PTSD and Brain Trauma...

[J.B. Stone]

Thanks JB a separate thread for PTSD is an excellent idea.

The unfortunate part is that there is so many great article written on it but so little being actually done.

We have to get the message out that this is real and the help they need is a necessity.

Thanks again

I believe the MOST unfortunate facet of the problem is the STIGMA which is attached to it.

This is not something people "choose" to do. It just happens, and in its more severe forms is incurable, but there are constantly little incremental steps which are found by the medical profession to aid in suppressing the symptoms....not to "disguise" them, but to make them tolerable or manageable by the individual. Having suffered from PTSD for over three decades, I've learned quite a bit about its debilitating effects and what can and cannot be done for its sufferers.

[J.B. Stone]

SEN. CRAIG TO SEEK TO AMEND VETERANS’ LEGISLATION WEDNESDAY
With nation at war, Craig will seek to improve benefits



June 26, 2007

Media contact: Jeff Schrade (202) 224-9093



(Washington, DC) Members of the U.S. Senate Committee on Veterans’ Affairs will meet on Wednesday to discuss and possibly amend five bills, which could impact veterans in both the United States and the Philippines.



Immediately after the conclusion of that meeting, the Committee will hold a hearing on the nomination of Charles L. Hopkins, of Massachusetts, to be the Assistant Secretary for Operations, Security and Preparedness for Veterans Affairs.



The hearing will be held Wednesday, June 27, in room 562 of the Dirksen Senate Office Building, starting at 9:30 a.m. Eastern. It is scheduled to be webcast live and available for viewing later on the Committee’s website: http://veterans.senate.gov./. Audio may also be available – during the hearing only – at http://www.capitolhearings.org/.



The bills to be considered are:



* S. 423, Veterans’ Compensation Cost-of-Living Adjustment Act of 2007 - Sponsor: Sen. Akaka - ten cosponsors, including Sen. Craig. The bill seeks to increase the rates of compensation for veterans with service-connected disabilities and the rates of dependency and indemnity compensation for the survivors of certain disabled veterans.



* S. 1163 (Committee Print), Blinded Veterans Paired Organ Act of 2007 - Sponsor: Sen. Akaka - five cosponsors. The bill seeks to improve compensation for veterans in certain cases of impairment of vision involving both eyes, and to provide for the use of the National Directory of New Hires for income verification purposes.



* S. 479, Joshua Omvig Veterans’ Suicide Prevention Act - Sponsor Sen. Harkin - 27 cosponsors. The bill seeks to direct the Secretary of Veterans Affairs to develop and implement a comprehensive program to reduce the incidence of suicide among veterans.



* S. 1315 (Committee Print), Veterans’ Benefits Enhancement Act of 2007 - Sponsor: Sen. Akaka. The bill seeks to enhance insurance and specially adapted housing benefits for disabled veterans, to expand benefits for Filipino veterans who served under U.S. command during World War II, and for other purposes.



* S. 1233 (Committee Print), Veterans’ Traumatic Brain Injury and Other Health Programs Improvement Act of 2007 - Sponsor: Sen. Akaka – 4 cosponsors, including Sen. Craig. The bill seeks to improve traumatic brain injury and mental health treatment, enhance travel reimbursement, expand outreach and access to care for rural and homeless veterans, and authorize funds for the construction and updating of VA facilities.



####



*

See this release online at: http://veterans.senate.gov/ranking_memb ... se_id=1058

[J.B. Stone]

Traumatic military deployments increase mental-health conditions, study says

JAMES KELLER



HALIFAX (CP) - There is a strong link between traumatic experiences during military deployments and the risk of mental-health problems, suggests a study that also concludes untreated conditions are an "enormous problem" in the Canadian Forces.

The study, published in the current issue of the Archives of General Psychiatry, was based on interviews with more than 8,000 active Canadian military personnel in 2002.

More than 30 per cent of respondents reported emotional problems in the previous year, including post-traumatic stress disorder, general anxiety disorder, depression and suicidal thoughts, among others. And personnel who said they witnessed atrocities such as mutilated bodies or mass killings were far more likely to be part of that group.

Furthermore, less than half of those experiencing some level of emotional problem used any form of treatment, such as medication, therapy, counselling or skills training.

Jitender Sareen, the study's lead researcher, said that discrepancy can have significant consequences for military personnel returning home.

"At an individual level, a person can have a lot of difficulties in their personal relationships, difficulties returning to work, thoughts about suicide," Sareen, who teaches psychiatry and community health sciences at the University of Manitoba, said Tuesday.

"The relationship between anxiety and depression and alcohol use in males is quite well know. When you're trying to deal with some of these memories of traumatic events, self-medication with alcohol can be common."

The study also explores why military personnel suffering from emotional problems didn't seek treatment - a trend that is also common among the general population.

Almost 40 per cent of the personal who had emotional problems but weren't getting help said they weren't seeking treatment because they didn't have confidence in the services available through the military.

Sareen said it wasn't clear whether those deficiencies were real or perceived.

"How much of this barrier is a perception of the services available or in actuality that the services are not good, that's difficulty to tell with this data," he said.

A spokesperson for the Canadian Forces wasn't immediately available for comment about the findings or the quality of care available to members of the military.

Sareen said the findings emphasize the need to improve mental-health services and education. He said the military appears to be taking the issue seriously, with five clinics for veterans suffering psychological problems already open across the country, and five more on the way.

"The survey was part of trying to understand what is needed, and I think having more clinics available is a step in the right direction," he said.

Sareen's research explores the sort of emotional scars that were brought into the national spotlight following the 1994 Rwandan genocide, particularly the story of retired general Romeo Dallaire, who led a UN peacekeeping force there.

Dallaire, now a senator, returned from Rwanda suffering from post-traumatic stress disorder. The horrors that he saw in the war-torn country drove him to early retirement and a suicide attempt. In 2003 he was found drunk in a public park near Ottawa, curled up under a bench.

Sareen said some research has suggested emotional problems may be similar in all peacekeeping missions where soldiers are asked to stand idle in conflict zones.

But the new study concludes that peacekeeping personnel who don't witness such atrocities are actually less likely to develop emotional problems than soldiers experiencing combat.

"There had been quite a bit of controversy in the literature, especially on peacekeeping and some of the issues on Rwanda and Romeo Dallaire and how generalizable were those experiences to the general soldier that goes to any (peacekeeping) mission," he said.

"If a soldier goes on a peacekeeping mission that does not involve combat or witnessing atrocities, they're not at increased risk."

http://www.recorder.ca/cp/National/070703/n070390A.html

[J.B. Stone]

MKULTRA: CIA Mind Control

by Jon Elliston
Dossier Editor
pscpdocs@aol.com

For many Americans, the 1950s were a docile decade. In U.S. history books, the period is mostly portrayed as a mellow, orderly one, especially in light of the social upheavals that followed in the 1960s. But for the CIA, the "I Like Ike" years were packed with adventure and action, much of it conducted outside of the public's view. Few programs were sheltered with more secrecy than the Agency's mind control experiments, identified together with the code-name MKULTRA.

Concerned about rumors of communist brainwashing of POWs during the Korean war, in April 1953 CIA Director Allen Dulles authorized the MKULTRA program, which would later become notorious for the unusual and sometimes inhumane tests that the CIA financed. Reviewing the experiments five years later, one secrecy-conscious CIA auditor wrote: "Precautions must be taken not only to protect operations from exposure to enemy forces but also to conceal these activities from the American public in general. The knowledge that the agency is engaging in unethical and illicit activities would have serious repercussions in political and diplomatic circles."

Though many of the documents related to MKULTRA were destroyed by the CIA in 1972, some records relating to the program have made it into the public domain, and the work of historians, investigative reporters, and various congressional committees has resulted in the release of enough information to make MKULTRA one of the most disturbing instances of intelligence community abuse on record. As writer Mark Zepezauer puts it, "the surviving history is nasty enough."

The most notorious MKULTRA experiments were the CIA's pioneering studies of the drug that would years later feed the heads of millions: lysergic acid diethylamide, or LSD. The CIA was intrigued by the drug, and harbored hopes that acid or a similar drug could be used to clandestinely disorient and manipulate target foreign leaders. (The Agency would consider several such schemes in its pursuit of Cuban leader Fidel Castro, who they wanted to send into a drug-induced stupor or tirade during a public or live radio speech.) LSD was also viewed as a way to loosen tongues in CIA interrogations.

