Is Vermont armed to address returning vets' mental health?
A wooden bear at the entrance to the South Burlington Vet Center greets arriving veterans with a sign that says, "Welcome home." A black-and-white POW/MIA decal in the front window reads, "You are not forgotten." And a bumper sticker behind the reception desk reminds visitors, "Women are veterans, too."
Another message, though not posted on the center's walls or windows, is understood implicitly by the mental-health counselors who work here: If you've taken fire in a war zone, your life will never be the same again.
Since 1979, the South Burlington Vet Center has been helping combat veterans cope with the emotional and psychological difficulties of readjusting to civilian life -- from mild, combat-related stress reactions such as anxiety, irritability and sleeplessness to severe depression, substance abuse and Post-Traumatic Stress Disorder (PTSD). The center's counseling services are free to all veterans and their families, regardless of where those vets served. Not surprisingly, most of the center's clients in the last 25 years have been Vietnam vets.
But that could change soon. In the last year, Vermont has experienced its largest military mobilization since World War II. Currently, nearly 1000 Vermont Army Reserve and Air National Guardsmen are deployed overseas; hundreds more will be called up in the coming weeks and months. And with the first wave of about 200 Iraq veterans due to return to Vermont in March, some military families, community members and local mental-health professionals are beginning to ask: Are we prepared for all the problems that may accompany their arrival?
Fred Forehand is director of the South Burlington Vet Center and one of its three mental-health clinicians. Forehand has seen the center's caseload double since April 2003, when the Iraq War began. He says that many of those clients have been to the center before, such as vets whose past psychological wounds were reopened by images of the wars in Iraq and Afghanistan. Others are Vietnam veterans whose sons and daughters are now serving in Operation Iraqi Freedom -- or who are being called to active duty again themselves.
But Forehand also points out that Iraq War vets are already coming through the center's doors. Thus far, their numbers are relatively small compared to the total caseload. However, that trickle could become a torrent as Vermont and northern New York State experience large waves of troops returning to civilian life.
"We're sort of in a holding pattern waiting for things to happen," says Forehand. "It's always been manageable, but we just don't know. There's a lot of uncertainty."
One unknown is how many returning soldiers will need long-term counseling and treatment. There's growing evidence that the nation's mental-health system could be inundated with tens of thousands of soldiers coming back from Iraq who suffer from moderate to severe psychological problems related to their tours of duty (see accompanying story). As The New York Times reported several weeks ago, a U.S. Army study found that about one in six soldiers serving in Iraq reports symptoms of serious anxiety, major depression or PTSD. And some experts predict that the number could be closer to one in three -- the rate experienced during the Vietnam War.
What will this mean for Vermont? Forehand says we can expect to see many of the same maladies that afflicted veterans of earlier conflicts, albeit in larger numbers: increased rates of drug and alcohol dependency, marital difficulties, spousal abuse, financial hardships, even homelessness. Last month, for example, United Press International reported that Iraq veterans are already turning up at homeless shelters around the country, raising concerns about a new generation of uprooted vets in numbers not seen since the post-Vietnam era. And the UK's Telegraph newspaper reported two weeks ago that the U.S. Army is now sending some troops to "Ômarriage enrichment' seminars and romantic getaways" to stem the skyrocketing rates of divorce and domestic violence among returning soldiers.
Another unknown: How will Vermont soldiers, who are by and large "weekend warriors," cope with the enormous stress of combat as compared to full-time military troops? On the one hand, unlike the soldiers who were drafted during Vietnam, Vermont's guardsmen and women are volunteers willingly serving their country. And the outpouring of community support for the troops in Iraq is at a level not seen since World War II, as evidenced, for example, by the proliferation of yellow ribbons, car magnets and "Vermont-made" care packages sent to the troops. Forehand says such emotional support goes a long way toward helping soldiers and their families cope with the strain of extended separation.
On the other hand, Vermont's soldiers are also much older than the troops who served in earlier wars. The average age of Vermont's Task Force Green Mountain battalion is 35; some Vermont soldiers heading to Iraq are as old as 58. And unlike the 19- to 22-year-old soldiers who made up the bulk of the fighting forces in Vietnam, many of Vermont's guardsmen and airmen were deeply entrenched in their communities, supporting spouses and children, owning businesses and so forth. Simply put, the U.S. military has very little prior experience to draw on for predicting how an older generation of soldiers will cope with combat stress and civilian readjustment.
