Why so many homeless vets? And what can be done? Really?

[Jackpine Radical]

The vast majority of vets have managed to reintegrate themselves into society, not always quickly, and usually painfully, but nevertheless in some measure successfully. What's different about the ones who didn't make it, the ones living under the bridges or sleeping on heating grates or freezing to death in an abandoned basement somewhere, dressed in tatters, hand locked around the neck of a liter of rotgut?

Well, most of those people are addicts or alcoholics or both. Some are psychotic as well. Most of them began their addictions when they were still in the military. The psychoses mostly showed up a little later.

A funny thing about addictions and addicts--people say "He's an addict" and lean back as if they have not only explained something, but have given themselves an excuse not to get emotionally involved. They treat the addiction as if it were the root cause of the problem, then they assume that the addiction arises because of some moral failing in the addict, so it's really the veteran's own fault that he's sleeping under the bridge, and that relieves us of the obligation to be concerned. What a wonderful, comforting blanket of self-justification for inaction one can weave.

The problem is, addictions don't just arise out of thin air. People start using drugs and alcohol for a reason. And, incidentally, the addictions are not primarily physiological problems. Cut off the supply to one drug, and they will simply switch to another. The meth epidemic began when people could no longer get cheap cocaine.

Addictions are not about poor moral fiber, and they are not primarily about physiological dependence. They are about something else. They are about drugging away psychospiritual pain. People do drugs for the most part because the drugs quiet the demons in their heads. People get those demons, for the most part, as the result of experiencing severe, emotionally damaging abuse, neglect, or trauma. The dry psychiatric term for these demons is Post-Traumatic Stress Disorder, or PTSD for short.

There is nothing quite as effective as a war for creating psychospiritual demons. Thousands of veterans are still living with the demons they acquired in Vietnam, and we are about to be flooded with hundreds of thousands of new demon-haunted veterans from Iraq.

Most drug and alcohol treatment programs are quite ineffective. One massive study of inpatient VA programs showed that only 20 to 25 percent of the graduates were still abstinent after one year. The reason for this is that the treatment programs work on what is often termed a "medical model." They believe that they are dealing with physiological problems, that the major issue for the user is coping with physical cravings for a substance to which his body has become habituated. But the physical habituation is only part of the problem, and in most cases is the least part of the problem. Conventional treatment does not address the real issues, which are the psychological ones.

We have a new generation of techniques for coping with PTSD and related emotional problems brought on by exposure to extreme abuse and trauma. One such method is called EMDR (short for Eye Movement Desensitization and Reprocessing). Another involves a combination of brainwave biofeedback and talk therapy. However, these methods are relatively expensive because they are conducted in series of individual treatment sessions and require extensive training on the part of the therapists.

Thus the veteran problem is by no means an easy one. Most of these individuals will require a combination of expensive psychotherapy and substance abuse treatment. Some of them, particularly those with severe mental illnesses, will require hospitalization while treatment is provided. They will need help learning new job skills. They will need housing, food, clothing, medications, training, and jobs.

We will only manage to cope with the problem of homeless veterans when we own up to its enormity and commit ourselves to providing the care and help that they need. Are we willing to do that? Are we willing to do that at a time when we find ourselves trembling on the verge of a new global depression?

[niyad]

1. k & r

thank you

[ayeshahaqqiqa]

2. War is a pyschic trauma as well

one that shocks a person on physical, emotional, and spiritual levels. I'm wondering if the homeless problem is worse now than it was, say, after WWII because the soldiers now (as in Viet Nam) know that they lost the war--and this time know that they fought based on lies.

[Jackpine Radical]

4. We took a lot better care of our vets after WWII, for one thing.

For another, I think the nature of the current war (and to a lesser extent, Vietnam) is inherently more psychologically traumatizing than was WWII. A lot more opportunities for guilt & shame, more dead infants & unarmed civilians...

[CTyankee]

14. I don't know, WW2 was a horrifying war. My late father in law was a naval

officer in the Pacific and had to pick the men who would be first to storm the beaches of those South Pacific islands as we fought our way across the ocean. I can't think of a more psychologically traumatic thing to be put through! Yet he came home from the war and never spoke of it. We learned that that was his job after he had died at age 78.

