Monday, May 30, 2011

Returning veterans encounter VA mental health meltdown


OFF THE WIRE

By Azriel James Relph
NBC News
Tales of 3 Marines underscore court decision blasting "unchecked incompetence" at agency.
 Susan Selke, the mother of a combat veteran who committed suicide in March, appeals to the VA to do
a better job taking care of vets suffering from mental  & disability ...........WTF   
 
Clay Hunt, a Marine sniper, served two combat tours  in Iraq and Afghanistan. When he came home with a Purple Heart and post traumatic stress disorder, Hunt asked the Veterans Administration for help. But getting medical attention was a two-year struggle. On March 31, Hunt committed suicide in his Sugar Land, Texas, apartment. He was 28. 
Philip Northcutt, 38, a fellow Marine, saw intense combat in Iraq in 2004 and was wounded. He was diagnosed with PTSD in the field, but he says he was merely given sleeping pills and an anti-depressant and told to keep fighting. When he came home, he struggled to adjust, spending time in jail and becoming homeless before he started receiving disability benefits more than four years later.
When Jordan Towers, 27, came home from Iraq in 2008, the Marine couldn’t escape the feeling that he was on another night patrol in Al Anbar province, and that each step might be his last. He angered easily and snapped at people for no reason. When he called the VA, he was told it would take three months to get an appointment. He was diagnosed with PTSD a year later, but six months after the diagnosis he is still waiting to hear whether his claim for disability benefits will be approved.
Three Marines, three cases where the U.S. government allegedly let down those who risked all for their country.
The stories of Hunt, Northcutt and Towers are not unique. Similar allegations are leveled in a lawsuit against the Veterans Administration filed by two veterans groups that argue delays in the process of evaluating and treating returning veterans with mental health problems are systematic.
‘Unchecked incompetence' On May 10, a federal appeals court judge ruled in favor of the plaintiffs, ordering the VA to drastically overhaul its mental health care system and accusing it of “unchecked incompetence.”
In a 140-page ruling, Judge Stephen Reinhardt of the 9th U.S. Circuit Court of Appeals in San Francisco said the agency was violating veterans’ constitutional rights by denying them guaranteed health care and benefits, citing the Constitution’s Fifth Amendment and its guarantee of freedom from unjustified governmental deprivation of property.
Reinhardt noted that some veterans with severe depression or PTSD were forced to wait eight weeks or more for a mental health referral.
Such delays can be critical, Reinhardt noted, citing internal VA communications indicating that 18 veterans commit suicide every day. The court also found that veterans appealing a disability rating to the Board of Veterans Appeal wait more than four years on average for their mental health benefits claims to be fully adjudicated.
The ruling accused both Congress and the Obama administration of failing veterans.  “We would have preferred Congress or the president to have remedied the VA’s egregious problems without our intervention,” wrote Reinhardt.
The scope of the problem also was highlighted in an April 2008 study by the RAND Corp.,which found that 18.5 percent of veterans deployed to Iraq and Afghanistan since 2001 suffered from PTSD upon their return home. Fully one-third were seen at a VA facility for mental health within one year, it said.
'The war doesn't stop' Towers, the Marine who sought help from the VA and was told to wait three months, said the lack of support for returning vets is absurd.
“When you leave a war zone,” he said, “the war doesn’t stop there. It continues on through the nightmares and flashbacks.”
Towers was deployed to Iraq in 2007, for what he expected would be a six-month tour. At its conclusion, he volunteered for a two-month extension so he could stay with his unit. “I was really tempted to go home,” he said, “but that would’ve been too much work to just leave these guys.”
He believes one night patrol in particular is the primary source of his anxiety. He was the point man on a patrol “outside the wire,” as Marines call enemy territory. “I really did think each step could be my last,” he said, adding that the uncertainty of the silence was worse than the roar of combat. “When I was fired upon, I’d get this huge adrenaline rush. And at that moment, that fear in me would go away.”
Diagnosed with PTSD in 2009, Towers applied to the VA for disability benefits in November 2010, but is still waiting to hear if his claim will be approved. In the meantime, he is working as a social media coordinator at a veterans outreach group.
He says he is still plagued by nightmares and flashbacks and has a hard time in real-life social situations. “The only people I talk to are veterans,” he said. “I don’t usually speak with the civilian population, even though I guess I am a civilian now.”
Northcutt, the Marine who says he was sent back into combat after being diagnosed with PTSD, has also been suffering from nightmares and flashbacks. He said he also injured his back and suffered a traumatic brain injury after multiple concussions – the first of which occurred during a firefight in the Iraqi city of  Ramadi, when  a rocket-propelled grenade landed 10 feet away. He spent a year at Camp Pendleton in California recovering, but whenever he tried to discuss his mental state with VA doctors, he said, he was given medication rather than explanations.
“They addressed my physical injuries, but as far as PTSD, it was like it didn’t exist,” he said. “There were some pamphlets people were handing out, but that’s it. There was no real discussion about how I was coping.”
