The American Legion Department of Colorado Blog

VA representatives will be on hand during national convention in Minneapolis to talk with veterans about the mental health treatment they’ve received.

The American Legion is asking its members planning on attending the 2011 National Convention in Minneapolis to share their stories of mental health treatment with the Department of Veterans Affairs.

The American Legion Veterans Affairs & Rehabilitation Division is working with VA on a mental health anti-stigma campaign called “Make the Connection.” During the national convention, VA representatives will be in the convention center to interview American Legion members about their mental health treatment to encourage other veterans to reach out for assistance.

Some veterans are living with a mental health issue but do not seek help; others may not even recognize they have a mental health condition. Stories of hope and recovery are at the heart of VA’s nationwide “Make the Connection” campaign, which encourages veterans to “make the connection” – with other people, with resources, with symptoms of mental health issues, and with treatment and support.

If you are a veteran who sought treatment for a mental health issue and received support – from any source – and are in a better place today because of it, VA wants to hear from you. Have your story videotaped at the national convention for use on the “Make the Connection” website. To share your story and learn more, contact SupportVets@reingold.com.

Convention attendees interested in sharing a story can email Jacob Gadd, the Legion’s deputy director of the Veterans Affairs & Rehabilitation Division, to schedule a time during the Convention to be interviewed.

On August 6, 2011 The American Legion’s Junior Air Rifle National Championship got under way with a shoot-off between two precision category competitors, the first time in the competitions 21 years. Afterward, the sporter category top eight competitors stood alongside each other with air rifles in hand for their first 10 shots.

It was a tight 10-shot sporter match between Mitchell Van Patten from Meridian, Idaho, and Renz Ibarra from Zion, Ill. But in the end, Van Patten claimed the sporter championship title by a mere two points, firing a 2295.9 out of a possible 2509.

“During the competition I try to tell myself to relax, and my favorite position is the one that I shoot,” Van Patten said. “My future plans are to make it to the Olympic Development Team and then on to the Olympics. And after all of that, I want to win the Olympics.”

Mitchell’s coach is his father, Brent, who says even if Mitchell wasn’t his son, he would still love to be his coach because of his dedication.

“Being his father and coach is sometimes very prideful and joyful and other times it can be frustrating. It’s an interesting balance,” Brent said. “But he is a teachable, coachable person who has lofty goals and he works hard to meet them. Besides natural talent and hard work, he is focused and has a lot of self discipline. And one thing I’m really impressed with is he comes back from adversity.”

The top eight precision competitors followed in the footsteps of the sporter competitors, standing side-by-side and firing 10 shots. With a five-point lead, Daniel Lowe from Olympia, Wash., claimed the precision champion title with a 2454.7 out of a possible 2509.

“My confidence comes from a close friend who gives me a motivational speech,” Lowe said. “He tells me what I can do because sometimes I doubt myself and begin to think I will do badly. So my friend always looks me straight in the eyes and tells me to do my best and be all I can be.”

Top five finishers: Precision – out of a possible 2509 points.

1. Daniel Lowe – 2454.7. From Olympia, Wash., and sponsored by Edward B. Rhoades Post 2.

2. Caleb Nelsen – 2449.5. From Ashland, Ohio, and sponsored by Frank A. Bender Post 473.

3. Kirsten Moyer – 2447.4. From Albuquerque, N.M., and sponsored by Post 49.

4. Kelsey Moral – 2441.9. From Sharpsburg, Ga., and sponsored by Post 57.

5. Rachel Martin – 2436.5. From Peralta, N.M., and sponsored by Post 85.

Top five finishers: Sporter – out of a possible 2509 points.

1. Mitchell Van Patten – 2295.9. From Meridian, Idaho, and sponsored by Lloyd Hutcheson Post 113.

2. Renz Ibarra – 2293.9. From Zion, Ill, and sponsored by Post 865.

3. Maneva Gill – 2281.2. From Pacifica, Calif., and sponsored by Post 238.

4. Alexandrea Provine – 2272.0. From Tucson, Ariz., and sponsored by Morgan McDermott Post 7.

5. Michael Stroud – 2269.7. From Des Moines, Iowa, and sponsored by Post 42.

The head of the nation’s largest veterans service organization says he is “greatly concerned” about the widespread use of an apparently ineffective medication by VA (Department of Veterans Affairs) doctors treating patients with post traumatic stress (PTS).