In his thorough book on MKULTRA and similar projects, The Search for the "Manchurian Candidate," John Marks reports that most of the CIA researchers tried LSD themselves. In fact, an early phase of the experiments was probably the setting for the first acid trip in the United States -- experienced by a courageous CIA man no less!

The fact that these experiments took place is remarkable in and of itself, but the story of the CIA's LSD trips approaches the unbelievably bizarre when the cast of characters is considered. In his recent history of the early exploits of the CIA, The Very Best Men, Evan Thomas describes Sidney Gottlieb, the Stranglovian scientist who ran the MKULTRA project: "Born with a clubfoot and a stutter, he compensated by becoming an expert folk dancer and obtaining a Ph.D. from Cal Tech. A pleasant man who lived on a farm with his wife, Gottlieb drank only goat's milk and grew Christmas trees, which he sold at a roadside stand." When he wasn't busy on the farm, Dr. Gottlieb was dosing subjects with LSD-laced drinks, scrutinizing their reactions, and searching for qualities of the drug that would benefit CIA covert actions.

The CIA's LSD experiments were conducted on many unwitting subjects, most often prisoners or patrons of brothels set up and run by the Agency, which had installed two-way mirrors in the establishments to allow for observation of the drug's effects (these studies were referred to as "Operation Midnight Climax"). Some of the MKULTRA subjects who were informed faced even more inhumane treatment: during one experiment in Kentucky, seven volunteers were given LSD for 77 days straight.

One of the experiments probably proved fatal. On November 19, 1953, an Army scientist and germ warfare specialist named Frank Olson, who was working on an MKULTRA project, was slipped a solid dose of LSD in his drink. Then, after spending eight days stumbling about in what many observers described as a paranoid, depressed state, Olson jumped through his hotel window in New York and fell ten stories to his death.

The Agency covered up its role in Olson's demise, and twenty-two years would pass before his family would learn of the events leading up to his death. When the CIA's acid exploits were made public in the mid-1970s, the Agency found itself facing heavy criticism. One Senate committee put it this way in 1975:

"From its beginning in the early 1950s until its termination in 1963, the program of surreptitious administration of LSD to unwitting non-volunteer human subjects demonstrates a failure of the CIA's leadership to pay adequate attention to the rights of individuals and to provide effective guidance to CIA employees. Though it was known that the testing was dangerous, the lives of subjects were placed in jeopardy and were ignored.... Although it was clear that the laws of the United States were being violated, the testing continued."

Though the most prominently discussed aspect of MKULTRA is the CIA's LSD work, the program included many other unusual investigations relating to the science of mind control. CIA researchers probed the potential of numerous parapsychological phenomena, including hypnosis, telepathy, precognition, photokinesis and "remote viewing."

These studies weren't conducted merely to satisfy the CIA's scientific curiosity -- the Agency was looking for weapons that would give the United States the upper hand in the mind wars. Toward that objective, the Agency poured millions of dollars into studies probing literally dozens of methods of influencing and controlling the mind. One 1955 MKULTRA document gives an indication of the size and range of the effort; the memo refers to the study of an assortment of mind-altering substances which would:



* "promote illogical thinking and impulsiveness to the point where the recipient would be discredited in public"


* "increase the efficiency of mentation and perception"


* "prevent or counteract the intoxicating effect of alcohol"


* "promote the intoxicating effect of alcohol"


* "produce the signs and symptoms of recognized diseases in a reversible way so that they may be used for malingering, etc."


* "render the indication of hypnosis easier or otherwise enhance its usefulness"


* "enhance the ability of individuals to withstand privation, torture and coercion during interrogation and so-called 'brainwashing'"


* "produce amnesia for events preceding and during their use"


* "produc[e] shock and confusion over extended periods of time and capable of surreptitious use"


* "produce physical disablement such as paralysis of the legs, acute anemia, etc."


* "produce 'pure' euphoria with no subsequent let-down"


* "alter personality structure in such a way that the tendency of the recipient to become dependent upon another person is enhanced"


* "cause mental confusion of such a type that the individual under its influence will find it difficult to maintain a fabrication under questioning"


* "lower the ambition and general working efficiency of men when administered in undetectable amounts"


* "promote weakness or distortion of the eyesight or hearing faculties, preferably without permanent effects"

Few of MKULTRA's objectives were realized, but the very conduct of these experiments caused many critics of the CIA to argue that successful or not, CIA scientists shouldn't pry at the doors of perception.


View MKULTRA Documents


Sources:

Gross, Peter, Gentleman Spy: The Life of Allen Dulles (Houghton Mifflin, 1994).

Thomas, Evan, The Very Best Men (Simon & Schuster, 1995).

Marks, John, The Search for the "Manchurian Candidate": The CIA and Mind Control (Times Books, 1979).

Mark Zepezauer, The CIA's Greatest Hits (Odionan, 1994).

http://www.insteadof.com/TerrorAttack/p27.htm

[J.B. Stone]

http://www.va.gov/opa/pressrel


Nicholson to leave VA and Return to the Private Sector
Under his Leadership, VA Makes Strides in Health Care and IT
Modernization
WASHINGTON (July 17, 2007) -- Secretary of Veterans Affairs, Jim
Nicholson announced today he has tendered his resignation to President
George W. Bush, effective no later than October 1, 2007.

Under Nicholson's leadership, the Department of Veterans Affairs (VA)
continued its evolution as a leader in health care innovations, medical
research, education services, home loan and other benefits to veterans.
He transformed the VA health care system to meet the unique medical
requirements of the returning combatants from Iraq and Afghanistan.

In his letter of resignation, Nicholson praised and thanked the
President for the honor of serving him and our Nation's veterans in this
key post at such a "critical time in our nation's global war on terror."


"The VA is a dynamic organization dedicated to serving our nation's
finest citizens - our veterans," Nicholson said. "It has been an honor
and privilege to lead the VA during this historic time for our men and
women who have worn the uniform. We have accomplished so much and the
VA is always striving to improve our services to veterans."

Nicholson said he wants to return to the private sector. "This coming
February, I turn 70 years old, and I feel it is time for me to get back
into business, while I still can." He said he has no definite plans at
this time.

He also addressed an assembled group of Washington VA employees and
those watching around the country on VA's closed-circuit television. In
his message to employees, Nicholson told them how privileged he felt to
have worked with them in fulfilling our nation's promises and
obligations to its veterans.

"VA has come a long way in meeting the growing needs and expectations of
our veterans and you deserve the credit", Nicholson said.

Nicholson, a Vietnam Veteran, was sworn in as Secretary of Veterans
Affairs on February 1, 2005.

During Secretary Nicholson's tenure at the Department of Veterans
Affairs:

* Directed each of our veterans of the global war on terror who come
to the VA for any kind of care to be carefully screened for brain damage
(TBI) and post traumatic stress disorder (PTSD).

* Hired 100 new Outreach Coordinators to provide services to
returning OIF/OEF veterans. The new coordinators are located in Vet
Centers throughout the country especially near our military processing
stations.

* Created a new Advisory Committee on OIF/OEF Veterans and their
families to advise him on ways to improve programs serving OIF/OEF
veterans.

* Directed the Veterans Benefits Administration to give priority to
Operation Iraqi Freedom and Operation Enduring Freedom (OIF/OEF)
veterans in its compensation and pension claim system.

[J.B. Stone]

"ATTORNEYS FOR VETERANS" LEGISLATION TAKES EFFECT

VA NEWS FLASH from Larry Scott at VA Watchdog dot Org -- 06-20-2007

The "Choice of Representation Act" becomes law.

Veterans may now use attorneys in the VA claims process

after filing the first Notice of Disagreement.






This is a landmark day for veterans who are filing a disability claim with the VA.

Today, the "Veterans' Choice of Representation and Benefits Enhancement Act of 2006" (S.2694) becomes law. This legislation is popularly-known as "Attorneys for Veterans."

The Disabled American Veterans (DAV) fought this legislation tooth-and-nail and managed to get repealer legislation introduced (H.R.1318). That never got out of Committee...so the law stands.

For an interesting look at all of this...and the arguments pro and con, use the VA Watchdog Search Engine, here...
http://www.yourvabenefits.org/ . Just type in "attorneys for veterans" without the quotes and use the exact phrase button.

