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By JOSHUA COFFMAN
FORT KNOX — “I feel lost.”
A wounded soldier in the warrior transition unit at the Army post wrote those three words on a form that asked about his plans for the future.
The questionnaire was part of a tracking program run by an increasing number of state-level veterans’ organizations that help injured soldiers make the move from the Army to the civilian world.
Pam Cypert, executive staff director for the Kentucky Department of Veterans Affairs, oversees the program at Fort Knox and Fort Campbell. The soldier’s form crossed her desk.
“I called him instantly,” she said.
The program seeks to inform soldiers about the process to receive VA benefits and puts them in touch with their state veterans’ organization upon discharge.
The branch in their home states follow up on the forms, making sure the soldiers have housing, information on loan programs and are moving along in their transition.
It gives them a leg up to find their way forward after leaving the military injured or disabled.
Between October and March, 56 veterans in the warrior transition program from other states and another 11 from Kentucky went through the program.
Cypert, herself a veteran, talked with a handful of WTU soldiers in a classroom earlier this year, instructing them on how to navigate through piles of paperwork and about the information needed to qualify for federal help.
“As soldiers you’re trained not to be whiners, not to be complainers; take some Tylenol and suck it up,” she told them. Instead, she encouraged the soldiers to “talk to your doctor about exactly what’s going on — get it in records.”
Cypert said the easiest way to be cleared for VA assistance is by documenting an injury while still enlisted.
However, post-traumatic stress disorder, a key ailment among soldiers returning from Afghanistan and Iraq, cannot be seen by the naked eye and can take months for symptoms to show up. Cases for soldiers seeking benefits can be complex.
Called shell shock in World War I but not recognized by the government in Vietnam veterans until decades after the war, the anxiety, asocial withdrawal and nightmares associated with it finally are receiving less stigma and more aid.
The departments of Defense and Veterans Affairs have streamlined their policies to ease transitions for soldiers and more attention and dollars have been given to treat brain injuries and PTSD. Still, as more is done to help, the number of cases continues to rise.
AN INVISIBLE PROBLEM. Last month the Pentagon announced that more than 40,000 service members have been diagnosed with PTSD since the start of the war in Iraq. The Army reported 10,000 new cases last year, up from 6,800 the year before.
In addition to those numbers, military medical analysts believe more than half of veterans who suffer from the disorder do not seek treatment.
A recent survey by the RAND Corp. found, of the 1.6 million troops who have deployed in the global war on terror, nearly one in five — 320,000 — experienced a traumatic brain injury ranging from concussions to major traumas. A slightly lesser number, 300,000, said they suffered from PTSD at some point.
About 7 percent said they experienced both a traumatic brain injury and PTSD or major depression.
At Fort Knox’s warrior transition unit, group sessions are held with a specialist in addition to anger and stress management classes.
The unit relies on a buddy support system and the Army program, Battlemind, which helps soldiers transition their mindset from the battlefield back to the home front.
Col. Susan Rogers oversees behavioral health at Ireland Army Community Hospital. She said the buddy-based system for PTSD treatment is effective for soldiers.
“They seem to do really well when they’re with their peers,” she said, “and they find out they’re not the only one experiencing these terrible things.”
A six-week program meets four days a week and is followed up with checkups and family support.
Other steps taken to improve mental health include a ban on alcohol in WTUs. That took effect March 1.
The focus on PTSD was directed from the highest levels of the Pentagon. A center for excellence has been established for mental health in addition to a Wounded Warrior Integration Team to address combat-related mental health issues.
Defense Secretary Robert Gates has expressed interest in considering awarding Purple Hearts for PTSD, which the military presently considers an illness rather than an injury.
The military also has called for its senior leaders to seek treatment if needed to further de-stigmatize the issue among junior soldiers returning from combat.
Many soldiers fear their career advancement will suffer if they seek treatment. A federal form needed for national security clearances includes a question about whether a person ever sought mental treatment. It now allows an exemption for combat-related occurrences.
Cypert said the Army’s efforts to encourage more soldiers to get treatment still faces challenges.
Of some WTU members’ mindsets, she said, “‘if I tell them I have an issue I’m going to stay here longer, so I’m going to keep my mouth shut.’”
SMOOTHING THE TRANSITIONS. Pilot programs to streamline Defense Department and VA processes have begun around Washington, D.C. and Fort Bliss, Texas.
At Fort Knox, WTU soldiers process into VA before leaving a unit, said its commander, Lt. Col. Gary Travis. That has not always been the case.
“What I want to see is a coherent bridge between military and civilian life,” he said. “I don’t want to see them on the Mall or under a bridge in D.C.”
Following more than 400 recommendations from five agencies, joint centers are planned and processes such as data sharing are being streamlined.
The way soldiers and veterans are medically evaluated also is being unified between the two federal agencies.
The VA is hiring hundreds more psychologists and thousands more claims processors.
In a February teleconference, Sen. Carl Levin, D-Michigan, chairman of the Senate Armed Services Committee, said a study of 1,400 PTSD patients, using Defense and VA disability ratings showed different results.
The Defense Department gave less than one in five of those in the survey a 30-percent-or-greater disability rating. The VA gave the same rating to nine of 10 of the same subjects.
“It’s record time that we acted,” Levin said.
As Pam Cypert wrapped up her class with WTU soldiers at Fort Knox, she said the monitoring program she oversees is still in its early stages.
Some installations, such as Fort Knox, have been easier to work with, she said, while others, such as Fort Campbell, have had more red tape — especially with a much higher number of its soldiers being deployed.
“We have to show the Army we’re here to help,” she said. “It’s in its embryonic stage. It’s going to take a couple years to get it all worked out.”
The wheels of transition continue to turn on most every front of soldier care. But those implementing the changes, from Capitol Hill and the Pentagon to Fort Knox, say they are committed to giving troops returning from present-day battles access to better health care than after any other American war.
And, like everything else in government, Cypert said that begins locally.
The Defense Department is “doing the best that it can, and VA is doing the best that it can,” she said. “But I really think the states can help at the community level.”
Joshua Coffman can be reached at (270) 505-1740.