offering one-on-one sessions before soldiers may need or want them.

Batres puts forward this demobilization process as a "best-practice model for the nation," some version of which can and should be implemented in every state. From his national post, he encourages National Guard and Vet Center directors to share strategies, in order to disseminate programs like New Hampshire’s.

MORE THAN 800 guardsmen and -women went through the first RSRP in New Hampshire, and more than 30 Vet Center counselors from across New England volunteered to help administer the one-on-one screenings. During those sessions, some soldiers requested immediate assistance, and made Vet Center or VA-hospital appointments right away. Many more, however, simply asked for follow-up calls from Vet Center representatives. In fact, more than half the soldiers who went through the process in February and March requested such calls.

The entire RSRP process is mandatory for New Hampshire guards, and that’s one of its benefits, says Captain Mary Hennessey, the state’s only female company commander, who went through the process herself in February. "They don’t single anyone out," she says. "They said, all of you are coming in.... Nobody had to know. They didn’t have to stand out in front of their peers."

Stigma is one of the biggest hurdles in getting veterans adequate mental health care, most experts agree. The same New England Journal of Medicine study that showed the high incidence of psychological suffering among Iraq and Afghanistan veterans also indicated that 40 percent feel uncomfortable seeking help. Many soldiers — especially guardsmen and –women hoping to continue their service — worry that their commanders will perceive them as weak if they ask for counseling. But when everyone has to go through the same screening, there’s less fear of being ostracized. In addition, all Vet Center sessions are confidential, says James Garrett, Region 1-A deputy regional manager. Indeed, the Army National Guard itself suggested that conversations between soldiers and counselors stay private.

When soldiers sit down with a Vet Center therapist — most of whom are Vietnam or Persian Gulf War veterans themselves — the "natural connection between veterans" adds another layer of comfort, Garrett says. "There are a lot of things that don’t have to be said between veterans who have been to war." Especially when many soldiers expect to be "meeting with a shrink, meeting with someone in a white coat," Beebe adds.

To that end, testimonial talks from Iraq-war veterans — like 28-year-old Garrick Lewis, who returned from his second tour of Iraq last September — have replaced many of the traditional post-service briefings. Lewis is an official VA employee, one of 50 Iraq-Afghanistan veterans hired last fall to do official outreach to returning soldiers. (Batres just received word that his department will have funds to hire 50 more this spring and summer.) Lewis, who talks to veterans all over New England, realizes that many of his fellow veterans view counseling as a sign of weakness, and he’s trying to combat that misconception. He reminds soldiers that all Vet Center meetings and records are confidential and can never affect their military careers. For the most part, Lewis thinks his message is getting through.

"It’s nice to hear a perspective from someone who’s been there, done that," he says. "I hear that over and over and over again — you know, ‘I’ll talk to you, I’ll listen to you because you’ve been there.’ "

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Issue Date: May 27 - June 2, 2005
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