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From the Archives: Veterans Cast Watchful Eye on the VA Medical Center

July 8, 2012 2 comments

Very rarely do I write anything that even edges up on hard news.  This story from 2000 is one of those exceptions.  It had to do with complaints filed against the Omaha VA Medical Center and the watchdog role local veteran activists assumed in agitating for change and monitoring government responses and remedies.  The Department of Veterans Affairs has a spotty even inglorious and sometimes infamous track record in attending to the medical needs of servicemen, past and present, and horror stories abound of poor conditions and treament experiences in veterans’ facilities.  Of course, much good is done as well.  But given that problems persisted before the last solid decade or more of returning combat vets requiring care the problems have, from I gather, only mutiplied in the crush of patients overwhelming the system.

 

 

From the Archives: Veterans Cast Watchful Eye on the VA Medical Center                

©by Leo Adam Biga

Originally appeared in The Reader (www.thereader.com)

 
A Call for Action
Last September saw the release of a long-awaited federal report stemming from an investigation by the Department of Veterans Affairs’ Office of Inspector General into complaints about the Post Traumatic Stress Disorder (PTSD) program at the Omaha VA Medical Center. The investigation followed requests by Sen. Bob Kerrey, D-Neb., and Sen. Tom Harkin, D-Iowa, to examine complaints made to them, many in impassioned letters and phone calls, by veterans.

After the October 1999 investigation, nearly a year passed before the inspector general issued a 50-page report substantiating such concerns as insufficient staff, poorly coordinated services, long scheduling delays, inadequately administered drugs and a weak patient advocacy program. Other beefs, including allegations about negligent care, were not supported. Kerrey characterized the findings as showing “there are serious problems…inside an organization that is for the most part dedicated to high quality care.” The report made 16 recommendations for addressing the problems. Concurrent with the PTSD review the entire medical center was the subject of a routine comprehensive inspector general assessment, the timing of which may have been pushed up given the heat coming down from Washington, and its report surfaced more concerns and remedies amid overall good health care practices. In what was described as a coincidence, the center’s director and chief medical officer retired in June.

A hospital spokeswoman said the center has already implemented several changes and is on pace to complete others by target dates. Veterans who called for the initial study are pleased with some changes but assert old problems still persist. Todd Stubbendieck, legislative assistant in Kerrey’s Washington, D.C. office, said,
“Our understanding is everything is being implemented there. We’ve heard no additional patient complaints.”

Raising Hell
The reports, written in the cold, clinical language of bureaucratic Washington, mute the rage some veterans express at the insensitive and unresponsive manner in which they insist they’ve been treated. David Spry, vice president of the local chapter of the Vietnam Veterans of America, has become a mouthpiece and advocate for their discontent. His own experiences as a post traumatic stress disorder patient (in Lincoln), as a veterans legal custodial aide and as a past Veterans Advisory Committee member at the Omaha VA facility put him in a unique position to assess center practices and to glean feedback from the veterans community. Much of the discord has centered on a few key staff members and administrators and their perceived arrogance toward veterans. “They treated us with disrespect and that’s what a lot of the complaints are about,” Spry said. “It’s like, They’re the system, and we’re only veterans. What do we know? They thought we had no brain, no mouth, no nothing once we left their building, but we were comparing our notes about this place with other veterans groups.”

Spry turned veterans’ dissatisfaction into a cause that eventually got lawmakers and government oversight bodies to take action. For Spry, a Vietnam combat veteran, the process of getting officials to finally take seriously the red flags he and others originally raised more than three years ago has been an odyssey akin to battle. The role of whistle blower has taken its toll, too. “It hasn’t been easy. In 1997 we started to complain vigorously to VA management about this. We got nowhere. Our complaints never even got into the minutes of the meetings of the Veterans Advisory Committee. The things we were concerned about were problems we didn’t seem to be able to get corrected internally, so we went to a congressman,” he said, referring to former Rep. Jon Christensen (R-Neb.). Veterans aired grievances to Christensen and VA officials but, Spry said, little headway was made. “Then, when Christensen became a lame duck, we were kind of at a loss.”