“It is alarming,” said Jimmie L. Foster, national commander of The American Legion, “that fully 20 percent of the nearly 87,000 veterans VA physicians treated for PTS last year were given a medication that has proven to be pretty much useless.”

According to a study conducted by the Department of Veterans Affairs itself and published recently in the Journal of the American Medical Association (JAMA), Risperdal, an antipsychotic medication commonly prescribed to veterans with post traumatic stress when antidepressants have failed to help, does not alleviate the symptoms of PTS.

“Not only that,” said Foster, “but Risperdal is not even approved by the Food and Drug Administration for the treatment of PTS.” Only two medications, Zoloft and Paxil, both antidepressants, are government-approved to treat PTS and neither drug, say researchers, is very effective at treating patients with a chronic form of the disorder. “I am greatly concerned that veterans suffering the ‘invisible wounds of war’ are receiving equally invisible care,” said Foster.

The American Legion has been concerned about the misapplication of PTS medications for some time. Last year, the Legion appointed an ad hoc committee to investigate the efficacy of existing treatments for PTS and TBI (traumatic brain injury) and explore alternatives to improve the science. The committee comprises officers of the Legion as well as lay, professional and government consultants. It convened its third meeting during the week of August 1. The JAMA article appeared on August 3.

Among the speakers at the Legion’s latest ad hoc committee meeting was Charles Hoge, M.D., who is considered to be one of the country’s leading experts on PTS and TBI. From 2002 through 2009, Dr. Hoge, a retired U.S. Army colonel, directed Walter Reed Army Medical Center’s research on the psychological and neurological consequences of the Iraq and Afghanistan wars. In light of the JAMA article, Dr. Hoge said he wondered if patients will continue to trust military and veteran medicine’s handling of PTS cases. He asked, “Is there a resistance and reluctance among servicemembers and veterans to receive and continue their mental health care?”

Another committee consultant and longtime associate of the Legion is Dr. Jeanne Mager Stellman, Special Lecturer and Professor Emerita of Clinical Health Policy and Management at Columbia University’s Mailman School of Public Health. She said, “This is the second major study showing that the drug therapies given to tens of thousands of our nation’s veterans for PTS are ineffective and are associated with a range of side effects (such as weight gain). It is time to clean this mess up (and) devote attention to the problem – not wait years for studies to be done, results to be published and still not have changes made.”

Commander Foster said he is urging Congress to conduct hearings on the ongoing difficulties being experienced by both the Department of Defense (DoD) and VA in the treatment of PTS as well as TBI. He is also prompting both the DoD and VA to speed up their research on the screening of PTS and TBI cases and the treatment of them. “Accelerated research, however, must be balanced with great care and absolute accuracy,” Foster concluded.

The Broomfield Veterans Memorial Museum is proud to announce the start of a new special exhibit titled, “THE CIVIL WAR – BATTLE OF GETTYSBURG”. The exhibit will extend from 23 July to 30 November 2011.

This year (2011) marks the 150th anniversary of the start of the American Civil War. We invite you to come visit the museum to learn about the historical events leading to the war, learn about some of the major battles of the war, view and read several soldier diaries, learn about the Civil War in the West and see a marvelous diorama of miniature toy soldiers depicting “Pickett’s Charge” at the Battle of Gettysburg. The diorama was conceived and built by local residents, Rodney Postillion and Joseph Jonas.

We are also very fortunate to have a Civil War expert, Bob Moulder, who will join us at the museum on the following Saturdays. Bob comes in a Civil War uniform and brings several items from his personal collection of memorabilia. Topics and uniforms he will illustrate are:

6 August & 13 Aug – Battle of Gettysburg – Union Infantry Officer at the Battle of Gettysburg

20 August – Union Navy in the Civil War – Union Navy Petty Officer

27 August – The Civil War in the West & Colorado – Battle of Glorieta Pass

Please join us on Saturday, 20 August from noon to 3 PM for a reception with refreshments at the museum to honor all those who have contributed to his exhibit. Come meet some very interesting people!

