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Veterans Health

New HBO documentary puts a much-needed face to complex veteran struggles with PTSD

“When I first got back home from Afghanistan, my dad was like, ‘Hey, if you ever want to talk, we’re here for you,'” retired Marine Joe Merritt says in “We Are Not Done Yet,” a new HBO documentary produced by actor Jeffrey Wright (“Westworld,” “Casino Royale,” “Boardwalk Empire”) and directed by Sareen Hairabedian. “But it never made sense to be like, ‘Hey dad, I watched people burn to death. Also, can you pass the mashed potatoes?’ Like, how do I start this conversation?”

Almost three million service members have deployed in support of American war operations since 2001. Of those who deployed to operations in Iraq or Afghanistan, approximately 14 to 20 percent suffer from post-traumatic stress disorder. Furthermore, female veterans experience military-related sexual trauma at a rate of over 32 percent.

“We Are Not Done Yet” goes well beyond the aforementioned black and white statistics, however, to tell the stories of 10 veterans from diverse backgrounds and experiences, all pursuing a process of healing and empowerment together through the arts.

“Grappling with PTSD, the ‘warrior poets’ share fears, vulnerabilities, and victories that eventually culminate into a live performance of a collaborative poem under the direction of actor Jeffrey Wright,” the film’s synopsis says.

Wright, along with retired Army officer April Harris, who spent 26 years in the service, discussed the groundbreaking film, misconceptions about PTSD and the much-needed personalization of these struggles during a recent interview with Military Times.

Jeffrey, how did you get involved in this project and what was it that first piqued your interest in veteran advocacy?

WRIGHT: I went to Sierra Leone in 2001, the first war zone I ever visited, and the scales fell off my eyes. I was seeing things for the first time after taking so much for granted. While going back three or four times a year for about a 10 years, I started a foundation with a couple retired senior officers from the U.S. Army. One became a real mentor to me and started to educate me firsthand about things that, as a civilian, I only understood — or misunderstood — from a distance. So, I just became a little more aware and curious, particularly as it related to our vets. After that, I started doing these readings through a group that was using Greek tragedies as platforms for discussion on PTSD. I went down to D.C. to see one of the shows and there were some representatives from the Pentagon there, so I asked them what I could do. A few weeks later, they introduced me to Seema Reza [chair and co-founder] of Community Building Art Works, which uses arts therapy programs with vets at Walter Reed.

One more critical milestone was when I was coming back from a trip with my kids. I was at an airport in rural Colorado and there was a guy sitting and waiting for his plane in a wheelchair, a triple amputee, just sitting there by himself. I went over just to say hello and he recognized me and told me his story. He described some of the folks who would visit Walter Reed when he was there — people from my line of work — to lend support. And I just thought, “What am I doing with my own time that I can’t come down and at least show some support in my own way?” But at the same time, I didn’t want to just come down for a photo op — I wanted to do something that could maybe be a little more useful. So, when I spoke to Seema and she said that they wanted to do this piece of theater, I thought, “This is right in my wheelhouse.” So, I just put my experience in my rucksack and came down, and the film was borne out of that process.

April, what was it like having Jeffrey come in and work with you?

HARRIS: Through the entire process, he was just a compassionate civilian who gave a damn. It never felt like working with Jeffrey Wright, the phenomenal actor. He was just somebody who was compassionate, somebody who cared, who offered us a space to do our work.

Jeffrey, what was something you learned about this group of veterans that you didn’t necessarily expect going in to this project?

WRIGHT: Too many of us on the civilian side have a monolithic view of men and women who serve in the military. What was the most striking thing to me was the way they shattered those misconceptions through the incredible power of their artistry. They are a group of warriors and serious, compelling artists. That was the thing that was most unexpected. And again, the diversity of their thoughts, experiences and backgrounds, which all came together in that room, just overrode my entire understanding about what we, as a public, perceive about those who serve in the military.

With 10 different stories, diversity was a definite strength in the film. What does even one vet opening up do for others who may be internalizing pain resulting from trauma?

HARRIS: First and foremost, it tells people that they’re not alone. It was important for me to tell my story for a number of reasons. First, I owed it to the troops. They need to see a leader stand up. We’re telling troops over and over to let someone know they’re struggling, but we’re not giving them the space to do that. Now, I’ve been given that opportunity to raise my voice higher and still take care of the troops. They’re not alone.

