Treating War's Toll on the Mind
Thousands of soldiers have post-traumatic stress disorder. Will they get the help they need?
Now the institute is looking at the accuracy of screening techniques and how to compensate and treat vets with PTSD, widely regarded as an easy condition to fake. And in another move that infuriated veterans groups, the VA late last year proposed a review of 72,000 cases of vets who were receiving full disability benefits for PTSD to look for fraud. The move prompted such an outcry that it was called off.
Studies and reviews aside, there isn't enough help available to veterans with PTSD. According to a report from the VA, individual veterans' visits to PTSD specialists dropped by 20 percent from 1995 to 2005-"a decrease in capacity at a time when the VA needs to reach out," the report stated. Secretary of Veterans Affairs James Nicholson says the VA sees 85 percent of new mental health patients within 30 days. "But that still leaves 15 percent and that's a big number. Could we do better? Yes."
Bush has called for a record $80.6 billion in the 2007 VA budget. That includes $3.2 billion for mental health services, a $339 million increase over this year's budget. However, those increases are being met by increasing demands for care, as well as rising cost-of-living allowances and prescription drug prices. "The bigger budget doesn't really add up to much," says Rieckhoff.
However frustrating and exhausting the process, most vets can avoid getting help only so long before friends and family push them into counseling or they get in trouble with the law. "It's almost like your family has its own form of PTSD just from being around you every day," says a former Army sergeant who worked as an interrogator in Iraq and asked that his name be withheld. "When I came back I was emotionally shut down and severely paranoid. My wife thought I was crazy and my son didn't realize who I was. Because of them, I got help."
Like many soldiers, he found it at one of more than 200 local Veterans Centers, which offer counseling for PTSD and sexual assault, a growing concern for women in the military. Vet Centers are part of the VA but operate like the anti-VA, free of the delays and bureaucracy. There is almost no paperwork, and the wait to see a counselor is rarely more than a week. It's no coincidence that when Doonesbury character B.D. finally went for help with his PTSD, he went to a Vet Center (story, Page 60). The centers are small and staffed mostly by vets, which creates the feel of a nurturing social environment rather than an institutional one. The free coffee is strictly decaf, and the approach is laid back. "Someone may come in asking about an insurance problem, and as we answer their questions, we ask them how are they feeling," says Karen Schoenfeld-Smith, a psychologist and team leader at the San Diego Vet Center, which sees a lot of Iraq vets from nearby Camp Pendleton. "That's how we get them into it." Many come just to talk to other vets.
It is that same need to talk that keeps Schrumpf E-mailing and phoning fellow marines and returning to Camp Pendleton every couple of weeks to hang out. "It is the only place I can talk about the killing," he says. Next month, Schrumpf will leave California for his home state of Tennessee, where he says it will be easier to raise a family. He's not worried about taking the war with him. In fact, in many ways he is more worried about leaving it behind. "The anger, the rage, and all that is just there," says Schrumpf. "And honestly, I don't want it to leave. It's like a security blanket." Or a movie, that just keeps on playing.