To best explain how this will work, I will use a VA document. That document here... http://www.vawatchdog.org/
07/nf07/nfJUN07/JUNFILES/
Attorney_fee_documents.doc

And, the entire document is printed below:

-----

June 6, 2007

Director (00/21) In Reply Refer To: 211A
All VA Regional Offices and Centers Fast Letter 07-15



Subject: Public Law 109-461

This letter provides information concerning the new legislation governing the recognition of agents and attorneys representing claimants before VA. Enclosure One provides general answers to questions employees may receive during interviews or when answering telephones.



Background

On December 22, 2006, the President signed Public Law 109-461. Section 101 of Public Law 109-461, the Veterans Benefits, Health Care, and Information Technology Act of 2006, amends chapter 59 of title 38, United States Code, governing the recognition of individuals for the preparation, presentation, and prosecution of claims for benefits before VA. The provisions shifting the entry point for paid representation are effective on June 20, 2007, and the provisions relating to fee assessments and review of fee agreements are effective upon publication of VA's final rule.



Summary of New Legislation

Section 101 of Public Law 109-461 makes the following amendments to 38 U.S.C. §§ 5902, 5903, 5904 and 5905:

• Eliminates the current prohibition on the charging of fees for services of an attorney or agent provided before the Board of Veterans’ Appeals (Board) makes its first final decision in the case. As amended, section 5904 will allow accredited attorneys and agents to charge fees for services provided after a notice of disagreement (NOD) has been filed with the VA Regional Office (RO) in the case.

• Authorizes the Secretary to collect an assessment from an individual recognized as an agent or attorney under section 5904 in any case where VA pays the agent’s or attorney’s fees from past-due benefits owed to a claimant. The amount of the assessment shall be equal to five percent of the amount of the fee paid to the agent or attorney from past-due benefits. The assessment may not exceed $100. An agent or attorney who is charged an assessment may not receive reimbursement for such assessment from the claimant. VA will deposit the amounts collected in an account available for administrative expenses for veterans’ benefits programs.

• Authorizes VA to regulate the qualifications and standards of conduct applicable to agents and attorneys.

• Adds four additional categories to the list of grounds for suspension or exclusion of agents or attorneys from further practice before VA.

• Authorizes VA to review fee agreements between agents or attorneys and claimants and order a reduction in the fee if the Secretary finds that the fee is excessive or unreasonable, although a fee that does not exceed 20 percent of the past due amount of benefits awarded on the claim will be presumed to be reasonable.

• Eliminates fee matters as grounds for criminal penalties under 38 U.S.C. § 5905.

• Subjects Veterans Service Organization representatives to suspension on the same grounds as apply to agents and attorneys.



Regulations

VA is amending its regulations governing the representation of claimants for veterans’ benefits in order to implement provisions of Public Law 109-461. VA published its proposed regulations in the Federal Register for notice and comment on May 7, 2007. After the proposed regulations are finalized, we will issue further guidance on the new regulations. Enclosure Two provides interim guidance for adjudicating attorney fee decisions after the entry point for paid representation changes on June 20, 2007, and the date the final regulations are effective.



Questions

Questions concerning this fast letter and other issues related to agent and attorney representation should be submitted to the VAVBAWAS/CO/21Q&A mailbox.


/S/
Bradley G. Mayes, Director
Compensation & Pension Service





Enclosure One – Guidelines for Answering Inquiries on Agent and Attorney Representation

When did the law change?

On December 22, 2006, the President signed Public Law 109-461. The provisions shifting the entry point for paid representation are effective on June 20, 2007.


What forms do I need to complete to authorize an agent or attorney to represent me?

Under current law, a claimant must provide VA with a signed VA Form 21-22a to appoint an agent or individual VSO representative for purposes of representation. Attorneys may continue to provide representation based on a letterhead declaration of representation or may use a VA Form 21-22a. No signature is required for claimants to appoint attorneys; however, VA still requires a VA Form 21-22a, signed by the claimant, to authorize the disclosure of claimant information to an agent or attorney.


May I limit the scope of the agent’s or attorney’s representation?

You may limit the scope of your agent’s or attorney’s representation regarding a particular claim by describing the limitation on VA Form 21-22a. As an example, you may limit your agent’s or attorney’s representation to only your claim for Post Traumatic Stress Disorder.


When is an agent or attorney allowed to represent me on a fee basis?

Prior to this new law, an accredited agent or attorney was only permitted to charge fees for services after the Board of Veterans’ Appeals issued a first final decision in the case. Under the new law, an accredited agent or attorney may charge fees for services after a notice of disagreement (NOD) has been filed with respect to the case. Such notice of disagreement must have been filed on or after June 20, 2007.


How does VA accredit agents and attorneys?

VA’s Office of the General Counsel is responsible for managing VA’s accreditation program. Prospective agents must submit a written application to the Office of General Counsel on which they provide background information relevant to a determination of good character and reputation. Following a satisfactory determination of character and fitness, agents must successfully complete a written examination administered by the Regional Counsel of jurisdiction. To be accredited under current law, attorneys must be a member in good standing of a State bar and indicate in writing that they are authorized to provide representation. Proposed regulations would add additional requirements for attorney accreditation to represent claimants before VA, but these have not been published as final rules, and, as a result, are not effective at this time.


How do I pay my agent or attorney his or her fees?

Fee agreements must be in writing and signed by both the claimant and agent or attorney. Generally, there are two types of fee agreements. If you sign a fee agreement that indicates you wish VA to pay attorney fees directly out of past-due benefits, VA will pay the agent’s or attorney’s fees out of any past-due benefits awarded to you. If you sign a fee agreement that indicates otherwise or is unclear whether VA is to pay past-due benefits directly to an attorney, you are responsible for paying the attorney’s fees.


What is the maximum fee that an agent or attorney is allowed to charge me?

The agent’s or attorney’s fees must be reasonable. Fees may be based on a fixed fee, an hourly rate, a percentage of benefits recovered, or a combination of such bases. Fees that do not exceed 20 percent of any past-due benefits are presumed to be reasonable. However, agents and attorneys may charge more than 20 percent for their services.


If I think that the fee is unreasonable or excessive, can I request VA to take action?

If you believe that your agent’s or attorney’s fee is unreasonable or excessive, you may contact the Office of General Counsel (OGC) at the following address: Office of General Counsel (022D), 810 Vermont Avenue, NW, Washington, DC 20420. OGC will review the fee agreement and determine whether the fee is unreasonable or excessive.


May I terminate my agent’s or attorney’s representation?

You may terminate your agent’s or attorney’s representation at any time. However, your agent or attorney may still be entitled to a fee.


Do I need to hire an agent or attorney to represent me before VA?

You do not need to hire an agent or attorney to represent you before VA. Specifically, VA has a duty to notify you of the information and evidence necessary to substantiate a claim and to assist you in obtaining such evidence. Veteran Service Organization (VSO) representatives are also available to guide you through the claims process, without charge. VSO representatives are well-versed in veterans benefits law and are well-equipped to successfully assist you through the claims process.



Is my attorney or agent allowed to call the regional office and speak with a VA employee?

Each regional office has an Attorney Fee Coordinator who is designated to serve as a liaison for attorney and agent matters. Please refer the attorney or agent to the regional office’s Attorney Fee Coordinator.





Enclosure Two – Interim Guidance for Adjudicating Agent and Attorney Fee Decisions

Beginning June 20, 2007, agents and attorneys may charge fees for representation provided after a notice of disagreement has been filed with respect to a case. This provision applies only to those notices of disagreement filed on or after June 20, 2007. VA is amending its regulations governing the representation of claimants for veterans’ benefits in order to implement provisions of Public Law 109-461. On May 7, 2007, VA published its proposed regulations in the Federal Register for notice and comment. However, until VA publishes the final Representation Regulations, continue to follow the current regulations and manual chapters with the following exceptions outlined below.

Overview of Exceptions

1. When an attorney or agent may charge fees for services.

The new legislation eliminates the current prohibition on charging fees for services of an attorney or agent provided before the Board of Veterans’ Appeals (Board) makes its first final decision in the case. As amended, section 5904 will allow an attorney or agent to charge fees for services provided after the date on which the claimant files a notice of disagreement with the VA regional office in the case. This amendment applies to those cases in which a notice of disagreement is filed on or after June 20, 2007.

2. When the attorney or agent must be hired.

The new § 5904 eliminates the requirement that the attorney or agent is retained within one year from the date of Board’s first final decision in the case. Under the new legislation, there is no requirement that the attorney or agent be hired within a specified time frame.

