A Female Veteran With PTSD – PTSD Impact on Being a Parent

Original Article found at: http://www.goodhousekeeping.com/health/a33968/female-veteran-ptsd/

PTSD Makes It Impossible for Me to Be a Mother

After combat in Iraq, Melissa Thurber fights a battle at home.

Each night, Melissa Thurber turns on a window air conditioner and the television in her bedroom, desperately hoping to block out the sounds of training missions from Hurlburt Field, an Air Force installation, near her home. C-130 jets roar over her neighborhood; training ordinance explodes on the range 10 miles away. The Florida-based photographer clutches her Chihuahua while her two bigger dogs lay nearby. Sometimes, she imagines she can smell the dust and smoke — and it snaps her back to Baghdad.

“Loud noises trigger my PTSD,” explains Thurber, who served as a medic on an 18-month Operation Iraqi Freedom deployment in 2003. “If I hear anything, then I know I’ll have nightmares that night. It can even be as simple as walking outside and the light reminding me of Iraq. I remember things very vividly.”

Those memories have haunted her for a decade. Over time, Thurber, one of the 20% of female veterans diagnosed with post-traumatic stress disorder, has figured out her other triggers: new situations, loneliness, people yelling at her, and certain smells. Scenes swim before her eyes, from fellow soldiers lost in the flash of a mortar attack to holding others’ hands while they died. She blacks out, goes into an uncontrollable rage, or is overwhelmed by crippling terror and depression. The disorder has destroyed her five-year marriage, spurred her to attempt suicide, and has her considering placing her daughter Delanie, 13, and son Blake, 7, in her family’s care.

She’s never violently lashed out at her kids, but Thurber admits that her lack of awareness during episodes makes her keep her distance. “I’ve never felt like a good mother,” she says through tears. “I just can’t connect with my children, as much as I’d love to. Every time I look at them, I always think very bad s*** is going to happen to them.”

The Call of Duty

Life wasn’t always this way. Thurber, an easygoing, artistic teen, joined the Army in 1998 before her senior year of high school in Massachusetts. After graduation, she worked as a medic with an aviation unit.

When she was called for active duty, Thurber was already raising an 18 month-old daughter. She’d started the process of trying to leave the Army — not because she didn’t want to be in the military but so she could live in Florida, near her parents. As a single mother, she had the option to defer her deployment, but Thurber felt that if she was going to ship out eventually, leaving sooner would be easier. “My daughter was so young at the time, I thought it was better to leave her with my parents when she’s not going to remember me being gone.” She shipped out in December 2003 — the same month Saddam Hussein was captured.

Melissa Thurber in Iraq

 Melissa Thurber during her deployment in Iraq.
Courtesy of Melissa Thurber

Combat in Iraq

Though initially bound for an aviation unit clinic, Thurber was reassigned twice and ended up in Baghdad on a “mobile collection team” (MCT). As part of the Iraq Survey Group, MCTs were tasked with finding weapons of mass destruction and serving as security detail, often in the heart of danger. One of them, MCT-9 was comprised of elite soldiers including the British Royal Marines, Army Rangers, and Navy Seals, and they needed medics, so Thurber was assigned to support the unit. “We went outside the wire almost every single day,” she recalls. “We saw combat. Our friends died in front of us.”

In 2004 Baghdad, the insurgency was raging. Car bombings were frequent; U.S. military and civilians were targets of kidnappings and beheadings. Thurber often went on missions in uniform and in civilian disguises to the Green Zone, Baghdad’s central area — without the protection of armored vehicles.

Thurber also served rotations with the 31st Combat Support Hospital’s casualty team. “I remember sitting with a soldier who’d been brought in and being the one to shut the machine off,” she says. “Then having to put him into a body bag, bring him to the morgue, and move on to the next one. You don’t have time to process what’s going on.”

Mortar attacks at the base were a common occurrence. “One of my greatest fears was having to go and use the Porta-John at the end of our area. What if a shell came then and I died going to the bathroom?” she says. “You were always thinking, Am I coming home today? Am I going to be able to call my daughter tonight?

Finally, after 18 months, Thurber returned home in the spring of 2005.

Back to a New Reality

The adjustment — to parenting and civilian life — was daunting. After a few months living with her parents, Thurber and her daughter, then 3, moved into their own Florida apartment. “That’s when my life changed.”