The cast and crew of

The cast and crew of “We Are Not Done Yet.” (HBO)

I also need to do this as a black woman and because of the stigma that’s placed upon struggling with mental illness in my own culture. Something that could have destroyed me has instead made me a strong person, and others can do that, too. I’m not here to give advice on how each person can do it, but the Department of Defense and Veterans Affairs needs to provide more options. And really, I’m holding DoD more accountable than the VA, because many of these issues could be identified prior to someone leaving the military, an environment that makes it so that we almost can’t talk about issues. Then these same people go on to have a difficult time justifying it on the civilian end.

Much about military culture, as you mentioned, is not conducive to openly expressing such issues. How do you feel the military can do a better job to facilitate communication?

HARRIS: Being victimized in the military, it’s almost like, as a civilian, I have to justify the wrongs that were done to me. It’s like I’m having to relive that victimization over and over again. Give us the space we need to communicate. I recognize the military was not designed to take care of patients — I was medical for 26 years. I know that. The military is designed to fight war. We patch you up and send you back out. If we can’t patch you up, you’ve got to go. But it’s how you’re sending us out. Send us out with respect, and respect us when we get out. We’ve lost a lot.

But I think we accomplished what we set out to do with this film. You watched it and you reached out. That dialogue has begun.

WRIGHT: One of the things I’ve learned in my life is that the first step toward problem solving is communication. And again, I’m speaking as a civilian, but it’s my understanding that when you’re in a battle, communication in great detail between your colleagues is critical. And there’s an internal battle going on for folks who put themselves in harm’s way. And if you’re not communicating on that battlefield as well, then you’re not going to solve those problems — you’re not going to win that fight. And I don’t think that burden has to be exclusive to military culture. We can all share it.

Many with little to no knowledge of PTSD were quick to characterize the Thousand Oaks, California, shooter as a troubled war vet suffering from PTSD, a dangerous narrative to those struggling with trauma. How do these blanket characterizations hurt those genuinely battling PTSD?

HARRIS: We need to stop making assumptions. There is no cookie cutter label or treatment that can be applied. My PTSD stems from being violated as a woman. You can’t treat combat PTSD the same way you treat my PTSD. And don’t make assumptions that I can’t be productive. If we have a chance to talk earlier on, when that trauma occurs, we’d have a better chance of recovering. I can recover later, but do I have to recover when I’m homeless? Or when I have no job? Or when I’ve already lost my family?

In my situation, even though there’s a reason for my behaviors, it’s still unacceptable. There is a reason, but I have to take responsibility for my behavior. And I don’t want to be lumped into a category — PTSD is so broad and hurting people has never been an issue.

WRIGHT: I’m sitting here watching a press conference from the White House [about the California shooting]. The major obstacle that we in the civilian community face — across the political spectrum — to understanding issues relating to our troops and vets is that too often that conversation is only about political manipulation and point scoring. We’re not getting the facts from the ground. We’re not getting the perspective of the men and women who served. We’re not getting access to their voices, because their voices are being muffled by the sound of people who are using their service to serve political agendas. Until that stops, we’ll not be able to solve the generational problems that we’ve seen regarding veterans and homelessness, veterans and disproportionate suicide rates or veteran difficulties reintegrating into society. We’ll not get there. Because what we’re getting instead is too much distraction away from the real target. We’re hearing the very issues that are most negatively affecting veterans being used as political props, yet these issues are not, in real time, being addressed. And that’s something I think all of us in American society should find intolerable.

April, how did completing this film help your own healing process?

HARRIS: Had I not put my search for healing into overdrive, I would not be here today, and I wouldn’t have a relationship with my two phenomenal sons – I would not.

Healing is not just through the arts, so I don’t want anyone to think the arts are the end all, but it’s an amazing supplement to the evidence-based treatment I’ve received. While I was able to use the treatment primarily for me, the arts are something I was able to share with my family, so this hasn’t just been healing for me, it’s been therapeutic for us as a family.

April, Jeffrey, thank you for taking time to tell us these stories. “We Are Not Done Yet” premiered on HBO on Nov. 8 and is currently available for streaming.

For today’s VA, it’s the best of times and the worst of times

A retired Marine makes it his mission to get former homeless veterans on track.

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Even after securing a place to live, some homeless veterans eventually end up back on the street. So one retired Marine has made it his mission to get those vets back on track. (James Williams/Staff)

WASHINGTON — In a White House press conference Wednesday, amid a host of other topics, President Donald Trump stated that because of his leadership “our vets are doing better than they’ve ever done.”