We like to think of WW2 and the "good war" but it was just as ghastly as what is going on now in Iraq, both for soldiers and for civilians (think of what the Allied firebombing of Dresden must have down to the people of that city). The difference with today has to be that we have a different attitude about war now than we did then and also that we took care of the soldiers when they returned.

[Jackpine Radical]

20. They won. They were heroes. They came home to parades.

I came home frm Vietnam with three bullet holes in my carcass, let my hair and beard grow, and snuck back into school, trying not to let anyone know where I'd been.

[CTyankee]

21. I do not disagree. Your point is well taken.

The Vietnam War was a morass. Our nation was embarrassed all over the world. Resentments have lingered and continue to affect the body politic even as recently as the 04 campaign, when such resentment surfaced with the Swiftboaters. The guy behind that had hated Kerry for his antiwar activities for decades!

You and your fellow soldiers were victims of that war. Your needs were ignored by a cynical Nixon Administration and the American people who just wanted you to go away and not remind them of our ignominious defeat.

I became radicalized during the Vietnam War and worked with a group called Clergy and Laity Concerned. Wm. Sloan Coffin was one of its leaders. We worked to raise consciousness about the war but did nothing for people like you (altho we were horrified by so-called antiwar people who did). But still CALC didn't follow through and do what was the morally right thing to do.

Sorry for the lengthy post here. But your answer made me stop and think "What did I do (after) the war?" I'm not happy with the answer...

[kineneb]

38. I went to Jr. College with lots of returned Vietnam vets

(fall-1976) The poor guys all had some tweak to overcome. I hope they did ok.

[Mend]

3. I would start at the beginning and evaluate the psychological make-up of

people who are enlisting in the military when there is no draft and the war has been going on for years. Who are these young people and why are they doing this? I think the answers would be interesting, especially if contrasted with other young people, maybe also economically challenged, who choose another solution to the question of what to do after high school.

[Jackpine Radical]

8. Well, if you really want to get into that,

I believe that most of those who end up with formal diagnoses of PTSD were "preconditioned" by experiences of trauma & abuse early in their developmental histories. Chronic anger and aggressive impulses are, quite understandably, often among the sequelae of early abuse. That's probably why they're finding so many "pre-existing conditions" (i.e. personality disorders) among the PTSD cases. Virtually all Borderlines and Antisocials have severe early trauma experiences.

[cutlassmama]

16. have them all.

[Mend]

25. the people I have seen grew up in chaotic, abusive, often alcoholic families, didn't do that

well in school (possibly some were ADD), enjoyed the adrenaline rush of combat and missed it when they returned, did the best in the military structure and were lost without it. I am not sure that they were able to developmentally complete "separation and individuation" that most kids work on by leaving home and being more on their own in college or at work. Instead, these kids are put in a regressive, strict authoritarian "family" and I think they got fixated there. It seems to be a wrong choice in how to grow up and the military just plain ruined some of them. Just my opinion.

[Demeter]

27. Even Worse, the Recruits Are Coming Off the Street, Literally

They haven't any support network: family, friends, wife, fiancee, parents.
They get some of that support in the service, but then they are brutalized by the job they are asked to do, the length of time they are asked to do it, the injuries they suffer and the lack of care they get, the cheeseparing with the bonus money, the lack of armor and other necessities, the lack of safety for the women from predators, and probably men, too, though it will be a cold day in Baghdad when we learn about that...

The list goes on and on. Our troops are treated worse than convicts in prison. And some people wonder why they are panhandling and freezing to death under bridges and in parks.

[ismnotwasm]

5. I only hope

That for every yellow ribbon that was ever a car through out this nation, there is someone reaching their hand out to our Vets. Thanks for posting this, because this issue is not going away.

(Operative word here, of course, is hope)

[leftofthedial]

6. stop loss them

and send them to Baghdad


(I'm amazed O'Lielly or Limpballs haven't suggested this.)

[Medusa]

7. Drugs. Alcohol. Mental issues.

combination of all three. And sometimes it's really tough to get these people in treatment programs of any kind. We think with our rational brains that we'd seek out help but they have these problems and they don't think like we think. How to reach them is as individualistic as the people involved. There is no one solution fits all answer which is why it's so hard to get them help.

