PTSD Combat

Baker had planned to ride his bicycle from Norman to Washington, D.C., and Gettysburg, Pa., to Marseilles, Ill., to support a new flag designed to honor fallen members of the military, the Norman Transcript reported March 8. He planned to fly the Honor and Remember Flag from his bike and encourage people along the way to sign a petition urging Congress to adopt the flag as a new national symbol by passing HR Bill 1034.

Baker was injured while serving as a firefighter in Kuwait in the 1990s when a Scud missile struck his barracks. Diane Zellner said he had seemed healthy enough to undertake the bike trip. "He was doing well, so this kind of took us by surprise," she said. Baker struggled with his health, but what people admired about him was how he moved forward despite his health problems and disabilities, she said. "He struggled every day, but he lived, he was going to do what he wanted to do," she said. Before he died, Baker made several blog posts from the road that can be read at www.honorandremember.org/kevin.html. His last post was Wednesday near Sherman, Texas. He said the weather was raining and 34 degrees, so he said the Honor Guard from Louisiana would pick him up and take him somewhere warmer. "He was doing something he loved," Diane Zellner said. "This was something he was passionate about."

Advocates for veterans report an increase in the number of Iraq and Afghanistan veterans facing charges such as domestic violence, firearms violations, breach of peace and drunken driving.A Connecticut lawmaker says the court system should be able to identify troubled veterans and refer them to mental health specialists, the same way family courts and drug courts work."Our troubled veterans may not need to be locked up if their combat experience has led to psychological wounds," said Senate Majority Leader Martin Looney, a New Haven Democrat who has introduced legislation to create a separate criminal docket for veterans.This mirrors actions elsewhere in the country. Some states are setting up veterans' courts or enacting laws to deal with veteran offenders. In 2008, Buffalo, N.Y., created the first Veterans Treatment Court after a judge noticed that hundreds of veterans were showing up in his courtroom facing minor charges. California and Minnesotahavepassed legislation to allow nonviolent veterans to forgo jail time if they can prove that their combat experience played a role in the criminal behavior.Looney said he introduced his bill after hearing stories about returning Iraq and Afghanistan veterans in Connecticut and across the nation ending up in jail. Connecticut also is using a $2 million grant from the federal Center for Mental Health Services to devise a program that will keep veterans with post-traumatic stress disorder out of jail.

Reluctant To Report SymptomsPeople with experience in overseas conflicts, or who work with those who have recently returned, often refer to one overriding symptom of post-traumatic stress disorder in recent veterans."Anger is a really big problem," said Jay White, an Iraq veteran and counselor at the Hartford Vet Center in Rocky Hill. It's one aftermath of the "high-octane environment" veterans experience in war, he said.According to the Connecticut Department of Veterans Affairs, 16,500 state residents have been deployed to Iraq and Afghanistan since the 9/11 terrorist attacks. That number includes soldiers in the Connecticut Guard, the reserves and active duty personnel. The high number of veterans returning from Iraq and Afghanistan with post-traumatic stress disorder presents a large challenge for the criminal justice system. And given that President Barack Obama last week authorized an additional 17,000 troops to go to Afghanistan this year, the number of people who could eventually experience PTSD is likely to increase.PTSD, triggered by an event or events so extreme that they cause trauma, can shatter a soldier's sense of safety and trust and cause a constellation of reactions, in addition to anger.

Tom Berger, former chairman of the PTSD committee of the Maryland-based Vietnam Veterans of America, said post-traumatic stress can easily manifest itself in criminal behavior. "It interferes with your thinking process. You have high anxiety. You do strange things like taking U-turns, or carrying loaded weapons in your car," said Berger, who has worked to change the criminal justice system for veterans. James Campbell's experience may typify that of many veterans. The 28-year-old Middletown resident now works as a veterans' employment representative for the state Department of Veterans Affairs. He said he returned home in a hyper-vigilant, ready-for-battle state of mind. Road rage and driving drunk were problems."When I got back, I felt I was indestructible, especially when I was drinking. I didn't care whether I would get into a car and drive drunk," he said. Berger said jail diversion programs should include treatment and recovery and a mentoring component. He said some Vietnam veterans incarcerated when they returned home from war remain in jail. Jim Tackett, director of veterans' services for the state Department of Mental Health and Addiction Services, said the state's jail diversion program will work closely with mental health officials, the veterans administration and the criminal justice system to identify veterans who need help. "Some veterans who commit minor crimes that are the direct result of traumatic wartime experiences need treatment, not incarceration," Tackett said.