Our Museum invites you to come and view our growing collection of uniforms and memorabilia from all branches of service and U.S. wars and conflicts from the Civil War forward. The Museum is the only standing Veterans Memorial Museum in the state of Colorado.

Location: #12 Garden Center, Broomfield, CO 80020

Normal Hours: Saturdays, 11 AM – 4 PM

www.broomfieldveterans.org

Special group visits can be arranged

By Marty Callaghan

President orders broad, interagency effort to reduce jobless rate among Post-9/11 veterans.

President Barack Obama announced his plans to ensure that America’s veterans have the support they need to get into the civilian workforce. The president unveiled his initiatives Friday morning in a speech at the Washington Navy Yard.

Obama outlined four proposals that aim to reduce the jobless rate among Post-9/11 veterans, which now stands at 13.3 percent.

• A new Returning Heroes Tax Credit for firms that hire unemployed veterans (maximum credit of $2,400 for every short-term unemployed hire and $4,800 for every long-term unemployed hire), and a Wounded Warriors Tax Credit that will increase the existing tax credit for firms that hire veterans with service-connected disabilities.

• The president challenged businesses to hire or provide training for 100,000 unemployed veterans or their spouses by the end of 2013. The Joining Forces program will lead this work with businesses and industry.

• The departments of Defense and Veterans Affairs, working closely with other agencies and the president’s economic and domestic policy teams, will lead a new task force to develop reforms to ensure that servicemembers receives the training, education and credentials they need to transition to the civilian workforce or pursue higher education.

• The Department of Labor will establish a new initiative to deliver an enhanced career development and job-search service package for transitioning veterans at their local One-Stop career centers. The Office of Personnel Management will create a “Best Practices” manual for the private sector to help businesses identify and hire veterans.

“The White House is acting on several initiatives that The American Legion has been urging President Obama to address ever since he took office,” American Legion National Commander Jimmie L. Foster said.

Foster said the president’s initiatives reflected The American Legion’s national effort to hire veterans through more than 100 career fairs it sponsors each year, as well as development workshops for veteran-owned small businesses and education roundtables that focus on issues that affect student veterans.

“We have about 1 million unemployed veterans right now,” Foster said. Most of them are young and worked in jobs that have been hit the hardest by the recession, such as construction, manufacturing, transportation and utilities.

“The American Legion wants employers and businesses to move aggressively to recruit more veterans. They are well trained, well qualified, responsible and reliable. We need to honor their service by giving them jobs.”

Peter Gaytan, executive director of the Legion’s Washington office, said that another 1 million servicemembers are projected to leave the military between now and 2016. “So joblessness among our veterans could become even worse if we don’t take decisive action now,” Gaytan said.

“These White House initiatives are just what our jobless veterans need, and just what the Legion has been recommending to the president.”

By Steve B. Brooks

Walter Reed mental health expert briefs Legion’s PTS-TBI Ad-Hoc Committee on where PTS efforts are falling short and what can be done to fix them.

Dr. Charles Hoge spent nearly 20 years in the military, retiring as a colonel in 2009. His specialties included psychiatry, which he put to use as head of psychiatry and neuroscience research at Walter Reed Army Institute of Research (WRAIR) from 2000-2009 – a time period that included a deployment to Iraq in 2004.

Now a senior scientist at WRAIR and in the Office of the Army Surgeon General, as well as an attending physician at Walter Reed Army Medical Center, Hoge has seen firsthand how the treatments of post-traumatic stress have fallen short during the war on terror. He shared those insights with The American Legion’s ad-hoc committee on PTS and traumatic brain injuries in Washington, Aug. 1.