She started having insomnia and nightmares — both common among PTSD sufferers — and a prescription sleep-aid from her doctor didn’t help. Thurber would stay awake all night and finally collapse from exhaustion around 6 a.m., right when her toddler would wake.

“I would put breakfast foods low in the pantry and taught her how to get them herself,” Thurber says regretfully. “I’d be sleeping and not watching my kid. Or if I was awake, I’d be sitting there not able to participate or feel joy.”

Thurber wasn’t officially diagnosed by Veterans’ Health Administration doctors until 2008, though she says she took her concerns to them within months of returning home. Out of options, she sent Delanie back to live with her grandparents while she dealt with what she was beginning to think might be PTSD. “I never wanted to abandon my daughter, but I was trying to learn how to live with something that I didn’t understand.”

Soon after, she met her husband. He provided safety and a boost to her depression, she says. Sleep finally came. On rare bad days, he helped with Delanie, who had returned to live with them again. Thurber says he never really acknowledged her PTSD, though, even when she would violently punch or kick her new husband in her sleep.

Melissa Thurber with Blake, left, and Delanie.
Melissa Thurber with Blake, left, and Delanie.
Courtesy of Melissa Thurber

Dark Days Return

Life was relatively stable for two years. But when she went off medication for her second pregnancy and then had a series of shoulder surgeries, her routine was disrupted  — and the uncontrollable anger surged back with a vengeance. “Many times, I would get outraged and black out,” Thurber says. “Once, I broke my hand punching a metal box and don’t remember it.”

Between the PTSD and the shoulder pain, she took a litany of medications: Trazodone, Seroquel, Clonipin, Prozac, and Xanax, as well as Lortab 10 (a kind of hydrocodone) and Tramadol. “I have no idea how I was able to walk around and function,” she says. “I was driving my kids to school and activities, but I don’t remember half of it.”

During that period, Thurber had a months-long affair. She says it began from a lack of control in the haze of her medication, though she admits she also enjoyed getting attention from someone during a time when her husband was gone frequently for work. But Thurber knew she was spinning out of control: “By the end,” she says, “I was practically begging my husband to find out. I did everything in my power to make him suspicious — because I felt like I was going off the deep end.”

The day after he learned the truth in January 2010, they were arguing in the living room when her latest round of medication arrived at the door. As she signed for it, Thurber decided she’d had enough — that she was tired of combatting her disorder and trying to rebuild her life. “I thought, F*** this,” she recalls. She grabbed the Seroquel, an antipsychotic, and downed the entire bottle. (Suicide attempts are also prevalent among female veterans with PTSD — and 22 American military veterans commit suicide each day.) Her husband called 911. After being stabilized in the hospital, she spent three days in a mental health facility.

Getting back on her feet — and off her medication — became even more complicated as her marriage grew increasingly volatile. Her husband, who she says still didn’t really believe in her PTSD, was extremely angry with her. “The whole time instead of thinking, This is his problem,” she says, “I felt like I messed up and deserved what was happening.”

One day, the bottom dropped out. Thurber worked as a technician at a dialysis clinic and had become friends with a patient, a woman in her early 20s. As Thurber pushed her out after a session, she coded in her wheelchair. “There was nothing we could do. We couldn’t save her.”

It was horrifyingly similar to her experiences in Iraq. Thurber stayed in bed for a week, not even calling her boss to explain her absence. “I didn’t move, do anything. Nobody really understood.”

Finding Focus

Thurber, who’d studied photography in high school, found an outlet in pursuing a new career. “I had an escape,” she says. “I didn’t always have to be at home, dwelling on this stuff. I could go out, feel good, and have fun. For a while it was great.”

But after her husband lost his job, went back to school and switched jobs, Thurber became the sole caregiver for the kids. “I’ve never considered myself to be a good mom, but I would do everything by myself that I can: Give them their baths, feed them, cuddle with them and watch a movie, put them to bed,” she says. The pressures on her mounted.

Her marriage continued to struggle. They separated in June 2014 but reunited that fall. While her husband was decorating the house with Christmas lights after Thanksgiving, Thurber just snapped. “I don’t know what triggered it, but I was irate when he came inside,” she says, explaining she hadn’t refilled her prescription for six days.