The few veterans courts in the nation are modeled on drug courts that allow defendants to avoid prison in exchange for strict monitoring. Most are only a couple of months old and it is difficult to track their effectiveness, but the results from the first court, which opened in Buffalo, N.Y., in January 2008, are striking. Of the more than 100 veterans who have passed through that court, only two had to be returned to the traditional criminal court system because they could not shake narcotics or criminal behavior, said Judge Robert Russell - a far lower rate of recidivism than in drug courts. "It's the right thing to do for those who have made a number of sacrifices for us," Russell said. "If they've been damaged and injured in the course of their service . . . and we can help them become stable, we must." There are no comprehensive statistics on how often veterans get in trouble with the law, and the majority never become entangled with the legal system. But psychiatrists and law enforcement officials agree that the traumas of combat can lead to addiction and criminality. Studies have shown that as many as half of the troops returning from Iraq and Afghanistan suffer post-traumatic stress and other disorders, and mental health is the second-most-treated ailment for returning veterans in the Department of Veterans Affairs system.

Since Russell's court started, veterans courts have opened in Orange and Santa Clara counties in California; Tulsa; and Anchorage, Alaska. Pittsburgh, southern Wisconsin, Phoenix and Colorado Springs, Colo., are opening or considering new courts this year. Some in Congress have proposed a federal program to help spread veterans courts across the country. Most veterans courts admit only nonviolent felony offenders, though some include violent crimes. Defendants are required to plead guilty to their crimes. In exchange for a suspended sentence that can include prison time, they must consent to regular court visits, counseling and random drug testing. Should they waver from the straight and narrow, their sentences go into effect. Orange County, Calif., Superior Court Judge Wendy Lindley started her veterans court in November after a young Iraq war veteran on her docket died of a drug overdose. "It was horrible," she said. As in most of the nation's nascent veterans courts, many of the defendants in Lindley's court fought in the Vietnam or Persian Gulf wars. But she has seen a few Iraq war veterans, all of whom had clean histories before joining the military but started getting into trouble after they returned.

A lot of soldiers say war is hell, and then, they won't say anything else. That wasn’t good enough for one west suburban playwright. She’s created a new collaboration called the Vet Art Project. It brings veterans and artists together to make art out of  war. The group's vision is a big one: it aims to be a national model for how veterans can tell their stories and get the public to listen.

Matt Ping sits across the circle from Crist. He’s a young vet who served in Afghanistan. PING: That transition from 16 months of isolation on the side of a mountain, and being secluded from American society and American people and then coming back and trying to be the same person you were before, it's really -- I don’t know if it’s even possible. A recent study by the Rand Corporation found that nearly 20 percent of soldiers who served in Iraq and Afghanistan have Post Traumatic Stress Disorder or depression. Only half, seek treatment. Ping says part of the problem is Americans don’t seem to know or care about the war or its soldiers. He recalls being in Afghanistan, in the thick of it, and soldiers not being able to reach anxious family members. PING: And that’s probably why the suicide rates are so high, because that’s the easiest out.  I mean, I'm not gonna lie. I sat there with a barrel of a gun in my mouth, thinking about pulling the trigger more than once. And you know I’m glad I didn’t because I was just in an altered state at the time.

It was during his first deployment in Iraq that Marine Cpl. David Tracy, 23, of Peekskill earned his Purple Heart."I was up top behind the gun when we stopped at a checkpoint and a roadside bomb exploded on the other side of the barrier," said Tracy, an infantryman who served as a machine gunner in Baghdad and Fallujah.

Legislation introduced recently by Rep. John Hall, D-Dover Plains, would lift the burden of proof from veterans who served in combat zones and have a diagnosis of PTSD, allowing them to receive disability benefits without having to prove that a specific incident caused the disorder.In the Iraq and Afghanistan wars alone, more than 100,000 veterans have been found to have PTSD, but only 42,000 have been granted service-connected disability for their condition, said Hall, chairman of the Veterans Affairs Subcommittee on Disability Assistance and Memorial Affairs.The disability claims backlog at the VA tops 800,000. A large percentage of that number are Vietnam veterans seeking compensation for PTSD, Hall said.