[Jackpine Radical]

9. An amazing number of them end up in jail,

as you might imagine. I have long advocated for mental health treatment for jail inmates--not just vets, but all of them--as the most effective way to reach this population, and incidentally to cut the crime & reincarceration rates.

[EFerrari]

10. It's not amazing once you understand that jail is our collective answer to

mental illness.

I could have had my ex jailed in a heartbeat for mental illness. In fact, my community got quite pissed at me for NOT having him jailed.

Getting actual treatment took years.

:shrug:

[Jackpine Radical]

11. Yeah, I know. Believe me, I know.

It's a purely economic thing. Psych hospital at $1200/day or jail @ $40/day. I live this stuff. I spent 13 years as a chief psychologist in community corrections before going full-time into a mostly forensic private practice. I conservatively estimate that I've done psych evaluations on 2,000 criminals. Sex offenders, murderers, drug dealers, the lot.

[EFerrari]

12. So, you really DO know.

When I started dealing with that, I was so naive. The first time I called 911, I asked if he could be taken to a hospital. I was told by a young cop, "I have a new baby and house payments. I have to arrest him". There went my innocence. Nothing like dealing with a decompensated acting out person twice your size in secret because you know jail is not a therapeutic community. I guess I'm lucky to be here to type this.

It's more than economic, though. There is the all American "blame the victim" dynamic here, too. If these people are *criminals* then we don't have to worry very much about a mental health care policy because they're just bad.

[Jackpine Radical]

18. 20 years ago I was working in a county psych hospital.

I did a lot of mental health commitments, several a month. The hospital itself closed at the end of 1990 due to a lack of funding, and virtually no inpatient commitments ever happen in this state any more. Instead, they're left out o the street until they accumulate enough petty (or major) offenses so we can send them up as habitual criminals. Last week I evaluated a murderer for a Not Guilty by Reason of Insanity (NGI) defense. I don't think his psychosis qualifies him for the NGI finding, but he shouldn't have been left to run loose on the streets; should have been committed instead of incarcerated, and long before the murder happened. The authorities had known he was nuts & dangerous for years.

[EFerrari]

22. Until you really get into a community, you don't know

how many known cases law enforcement simply tries to manage as best as they can. Policy, funding, time constraints, it's not pretty. They're cops, not shrinks but we expect them to handle these cases every day.

[ismnotwasm]

13. I attended a forensic nursing conference

One of the speakers was worked for a local penitentiary. The nurses in charge of the inmates with mental problems developed a program that cut the recidivism rates way down. Not only did these nurses ensure treatment and support while the inmates were incarcerated, they made sure they were released with support systems in place and did follow ups. I can't remember all the details, but it was an amazing program, and very successful.

I'm going the same conference this year, and I'll ask about specific programs for Vets.

[EFerrari]

15. Wow. That's so good to hear. The two times Doug managed

to get arrested and spend time in jail, he got nothing. And as an extra bonus, he was released off of his meds and if anything, more unstable than when he was taken in.

[Jackpine Radical]

19. There should be programs like that for everyone, not just vets.

At least 90% of street criminals have incredible histories of childhood abuse & neglect in incredibly dysfunctional families. They never have a chance from the cradle.

[dysfunctional press]

17. a lot of the people who go into the service do so out of economic necessity...

and may have been borderline homeless before going in, and now that they're out they may problems that render them unable to support themselves.

[Mike03]

23. Extraordinary OP

This is an excellent post, and I have little to add other than it is a topic that both fascinates and horrifies me.

The addiction aspect is certainly one pillar, but one thing to consider about this war is that unlike Viet Nam none of these soldiers are drafted; therefore, I would conclude most of them are in the services for financial reasons to begin with. This would make their situations more economically volatile to begin with, and the deterioration of the U.S. military's loyalty to its veterans just exacerbates the issue.

Are they addicted to the same drugs that prior veterans were addicted to? In Nam, wasn't it mostly alcohol and opiates? This new generation of veterans may have been exposed to a more hazardous array of substances, such as amphetamines and various psychological pharmaceuticals.

Did you happen to read the story in the January 13th edition of THE NEW YORK TIMES, entitled "Across America, Deadly Echoes of Foreign Battles"?
If this article is any indicator, this will potentially be the most violent and troubled generation of veterans we have ever seen.