During the screaming match that ensued, she ran to the bathroom. He followed, blocking her in. The fight escalated. She recalls punching him in the back to get him to move. Then he called the police and had her arrested in front of her children. “It was mortifying.”

Thurber stayed in jail for three days because her family refused to pick her up. Her husband was also awarded a temporary restraining order. Fortunately, she says, the court looked at her PTSD and decided she needed help, not prison. She’s been attending court-ordered counseling ever since.

“I feel like I’ve never been given the opportunity to show that I am a good person,” she says, “because this monster that I can’t control likes to come out a lot.”

Delanie and Blake Thurber and one of their dogs.

 Delanie and Blake Thurber and one of their dogs.
Courtesy of Melissa Thurber

Motherhood with Mental Illness

For now, her son lives with his father. And she believes living elsewhere might be a better choice for her daughter, too. “I want to be a mom. I want to be their mom,” she says. “But I’m not good at it, even though I love them and I try.”

“PTSD is a hole that I can’t get out of,” Thurber says, adding that years of medication, counseling programs and other treatments haven’t stopped her anger or panic attacks. Plus, some prescriptions make her unable to drive to activities like school and nightly soccer practice. “I’d rather not be around my kids if they can be with somebody who can do more for them than I can,” she says. “That might be best because I don’t have full control over it. I want to, but I don’t.”

Her children know she has the disorder, but don’t really understand why it affects her relationship with them. “They don’t get why I won’t take them to the water park or why if we go to the 4th of July Fireworks, I have to park away from everybody else and hold my little dog,” she says. “If I’m in my dark bedroom sitting by myself, they know Mom is done for the day and to leave me alone. They shouldn’t have to deal with that.”

Still, she hopes to eventually find herself on the other side — and able to be a healthy parent to both her children. In addition to counseling and medication, she leans on a close group of former soldiers, many of whom also have PTSD. She’s working on a book of photographs and interviews with other veterans with the disorder. And she’s planning on moving away from the base.

“I have good days and bad days,” Thurber says. “I wish people understood PTSD more: We didn’t sign up for it, we signed up to serve our country. And while it’s not something I’ll ever be able to ‘cure,’ I desperately want to be able to live with it without fearing what I might do.”

Melissa Thurber with her children Blake (left) and Delanie.

 Courtesy of Melissa Thurber

About 8% of the U.S. population will have PTSD at some point in their lives (around 8 million adults during a given year). For veterans of Operations Iraqi Freedom and Enduring Freedom, those numbers climb to about 20%. Symptoms of PTSD for anyone who has experienced a trauma include nightmares and flashbacks to trauma, anger, jumpiness, depression, and alcohol or substance abuse. If you or someone you know is experiencing symptoms that last for three months or more, visit the U.S. Department of Veterans Affairs or the National Alliance on Mental Illness for help.


IG Report: 300,000 Veterans Died While Waiting for Health Care at VA

Article Taken From: http://www.military.com/daily-news/2015/09/04/ig-report-300000-veterans-died-while-waiting-health-care-va.html#.Ve9OEbQH-os.email

WASHINGTON — More than 300,000 American military veterans likely died while waiting for health care — and nearly twice as many are still waiting — according to a new Department of Veterans Affairs inspector general report.

The IG report says “serious” problems with enrollment data are making it impossible to determine exactly how many veterans are actively seeking health care from the VA, and how many were. For example, “data limitations” prevent investigators from determining how many now-deceased veterans applied for health care benefits or when.

But the findings would appear to confirm reports that first surfaced last year that many veterans died while awaiting care, as their applications got stuck in a system that the VA has struggled to overhaul. Some applications, the IG report says, go back nearly two decades.

The report addresses serious issues with the record-keeping itself.

More than half the applications listed as pending as of last year do not have application dates, and investigators “could not reliably determine how many records were associated with actual applications for enrollment” in VA health care, the report said.

The report also says VA workers incorrectly marked thousands of unprocessed health-care applications as completed and may have deleted 10,000 or more electronic “transactions” over the past five years.

Linda Halliday, the VA’s acting inspector general, said the agency’s Health Eligibility Center “has not effectively managed its business processes to ensure the consistent creation and maintenance of essential data” and recommended a multi-year plan to improve accuracy and usefulness of agency records.