Jailed, then left homeless Northcutt, who had run his own screen-printing business before being deployed, said he couldn’t manage a business any longer. “I couldn’t remember clients’ names, I couldn’t remember dates,” he said. “The crazy part is, I couldn’t figure out why.”
He said he was given “a grocery bag full of pills,” which he started to take while drinking heavily. He was arrested in Los Angeles for possession of marijuana — which he said was prescribed under California’s medical marijuana law — and spent a year in jail. He sought help from the VA when he got out, but after finding out that it would be nearly three months before he could see a doctor, he gave up and went to San Francisco, where he walked the streets and slept on a park bench.
“How I didn’t kill myself or someone else in that time is a miracle,” he said.
Northcutt eventually found Swords to Plowshares, a nonprofit group that helps veterans make the transition to life after war. Staff there helped Northcutt get into a residential treatment center for combat veterans and
helped him file a disability claim with the VA.  Northcutt, a father of three, received a low disability rating and no provision for his children. He has been waiting nearly a year to hear the outcome of his appeal.
The story of Hunt, the Marine who committed suicide, is especially poignant, given that he became a spokesman for veterans upon his return.
While he was at war in Iraq, Hunt was shot in the hand by a sniper and watched friends die in other ambushes that he survived. At home, he struggled with the demons of PTSD and the VA, which misplaced his disability paperwork for months.
Even after he was diagnosed with PTSD, and had a history of suicidal thoughts documented, it took weeks for him to get to see a VA mental health specialist when he moved from California to Texas. He waited even longer to get anti-depressant medication mailed to him. 
“You fight for your country, then come home and have to fight against your own country for the benefits you were promised," Hunt told the Los Angeles Times in May 2010, one year before his death.
His accomplishments on and off the battlefield were exemplary, but his struggles at home were all too common.
A spokesman, then a casualty Hunt worked as a spokesman for PTSD with the nonprofit Iraq and Afghanistan Veterans of America, appearing in the award-winning “Camouflage” public service announcement, where he and other veterans seemed to appear out of thin air to remind fellow service members that they are not alone. He also went to Haiti with a group from the nonprofit Team Rubicon after the January 2010 earthquake to deliver humanitarian aid – even though he still suffered from the memory loss, panic attacks and depression associated with PTSD.
His mother, Susan Selke, said her son made a tremendous effort to navigate the VA procedures.
“He really believed that the system could take care of whatever his needs were,” she said. “He really worked that system the way you have to, and what was hard was to watch how much energy, how much effort it took to do that.”
Despite his diligence, Hunt still could not get ahead of the paperwork.  He was waiting to hear back from the VA on an appeal of his low disability rating when he took his own life. 
“If he had had better care, he maybe would not be dead today,” said Selke.  “It’s inexcusable.”
The list of tragedies goes on.  Among other cases cited in Judge Reinhardt’s ruling: One veteran who called to report suicidal thoughts was told he was number 25 on a waiting list for treatment. He committed suicide. Another Marine who was at the Pentagon on Sept. 11, 2001, and later served in Iraq was diagnosed with PTSD and repeatedly told the VA that he was suicidal, but still had to wait almost eight weeks to be seen.
“It’s the American tragedy,” said Northcutt. “We engage in these wars, we send our guys to fight in them, and then we don’t take responsibility for what we’ve done to them.  We call them heroes, but then we disregard them like trash.”
More than 1 million await claims decisions Paul Sullivan, executive director of Veterans for Common Sense, which filed the lawsuit against the VA along with Veterans United for Truth, said there are more than 1 million veterans currently awaiting decisions on disability claims.
“The court has told the VA, ‘Stop the delays. Stop the denials,’” said Sullivan. “The waiting must end. Too many vets are dying, seeing their houses foreclosed, seeing their health deteriorate and watching their families fall apart, while the VA sits on piles – mountains – of paperwork.”
  1. Sullivan said that, as of December 2010, 654,000 veterans of Iraq and Afghanistan have been treated at VA hospitals and clinics. “That’s 10,000 new first-time patients flooding into VA hospitals every month,” he said.  “That’s one new patient every five minutes – and the VA has no plan to take care of them.”
The VA would not comment on the ruling, or on whether it will appeal. But officials say they have placed high priority on reducing delays and improving mental health care, including increasing staffing on its suicide prevention hotline and a $2 billion effort at the Veteran’s Benefit Administration to “break the backlog” of claims applications.
Meanwhile, Susan Selke recently received a letter from the VA approving an increase in her son Clay Hunt’s disability benefits.
It arrived five weeks after his death.
“They go and give their all for their country, and then have to come back and fight for their benefits,” she said. “It's ridiculous. It's just ridiculous. We are just a better country than that and we are not doing a good job of taking care of them.”

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