3. To whom may VA directly pay fees.

Under the previous § 5904, VA was only authorized to directly pay an attorney his or her fees from past-due benefits. VA was not authorized to pay fees directly to an agent. Under the new § 5904, VA is authorized to pay both attorney’s and agent’s fees from past-due benefits owed to a claimant. Until new regulations implementing this change are published, VA regional offices should administer direct-pay fee agreements involving agents in the same manner as attorney direct-pay fee agreements are administered.




Process for Determining Agent or Attorney Eligibility for Direct-Fee Agreements

Follow the four criteria below to determine whether VA is authorized to directly pay fees to an attorney or agent from the claimant’s past-due benefits.

1. Has the claimant filed a notice of disagreement with respect to the case?

• If yes, go to Step 2.
• If no, the attorney or agent is not eligible for fees to be paid by VA.


2. Will the past-due benefits result in a cash payment?

• If yes, go to Step 3.
• If no, the attorney or agent is not eligible for fees to be paid by VA.

3. Is the fee agreement wholly contingent on whether or not the matter is resolved in a manner favorable to the claimant?

• If yes, go to Step 4.
• If no, the attorney or agent is not eligible for fees to be paid by VA.

4. Is the fee agreement limited to 20 percent, excluding expenses, of the total amount of any past-due benefit awarded on the basis of the claim?

• If yes, the attorney or agent is eligible for fees to be paid by VA. Follow the normal procedures in the manual. See M21-1MR, Part 1, 3.C
• If no, the attorney or agent is not eligible for fees to be paid by VA. Follow the normal procedures in the manual. See M21-1MR, Part 1, 3.C

http://www.vawatchdog.org/07/nf07/nfJUN ... 2007-1.htm

[J.B. Stone]

Afghanistan's stress toll leaves military seeking better treatment options


ALISON AULD



(CP) - About once a week, David would quietly leave his office, drive a half-hour away and change out of his uniform before sitting down with a doctor for a regular appointment.

For months, the young soldier ventured far from his military base in Edmonton to seek help for a problem that had robbed him of his sense of humour and left him haunted by memories of comrades' bodies being loaded into helicopters in the deserts of Afghanistan.

It was a hassle, but it was the only way he felt he could get the treatment he needed without facing repercussions from a military he and others say is failing soldiers traumatized by the rigours of war.

"They've made it impossible," David, who insisted on using a pseudonym, said in an interview from his Edmonton home.

"I had to drop my treatment because I couldn't get the time off from work and I was embarrassed to tell the people I work with. Once you start going to see someone to help you out, they treat you like you can't do your job no more.

"You come home and you almost feel like the army's turning its back on you."

The blunt criticism comes as the Canadian Forces begins to deploy a fresh batch of troops to the country's restive southern flank, and welcome home still more who have endured everything from the tedium of life on a military compound to the stress of heavy combat.

It's likely some of them will suffer from what the medical community benignly refers to as "operational stress injuries" - a range of afflictions that includes alcoholism, depression and post-traumatic stress disorder, or PTSD.

Numbers obtained by The Canadian Press show that of 1,300 Forces members who served in Afghanistan since 2005 and underwent a post-deployment screening, 28 per cent had symptoms suggestive of one or more mental health problems.

Of those, 16 per cent showed signs of high-risk drinking and just over six per cent were possibly suffering from PTSD. Five per cent showed symptoms of major depression.

The numbers aren't alarming, says Dr. Mark Zamorski of the deployment health section of the Canadian Forces, but they do show how negative combat experiences are contributing to mental health problems.

For example, only eight per cent of troops who completed post-deployment questionnaires after rotations in Kabul - a less hostile mission than the current operation in Kandahar - showed signs of mental health issues.

"The magnitude of the health impact is about what we'd expect given the nature of the deployment," Zamorski said in an interview from Ottawa where he conducts research on ways to mitigate adverse health consequences on members of the Forces

"Mental health problems are a major source of casualties these days."

PTSD is a complicated disorder characterized by what Zamorski described as "the intrusive re-experiencing of a traumatic event." That can happen through nightmares, flashbacks and vivid memories, all of which can cause problems sleeping, expressing emotion, anger and avoidance of situations that remind someone suffering from PTSD of the traumatic event.

For David, the signs began surfacing about six months after he was back from what was his first deployment. His wife and family kept telling him he was different, that he didn't laugh like he once had and that he was hanging out only with the guys from his tour.

"You don't see the problems right away," he said. "My wife kept mentioning it. So I went civvy street (to get help) because I didn't want to go on base. We have tons of psychiatrists on base, but you won't see anybody going to them because you can't - it's during the workday and everyone sees you, so who wants that?"

But while David is reluctant to openly deal with a mental health disorder, former corporal Brian Stevens says his plea for help went unheeded by military superiors.

Stevens, a 10-year veteran of the Canadian Forces, served in Afghanistan from August 2005 to March 2006. It was a rude awakening for the soldier from a small town in Nova Scotia, who on his first overseas deployment spent much of his time away from the main Kandahar base and taking fire while driving the area's treacherous roads. Witnessing the extreme poverty and dismal humanitarian situation didn't make it easier.

When he returned home, he displayed the telltale signs of a stress injury. He was irritable, couldn't sleep, flew into rages and became indifferent to most things, especially the authority of the military. Soon he was drinking heavily and racing down rural highways with a beer between his legs.

That summer, he hit rock bottom, indulging in a panoply of drugs that included intravenous cocaine, Dilaudid, OxyContin and morphine - drugs he insists he had never tried before.

"I never thought I'd stick a needle in my arm, but when I came home I did," he said from Edmonton, where he was recently living after being released from the military.

"I went right off the rails. They didn't know how to deal with me, you know: 'How do we deal with a junkie?' There was nothing in the rule book, so they didn't do nothing."

His mother Bonnie said she noticed marked changes in her son, who was once outgoing and talkative. He spent most of his time sleeping, became moody and withdrew into himself.

"He wouldn't get up out of bed in the morning to go to work and they'd send the military police and that wasn't like him at all," she said from her home in Salmon River, N.S.

"The military didn't seem to understand. He would go AWOL and he wouldn't know why and all they'd do was throw him in jail instead of giving him the help he obviously needed."

An already bad situation grew worse when he and four other soldiers at CFB Gagetown, N.B., were charged with trafficking in cocaine, ecstasy and marijuana. Stevens denies selling drugs, but is facing a court martial on Sept. 11 and could be sent to prison if convicted on the four counts against him - a place not unfamiliar to him.

Stevens, 32, landed in a military prison in Edmonton for 30 days last Christmas for repeatedly going absent without leave. He had already spent time in a prison facility at his base at Gagetown for a similar offence. It was in Edmonton where he says a physician diagnosed him with PTSD.

He claims he begged his bosses to lock him up in Edmonton, hoping it might help him kick a habit that he says had eaten up about $100,000 and killed his career.

"I said, 'Do something, send me to jail - I'm going to be dead in a month if you don't do something,"' he said. "Prison was my only way to get help. I said if that's the only thing you've got, I'll take it.

"It's pretty sad that a soldier has to ask to go to jail."

Zamorski, who couldn't comment on Stevens's case, insisted people seeking help will usually get it, but that soldiers also have to be held accountable for their behaviour.

"No system is perfect," he said. "Some people are very difficult to help for a lot of reasons."

The military says it has gone to great lengths to make sure soldiers are as prepared as they can be before they deploy to deal with stress injuries as they develop. Officials have also added several screening steps when soldiers return to help identify signs of stress disorders.

Troops are briefed in theatre before they return to Canada on what it will be like adjusting to life at home and back in the garrison.

All soldiers who have been away for more than 60 days have to complete a detailed questionnaire that can indicate if they might have an operational stress injury. And they are supposed to undergo an interview with a health professional. If they are found to be in need of help, Zamorski says they can take advantage of several resources on and off base.

There is a new anonymous toll-free number staffed by health practitioners, specialized operational stress injury clinics, and trauma and stress support centres on bases across the country. And Ottawa has pledged to boost the number of mental health workers to more than 400 by 2009.

Some soldiers are also now trained in identifying potential stress problems so they can offer peer support while overseas.

"I'm proud that we really are doing the very best we can to take care of people who serve the country," he said. "Not that we don't have some work to do in terms of combating stigma in particular, but we have mechanisms to try to identify people early and we've got multiple mechanisms for care."

But only a fraction of redeployed troops have completed the questionnaire or undergone the interview, raising the likelihood that some are falling through the cracks.

