Local veterans counselors are few and far between in the region
Published June 25, 2008
By Casey Farrar
A Vietnam veteran in his 60s who has been divorced three times and said sometimes he drinks his problems away.
An Iraq veteran and reservist who has applied for 63 jobs since he returned, but has never heard back from any employer after telling them he might be called back to war.
A veteran of the Gulf War who says he sought help for depression when he saw his children suffering from his mood swings.
All of them have seen the face of combat, and each has a very different story to tell.
But when they are in this conference room in Keene every Thursday among other veterans, they say they feel understood.
A 24-year-old veteran of Iraq from Keene, who asked that his name not be used, says it took a suicide attempt several months after his return to recognize the magnitude of his depression.
He said talking to the other veterans in the group has helped him understand that what he feels is normal.
Leading the group is Anthony “A.J.” Paige, a veterans readjustment counselor for Monadnock Family Services in Keene who is himself a veteran of the U.S. Army.
During his 23 years in the Army, Paige saw his share of combat in Somalia, Central America and the Persian Gulf.
In the nearly three years since Paige began counseling veterans at Granite Hills, a branch of Monadnock Family Services, the number of veterans walking through his door has increased seven-fold.
In 2006, Paige worked with eight veterans who had been referred from regional veterans centers. In 2007, 23 veterans sought treatment at Monadnock Family Services, and this year that number has jumped to 58.
All of the veterans Paige sees are men. He said a female veteran has also sought treatment with him, but because he counsels her husband, who also is a veteran, Paige is unable to see her. She is forced to travel to Manchester for treatment.
Nearly a quarter of the veterans he sees have returned from Iraq and Afghanistan. He also counsels 26 Vietnam veterans, nine veterans who served in the Gulf War, two veterans of Bosnia and Kosovo, two veterans of Somalia, three veterans of conflict in Central America, one veteran of World War II and a veteran of Grenada.
“(Veterans) are very proud people,” Paige said. “They have an enormously tough time talking because they come from our society, which tells people big boys don’t cry.”
That mentality is enforced in the military, Paige said, where losing focus for only a second can be the difference between life and death.
“You suck it up. You drive on. You accomplish the mission,” Paige said.
Most of the veterans Paige sees have symptoms of post-traumatic stress disorder including depression, trouble sleeping, anger, and isolation. Some battle substance abuse and several have been homeless. All said they’d considered suicide at one time or another.
The veterans at the group meeting said they are sometimes asked difficult questions about combat or feel people don’t believe their stories, making it hard to relate to those they were once close to.
“Sometimes people will ask, ‘Did you ever shoot anyone?’” said a recently returned Iraq veteran. “And you know they just don’t understand, but it makes you wonder how someone can ask something like that.”
Post-traumatic stress disorder was first recognized by the American Psychological Association in 1980. It is caused by exposure to a life-threatening situation and feelings of helplessness and can result in flashbacks of a traumatic incident months or years later.
Recent reports showing an increasing suicide rate among soldiers, combined with a rising number of diagnoses of post-traumatic stress disorder and traumatic brain injury, are leading Paige and others in the mental health field to say long-term care for veterans needs to improve.
“Unfortunately, we live in a nation that has a bad tendency to be a throw-away society,” Paige said. “Once we’re done using you, once you’ve served your purpose and the rounds are done going down-range and the bullets are done flying, ‘it’s have a nice life.’ ”
The U.S. Army recently reported 115 confirmed soldier suicides in 2007, both stateside and abroad — the highest number recorded since the Army began keeping such records.
In 2006, 102 suicides were reported. Neither of those figures includes suicides among veterans no longer in the service, which are not tracked.
Rates of post-traumatic stress disorder diagnosed by the Army also jumped in 2007, increasing by 50 percent.
A recent study by the RAND Corp., a health and government policy research program, showed one in five returning veterans from Iraq and Afghanistan report symptoms of post-traumatic stress disorder or major depression.
Of the nearly 1.6 million troops deployed to Iraq and Afghanistan, 300,000 have reported symptoms, yet only 53 percent of those sought help from a medical provider over the last year, according to the RAND study.
The U.S. Department of Veterans Affairs recently announced an effort to ramp up suicide prevention with the creation of an advisory panel.
The Department of Defense also announced it will expand the network of mental health care providers who accept the military’s TRICARE health plan and teach civilian providers how to screen for traumatic brain injury.
In New Hampshire, nearly 125,000 veterans have returned from Iraq and Afghanistan and 28,000 are registered for medical coverage with the Manchester Veterans Administration Medical Center, according to Debra N. Krinsky, a spokeswoman for the center.
Krinsky said many veterans in the state go to the White River Junction Veterans Administration Medical Center in Vermont, and with veterans traveling out of state for treatment, it’s impossible to pin down exactly how many of the state’s veterans are being treated for service-related injuries.
Statistics on the number of veterans in the state diagnosed with post-traumatic stress disorder are not available.
Nine of 14 research studies at the Manchester medical center this year focus on post-traumatic stress disorder, according to center officials. The research is funded through grants from the Veterans Administration, the National Institute of Mental Health, the U.S. Army and the American Society of Addiction Medicine.
Paige says many soldiers returning from war are discouraged from seeking help because of the stigma attached to a mental health diagnosis.
They also face mountains of paperwork and frequent office visits to file claims with the Veterans Administration, Paige said.
Many are referred to Granite Hills by the veterans center in White River Junction, Vt. Others come after being treated at area emergency rooms or walk in from the streets.
For some veterans, getting counseling in Keene is easier than traveling to White River Junction or Manchester, which are each about 60 miles away.
The centers are also overloaded, meaning the average counseling session lasts about 20 minutes there, Paige said.
In contrast, at Granite Hills veterans are scheduled for hourly sessions, and sometimes stay longer if they need extra time, he said. They usually begin group therapy weeks or months after their counseling begins.
Since he is the only counselor at the center working full-time with veterans, the number of veterans who can receive treatment locally is limited, Paige said.
But funding at Monadnock Family Services and other counseling services around the state is tight, making it difficult to beef up veterans counseling staff.
“The Easter Seals, the Veterans Administration, the federal government and the Army all have a lot of money they want to shift toward the vets,” Paige said. “The problem is they haven’t quite figured out how to shift it down here to the trenches.”
In the meantime, several veterans gathered at the group counseling meeting in Keene last week say they have to wait months, and in some cases years, to get treatment for medical and mental health problems related to their time in the service.
For the Veterans Administration to cover the cost of treatment, veterans have to file claims that take an average of nine months to receive approval. Denied claims can be held up in the appeal process for more than two years, Paige said.
But the veterans who take part in the Keene group meetings say in the end, not coming in for help would be worse than jumping through the federal hoops.
“The more and more you wait around, the more and more isolated you feel and the worse all those feelings become,” said one veteran of the Gulf War at a weekly group meeting. “At least here we can talk to each other about it and feel like someone understands.”
Casey Farrar can be reached at 352-1234, extension 1435, or firstname.lastname@example.org.