A Tale of Two Soldiers
Veterans Affairs Expects One-Third Of Iraq War Veterans Will Seek Treatment For Post Traumatic Stress Disorder—But Former Soldiers Need To Act Fast To Get Va Treatment
“Hearing [that] loud sound made me want to take cover,” Dupree says. “But I just laid there and closed my eyes, reminding myself that I’m not over there anymore, so I’ve got to get through it.”
Dupree thinks his episode was a symptom of a psychological condition known as Post Traumatic Stress Disorder (PTSD), an anxiety disorder brought on by exposure to extreme traumatic events. PTSD is treatable with individual or group therapy, behavioral therapy, and medication, which may reduce the anxiety and depression produced by the illness. Mental-health professionals say that without treatment, the effects of PTSD can be severe, and may impair an individual’s ability to function in society.
Dupree is not getting treated for his PTSD symptoms, which thus far have included insomnia, flashbacks, and reactions to loud noises. As on that morning in April, so far he has just waited for these storms to pass.
For Dupree, and likely many other veterans like him, “getting through it” means avoidance—which itself is another symptom of PTSD. Dupree has tried to forget about the “plenty” of dead bodies he saw, the members of his unit who were injured or killed, and the Iraqi civilian that he saw blown up by an explosive device just a few feet from him. The Army has all soldiers returning from Iraq fill out a survey as part of their debriefing, which asks them to assess whether or not they may need counseling or mental-health care. On his survey, Dupree answered that he did not.
“I looked over it, and I said [to myself] ‘I’m fine,’” he says.
After all, Dupree says, he had more pressing things to worry about at the time than PTSD, such as returning to the work force and taking care of his growing family (he and his wife Mieasha already have a child, and are expecting a new baby this month).
Representatives from Veterans Affairs fear that there are many more soldiers like Dupree whose PTSD symptoms are going untreated. An estimated 2,000 veterans are expected to return to Maryland when their tours of duty in Iraq are through, and all will be eligible for VA services, including mental-health care.
“And as the number of soldiers deployed continues to increase, that number will increase,” says Sonja Batten, coordinator for the trauma-recovery programs for the VA Maryland Healthcare System.
Nationwide an estimated 17.1 percent of Iraq War veterans have already experienced PTSD symptoms, and that number is expected to rise according to a July report in the New England Journal of Medicine. Locally, only 344 Iraq veterans have come into Maryland VA Hospitals this year for any reason, according to Batten. So far 74 of those veterans have sought mental-health care.
“We expect about one-third of soldiers exposed to traumatic events will recover on their own,” Batten says. “About one-third will have some problems but not at the level of PTSD, and about one-third will develop a full case of PTSD.”
In addition, she says, some may experience a very delayed onset of the disorder.
“By and large there will be some symptoms that are present in someone who is going to develop PTSD,” Batten says. “But we do see examples of people who don’t develop a full case of PTSD until there’s another large stressor in their life, such as another traumatic event, the death of a loved one, or even retirement.”
That’s bad news for National Guardsmen and reservists like Dupree who have served in Iraq, because there is a clock ticking on their eligibility for free veterans’ benefits.
“According to a recent Veterans Health Administration directive, active duty National Guardsmen who are reservists are eligible for two years of free care for conditions related to their time in the military, for the two-year period after their discharge from active duty,” says Chris Buser, social worker and seamless transition coordinator for Veterans Affairs. Buser says this directive was conceived by former VA Secretary Anthony Principi, who stepped down last week from his cabinet post to cut federal spending costs. If a person seeks treatment after that two-year window closes, he says, the person must provide evidence that their health problem is related to their active duty, and will be eligible for benefits based on income.
“Veterans who have served their tour honorably in one of the four branches of service would be eligible for benefits for their entire lives based on two years of active duty, an honorable discharge, and meeting the current financial status, which is a family salary of less than $37,000,” Buser says. “If the reservist or National Guardsman comes back from combat, they have a two-year period in which they can receive free health care from the VA. If, after the two-year period, the veteran can prove that the condition they are in need of care for occurred while on active duty, they can establish a service-connected disability, and will not be expected to make payments for their care for that disability. But if a veteran’s family salary is beyond $37,000 dollars financial eligibility, they can enroll for care—but they have to pay for it.”
The problem with this policy, some say, is that it can take some veterans many years to realize or admit they have a serious PTSD problem. Don Cornelious of East Baltimore is a veteran of the Gulf War. He served as an Army specialist for one year, from August 1990 to August 1991, and has been experiencing PTSD symptoms ever since. He says that it took him 10 years to finally deal with it.
“Initially, when I came home, I wasn’t aware that I had a problem,” says Cornelious, who recalls cleaning up dead bodies in the aftermath of an attack in Kuwait. (”They were burnt to a crisp, and all you could see were their skeletons.”)
Back in Baltimore, he experienced flashbacks, hypervigilance, and insomnia. But he did not seek counseling—instead, he started using marijuana, cocaine, and alcohol almost immediately upon his return. He says he eventually suffered from alcohol and drug addiction, had a failed marriage, and engaged in various criminal activities. It took him all of these setbacks— plus a three-year prison term—to finally seek help for his problem. He has been was one of Batten’s patients at Baltimore’s VA Hospital on Green Street since 2003.
Cornelious thinks the military ideology is partly to blame for the fact that some soldiers try to cope with the symptoms on their own.
“The military trains us to act—and not think about what we act on,” Cornelious says. So they teach us to numb our feelings and not to deal with them. So to come home and admit that you have a problem [of a mental health nature] is out of character for a soldier who has been taught to be hardcore. . . . When I got out, I had benefits from the VA for the rest of my life. And these guys only have two years to claim some sort of problem? Look how long it took for me to get help.”
“There’s an attitude that soldiers should pick themselves up by their own bootstraps,” Veterans Affairs’ Buser says. “And there’s also a certain amount of stigma attached to admitting that you have a problem—especially a mental health problem.”
Dupree says that he will get help if he needs to—when he gets around to it. But hopefully, he says, he will not run out of time to claim his VA benefits.
“I think about the fact that I could be a ticking time bomb, and the fact that just because the symptoms went away for now, doesn’t mean that everything is good,” he says. “I think, eventually, I’ll go see somebody about it.”
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