Yet his critics contend that over the last eight months, the Department of Veterans Affairs has never been in more disarray, with a confusing series of leadership scandals and management overhauls further diminishing public faith in the institution.

They both may be right.

“It really is the tale of two VAs right now: It’s the best of times, it’s the worst of times,” said Melissa Bryant, chief policy officer for Iraq and Afghanistan Veterans of America.

“We’ve had major legislative victories years in the making. But a lot of what we have seen in 2018 has been political theater, unfortunately.”

This Veterans Day, VA leaders once again find themselves at a critical moment for the department. Trump just signed into law the largest VA budget ever, topping $200 billion. Congress has given him nearly every major piece of legislation on veterans policy he has requested, including new rules that make it easier to fire poorly performing VA workers and reforms that aim to speed up the benefits claims process.

But as deadlines loom for implementing numerous health care and management initiatives, Democrats in the House are already preparing new scrutiny over how policy decisions are being made inside VA and what unplanned side effects those changes will have.

It’s a stark change from a year ago, when VA was arguably the most stable and successful part of Trump’s Cabinet.

On Veterans Day 2017, at Arlington National Cemetery in Virginia, then VA Secretary David Shulkin lauded the president for “strengthening our ability to provide high quality care and benefits while also improving outcomes for veterans.” Trump in a separate event lauded Shulkin for “doing an amazing job” caring for America’s former military members.

Within five months, Shulkin was fired.

Ongoing leadership woes

Shulkin’s dismissal in March set off months of leadership confusion at VA. The former secretary to this day insists he was fired because of his opposition to plans to privatize portions of VA health care that were advanced by political operatives in the Trump administration. The White House has said Shulkin resigned after the president lost faith in his leadership.

The day Shulkin’s departure was announced — on Twitter, by the president, with little advance warning to the secretary — Trump also announced his pick to replace him: White House physician Rear Adm. Ronny Jackson. The Navy officer had never worked in the department before, and his lack of experience raised concerns among veterans advocates.

Within a month, Jackson was also gone. Reports of unprofessional behavior at the White House medical office (including drinking, improper medication distribution and hostile management practices) forced him to withdraw his name from consideration.

It took Trump four months to get his next full-time VA secretary in place. During that span, key decisions on electronic medical records systems and VA health care programs were met with legal challenges asserting that Trump’s interim appointments were in violation of federal law.

When VA Secretary Robert Wilkie — a career bureaucrat with experience on Capitol Hill and at the Pentagon — was confirmed, he promised to bring stable and calm leadership to the department.

But just a few weeks after he began work, a ProPublica report detailed how three of Trump’s business associates (all members of his exclusive Mar-a-Lago country club) were influencing a host of department plans and policies without any public scrutiny.

In the last few months, Wilkie has worked to dismiss assertions that his leadership is already undermined by the same officials who sparred with Shulkin and those outside influences. At a Senate Armed Services Committee hearing in September, Wilkie described the department as “calm” now. He promised lawmakers he is “the sole person” leading VA.

Democratic lawmakers remain unconvinced. They’ve asked — unsuccessfully — for more information on potential outside influencers.

Meanwhile, veterans groups thus far have reported little interaction with the new secretary, a break in typical protocols for the department’s top official. While Wilkie has made numerous appearances on the topic of homelessness and drug abuse prevention in recent weeks, the new secretary maintains a significantly lower profile than Shulkin.

Privatization or choice?

Amid the leadership turmoil, lawmakers on Capitol Hill have continued to churn out a host of major bills related to veterans policy, including this summer’s VA Mission Act. The measure has the potential not only to define Trump’s legacy regarding veterans but also radically reshape the department for years to come.

Among other sweeping changes, the Mission Act calls for an overhaul to VA’s community care programs, which allow veterans to get medical appointments with private-sector doctors at the federal government’s expense. Trump has repeatedly referred to it as giving veterans “choice” in their medical care.

Wilkie and other department leaders are now in a year-long process now of hammering out the details for who will be eligible for the outside care, how much involvement in those decisions VA doctors will have, and how the pay structures will work.

“The hardest question at the heart of the Mission Act is how much should the private sector do for VA?” said Phil Carter, a senior policy researcher at the RAND Corporation who specializes in military and veterans issues. “That influences everything else.”