Halliday’s report came in response to a whistleblower who said more than 200,000 veterans with pending applications for VA health care were likely deceased.

The inspector general’s report substantiated that claim and others, but said there was no way to tell for sure when or why the person died. Similarly, deficiencies in the VA’s information security — including a lack of audit trails and system backups — limited investigators’ ability to review some issues fully and rule out data manipulation, Halliday said.

The VA has said it has no way to purge the list of dead applicants, and said many of those listed in the report are likely to have used another type of insurance before they died.

VA spokeswoman Walinda West said Wednesday the agency has publicly acknowledged that its enrollment process is confusing and that the enrollment system, data integrity and quality “are in need of significant improvement.”

Sens. Johnny Isakson, R-Ga., and Richard Blumenthal, D-Conn., chairman and senior Democrat of the Senate Veterans Affairs Committee, said in a joint statement that the inspector general’s report pointed to “both a significant failure” by leaders at the Health Eligibility Center and “deficient oversight by the VA central office” in Washington.

The lawmakers urged VA to implement the report’s recommendations quickly to improve record keeping at the VA and “ensure that this level of blatant mismanagement does not happen again.”

As of June 30, VA has contacted 302,045 veterans by mail, asking them to submit required documents to establish eligibility, West said. To date, the VA has received 36,749 responses and enrolled 34,517 veterans, she said.

“As we continue our work to contact veterans, our focus remains on improving the enrollment system to better serve veterans,” West said.

The Health Eligibility Center has removed a “purge-and-delete functionality” from a computer system used to track agency workloads, West said. VA will provide six months of data to demonstrate that any changed or deleted data on VA workloads has undergone appropriate management review, with approvals and audit trails visible, she said.

— The Associated Press contributed to this report.

IG: Investigations of military child deaths flawed

In a review of how the military investigates child deaths, the Pentagon’s Inspector General found that 71 percent of criminal probes of child fatalities were flawed because investigators did not follow all required procedures, according to a new IG report.

The IG conducted a detailed review of the 82 child deaths — including eight homicides — that occurred over two years to evaluate the quality of investigations conducted, according to the report released Dec. 22.

Specifically, the IG reviewed the performance of the three military criminal investigations divisions, which include the Army’s Criminal Investigation Command, or CID, the Naval Criminal Investigative Service, or NCIS, and the Air Force’s Office of Special Investigations, or OSI.

Child death investigations often involve looking for signs of neglect or abuse that could result in criminal prosecution.

The IG found no problems with 18 cases, or about 22 percent.

In 64 of the child deaths, or 71 percent, the IG found “minor deficiencies.” That included, for example, cases where:

• Investigators failed to collect or review appropriate medical records

• Investigators failed to record fingerprint impressions, mug photographs and DNA evidence

• Supervisors failed to conduct the required reviews of the investigations

In the case of six child deaths, the IG identified major problems with the investigation that likely affected the “integrity” or the “outcome” of the investigation. Those problems included:

• Investigators failed to collect key evidence from the death scene, the potential suspects, or the remains of the child victim

• Investigators failed to properly examine the potential crime scene, which may have resulted in the loss of crucial evidence

The Army’s CID was singled out for an especially large number of flawed cases. Of the 43 child deaths that CID investigated, four, or less than 10 percent, were found to be without problems. In 35 cases, the deficiencies were considered minor and in four cases the IG said the flaws were significant and likely affected the outcome of the investigation.

Many of the Army CID cases were flawed because they failed to document any headquarters-level quality assurance reviews, which are required under Army policies, according to the IG report.

The Army CID leadership concurred with the IG’s findings and in a Dec. 1 letter promised to improve its child death investigations. “CID is an organization dedicated to providing high quality death investigations to ensure justice for the victims,” an Army officer, whose name was redacted in the IG report, wrote in the agency’s official response.

The IG reviewed child fatality investigations that were closed during fiscal years 2012 and 2013.

The 82 child death investigations reviewed included eight that were ultimately ruled to be homicides, 20 that were ruled accidental and 30 that were ruled to be by natural causes. Three were suicides and in 19 investigations, there was no determination about the manner of death, the report said.

Of the six death investigations that the IG said were flawed enough to warrant further review, two of them were reopened for additional investigation and potentially revised findings.