“(Servicemembers and veterans who get) mental health care maybe get one visit or two visits or three visits, and over half are dropping out and not completing a sufficient number of sessions for treatment to be meaningful in terms of recovery,” Hoge said. “Despite everything we’re doing, the overall reach of treatment for our servicemembers… is relatively low. So then we start asking the question, ‘Why is that happening?’

“Certainly we know there’s stigma, which is the concern the individual has about how others will view him or her if they see a treatment – ‘My peers will view me differently, my leaders will treat me differently, it will affect my career’ – those are the stigma.”

Hoge said that other issues, such as getting off work and getting childcare, also interfere with treatment plans, as do the negative perceptions that servicemembers and veterans have of mental health care.

“Those are things like, ‘I don’t trust mental health care. I don’t think it’s going to work. It’s a last resort. It’s not for me. If I go see a mental health professional they’re just going to prescribe me pills,’” Hoge said. “I can’t say 100 percent the reason so many veterans and servicemembers drop out of treatment is because of negative perceptions because we don’t have that direct link yet. But we do know that… in a couple of studies now, it’s the negative perceptions which are more strongly predicting the utilization of services to begin with. Some of the traditional ways in which we thought about the reasons why veterans don’t come into see us we may need to rethink a little bit. It’s not just only about stigma; it’s also about these negative perceptions.”

Hoge said that while it is clear there are evidence-based treatments that work and are mandated in every Department of Veterans Affairs facility, “The problem is that if the veteran doesn’t like the treatment for whatever reason and drops out of care, it doesn’t matter how good the treatment is,” he said. “How do we deliver evidenced-based care in a way that meets the veteran where he or she is and is a way that is conducive to them being most willing to remain in care?”

Just days after briefing the committee, Hoge addressed that issue with an editorial in the Journal of the American Medicine Association that accompanied a study titled “Adjunctive Risperidone Treatment for Antidepressant-Resistant Symptoms of Chronic Military Service-Related PTSD.” [1] The study reported that among patients with military-related PTS who show a resistance to serotonin reuptake-inhibiting antidepressants, the six-month treatment with risperidone compared with placebo did not reduce PTS symptoms.

In his editorial [2], Hoge wrote that simply medicating PTS sufferers isn’t the answer. “Improving evidence-based treatments, therefore, must be paired with education in military cultural competency to help clinicians foster rapport and continued engagement with professional warriors,” he wrote. “This includes sensitivity and knowledge in attending to difficult topics, such as grief and survivor’s guilt stemming from loss of team members, ethical dilemmas in combat, or situations associated with feelings of betrayal (e.g., poor leadership, rape by fellow team member.)

“Significant improvements in population care for war veterans will require innovative approaches to increase treatment reach. Attention to the occupational context, combat physiology, and mental and physical comorbidities is essential. Validating and implementing collaborative care models based in primary care should be a high priority. Matching evidence-based components of therapy to patient preferences and reinforcing narrative processes and social connections through peer-to-peer programs are encouraged. Family members, who have their own unique perspectives, are essential participants in the veteran’s healing process and also need their own support …”

Hoge told the committee that one of the ways to improve treatment reach is delivering care that is most conducive to veterans staying in care. “It may not necessarily be, ‘Here’s my prescription for medication’ or, ‘Here’s my prescription for full-on exposure therapy. Maybe I need to tell them, ‘There are several things that are going to help with treatment. Which one of these are you most comfortable with?’” Really engage the person in that way first.”

“Post-deployment health,” Hoge said, needs to be thought of in a “holistic manner. There’s a gradual movement toward that. Those sorts of programs where there’s better case management… and team care within the primary-care structure, that’s now rolling out across the VA, and I think that’s a very positive direction.”

During the committee’s two days of meetings, it also heard from VA’s Drs. Joel Kupersmith, Matthew Reinhard, Julie Chapman, Sonja Batten and Alison Cernich, Matthew Stiner of Justice for Vets, and from Legion staff for briefings on the System Worth Saving program. The committee also considered potential resolutions to guide the Legion in its further investigations into PTS and TBI.

Check back at legion.org in the coming days for more stories from the committee’s meetings.