Out of about 4,800 people who had returned from Afghanistan and were required to have the screening, 2,900 were still due for it and only 1,257 had completed the questionnaire.

The reason for the low numbers?

"The units are too busy doing other things, like getting ready for the next operation," said Zamorski.

David recognized that while officials are trying to help, they're not making time for soldiers to seek treatment or even be evaluated.

"We're just so busy training that it's almost impossible to hold on to the guys and make sure they're OK," he said. "There's not enough connection after you get back because we're just too busy."

Despite the growing pains in the Forces' expanded mental-health program, some soldiers praise the military for finally improving a system that has been widely criticized for its neglect of soldiers' welfare.

When Cpl. Will Salikin returned to Canada from Afghanistan after his deployment last July he was in a drug-induced coma with massive head injuries, a host of other health problems and only sketchy memories of the moments before a bomb hurled him through the air.

He had been travelling west in a convoy from the Kandahar Airfield on Jan. 15, 2007, when a suicide bomber rammed his light-armoured jeep, detonating rockets and "throwing it up in the air and across the street." The blast killed Canadian diplomat Glyn Berry and seriously injured his section mates, leaving one of them a double amputee.

Salikin, now back at his base in Edmonton, awoke at the University of Alberta Hospital with a shattered radius and ulna, burns, compromised movement in his right side, no recollections of the incident, slight neurological issues and a bacteria common to Afghanistan.

The 24 year old spent more than a month in hospital recovering from his physical wounds, but soon began to wonder if he was in need of help for more elusive issues that had begun to reshape his personality.

At home, little things like the way his fiancee placed the coffee table next to the sofa would enrage him. He no longer wanted to hang out with his many friends. He began harbouring grudges over trivial annoyances. And every morning he would awake exhausted at 4:30 a.m.

"Before my accident, I was a pretty laid-back person. Now I will fly off the handle for absolutely no reason whatsoever," he said in an interview.

"I would say that I'm significantly different now. I used to be a person who could make friends with everyone easily. Now, I'd rather hang around by myself. I'm not interested in friends."

Salikin, who was with the 3rd Battalion Princess Patricia's Canadian Light Infantry, finally sought help last September when he went to a psychiatrist on the base. The military hadn't indicated the service was available, leaving him on his own to find treatment.

"That's where the army dropped the ball. Nothing really was offered to me. I had to seek it out myself, but then they were fully helpful," he said. "Hopefully no one else has the same experience of having to walk through everything by themselves."

He ended up seeing a psychiatrist about twice a week to work on issues his doctor says could be linked to PTSD or another stress injury. Salikin, who has shifted to headquarters for a desk job, said the quality of military care rivals civilian services.

The challenge for the Forces, as it is for the civilian world, is to eliminate the stigma surrounding mental-health illnesses in the military's tough-guy culture and the long held belief that psychological ailments equal weakness.

A directive contained in a recent Defence Department briefing note states that due to the effect of operational stress injuries, "all unit commanding officers will assume a pro-active role in promoting a culture of support, understanding and caring towards injured personnel."

Zamorski said the higher profile of mental health issues and treatment options are helping reduce the stigma, but some soldiers don't believe it will ever be done away with entirely.

"We've come a long way, but we're still a bunch of guys in the army," said David, who's reconsidering his future in the Forces. "It's half our fault too. I was just too proud to go. We do have avenues, we just got to start taking them."

But for those like Stevens, now drug-free and who was recently working as an attendant at an ice arena, pride had little to do with his inability to get the help he needed.

"There should be safeguards in place to prevent the escalation of it, like what happened to me. I should have been stopped long before I was," he said.

"I was a great soldier the first nine years. I was a proud soldier. I was in the infantry and did what I had to do and in the end I lost out. And I'm still losing out."

-

Some facts on post traumatic stress disorder:


Symptoms: Irritability, anger, guilt, grief or sadness, emotional numbing, helplessness, loss of pleasure derived from familiar activities, difficulty feeling happy, difficulty experiencing loving feelings, fatigue, insomnia, vulnerability to illness.

Definition: PTSD is described as a complicated disorder characterized by the intrusive re-experiencing of a traumatic event, such as rape, warfare or the threat of physical harm. That can be in the form of nightmares, flashbacks and vivid memories, all of which can lead to problems sleeping, expressing emotion and avoidance of situations that remind sufferers of the traumatic event.

Number of cases: Of 1,300 Canadian soldiers who have returned from Afghanistan since 2005 and underwent screening, 28 per cent had symptoms suggestive of one or more mental health problems. Just over six per cent of those were possibly suffering from PTSD. Five per cent showed symptoms of major depression.

[J.B. Stone]

NEW BILL PASSED IN THE HOUSE, AWAITING SENATE APPROVAL....

House Report 110-268 - VETERANS' HEALTH CARE IMPROVEMENT ACT OF 2007



PURPOSE AND SUMMARY

H.R. 2874, the `Veterans Health Care Improvement Act of 2007,' was introduced on June 27, 2007, by Representative Michael H. Michaud of Maine, the Chairman of the Subcommittee on Health. The legislation would make certain improvements in the ability of the Department of Veterans Affairs (VA) to provide treatment and care to veterans suffering from mental health issues as well as veterans who are homeless. This bill would further assist low-income veteran families living in permanent housing.

H.R. 2874 would:

1. Authorize VA to establish a grant program for nonprofit entities to conduct workshops to assist in the therapeutic readjustment and rehabilitation of Operation Enduring Freedom or Operation Iraqi Freedom (OEF/OIF) veterans. VA would determine that a nonprofit entity has the experience and expertise to conduct such programs and require the grants be used exclusively for the benefit of veterans. VA would submit a report to the House and Senate Veterans' Affairs Committees detailing the number of grants made each fiscal year, and the total number of veterans participating in workshop programs funded by the grants. The amount of the grants would be limited to $100,000 for each calendar year and there would be $2 million authorized each fiscal year to carry out the program. Authority for the grant program would terminate on September 20, 2011.

6. Require VA to provide for readjustment counseling and mental health services for OEF/OIF veterans through programs which would provide peer outreach services, peer support services, and readjustment and mental health services. Such services would include contracting with community mental health centers in areas not adequately served by VA and contracting with nonprofit mental health organizations to train OEF/OIF veterans in outreach and peer support. Directs VA to conduct training programs for clinicians that have contracts with VA to provide such services.

http://thomas.loc.gov/cgi-bin/cpquery/? ... TOC_31277&

[J.B. Stone]

Subcommittee on Health Passes Veterans’ Health Care Improvement Act (7/11/07)

Bill addresses veteran homelessness, mental health care, and readjustment assistance

WASHINGTON, DC – Today, Congressman Mike Michaud, Chairman of the House Veterans’ Affairs Subcommittee on Health, led a subcommittee markup on his bill, H.R. 2874, the Veterans’ Health Care Improvement Act of 2007. The purpose of this bill is to improve VA’s capacity in several areas, including mental health and homelessness. The bill passed the subcommittee unanimously.

“Many of our veterans are exposed to unique stresses during their military service,” said Michaud. “Therapeutic readjustment programs have helped our veterans deal with a number of health related issues, including post traumatic stress disorder. This bill will allow the VA to make grants to conduct workshop programs that have been shown to assist in therapeutic readjustment and rehabilitation.”

H.R. 2874 also expands readjustment and mental health services for Operation Enduring Freedom and Operation Iraqi Freedom veterans. Expanding access to these programs for veterans is important because an increasing number of recent veterans are suffering from traumatic brain injury (TBI) and post traumatic stress disorder (PTSD). In fact, according to the Government Accountability Office, an estimated one-third of veterans returning from Iraq and Afghanistan are facing mental health challenges, and up to 300,000 troops are expected to return from Iraq suffering from TBI.

H.R. 2874 contains several other provisions that seek to improve veteran’s health care and assistance for homeless veterans.

“Each night, as many as 200,000 veterans, both male and female, are homeless. Many more veterans are at high risk of homelessness because of poverty, dismal living conditions, and lack of support,” said Michaud. “This bill takes steps to improve homeless assistance programs provided by the VA, and we will be doing more in this area in the coming months.”

The bill expands and extends the successful VA program of referral and counseling for at-risk veterans transitioning from certain institutions. The program is extended until 2011 and expanded from 6 locations to 12. These services are largely directed toward incarcerated veterans. Section 8 of the bill requires the VA to ensure that domiciliary programs are adequate in capacity and safety to meet the needs of women veterans. And critically, section 9 of H.R. 2874 authorizes funding for the Secretary to provide financial assistance to eligible entities to provide supportive services for very low-income veteran families residing in permanent housing.