 

 

 

 

Making the Case
That’s when, in 1998, Spry and fellow Vietnam Veterans of America service officers brought complaints, which grew in the wake of a national hospital accreditation survey, to the inspector general office, the Senate Subcommittee on Veterans Affairs and Kerrey. Spry said a year elapsed before Kerrey’s office took serious interest. Then, at the request of top Kerrey aides, Spry and his comrades were asked to gather veterans’ gripes and, once Kerrey saw the more than 100 letters of complaint, he asked the inspector general office to get involved. At the time, Kerrey said, “…this Vietnam Veterans post has made a persuasive case that something’s going on here that’s not good.” According to Spry, “This organization of ours really became quite passionate about this. We really pushed very hard. We had a lot of people looking into this and we finally got somebody to listen to us. It helped tip the scales when Sen. Kerrey came on board.”

Long before the inspector general weighed-in, the VA Medical Center followed-up its own internal program review by inviting the director of the VA system’s National Center for PTSD, Fred Gusman, to conduct an on-site assessment of the Omaha PTSD program in July 1999. Hospital spokeswoman Mary Velehradsky said, “We recognized we did have some systems problems as well as some patient care issues, and our inviting Mr. Gusman was a way to have another set of eyes look at that and to fix the problems and to make it a stronger program.”

Gusman’s findings of a “systemic problem” was confirmed by the inspector general, which included Gusman’s data in its report. He has made a follow-up visit to the hospital and, with inspector general staff, is overseeing program modifications.

 

 

A Thorn-in-the-Side
By the time the inspector general took a hard look at the Omaha facility, Spry said he was persona non grata with hospital officials. “I became a little too much of an irritant and they banned me from the facility except for medical treatment for my own service-connected disabilities. But that wasn’t good enough. They took away my freedom of speech, too. I am to have no contact with anyone or anyone with me. They’re doing anything they can to shut me up.” Veteran Tom Brady, who worked with Spry to document complaints about the center, said Spry has been singled-out: “Certainly, there are consequences to exposing practices that are subject to sanctions. He’s been one of the driving forces behind a lot of things and now they treat him like he’s a dangerous person.” Velehradsky confirmed the restrictions but added, “There are reasons people can be banned from a facility and I can guarantee you there was nothing connected to the IG (inspector general) incident.” She did not specify the reasons in this case.

As unofficial watchdogs, Spry and Brady chart the center’s progress in making changes. “We’re trying to monitor what’s going on, but we’re limited in going up there. From what we can tell, they have implemented a number of things that we’re really happy about. We’ve seen improvements in scheduling, in medications and in one-on-one therapy. We’ve seen a considerable difference in staff morale. The hospital is a lot happier.” But he and Brady remain critical of some program staff they feel lack expertise in working with PTSD patients. A psychologist whom the majority of complaints was filed against remains while a popular social worker has left. The two veterans also continue to be disenchanted with what they feel is the distant voice veterans have there. “We’re still not a cooperating partner — not because we don’t want to be,” Spry said.

According to Velehradsky the center has long had in place mechanisms for veterans to speak out with management and has recently increased these feedback avenues. She said the PTSD program has been strengthened with new procedures and the addition of specialized staff. She added recent patient surveys indicate high approval ratings and that veterans not wishing to be treated in the Omaha program have the option of being seen in a Lincoln clinic.

Standing Guard
It is perhaps inevitable disenfranchised veterans and entrenched VA Medical Center managers see things differently. Where Spry feels “it’s kind of a shame we had to go to this extent to push the bureaucracy around to get them to look at things,” Velehradsky said: “When you have an outside set of eyes look at your program and make recommendations it does make you stronger. We welcome it. It’s been very helpful and we continue to make improvements.”

While Kerrey has termed the VA episode a victory for veterans, the ever vigilant Spry remains wary and vows to carry on the fight if need be. His never-say-die attitude was formed as a Marine in Vietnam while under siege from overwhelming forces at Khe Sanh during the Tet Offensive in 1968. “I kind of made a commitment to myself and to the 1,500 of us who died at Khe Sanh that I don’t ever want to lose another battle again. And that’s why I’ve fought this (VA) thing. Have I been tenacious about this? I certainly have. All I want to do is make things better.”