Vermont's returning vets could also present another unique challenge: More women are serving in the military than ever before. Female soldiers now comprise about 10 percent of the Vermont Army National Guard, and about 15 percent of the Air National Guard. Currently, about 70 Vermont women are deployed overseas. How these female soldiers will cope with the emotional scars of war is another unknown. As Forehand puts it, "The war zone doesn't respect gender."
Vermont's military commanders say they're not just waiting around for the other shoe to drop. Jon Coffin is outpatient director at the Howard Center for Human Services, as well as a colonel and staff psychologist in the Vermont National Guard. He says that when it comes to preparing Vermont's troops and their families for the stress of combat and their eventual return to civilian life, the Vermont Guard is "light years ahead" of where it was in Vietnam.
Shortly before Christmas, for example, Coffin was in Mississippi visiting with Vermont soldiers who were training for their overseas deployment. His job, Coffin explains, was to "stress-inoculate as many people as I could by telling them that we will be taking care of them upon their return.
"If people come back with PTSD, we're locked and loaded to work with them," he continues. "We're hoping in the main, however, that people aren't going to come back with PTSD. They're going to come back with normal stress reactions that you and I would have being in a really weird situation. "Coffin knows firsthand what that's like. As a combat veteran of the Southeast Asia conflict, he still sleeps with earplugs because he's "a bit hyper-vigilant." Hyper-vigilance is a normal stress reaction to warfare, and one of the many symptoms explained in the handouts given to returning soldiers and their families. Those handouts cover everything from the signs and symptoms of PTSD to "reunion stress" -- the emotional letdown and other difficulties that sometimes accompany a soldier's return, such as the awkwardness of reconnecting with spouses, children and friends, and re-acclimating to jobs and other civilian duties.
Another lesson learned from Vietnam, says Coffin, is that returning vets aren't rushed back into civilian life -- it's not as if they're kicking in doors in Fallujah one day and walking the streets of Burlington the next. Returning troops undergo a series of group and individual debriefing sessions with peers and mental-health counselors, a process that's been shown to significantly reduce the incidence of serious readjustment difficulties. Moreover, about six weeks after they return, soldiers and their families attend a readjustment session to discuss everything from their medical and psychological difficulties to financial problems.
For returning soldiers or family members who experience more severe problems, Coffin says that the Vermont National Guard has trained about 40 people in crisis-intervention techniques, many of whom are recent combat vets themselves. "We've got a pretty high-powered presentation," Coffin says. "People are transfixed by it. They can't get enough of listening to their stories.
"I don't know what we'll need," he adds. "Maybe no one will ever want to talk to a counselor. Or maybe a hundred will. But we'll be ready."
Nevertheless, some Vermonters aren't convinced that enough is being done to prepare the civilian sector. The experience of Vietnam taught us that some returning vets will want nothing to do with the VA, the Vet Center or anyone else associated the U.S. military. "My God, it's deja vu all over again," says Dave Ross of the Vermont's Veterans for Peace. He points out that just as many Vietnam veterans died of suicides, drug and alcohol overdoses and single-passenger car accidents after the war was over as were killed during the conflict itself. He says that Vermont's civilian sector needs to come to grips with that reality because, "We're just starting to see the tip of the iceberg emerge."
Another Vermont group, Military Families Speak Out, faxed a letter to Governor Jim Douglas on December 15 asking him, among other things, for a meeting to discuss what is being done to prepare the state's civilian agencies -- homeless shelters, substance-abuse programs, domestic-violence groups -- for readjustment problems. So far, Douglas has expressed no interest in such a meeting. And according to Senator Jim Leddy (D-Chittenden), who chairs the Senate Health and Welfare Committee, there is no coordinated statewide effort yet to address this issue for civilian agencies. Although the Legislature appropriated $50,000 last year for the National Guard to "use as it sees fit" for family support, Leddy admits that won't be nearly enough.
"I think our Guard is a doing a great job in this area," Leddy says. "But I believe we'll need to do much more than that because that was a year ago, long before we had any awareness of what this war is doing to us in terms of the numbers of Vermonters called to active duty."
This week, Representative Bernie Sanders announced that he secured $500,000 in additional funding for the VA Health Care Center in Colchester. Sanders' Communication Director Joel Barkin says that at least some of that money has been earmarked for counseling services for returning guard members and their families.
Nevertheless, an informal phone survey of Vermont's social-service agencies revealed that this issue isn't even on many of their radar screens yet. One exception: Women Helping Battered Women, the Burlington domestic-violence shelter, reports that it's been working with women whose partners were abusing them before they were deployed overseas. Although these women are relieved that their physical abuse has ended, they're feeling guilty about their partners being in harm's way. And, perhaps, worried what life will be like for them once the men return.