ON MEMORIAL DAY

Broken promises to our veterans

by Michael Blecker San Francisco Chronicle

Thousands of Iraqi and Afghanistan veterans are returning home only to become casualties of war - at their own hands. Suffering from psychiatric injuries, 1,000 veterans under Veterans Administration care are attempting suicide each month. Almost 40 percent of the young men and women returning from combat almost have proven mental health injuries that include Post Traumatic Stress Disorder, major depression and traumatic brain injury.

But when they seek help, disabled veterans face a claims system so mismanaged and inefficient that they often must wait more than five years for any assistance. The Department of Veterans Affairs is choking on a backlog of some 600,000 unresolved benefits claims. Even after their eligibility has been established, thousands of veterans cannot obtain adequate mental health treatment. While they wait for the care they are owed, veterans are dying. About 126 veterans per week commit suicide. Vast numbers of veterans are living with mental illness, sometimes so severe that they are unable to work. Nationally, about 154,000 veterans are homeless on any given night and twice that many are homeless at some time during the year.

In a federal court lawsuit tried in San Francisco last month, two veterans' organizations asked Judge Samuel Conti to order the VA to streamline its systems for deciding benefits claims and obtaining mental health treatment. A decision is expected within a month.

During the trial, the VA vowed to do better, but history warns us against taking the VA's promises on faith. For example, a year ago, the VA adopted a Mental Health Plan for Suicide Prevention, which included many well-meant resolutions. But, in practical terms, none of the recommendations in this plan has been implemented, and none of its stated goals has been met. The suicides continue.

The VA's mental health professionals who work directly with veterans are skilled and caring, but the attitude of the VA bureaucracy is apparent from an internal e-mail from the VA's head of mental health, Dr. Ira Katz, that surfaced during the trial. At a time when the VA was publicly reporting only 790 veteran suicide attempts in all of 2007, Katz wrote, "Shh! ... Our suicide prevention coordinators are identifying about 1,000 suicide attempts per month ... Is this something we should (carefully) address ... before someone stumbles on it?" The VA seems to rate "damage control" as more important than caring for veterans who have been injured while serving our country.

Nonprofit organizations, such as Swords to Plowshares in San Francisco, try to pick up the pieces of veterans' broken lives, but they cannot possibly meet the overwhelming need. In San Francisco, these nonprofits can provide only a few hundred beds where veterans can receive targeted, residential mental health treatment, while at least 1,200 to 1,500 veterans live on the street, and hundreds more sleep in cars, parks and churches.

We learned from the experience of Vietnam veterans that allowing this situation to persist will lead to epidemics of unemployment and underemployment, homelessness and family breakdown. Sens. Barbara Boxer D-Calif., and Kit Bond (R-Mo.) have introduced the Honoring Our Nation's Obligations To Returning Warriors (HONOR) Act, which would improve efforts to prepare soldiers for the stress of combat, and provide supportive services for families. Please ask your congressional representative to support the Honor Act and to demand that the VA fulfill its mission of caring for our wounded soldiers after they come home.

Some numbers we should not forget

-- The suicide rate of veterans is at least three times the national suicide rate. In 2005, the suicide rate for veterans 18- to 24-years-old was three to four times higher than non-veterans.

-- About 154,000 veterans nationwide are homeless on any given night. One-fourth of the homeless population is veterans.

-- There are more homeless Vietnam veterans than the number of soldiers who were killed during that war.

-- It takes at least 5.5 years, on average, to resolve a benefit claim with the Veteran's Administration.

-- More than 600,000 unresolved claims are backlogged with the Veteran's Administration.

-- Approximately 18.5 percent of service members who have returned from Afghanistan and Iraq currently have Post-Traumatic Stress Disorder or depression.

-- 19.5 percent of these veterans report experiencing traumatic brain injury.

-- Roughly half of those who need treatment seek it, but only slightly more than half of those who receive treatment receive at least minimally adequate care, according to an April 2008 Rand Report.

Sources: Veterans Administration, U.S. Court of Appeals for Veterans Claims, Rand

Michael Blecker is the executive director of Swords to Plowshares in San Francisco, and Vietnam combat infantryman.