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Bob Kerrey weighs in on PTSD, old wars, new wars, endings and new beginnings

January 27, 2011 6 comments

For many Nebraskans, myself included, Bob Kerrey has always been a fascinating figure.  Unusual for a politician from this state, he exuded a charisma, some of it no doubt innate and genuine, and some of it I suspect the reflected after glow of our idealized projections.  As a combat war veteran who overcame the loss of a leg in service to his country, he was a valiant survivor .  As a brash political upstart and liberal Democrat in solidly conservative and old-boy-network Republican Nebraska his was a new voice.  His good-looks and suave ways gave him a certain It appeal. When he landed in the governor’s office and struck up a romance with actress Debra Winger, who was in state to shoot scenes for the film Terms of Endearment, it only confirmed Kerrey as a rising star and player in his own right.  His long career in the U.S. Senate is probably most memorable for the number of times he was mentioned as a possible candidate for the Democratic presidential nominee race.  He did end up running but it soon became clear his magic did not resonate with the masses.  More recently, he dealt with the unpleasant truth of hard things his unit did during the Vietnam War.  He left the political arena for a university presidency only to find himself at odds with faculty and student groups who eventually called for his ouster.  As he prepares to leave the world of academics for some as yet unnamed new venture, he seems like a lot of us who come to a point in life where it’s time for reinvention and renewal. The following story for The Reader (www.thereader.com) is obstensibly a sampler of his views on Post Traumatic Stress Disorder as it relates to active duty military and war veterans, but it also serves as a look into how he approaches and articulates issues. I also have him weigh in on the Tucson shooting.  At the end of the piece I address some of the currents in his professional life that find him, if not adrift exactly, then searching for a new normal.

 

Bob Kerrey

 

 

 

Bob Kerrey weighs in on PTSD, old wars, new wars, Eedings and new beginnings

©by Leo Adam Biga

Published in The Reader (www.thereader.com)

 

Vietnam war veteran and former Nebraska governor and U.S. Senator Bob Kerrey will be in Omaha Jan. 31 to salute At Ease, an Omaha program providing confidential behavioral health services to active duty military personnel and family members.

Founded by Omaha advertising executive Scott Anderson, At Ease is administered by Lutheran Family Services of Nebraska. Kerrey, whose embattled New School (New York) presidency ended January 1, is the featured speaker for the At Ease benefit luncheon at Qwest Center Omaha.

Reports estimate up to one in five Iraq and Afghanistan war veterans — some 300,000 individuals — suffer from Post Traumatic Stress Disorder (PTSD) or major depression. Controversy over strict U.S. Veterans Administration guidelines for PTSD claims has led to new rules that lessen diagnostic requirements and streamline benefits processing.

Last summer Kerrey, a board member with the Iraq and Afghan Veterans of America (IAVA), publicly criticized a VA policy banning its physicians from recommending medical marijuana to patients.

“There are doctors who are strongly of the view that marijuana prescribed and monitored can be beneficial for a number of physical and mental conditions,” he says. “And in those states where medical marijuana is legal I think the VA should allow it.

“If a doctor can prescribe medical marijuana for somebody who’s not a veteran, it doesn’t seem to me to be right for that doctor not to be able to prescribe it for a veteran.”

Kerrey, speaking by phone, says he keeps fairly close tabs on veterans’ affairs.

“I would say I stay more current on veterans health and veterans issues than I do on other issues. I’ve made a few calls on the Veterans Bill of Rights that (Sen.) Jim Webb pushed. I get called from time to time to help people that are having problems. It’s much harder to help somebody when you’re not holding the power of a senate office or a governor’s office.”

Kerrey strongly advocates the work of IAVA, founded in 2004 by Paul Rieckhoff, a former Army First Lieutenant and infantry rifle platoon leader in Iraq.

“It’s a very good organization for any Iraq or Afghan veteran that’s looking for somebody they can talk to,” says Kerrey. “They’re very careful not to duplicate what the VFW (Veterans of Foreign Wars) and the DAV (Disabled American Veterans) and the (American) Legion are doing.

“They don’t have buildings, they just have basically networks of Iraq and Afghan veterans who are trying to help each other.”

He suggests the number of veterans needing help for PTSD is so vast that only a combined public-private initiatives can adequately address the problem.