Antonette Zeiss, deputy chief of the VA's Mental Health Services, said members of the current generation of veterans are being encouraged to come in sooner so they can get treatment, even if they are not eligible for benefits. State-of-the-art treatment should now be available without delays, she said.But PTSD is not the whole story, said Zeiss, a clinical psychologist. There are 442,862 veterans enrolled with the VA who have a diagnosis of PTSD out of a total 1,662,375 with some mental-health diagnosis, she said.Continuing conflicts mean those numbers will grow. Up to 17 percent of veterans who have served in Iraq and Afghanistan have PTSD, major depression or other mental-health problems, Dr. Joseph T. English told Congress last year. He is chairman of psychiatry at New York Medical College in Valhalla, which is affiliated with the VA hospitals at Montrose and Castle Point.

The Injured Marine Semper Fi Fund, hosted by Marine Corps Base Camp Pendleton, screened the film, “Cover Me,” at the South Mesa Club here, March 5, to help raise awareness and educate Marine leadership about combat operational stress. The film’s conception was centered on the Corps’ need to let Marines know it is all right to seek medical help for combat operational stress and in doing so, their careers will not be adversely affected. Award-winning producer Norman Lloyd directed the film, which features interviews with Gen. James N. Mattis, commander, US Joint Forces Command, Gen. James T. Conway, commandant of the Marine Corps and Sgt. Maj. Carlton W. Kent, sergeant major of the Marine Corps. The film also contains interviews with service members who have experienced combat operational stress and medical experts experienced in treating it.

Tucker received a medical discharge from the Army last year and he now is Officer Chris Tucker of the Savannah-Chatham Metropolitan Police Department. "You still get to serve your community and your country in other ways," he said. At age 26, he is a veteran of three combat tours. The patrol skills he learned on the streets of Baghdad, Fallujah and Sadr City come in handy as he drives his police cruiser around the neighborhoods of his Savannah precinct.

As the war hits the six-year mark, Tucker is part of a history -- and a legacy -- still being written as the military tries to better understand the depth of the damage to those exposed repeatedly to the violence. "I still have the nightmares and wake up and find myself downstairs and I don't know how I got there," Tucker said. "I still see and dream the same things. ... Faces. Kids' faces. People that you have engaged or you have had contact with. ... You see your colleagues blown up. Things like that." He left the Army with a sour taste. He was sent back for his third tour despite the nightmares, depression, major hearing loss and painful injuries to his back and both feet. Then, the Army decided to give him a medical discharge for his back issues even though Tucker believes he could have recovered with rehabilitation. But he tries not to dwell on his frustration. "I try to distance myself from it as much as I can, because for me, the more I think about it, the more I reflect on what happened and what we did, the more I think the dreams and the nightmares actually come back."

Police Cpl. Randy Powell is 50 years old and became a grandfather just last week. Watch Tucker and Powell tell their stories » Powell served nearly 20 years ago in the Persian Gulf War, then in 1992 took an early retirement package when the Army was downsizing after the war. The deal required him to stay on what the military calls the IRR -- the Individual Ready Reserve -- but even as troops were sent to Afghanistan after 9/11 and then to Iraq for repeat combat tours, Powell heard nothing. Then last year, nearly 15 years after leaving the military, he was told to report to a local Reserve center. Another request came in January of this year. Both times, after some perfunctory paperwork, Powell was sent home. But when he returned home from work one day last month, an overnight letter from the Army had arrived with orders that he was being activated for an Iraq deployment. First, starting next month, he'll have refresher training on radar systems at Fort Jackson in South Carolina.

Obama said her commitment to improving family support began two years ago at the beginning of her husband's campaign, after hearing about the challenges military spouses faced. "I spent a lot of my time talking about issues that really affected me as a working mom," Obama said. "I met more and more military families who were not just struggling with those basic issues that all civilians are dealing with, but they were tacking on multiple tours of duty and having to figure out how do you keep a family together when you moved 10 times in the same number of years." "I was moved by the power of those stories, and I committed to myself then that if I was blessed with the opportunity to be the nation's First Lady, then I would make the issues facing military families a top priority for me," she added. The First Lady said some of the issues military families faced included quality education on military posts, adequate childcare for families who live on- and off-post and for military spouses, how to balance higher education, careers and family support during deployments.