By Cameran Richardson

The 21st annual American Legion Junior Air Rifle Championship gets under way Aug. 4-6 at the USA Shooting Range located at the Olympic Training Center in Colorado Springs, Colo.

During the event, 30 competitors shoot in either the precision or sporter category with a .177 caliber air rifle in three positions: standing, kneeling and prone. The top eight shooters in both the sporter and precision category will move on to the finals.

During the finals, one contestant will win the championship title in his or her respective category along with a $2,500 scholarship donated by the Sons of The American Legion.

Provision of proposed bill would strengthen USERRA and servicemembers’ rights to leave their jobs for medical treatment.

American Legion National Commander Jimmie L. Foster wrote a letter July 22 to Rep. Lloyd Doggett of Texas, supporting his “Wounded Veteran Job Security Act” draft legislation.

If passed, the bill would prohibit discrimination and acts of reprisal by employers against veterans who must temporarily leave their jobs to receive treatment for service-connected illnesses, injuries and disabilities. The measure would further strengthen provisions of the Uniformed Services Employment and Reemployment Rights Act (USERRA).

Passed by Congress in 1994, USERRA protects the rights of servicemembers to be reemployed after returning from active duty, including reserve or National Guard members.

“It was the intent of Congress by enacting USERRA,” Foster wrote in his letter, “that no veteran be denied employment, reemployment, advancement or discrimination in employment for serving their country.

“Servicemembers who honorably defend their country depend on USERRA to protect their civilian jobs when they are activated and sent to war. This amendment to USERRA will enhance that protection.”

Joe Sharpe, the Legion’s Economic Division director, said that Doggett’s proposed bill addresses an inequity that has long existed in the work force. “We need this protection for our disabled veterans, to make sure they aren’t being treated unfairly by their employers. These men and women have sacrificed enough already for their country. They don’t need to be harassed in the work place for making those sacrifices.”

Doggett’s bill has yet to be introduced in the House of Representatives for consideration.

By Craig Roberts

A Senate Veterans Affairs’ Committee hearing on July 27 addressed growing concerns about the long-term economic effects of the wars in Iraq and Afghanistan.

Dean Stoline, deputy director of The American Legion’s Legislative Division, attended the “Lifetime Costs of Supporting New Veterans” hearing and reported that the committee chair, Sen. Patty Murray of Washington, said in her opening remarks that she wanted to begin the process of determining present and future needs of this generation of veterans and their impact on VA and funding.

Murray went on to say that the “costs of caring for our veterans and families must be [accounted for] long after the fighting is over.” She believes the sheer number of new veterans poses a financial challenge to the Department of Veterans Affairs, especially in expenditures related to long-term health care and disability benefits.

“Specific areas of concern she mentioned were mental-health costs, caregiver issues, more complex benefit claims and adjudications, the economic impact of multiple deployments on veterans and families, and the lack of job, education and health-benefit integration,” Stoline said. “She also acknowledged that some long-term costs are not known at this time.”

Murray concluded her remarks, Stoline said, by saying that government must make proper investments in veterans care and benefits, but Congress must be mindful of the necessity to reduce the national debt and deficits. “But she also stated that, regardless of any fiscal crisis, we cannot balance our budget at the expense of the health care and benefits our veterans have earned,” he said.

Stoline reported that a series of witnesses amplified and expanded upon Murray’s points, including one Government Accountability Office expert who pointed to the legal and fiscal challenges facing VA as it seeks to renovate and expand its medical facilities to meet future needs.

Especially poignant, Stoline said, was a presentation by the wife of a severely wounded Marine who had lost all his limbs in an IED blast. She related her difficulties with the new Integrated Disability Evaluation System that supposedly streamlines a wounded warrior’s transition from the Department of Defense health-care system to VA.

In appealing for assistance from Murray, according to Stoline, the Marine wife said one document sat on a transition worker’s desk for 70 days. “Her husband is now on the list for retirement,” Stoline said, “but she feels that the problems they are having getting military benefits will continue as they enter the VA health-care system.”

Stoline noted that, while an invitation to testify was extended by the committee, VA did not send a witness to this hearing. Stoline indicated that more congressional hearings are likely to be scheduled on this topic.