About one-third of all VA medical appointments today are already conducted by physicians outside the department’s system. Supporters of further increasing outside care options argue veterans shouldn’t have to wait in VA lines for basic care they could receive in the private sector.

But critics, including federal unions, argue the that real goal of these moves is to siphon federal money into outside companies, providing less specialized care while crippling the existing VA hospitals’ ability to meet veterans’ needs. They’ve labeled many of Trump’s proposals as a “privatization” of the department’s mission.

Wilkie, in his confirmation hearing this summer, said he wholeheartedly opposes privatizing VA services, but left ambiguity in that definition.

“If we believe that the veteran is central, we can also make the argument that as long as VA is at the central node in his care, and that that veteran has a day-to-day experience with the VA … that reinforces the future of VA,” he told senators. “That’s what I believe in.”

The debate over where to draw those lines was already contentious before the midterm elections. Now, with Democrats set to take over the House Veterans’ Affairs Committee agenda, the issue of private-sector care is likely to dominate much of the conversation in months to come.

In September, Rep. Mark Takano, D-Calif. and the leading candidate to be chairman of the veterans committee in January, promised in a letter to colleagues to “make necessary reforms to the Veterans Health Administration … while rejecting conservatives’ calls to privatize health care.”

Other fights ahead

That’s not the only Trump administration priority in the crosshairs.

Several lawmakers from both parties have expressed concerns over VA’s planned move to a shared electronic health record with the Department of Defense, hailed by Trump and Shulkin as a game-changer for veterans care.

If successful, the multi-year project would more easily allow veteran patients to access and share their medical history, from the first day they enlist to their geriatric appointments. But while praising the idea, lawmakers have questioned whether the effort is properly funded and managed.

The same goes for VA staffing. Trump has promised to bring in more doctors and oust staffers who are performing poorly. Democrats have charged that Trump’s VA has instead used accountability legislation from 2017 to fire low-level employees without filling other much-needed positions.

“Everything is in the air right now,” said Joe Chenelly, national executive director at AMVETS. “We don’t know what the Mission Act will look like. We don’t know how health records are going to be. We don’t know about these budget cuts that Trump has talked about for federal departments.

“There are just a ton of questions unanswered.”

Trump’s 2016 campaign pledge to start a new hotline for veterans complaints has earned some goodwill from the community, but individuals using the service have reported mixed results with getting answers on their problems.

His VA has received harsher reviews for its opposition to paying benefits to “blue water” veterans who served in Vietnam and claim toxic exposure to chemical defoliants. And in recent months, dissatisfaction has risen among student veterans as another round of benefits payouts issues has plagued the post-9/11 GI Bill system.

In the September 2018 Military Times poll of active-duty troops, more than 40 percent said they had an unfavorable view of VA. Only 20 percent described their feelings as favorable.

Wilkie has acknowledged that along with his policy priorities, rebuilding public trust in the institution is a critical part of his work ahead.

“The state of VA is better,” he told senators at the September hearing. “I didn’t say good or excellent. It is better. And I do think we’re headed in the right direction.”

VAVS Representative and Deputy Representative Responsibilities

VAVS Reps & Deps

At the VAVS meeting the other morning the attached explanation of the duties of Representatives and their Deputies of our VA Hospitals was passed out to those of us attending. I thought it would be interesting to some of you.

     On another note, a month or so ago the Bedford VA sent out a questionnaire asking Reps and Deps to vote to keep the VAVS meetings as they currently are, half held at 10am in the morning and the other half for the remainder of the year at 7pm.  The other way to vote would have all the meetings at 10am for the whole year.    The majority voted for all meetings to be held at 10am.   I voted for keeping it the way it is now, half morning and half evening.  Those who work would have a chance to attend at least half of the meetings.  I don’t like the results but will have to live with it.
     The National Salute will be on Feb. 14th, Valentine’s Day.  This is when we deliver Valentines to the residents.  As reported before, I get them homemade from the Elementary School in Hudson.
     As last year, when Arty Marchetta was third Vice,  our present Third Vice was in attendance.  Doing their job the right way!  Thanks Arty and Wayne Anthony.  Also in attendance was the Ladies Auxiliary Rep, Georgia Gadbois.   Rep Dick Burnell, and Deputies Walter Spencer and Steve Arsenault were excused.

Al  Temple
atemplesr@verizon.net

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