The bill also creates a new grant program to encourage innovative transportation options to improve access to VA health care in rural areas and provides permanent authority for VA treatment of participants in DOD chemical and biological testing.

[J.B. Stone]

Lawsuit says VA mishandled claims


Execuitive Director of Veterans for Common Sense Paul Sullivan is part of a class-action lawsuit filed Monday against the U.S. Department of Veterans Affairs that is struggling to meet growing demands from veterans returning home from the wars abroad.





By Laura Parker, USA TODAY

WASHINGTON — A coalition of disabled Iraq war veterans sued the Department of Veterans Affairs on Monday, accusing the VA of illegally denying or delaying claims for disability pay and mental health treatment.
The lawsuit names Secretary of Veterans Affairs Jim Nicholson and Attorney General Alberto Gonzales, among others, and asks for sweeping changes in the way the federal government handles claims of more than 1.6 million veterans who have served in Iraq and Afghanistan since 9/11.


"We're asking the court to set time standards. When veterans apply for medical care, it takes months and years," said Gordon Erspamer, one of the attorneys who filed the suit. He said changes are needed now "because of the huge influx of claims that will be coming through the pipeline in the next year or two."

Filed on behalf of an estimated 750,000 veterans suffering from post-traumatic stress disorder, the lawsuit is the latest in a list of complaints about the quality of medical care provided to veterans returning from war. This month, a federal appeals court in San Francisco ordered the VA to pay retroactive benefits to Vietnam veterans exposed to Agent Orange who have contracted leukemia.

VA spokesman Matt Smith declined to comment on the pending lawsuit. He told the Associated Press that the VA "ensures … servicemembers have access to the widely recognized quality health care they have earned."

Some of the alleged shortcomings named in the suit include:

• A backlog of up to 600,000 disability payments, with delays of up to 177 days for initial claims.

• A shortage of treatment programs for post-traumatic stress disorder.

• A classification of post-traumatic stress disorder claims as "pre-existing personality disorders" in order to deny veterans disability or medical treatment.

Steve Edwards, an Army sergeant who returned from Iraq in 2005, said he almost lost his house while he waited 14 months without income for disability compensation for post-traumatic stress disorder. "The system is broken," he said Monday.

[J.B. Stone]

Frustrated veterans lash out at VA care

Web Posted: 08/05/2007 11:07 PM CDT

Tracy Idell Hamilton Express-News

Angry veterans shouted down U.S. Rep. Ciro Rodriguez as he tried to bring order to a forum for veterans held downtown Sunday. "We know, we understand, how crucial this issue is," the San Antonio congressman tried to tell an overflow crowd of veterans who had been invited to ask questions and share experiences with U.S. Rep. Bob Filner D-Calif., chairman of the House Committee on Veterans' Affairs, along with Rodriguez and two other Democratic congressmen from Texas.

But Rodriguez was drowned out and ultimately gave the floor to Jack E. Long, one of several vets who heckled the moderator as she tried to read e-mail questions that had been sent to the congressmen in advance.

"Don't try to talk over me!" Long yelled to Rodriguez as he clutched his wife's hand. "I've had PTSD for years, and I've been turned away from the VA five times! I served my country for 44 years!"

Veterans and their families around him cheered and clapped. Then they set about telling the congressmen that a nation that claims to support its troops hasn't done well by them since they served; many of them said they've had to deal with PTSD, or post-traumatic stress disorder.

Hancock Darrell refused to sit until he, too, could tell his story.

"I've had PTSD for 24 years," Darrell shouted. "I've been diagnosed five times. But what does the VA say? 'We need more information.' And they turn me down again."

Again the crowd erupted.

Filner then told the audience — packed into the Buena Vista Building Theatre at the University of Texas at San Antonio's Downtown Campus — that the House had committed "tens of billions" into the 2008 budget for PTSD. He said he was working to change the adversarial relationship the Department of Veterans Affairs has with so many veterans, especially those of the Vietnam era.

"I want to run a claim system like the IRS," he said.

(Gloria Ferniz/Express-News)

Don Frazier, an Army veteran who served in Vietnam, is one of many military retirees who participated in a forum organized by members of the House Veterans' Affairs Committee at UTSA's Downtown Campus.

Such a system would accept a veteran's claim on its face rather than force the veteran "to prove Agent Orange caused this."

"You shouldn't have to prove anything," Filner said. "You served us; now we should be serving you."

U.S. Rep. Charlie Gonzalez of San Antonio, who joined Filner, Rep. Henry Cuellar, D-Laredo, and Rodriguez on the stage, took the microphone to plead for unity.

"We're not fighting smart," he said. "We're fighting ourselves here today. We have to show people that veterans are not part of our past."

The key to a healthy volunteer military, he said, is showing young people who might be interested in serving that they will be taken care of after they leave the military.

Rodriguez, who sits on the Veterans' Affairs Committee, noted that 80 percent of veterans get no care from the VA, many because they've become disillusioned with an agency that has a backlog of claims close to 800,000 — claims that can take years to resolve.

In his opening remarks, Filner said he had come to listen and learn, and he asked the capacity crowd how many had served in Vietnam. The majority in the room raised their hands.

"Thank you for your service," he said, "And I am sorry. We did not do the job for you."

More than 200,000 homeless Vietnam veterans will sleep on the streets tonight, he told the crowd, and as many Vietnam veterans have now committed suicide as died in the war.

"And that is a moral disgrace," he said to approving murmurs. "We must correct it as best we can and make sure it never happens again."

The ratio of injured to killed in today's wars is a staggering 17-to-1, he said. In Vietnam, it was 3-to-1.

"We spend $1 billion every two and a half days" in Iraq and Afghanistan, he said. "Supporting our troops at home needs to be part of that cost."

Congress has added $13 billion to the 2008 budget for veterans affairs, Filner said, calling it "the largest increase ever."

"The resources will be there. It's our job to make sure they serve you."

Long before the audience was ready, the hourlong session came to a close and the congressmen headed to Del Rio for another veterans forum Sunday evening.

[J.B. Stone]

For war vets, new help from states
By John Gramlich, Stateline.org Staff Writer



After more than a year of patrolling the deadly roads of Iraq’s volatile Anbar province, Staff Sgt. Jeff Anderson of the Minnesota National Guard returned home in late April – only to face a new set of challenges.
The 31-year-old owner and manager of a lakefront lodge in Walker, Minn., came back to a business that was in financial trouble after his 19-month absence. His father was recovering from a stroke, leaving no one to care for his 7-year-old son, Quinn.

To make matters worse, Anderson still had to come to terms with the war itself. Just weeks before he left Iraq on a financial-hardship discharge, one of his friends and fellow soldiers – 28-year-old Sgt. Greg N. Riewer – was killed by an improvised explosive device (IED) near Fallujah.


Now, like thousands of other U.S. soldiers who recently have returned from Iraq and Afghanistan, Anderson is trying to find his feet in the civilian world after spending months in a war zone. The Minnesota National Guard is determined to help him. Starting on Saturday (Aug. 11), Anderson will participate in a first-in-the-nation program created by the state Guard to give its returning soldiers more assistance as they adjust to life at home.


The program, called Beyond The Yellow Ribbon, requires all returning Guard members from the state to attend regular counseling sessions to address everything from paying bills to reconnecting with family members, with special emphasis placed on “negative behaviors associated with combat stress.” The initiative has been hailed by Gov. Tim Pawlenty (R) and could become a national model under a bill being considered in Congress.

“It’s quite a transition from seeing all that over there and then coming back over here and getting back to normal life,” Anderson said, acknowledging the need for the program. He could be joined in his counseling this weekend by soldiers he served with in Iraq, most of whom recently returned after 22 months – the longest tour of any U.S. military unit since the war began.


Minnesota’s program places it among a growing number of states that are exploring new ways to reach out to returning soldiers, especially members of state-run National Guard units. While state governments have unveiled scores of measures in recent years to repay veterans for their service – offering them financial benefits such as education credits and tax relief – states now are focusing more attention on how to help soldiers re-enter society, experts say. In many cases, that includes caring for veterans’ psychological health.

Illinois last month announced another first-in-the-nation plan that will require its returning National Guard members to be screened for traumatic brain injuries, which frequently occur when soldiers are close to heavy explosions such as IED blasts, often go undetected and can have mental-health repercussions. The state also will set up a 24-hour hotline for those suffering from post-traumatic stress disorder (PTSD), which can cause nightmares, flashbacks, anger and other symptoms.