By Andy Romey

Legionnaires in Jewett City, Conn., are behind a multimillion dollar housing complex that could revolutionize the fight against veteran homelessness.

Legionnaires in Jewett City, Conn., are manning the front lines in the fight against veteran homelessness.

In the quaint eastern Connecticut town, members of LaFlamme-Kusek Post 15 are the driving force behind American Legion Veterans Housing Inc., an ambitious program that will give free housing to former military members who have fallen on hard times. The $5.2-million project will create 18 apartments for veterans using the upstairs of the post building and the adjacent property, where a four-floor housing unit is being constructed.

Advocates say the residential complex could become a national model for fighting veteran homelessness.

“When I started this, I said, ‘Well, it’s a shot in the dark.’ But right now, we’re under construction,” says Bill Czmyr, project president and longtime Legionnaire. “I never dreamed this was going to happen.”

The initiative’s beginnings are as grassroots as its goals. A reputed member of Post 15, Czmyr was often asked around town what he and fellow Legionnaires planned to do with the two vacated floors on top of their post building. In 2003, he told someone on a whim that they’d look into converting the space into apartments for veterans.

His seemingly flippant idea gradually picked up momentum, as he got estimates from local contractors for construction costs and assembled a makeshift fundraising crew filled with locals willing to volunteer their time and expertise. They filed for official nonprofit status and began meeting weekly, officially as American Legion Veterans Housing Inc.

“No one ever told me I was crazy, no one ever told me to get out of here,” Czmyr says. “They just said, when you get enough people to have a meeting, let us know.”

The project eventually drew the attention of Rep. Joe Courtney (D-Conn.) Officials from his office were sent to inspect the post building and assess Czmyr’s plans. Approving of the project, Courtney signed off on a $200,000 federal earmark to it.

Soon, other donations began rolling in. The Connecticut Housing Finance and Authority committed $3.8 million and the state Department of Community and Economic Development pledged $500,000.

An idea hatched from small talk between townspeople became, over an eight-year period, a massive, multimillion dollar endeavor that has drawn the attention of government officials and experts in the field of homeless advocacy.

“We’re under construction now,” Czmyr says. “I get emotional when I talk about it.”

The residential complex will house veterans on a permanent, not a temporary basis, making it unique to other projects of its kind. Traditionally, veterans have only been allowed a two-year stay in the low-income housing projects the VA has thrown its support behind.

Plans are different, however, in Jewett City. Veterans of all types – male and female servicemembers and their families – can live in the apartments indefinitely because VA is footing the $875 upkeep bill, using the veterans’ housing stipends.

“It’s going to maintain the apartment, a small fraction will go to the veteran for personal needs,” Czmyr says.

Czmyr’s work is still far from done. The fundraising isn’t over for him and his cohorts, who meet weekly in a makeshift headquarters along the town’s main strip.

When they founded it, members of the American Legion Veterans Housing Inc. hoped to raise $760,000 to cover incidentals for each apartment. So far, they’ve reached about $380,000 in donations from businesses and individual contributors.

“I’d like to see each veteran in the nation donate just $1,” Czmyr says. “I’m not asking for $20 or $100… That’s all we’re looking for. This is veterans helping veterans.”

Donations can be pledged through the group’s website: http://talvhi.community.officelive.com/Donations.aspx. Construction began on the project during the spring. Currently, the original post is being revamped and the foundations of the new building are being set. The complex hopes to open its doors to residents in the first quarter of next year.

“They are sandblasting the exterior of the original building and reframing it,” says Avery Tillinghast, fundraising chief for the fundraising organization. “In a week or two they are taking down the old roof and putting a new one on.”

Seeing its completion and success has taken on great personal meaning for Czmyr, who empathizes deeply with anyone who spends a night outdoors without a roof over their head.

“I grew up on a farm where, when the woodstove went out, it was just as cold inside as it was outside,” he says. “And I said, ‘People who are living out there have to be freezing.’ I just knew that if there was an opportunity to help them, I was going to accomplish that.”