She said a lot of family members spoke to her about streamlining the available support so that it is more consistent at all bases. She said it is equally important to make information available to families to prevent hardships once they transfer to different bases.

Obama wants to put a call out to the nation to be mindful that we are a nation at war. "There are troops out there right now fighting for our freedom and our security," she pointed out. "When they go, they leave behind families. The First Lady extended the opportunity to help military Families to the rest of the nation, whether they lived in military communities or not. "It's incumbent upon us as a nation to look in our schools and figure out which child has parents that's deployed and be aware of that and be conscious of that," she said. "It's incumbent upon us to look in our own back yards to our neighbors and to figure out who's out there serving our country and what kind of support that they need. We need to make sure, as a community, that we're coming together around those families."

It is notable that the Army only began keeping records on suicides in 1980, a policy likely fueled by the cascade of attempted and successful suicides by Vietnam veterans. In 1983, with the introduction of the diagnosis of Post Traumatic Stress Disorder (PTSD) in the American Psychiatric Association’s Diagnostic & Statistical Manual, the military and VA began, finally, to acknowledge the debilitating effects of this combat-related trauma reaction. Increased risk of suicide is among the many symptoms of the half-million Vietnam veterans diagnosed with chronic PTSD. Using the most conservative estimates, there may be as many as 75,000 active duty military or recently discharged veterans with PTSD or significant symptoms of PTSD, according to psychologist Alan Peterson of the University of Texas. Peterson is a researcher with a multidisciplinary consortium recently awarded a $25 million Department of Defense grant to study behavioral treatments for PTSD.To date, there has been no comprehensive epidemiological study on military suicides resulting from PTSD. In 1988, however, the Centers for Disease Control presented congressional testimony, confirming 9,000 suicides among Vietnam combat veterans.

According to figures obtained by the Associated Press, there has been a steady increase in suicides since 2003, totaling 450 active duty soldiers, with the highest numbers occurring in the past year. Military suicides vary considerably between branches of the service, with the Army and Marine Corps frequently reaching the highest annual rates. Longer and more frequent deployments and the primacy of ground combat operations are factors often blamed for the Army’s higher rates of physical injury, mental illness and suicide. In October 2008, the Army announced a five-year, $50 million collaborative study with the National Institute of Mental Health to address suicide. In a rare public admission of the urgency of the problem, Dr. S. Ward Cassells, assistant secretary of defense for health affairs, stated in the New York Times, “We’ve reached a point where we do need some outside help.” Such efforts are encouraging but will yield little immediate assistance to active duty soldiers, returning veterans and their families.

Tim Mechaley trained fellow Marines to fire .50-caliber machine guns. He qualified as a marksman. He fought in the battle for Fallujah and received a combat medal with a "V" for valor. Back home, he uses a rifle for target shooting. Yet, when Mechaley sought to buy a 9-mm Ruger pistol for protection at his midtown apartment, the Omaha Police Department rejected his application for a gun permit. "I was trusted by the {federal} government to carry a loaded weapon, but now I am not allowed to purchase one by my local government," he said. Mechaley, 32, has received counseling for post-traumatic stress disorder related to his service in Iraq. While completing an application for a gun permit, he responded "yes" to a question that asked whether he was being treated for a mental disorder. "I circled yes because I wanted to be completely honest," he said. As explanation, he wrote "PTSD from Iraq Marine combat veteran" on the form. Mechaley's application on Jan. 10 was rejected, he was told, because of that answer. After talking with police, Mechaley said he had been "too truthful" on the application.

Mechaley said his PTSD symptoms have improved with counseling. While serving in Iraq in 2004 and '05, Mechaley watched eight friends die in combat. When he returned home, he began to suffer from flashbacks and had trouble sleeping. He was diagnosed with PTSD and started going to counseling. In 2006, he was recalled to active duty to help train Marines to shoot. He still serves in the Marine Reserves. "I used to go in (to see the counselor) once a week while I was in the service, but everything is so much better now," he said. "I no longer have flashbacks or trouble sleeping, and I see the counselor only about once every three months."