Florida, Massachusetts and Wyoming also recently have acted to assist returning veterans, particularly those with PTSD and other mental-health conditions. A June report by a Pentagon task force found that thousands of U.S. military personnel – including nearly half of all Army National Guard members who have seen action in Iraq or Afghanistan – have reported psychological problems after tours of duty.


Minnesota’s Beyond The Yellow Ribbon program is groundbreaking because it requires most returning soldiers to attend counseling as soon as 30 days after arriving at home. The idea is to provide an immediate support structure to soldiers “with no training on how to be civilians again,” according to Lt. Col. John Morris, a chaplain in the state National Guard who developed the program at the request of Pawlenty.

“If I put someone in prison for 22 months, I’d give him a parole officer and a halfway house [when he leaves],” Morris said, noting how long some of Minnesota’s soldiers were deployed.

But some Minnesota National Guard soldiers remain skeptical. Staff Sgt. Brad Gerten, who returned from Iraq last month and works as a correctional officer, is wary of mandatory counseling sessions because they will force him to miss more work. He said he already feels as though he is "taking advantage" of his employer; after his 22-month deployment, Gerten has spent more time away from his job than at it.


“When you’re gone that long, you just want to get home and get on with your life,” Gerten told Stateline.org.

In Illinois, the state “want[s] to be there when our guys need help,” said state Department of Veterans Affairs Director Tammy Duckworth, herself a National Guard member who lost both legs and injured her arm when her helicopter was shot down in Iraq in 2004.

Duckworth, who attracted national attention as an outspoken critic of the Iraq war during an unsuccessful campaign for the U.S. House last November, has lent a recognizable face to Illinois’ outreach efforts. She was the driving force behind the state’s push for mandatory brain screenings and PTSD support services, which will cost an estimated $10.5 million a year.

The screenings – which will be available free to all Illinois veterans, not just the state’s National Guard – will include a written questionnaire and medical evaluation. Duckworth likened the screenings to checkups that a high-school football player would receive after a season of rough games.

The PTSD hotline is essential for those who live too far away from federal veterans’ facilities to receive immediate attention, Duckworth said. Psychiatric professionals will staff the hotline around the clock, she said.

[J.B. Stone]

Helping vets beat new foe
Posted: Friday, Aug 10, 2007 - 12:52:44 am MDT
By CANDACE CHASE The Daily Inter Lake

Veteran starts support group for troops with PTSD
Lawrence “John” Sheehan realized he had to do something to help others when he was a patient at a VA facility in Sheridan, Wyo.

Just as he finished his program, he noticed two Iraq War veterans, 19 and 20 years old, who were arriving for treatment.

“I saw myself in their eyes,” he said.

*
Sheehan, a veteran of the Vietnam War, spent years fighting a disability with no medical classification until the 1980s. But veterans have always known that hard combat wounded some warriors for life.

Over the years, soldiers have described victims as shell-shocked or suffering from combat fatigue. After extensive research after the Vietnam War, the mental syndrome had a name: post-traumatic stress disorder, or PTSD.

Sheehan knows the symptoms all too well.

Nightmares, bursts of anger, emotional distancing, addiction, startle responses and hyper-vigilance defined his daily existence for almost 40 years.

“All these things lead to shame and guilt and self-hatred,” he said.

His extended stay at the Sheridan VA treatment facility turned his life around.

Therapy gave him tools to cope with the ups and downs of his mental disorder. New research into physiological causes of PTSD brought Sheehan understanding and self-forgiveness.

“They told me in Sheridan that it [traumatic experience] causes chemical changes in your brain,” he said. “It inhibits you from making the right decisions.”

After decades of not discussing his experiences or feelings, Sheehan said he has learned to talk in a controlled way as an emotional safety valve. He organized a new PTSD support group which meets Saturday, Aug. 11, to offer this relief to others.

“A combat vet relates more to another combat vet than a professional,” Sheehan said. “These kids who are coming home — they’re going to need someone to turn to in their darkness.”

Although he went to war in Vietnam decades ago, the fallout from too many battles and personal loss hasn’t changed in the era of in Iraq and Afghanistan. Sheehan wants to stem a rising tide of soldier suicides.

“PTSD is rampant because of the multiple tours and length of tours,” he said.

Sheehan followed the same path to post-traumatic stress disorder.

His journey began in 1964 when he joined the Marine Corps at 18, inspired by John Wayne and the movie “The Sands of Iwo Jima.” Reality was a million miles from Hollywood.

Sheehan became part of the 1st Battalion of the 9th Marines. His unit endured the longest sustained combat and suffered the highest killed-in-action rate in Marine Corps history.

Unit legend contends that their battalion killed Ho Chi Minh’s son. The story goes that the president of North Vietnam vowed revenge, deeming the 1st Battalion of the 9th Marines “The Walking Dead.”

This threat became the battalion’s slogan as well as its fate.

“It was pretty insane,” he said. “Only 47 of 800 came home.”

“Walking Dead” also aptly described the few, such as Sheehan, who didn’t fly home in a flag-draped coffin.

After two years of brutal combat, Sheehan was declared “mentally unstable” by the Marine Corps. He was in his second tour of duty in Vietnam.

“I was sent to a psych ward in a Navy hospital in Japan,” he recalled.

After a stay in the hospital, he received a medical discharge instead of a cure.

Sheehan came home incapable of fitting back into the normal flow of work or personal life. His first marriage collapsed as he kept “stuffing and stuffing” his memories and emotions. He also treated painful thoughts with alcohol, a pattern he established in the Marine Corps.

“I learned to drink after missions so I could relax,” Sheehan said.

Years passed but nothing changed in the downward spiral of his life. He couldn’t hold a job or nurture a relationship.

In 2005, Sheehan finally sought help at the VA Medical Center in Sheridan, which specializes in post-traumatic stress disorder.

“When I got there, it was do or die,” he said. “I thought ‘You’re getting ready to move into your 60s.’”

After working with one PTSD group at the VA hospital, Sheehan asked his therapists and caseworkers to let him stay to participate in more sessions. He said he was learning about himself and gathering tools he needed to succeed.

“It’s been an uphill battle,” he said. “But I do okay — I’m staying clean.”

He remembers the irony of one of the staff members telling him as he left that he had looked like “the walking dead” when he first arrived at Wyoming medical center.

Sheehan now has a passion to share what he learned to keep his disorder in check. When he has a bad day, he said he gathers his tools and starts working on his feelings.

“Sometimes I just get quiet within myself and let it pass,” he said.

Sheehan has received backing and a group room at Pathways Treatment Center to hold the PTSD support meetings. He also has his therapists, Bob Jordan of the VA Medical Clinic and Dave Segerstrom of Montana Behavior Health, as resources.

He teamed up with Allen Erickson of Northwest Montana Veterans Food Pantry to facilitate the meetings. They plan to use a 12-step program modeled on AA but customized by Vietnam veterans to alleviate the suffering of those with PTSD.

He doesn’t expect a huge crowd when he holds the first meeting at 5 p.m. Saturday.

“It’s hard for someone with PTSD to reach out,” he said. “Your first reaction is to hide it. Then isolation sets in.”

Sheehan said some Vietnam veterans still live a hermit’s life out in the woods here. He believes vet-to-vet holds the best hope of reaching them as well as those just back from war in the Middle East.

“Combat vets are all brothers,” he said. “I’m doing this from my heart. I want people to know there is hope.”

For additional information about the group, call Sheehan at 212-5157.

Reporter Candace Chase may be reached at 758-4436 or by e-mail at cchase@dailyinterlake.com

http://dailyinterlake.com/articles/2007 ... news02.txt

[J.B. Stone]

War Stress Pushing Army Suicides Higher
By PAULINE JELINEK 08.16.07, 6:49 PM ET





WASHINGTON - Repeated and ever-longer war-zone tours are putting increasing pressure on military families, the Army said Thursday, helping push soldier suicides to a record rate.

There were 99 Army suicides last year - nearly half of them soldiers who hadn't reached their 25th birthdays, about a third of them serving in Iraq or Afghanistan.

Col. Elspeth Ritchie, psychiatry consultant to the Army surgeon general, told a Pentagon press conference that the primary reason for suicide is "failed intimate relationships, failed marriages."

