Veterans battle shocks of war

By Jaime North
The Daily Item

May 17, 2008 06:34 am

— DANVILLE -- A movement has been launched to find ways of helping rural veterans better handle the stress of combat, many of whom have yet to return from serving oversees.
An estimated 1.4 million troops have served in Iraq and Afghanistan, including more than 410,000 of them civilian soldiers serving in National Guard and Army Reserve units, all exposed to some level of combat stress, military officials say.
Still, more than 101,800 troops remained deployed.
The impact of war has even hit home in the Valley, where officials estimated roughly 226,090 veterans live within the Geisinger Health System coverage area. Many of them, officials say, continuously battle the effects of witnessing destruction, gruesome injuries and death while serving overseas.
As a result, more veterans are exhibiting early symptoms of Post-traumatic Stress Disorder (PTSD), an anxiety disorder that can occur after experiencing a traumatic event. The effects can lead to drinking or drug problems, divorce, domestic violence, job loss and even suicide.
Geisinger has thrust itself to the frontline of trying to help when it hosted a first-of-its-kind national conference earlier this week on how PTSD impacts rural families and how local health care providers can work together to provide treatment counseling for the mysterious illness.
Resources few
Veterans now living in rural areas are left with little resources to find help with their anger, stress and anxiety, according to Dr. Charles Figley, director of the Traumatology Institute at Florida State University and a PTSD expert.
"Never before have we asked so few civilian soldiers to do so much," said Dr. Figley, also a Vietnam veteran. "Many forget during Vietnam that joining the National Guard was a way to get out of going to war. Today, that's not the case. Without a draft, these volunteers are being pulled time and time again for duty, then returning home to rural areas that are ill-equipped to help them."
Dr. Figley was the among the featured speakers, which included military psychologists, veterans affairs officers and Geisinger researchers, who spoke about the challenges of not only identifying veterans with PTSD but getting them adequate treatment in rural areas.
"We're especially concerned with screenings, referrals and mental health services in primary care," Dr. Figley said. "The hope is health systems like Geisinger can develop a model program for helping civilian soldiers and their families. We want to promote cooperative agreements with the community leaders and primary health care providers. There needs to be a commitment to referring these veterans and addressing their needs."
Understanding needed
Geisinger is hoping to engage family physicians to better understand PTSD, as well as expand its own PTSD research. The initiative is important because so many effected veterans live under the Geisinger umbrella, according to Dr. Glenn Steele Jr., Geisinger's president and chief executive officer.
"The (PTSD) epidemic cuts right through industrial America and into our region," Dr. Steele said. "Take a look at the economic culture and who enter the National Guard and Army Reserves. It's our middle-class workers. The repeated tours are something pretty dramatic and a significant contributor to this epidemic."
The goal, he said, is to extend services to the veterans and their families rather than rely on them to seek help on their own.
"Our program here is to disseminate care out, not pull patients into Geisinger Medical Center," Dr. Steele said. "We can improve the dissemination of behavioral health care in rural areas through partnerships and shared resources. This is an approach that could work nationally. I cannot image our country to turn its back on our vets."
Although the military has a limited system in place to treat PTSD, the concern is how to identify and treat the veterans when they leave the service, according to Dr. William Nash, a Marine Corps captain with its Stress Injury Management Unit. This is especially true regarding civilian soldiers, he said.
"Sometimes it's difficult, if not impossible, to convince someone who is experiencing PTSD to believe they have something wrong with them," Dr. Nash said. "They sure as heck don't want to see anybody for help."
Dr. Nash said veterans typically don't trust strangers and are less likely to seek help on their own after experience subtle symptoms of PTSD, such as having nightmares and developing a quick temper.
"They're certainly not going to go and spill their guts and admit they have a weakness to someone they don't know," said Dr. Nash, who acknowledged, along with other officials, that few clinical physiologists are trained to deal with PTSD.
Dr. Figley estimated roughly 10 to 20 percent of military clinical psychologists are trained and less than 10 percent of civilian psychologists are. He, as well as other officials, said an important first step would be to establish a community network for veterans to find comfort in.
From there, appropriate referrals to health providers can be made, Dr. Figley said.
Help falls short
"Three of 10 veterans have met the criteria of a mental disorder and fewer than half received help for it," Said Dr. Figley, citing a recent study of veterans serving in Iraq and Afghanistan. "There is no well coordinated or well disseminated approach to provide behavioral health care to service members and their families.
"This is shocking because PTSD really came to light in 1980. It's always been there, so there is nothing new there. These studies are limited, however, because there isn't enough research on National Guard and Reserve veterans. There is still a lot of unknown there."
n E-mail comments to jnorth@dailyitem.com.

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