“You start off with an estimate of 300,000 PTSD sufferers from Iraq and Afghanistan and multiply by it two or three, depending on how many family members are going to be affected, and you’re talking about maybe a million people,” he says.

“This is a difficult thing for the Veterans Administration or other government entities to handle all by themselves. Non-governmental efforts are typically supplemental — all by themselves they’re not going to get the job done (either).”

He views At Ease as a non-governmental response that can help address problems at the local level.

“It’s hard to figure out what to do for a million, but if you’re talking about 50 or 60 or a hundred or just one, there’s something you can do, and that’s what At Ease is doing through Lutheran Family Services. It’s a great example of how when you say, I’d like to do something to help, there are venues, there are ways to help. It’s a terrific story.”

His remarks at the fund raiser will make that very point.

“My focus will be on how possible it is for a single individual, in this case Scott Anderson, a nonmilitary citizen with no direct contact with PTSD, to do something. And his program’ saved lives, it’s made lives better.”

In this belt-tightening era, Kerrey says nonprofit-volunteer efforts can make an especially vital impact.

“We hear so much about things unique to America that there’s a tendency at times to be skeptical. But our nation’s volunteer, not-for-profit efforts are unique in the world. The financial and volunteer time giving that occurs is a real source of strength that doesn’t show up on economic analyses,” he says, adding that veterans’ problems are “not going to be made easier if in a moment of budget cuts we cut back on mental health services.”

Attitudes about mental health disorders are much different now than when he returned from combat in Vietnam, where he led a Navy SEAL team. Kerrey was awarded the Medal of Honor. Thankfully, he says, the stigma of PTSD is not what it used to be.

“First of all, I think mental illness is seen much differently today — much more mainstream, much more comparable to physical illness. I think you’d probably have a hard time finding somebody in Nebraska that doesn’t have somebody who’s experienced a trauma producing some kind of disability.

“I would say the mental trauma is in a demonstrable way more disabling than the physical trauma. And the two can be connected. I think generally today people accept that. I’m sure there’s still a lot of people who think of PTSD as connected to Vietnam but I think that’s the exception rather than the rule. The rule is it’s seen more broadly as a condition that can affect anybody, both in and out of combat.”

Repeated deployments in Iraq and Afghan, he says, have added new stressors for “guys rotating in and out multiple times. It’s one thing to go over your first time and wonder whether or not an IED is going to take you out, but to have to go over a second, a third, a fourth (time) — at some point it has to harden you when you get home. It has to have a terrible impact on you.”

He believes whatever care veterans receive must be personal and consistent.

“The most important thing is sustained support because what you need is somebody you can call when you’re having trouble,” he says.

Although he never suffered PTSD, he dealt with losing a limb and adjusting to a prosthesis. He endured physical pain and memory-induced night sweats. He says while recovering from his injuries “some of the most important things given to me were by volunteers who would just come in and say, ‘It’s going to be all right.’ It’s extremely important for another human being to be there and demonstrate they care enough about you to spend time with you.”

On other topics, Kerrey says the recent Tucson shooting may hold cautionary lessons. Alleged gunman Jared Lee Loughner made threats against his target, Congresswoman Gabrielle Giffords, a Democrat sharply criticized by the Right. Kerrey says while rhetoric is part of this society’s free exchange of ideas, labeling an elected official a danger may trigger an unstable person to act violently.

Meanwhile, Kerrey, who was to have remained New School president through July, has given way to David Van Zandt. Kerrey remains affiliated with the school. His fate as president was sealed when senior faculty returned a 2009 no-confidence vote. Until last summer Kerrey had been in negotiations with the Motion Picture Association of America to become the trade group’s president.

About his New School experience, he says, “I’m grateful for the chance to have done it. I learned a lot. I got a lot done. I made a lot of friends.” He also ran afoul of vocal student-faculty blocs. His well-known political skills failed him in the end.

“I certainly didn’t expect my term as university president was going to be free of situations where something was going to be upsetting. I was not an altogether cooperative student when I went to the University of Nebraska. I’ve seen university presidents hounded, harassed, criticized before I became one, so it didn’t really surprise me.”

With the MPAA no longer courting him, Kerrey says he’s looking to do “something in public service — something I think is not going to get done unless I do it,” adding, “It’s much more likely I’m going to be spending more time back there (Nebraska).”

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