Nonprofit, public-interest journalism, 2000–2010

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Budget Said to Shortchange Veterans / Mental Health Services May Fall Short

By Michael Standaert

According to a recent Pentagon estimate, 30 percent, or about 100,000 troops, have or will develop mental health issues such as post-traumatic stress disorder, or PTSD, after coming home.

And with the federal Veterans Affairs budget falling short of what both its staff and critics have called for, veterans’ advocates fear the government is unprepared for what might be a growing problem.

Since the invasion of Iraq, the Veterans Affairs Department has been offering two years of free health care, including mental health, to combat veterans.

And the Defense Department recently began giving a questionnaire on “post traumatic stress disorder [and] psychological and social readjustment” to veterans three to six months after returning, according to Dr. William Winkenwerder Jr., the assistant defense secretary for health affairs.

Michael O’Rourke, a health care expert with the Veterans for Foreign Wars in Washington, D.C., said six months is not long enough, because PTSD is “insidiously slow in coming on … It’s known as post-traumatic because [it] doesn’t present itself the day they get back.”

This adds up to a “looming problem,” according to Paul Rieckhoff, a former infantry platoon leader and founder of the veterans advocacy group Operation Truth.

“There is little transitional support available for returning veterans,” he said. “There is not enough therapy and prevention education support yet for our troops.”

Telephone and email inquiries to the Veterans Affairs and Defense Department press offices in Washington were not returned. Regional VA staff acknowledged budget problems, but said mental health services had improved.

Gene P. Gibson, the public affairs officer at San Francisco’s VA medical center, said her facility is “well-positioned to provide service to veterans in our area.”

She said that in the past outreach has been held up by problems in tracking veterans after they return, by a lack of communication between the Defense and Veterans Affairs departments, and by a prohibition on spending taxpayer money on advertising.

“In all the years past, the veterans have had to find us,” something they have not always been willing to do, she said. “[W]hen you go back to civilian life, the last thing you want is someone telling you, especially when you’re healthy, [that] you have to go to the VA.”

For Operation Iraqi Freedom, Gibson said that the Defense Department has begun forwarding discharged soldiers’ contact information to Veterans Affairs, which then sends a letter informing them of their benefits.

She also noted that every VA hospital now has a combat case-manager who contacts local veterans to help connect them with a range of health services.

Gibson describes veterans as “not merely patients, but heroes,” and said staff at the San Francisco medical center tries to work around budget restrictions by visiting “veterans’ service organizations, civic organizations, charitable organizations, we go to health fairs, anything we can do at little or no cost. We aren’t supposed to be spending tax dollars on [advertising] … the money has to be spent on health care.”

In Ohio, a VA nurse who spoke on condition of anonymity praised the dedication of her colleagues, and said the quality of care offered in her region is “excellent.”

She said the local VA hospitals are ready for the influx of Iraq veterans, but noted that the three local psychiatric wards each have “only 29 beds … and that’s not a lot.”

Handling new admissions along with aging veterans from World War II, Korea and Vietnam, who suffer from maladies such as Alzheimer’s disease or dementia, could overload the system, she said.

Many of the complaints come down to funding, and at times the rhetoric has been bitter.

Former Veterans Affairs Secretary Anthony Principi sought to boost his 2005 budget by $1.2 billion, but ultimately came away with only a $500 million increase in medical care.

The projected 2006 Veterans Affairs health care budget submitted to Congress by the Bush administration has an even bigger gap — $3.1 billion short of what the veterans’ advocacy project Independent Budget has requested.

The federal veterans’ budget infuriated former Veterans of Foreign Wars Commander-in-Chief Edward S. Banas Sr., who said the Bush administration’s 2005 veterans’ allocations are a “disgrace and a sham.”

Banas’ successor, John Furgess, said on Feb. 7 that the 2006 budget was “shameful” because it “doesn’t acknowledge that the costs of war continue long after the last shots are fired.”

The VA nurse in Ohio listed a number of improvements she would make to her hospital’s facilities, but said even boosting the department’s budget would only be a partial solution due to “random waste” and bureaucratic “twists and turns.”

“Money is spent foolishly,” she said, “without any accountability. People pay triple for what they could get cheaper. Because it’s the government, [vendors] charge more … Because they’re using other people’s tax dollars, nobody seems to care. The money could be spent in better ways for veterans, for all that is lost for ridiculous things.”

Newsdesk.org staff contributed writing and editing to this article.