Between the cost to help them, and the cost to society of what they may be capable of, we are looking at another trillion dollars this ridiculous war will cost us.

[nadinbrzezinski]

24. Very good.... and by the way, you still have vets from WW II

and Korea too.

Hell, I know one reason my dad drinks is to allay the demons from WW II and the holocaust

Remember, the monsters are not only limited to the vets... but also to families and to the victims of war.

[flashl]

26. The addiction problem. Well, the military 'medicate' soldiers

The Iraq War—On Drugs

In Iraq and Afghanistan, when “suck it up” fails to snap a soldier out of depression or panic, the Army turns to drugs. “Soldiers I talked to were receiving bags of antidepressants and sleeping meds in Iraq, but not the trauma care they needed,” says Steve Robinson, a Defense Department intelligence analyst during the Clinton administration.

Sometimes sleeping pills, antidepressants and tranquilizers are prescribed by qualified personnel. Sometimes not. Sgt. Georg Anderas Pogany told Salon that after he broke down in Iraq, his team sergeant told him “to pull himself together, gave him two Ambien, a prescription sleep aid, and ordered him to sleep.”

Other soldiers self-medicate. “We were so junked out on Valium, we had no emotions anymore,” Iraq vet John Crawford told “Fresh Air” host Terry Gross. He and others in his unit in Iraq became addicted to Valium.

In These Times

[Jackpine Radical]

28. In the 1st Cav in Vietnam (then a helicopter-borne infantry division),

the helo pilots flew on Librium. They ate it like candy.

[flashl]

31. Please know ,,,

I am not judgmental about the use of meds, but merely pointing to a connection that many seem to look over. There are also stories about returning Iraq soldiers 'seeking' illegals drugs, when the drug they are seeking is 'legal' while in Iraq.

Several years ago, after an extensive study by the UK on its veteran population 'military to prison pipeline'. They funded specialized re-entry programs which improved soldiers successful integration into mainstream.

[Jackpine Radical]

37. Well, I AM judgmental about meds under most circumstances.

But had I been a chopper pilot, I think I'd have been on the Librium too. As it was, just as a grunt I flew around in those things a whole lot more than I liked. Not tht I liked being on the ground either, come to think about it.

[Orwellian_Ghost]

29. K&R n/t

[dorkulon]

30. Why are homeless vets so much more tragic than regular homeless people?

Seriously. I mean, all this talk--including from Edwards--about homeless vets, as if homeless civilians are no big deal. :wtf:

[Jackpine Radical]

32. Because the vets got that way by

putting their lives on the line for ther country? Because they gave up a great deal of personal freedom and endured terrible conditions when told to do so by people whom they (often mistakenly) trusted? Because, at least in the case of Vietnam, most combat troops did not willingly volunteer but went anyway when called upon?

Other than a few minor things like that, I can't think of any good reason.

[dorkulon]

33. Ok then, fuck the non-veteran homeless, I guess.

After all, it's not like homeless civilians have been through any hardship. :eyes:

[Jackpine Radical]

34. a) I didn't say anything of the sort

b) Your reaction is uncalled for and over the top.

[dorkulon]

35. You're right, I'm being a bit over the top.

It just bothers me how commonly accepted the idea is that veterans are "worth more" than regular people. I can't find a reliable number for how many homeless people there are, but obviously it is a lot more than just the number of vets. We're talking about real men, women and children, and it seems kind of heartless to me to focus only on vets. Edwards says there are 200,000 homeless vets--but how many homeless PEOPLE are there, and how is their plight any more tolerable?

[Jackpine Radical]

36. I don't know what the numbers are, but as a matter of fact

25 years ago or so, my wife was the prime mover in creating homeless shelters in Madison, WI. Her program is still running there. A few years ago, I set up a clinic to provide free psych services to homeless people, largely women & children, in the town where we now live. A good friend of mine, a retired Army doc (and ardent pacifist and advocate for universal health care) has set up a free clinic here, where he puts in about 3 days a week practicing pro bono medicine for the poor. So be a little careful about the wild shots. I chose to write about veterans in this post.

How much are you doing for the homeless?