She said that although the military is worried about the stress caused by repeat deployments and tours of duty that have been stretched to 15 months, it has not found a direct relationship between suicides and combat or deployments.

"However, we do know that frequent deployments put a real strain on relationships, especially on marriages. So we believe that part of the increase is related to the increased stress in relationships," she said.

"Very often a young soldier gets a 'Dear John' or 'Dear Jane' e-mail and then takes his weapon and shoots himself," she said.

The report resonated on Army bases and among war supporters and critics around the nation.

"It can get pretty depressing even when you're not in harm's way," said Sgt. Carlene Bishop, a 25-year-old from Reading, Pa., who serves in the 10th Mountain Division and returned from Iraq in May. "You're away from home, you have to put your life on hold. I know soldiers whose marriages have broken up or who couldn't pay their bills."

Carol Banks, whose husband is a chaplain for a battalion preparing for another deployment from Fort Hood in Texas later this year, said soldiers are under a tremendous amount of stress - young and suddenly faced with war on top of the regular struggles of finances and family life.

"It just piles up, one thing on top of another," said Banks. "There is help available, but I think a lot of soldiers don't want to use it."

The 2006 total - the highest rate in 26 years of record-keeping and the largest raw figure in 15 years - came despite Army efforts to set up new programs and strengthen old ones for providing mental health care to a force stretched by the longer-than-expected conflict in Iraq and the global counterterrorism war entering its sixth year.

The Army has sent medical teams annually to the battlefront in Iraq to survey troops, health care providers and chaplains. It has revised training programs and bolstered suicide prevention, is trying to hire more psychiatrists and other mental health professionals and is in the midst of an extensive program to teach all soldiers how to recognize mental health problems in themselves and others - to overcome a culture that attaches a stigma to seeking help.

"I am deeply concerned but not surprised" by the new report, said Sen. Patty Murray, D-Wash., a member of the Veterans Affairs Committee. She cited the stresses of longer and repeated tours of duty and her suspicion that many in the military don't understand how to deal with post-traumatic stress disorder.

"I think there is just an inner denial among some that PTSD is 'you're just not tough enough,'" she said.

The Army has been working to overcome the stigma associated with getting therapy for mental problems after finding that troops were avoiding counseling out of fear it could harm their careers.

Among findings in the new report:

_ Of the 99 suicides, 30 were soldiers serving in Iraq and Afghanistan at the time of their deaths, 27 of them in Iraq.

_ 69 were committed by troops who were not deployed in either war, though there were no figures immediately available on whether they had previously deployed.

_In a half million-person Army, the toll translated to a rate of 17.3 per 100,000, the highest since the Army started counting in 1980.

The rate has fluctuated over the years, with the low being 9.1 per 100,000 in 2001. The Centers for Disease Control and Prevention said the suicide rate for U.S. society overall was about 11 per 100,000 in 2004, the latest year for which the agency has figures. The Army said that when civilian rates are adjusted to cover the same age and gender mix that exists in the Army, the rate is more like 19 to 20 per 100,000.

_The 99 suicides compare to 87 in 2005 and are the highest total since 102 were reported in 1991, the year of the Persian Gulf War, when there were more soldiers on active duty.

Investigations are still pending on two other deaths and if they are confirmed as suicides, the number for last year would rise to 101.

_About a quarter of those who killed themselves had a history of at least one psychiatric disorder. Of those, about 20 percent had been diagnosed with a mood disorder such as bipolar disorder and-or depression, and about 8 percent had been diagnosed with an anxiety disorder, including post traumatic stress disorder - a signature injury of the conflict in Iraq.

_Firearms were the most common method of suicide. Those who attempted suicide but did not succeed tended more often to take overdoses and cut themselves.

Tracy Willis, whose husband is a finance officer deployed in Iraq, said even though her husband works mostly inside a base, "There's no safe job in the Army."

"Being over there is a dangerous place," said Willis. When her husband returned home to Fort Hood for a break, she noticed he was jumpy in his sleep, unlike himself.

"It was a big scare," she said. "I don't want him to come home and feel he can't handle this."

Though the Army has boosted programs for family members as well, Willis, 24, said she's not sure what kind of help or information is available for soldiers like her husband. She's heard discussions of post-traumatic stress disorder but wouldn't know where to turn.


Associated Press reporter Michelle Roberts contributed to this report from San Antonio, Texas, and William Kates from Fort Drum, N.Y.

[J.B. Stone]

Army Releases Suicide Data, Promotes Prevention Programs
NationalBy Sgt. Sara Wood, USA - Though its number of suicides increased in 2006, the Army's suicide rate still is lower than the rate for the same age and gender group in the overall U.S. population, according to a report the service released.



Washington, D.C. - American Forces Press Service - infoZine -The Army Suicide Event Report, which tracks suicide attempts and completions and the factors involved, showed that in 2006 there were 99 suicides within the Army, 30 of which occurred in Iraq or Afghanistan. This is an increase from 87 suicides in 2005 and 67 in 2004.

According to the report, the Army's suicide rate for 2006 was 17.3 suicides per 100,000 soldiers. This compares to the overall U.S. population rate, for the same age and gender group, of roughly 19 suicides per 100,000 people.

"The loss of any member of the Army family is a tragedy, and the Army has made prevention of suicide a top priority," Army Col. Dennis W. Dingle, director of the Army's Human Resources Policy Directorate, told reporters at a media roundtable today. Dingle noted that the number of confirmed suicides in the Army has been rising since 2003, and leaders are emphasizing suicide prevention and education programs to counter that trend.

"Our message to you today is that the Army recognizes this issue and is taking deliberate steps to mitigate those risks that may contribute to suicidal behavior," Dingle said. "Our prevention efforts do help our soldiers and their families deal with the challenges they face every day."

A majority of suicides in 2006 involved firearms, the report says, and the most common contributing factors were failed personal relationships and occupational, legal and financial problems. The report did not find a direct relationship between increased deployments and suicides, Dingle said.

Army officials do recognize that increased deployments put strain on soldiers and on their relationships, so deployment frequency and length was closely examined in this report, Army Col. Elspeth C. Ritchie, behavioral health psychiatry consultant to the U.S. Army surgeon general, said at the roundtable. While the data has not shown a correlation between those factors and suicides, other studies, such as the Mental Health Assessment Team, have found that longer and more frequent deployments have increased the rates of post-traumatic stress disorder, anxiety and depression, she said.

"We have not yet seen an increase in suicides in multiple deployers or those who have been there longer; we may over time," Ritchie said. "We're certainly looking for that and certainly wanting to do everything we can if we do see that as an issue to mitigate any of those factors there. ... The senior Army leadership is paying very, very close attention to these issues."

This report is one of many ways the Army is working to gather information and improve its suicide prevention and training, Ritchie said. The Army is focused not only on preventing suicide, but also on increasing awareness about mental health issues and decreasing the stigma associated with seeking mental health care, she said.

In mid-July, the Army began a new training program for post-traumatic stress disorder, brain injuries and stress. This training will be given to every soldier -- active-duty, National Guard and Army Reserve -- within 90 days, Ritchie said. The Army also is taking the data gathered in this report and others and integrating it into their suicide prevention and training program, she said. For example, the Army's suicide prevention has historically focused on young men, but lessons learned recently have caused them to expand the program to focus on women and older men as well.

The Army also is working on hiring 250 more mental health professionals, and all the Army's medical personnel are being trained in recognizing post-traumatic stress disorder, brain injuries and suicide risk, Ritchie said. In addition, the Army is instituting programs to reduce the stigma associated with seeking mental health care, she said.

"We need to make sure that all our soldiers know that it's OK to come in and get help, and we're there to offer it for you," Ritchie said. "I think it is very important for everybody to recognize how difficult a completed suicide is on the soldier's family, on the soldier's unit, on the friends, on the whole system, and the pain and hurt of a suicide lasts for years."

It's difficult to know how effective a suicide prevention program is, Dingle said. However, Army leaders have taken a great deal of feedback from soldiers in the field about what solutions would work for them, and have integrated it into their training programs, he said.

"We continue to adapt the program to get to training and awareness training and intervention techniques that will help our soldiers deal with those stressors that could ultimately lead to suicide," he said.

The feedback from the new training programs has been positive, Ritchie said. She said she has taught some classes herself and has been surprised at how willing soldiers are to open up and talk about their experiences. The Army will be able to track the effectiveness of the programs by monitoring the increase in referrals to behavioral health services, she said. The first data collection for this evaluation will be around Sept. 1.