A Military Times investigation in 2013 found 29,552 cases of child abuse in the Army alone between 2003 and 2012. The abuse led to the death of 118 Army children; 1,400 of the cases included sexual assault.

Subsequent inquiries by Military Times uncovered similar statistics in the other services.

Between 2008 and 2012, there were 5,755 cases in the Air Force, 267 of them sexual, resulting in 16 deaths.

The Marine Corps figures for 2011 and 2012 showed 1,591 cases, 47 of them sexual, with six deaths.

The Navy reported 3,336 cases between 2009 and 2012.

Original Source: http://www.militarytimes.com/story/military/crime/2014/12/23/child-deaths-ig/20815991/

Crazy, But Not Dishonorable

By Ray Parrish

Let’s get right to the bottom line. According to 38 USCS, section 5303(b): “if it is established to the satisfaction of the Secretary that, at the time of the commission of an offense leading to a person’s court-martial, discharge, or resignation, that person was insane, such person shall not be precluded from benefits under laws administered by the Secretary based upon the period of service from which such person was separated.”

Wow! Veterans can’t be denied VA benefits even if they left the military with “bad” discharges, down to and including DD’s (Dishonorable Discharges), if they can present a “credible” psychological evaluation that shows that they were “insane” at the time of the misconduct! They don’t have to show that the misconduct was “caused” by the mental disorder and it can be any diagnosis (PTSD, depression, anxiety, schizophrenia, etc.). You don’t need to get the military to “upgrade” the discharge or wait for Congressional or Presidential clemency.

A “credible” evaluation is one that bases its conclusions on the veteran’s military records and explains how they show the symptoms of “insanity,” using the VA’s definition of insanity printed below. The evaluation can also use medical records (military or civilian) and previous evaluations, and can make reference to notarized statements of friends and family to verify facts and the veteran’s behavior. Free evaluations and treatment are offered by volunteer mental health professionals at The Soldiers Project (877-576-5343). To find someone who’s ready to do the evaluation, call the VVAW therapist, Hans Buwalda at 773-370-4789. File a claim with the VA, be prepared to appeal denials, and don’t miss any deadlines.


Insanity Definition for VA Claims
38 CFR & 3.354
Determination of Insanity

(a) Definition of insanity. An insane person is one who, while not mentally defective or constitutionally psychopathic, except when a psychosis has been engrafted upon such basic condition, exhibits, due to disease, a more or less prolonged deviation from his normal method of behavior; or who interferes with the peace of society; or who has so departed (become antisocial) from the accepted standards of the community to which by birth and education he belongs as to lack the adaptability to make further adjustment to the social customs of the community in which he resides.

(b) Insanity causing discharge. When a rating agency is concerned with determining whether a veteran was insane at the time he committed an offense leading to his court-martial, discharge or resignation [38 U.S.C. 5303(b)], it will base its decision on all the evidence procurable relating to the period involved, and apply the definition in paragraph (a) of this section.

The public and the military have become more aware of the “invisible wounds of war,” thanks in large part to decades of work by VVAW members on this issue. We can hope that more veterans will seek treatment for mental health problems as we win the battle to de-stigmatize all mental disorders, especially PTSD (Post Traumatic Stress Disorder). So spread the word far and wide about this.

Ray Parrish is the Benefits Director at VVAW’s Military and Veterans Counseling Service.

Helping Veterans Obtain VA Benefits Saves Local Healthcare Budget Dollars

By Ray Parrish

Many veterans use non-VA healthcare facilities because VA regulations place bureaucratic hurdles in front of the veterans who are least able to overcome them and the people that these veterans go to for help either don’t know how or simply refuse to serve them because of their own prejudice.

There’s an ever-growing population of veterans, from ALL eras, with severe, untreated mental disabilities, especially PTSD (Post Traumatic Stress Disorder). So severe, in fact, that the most out-of-control veterans commit some kind of misconduct while still in uniform and they end up with an “other than Honorable” military discharge. The VA has rules that allow them to grant benefits to these vets, but veterans are told the opposite by everyone they go to for help, until they come to our office. The VA denies the claims in the beginning and many veterans don’t know that they need to appeal and ask for a “character of service determination.” They can then win full benefits with an appeal if it includes a properly worded psychological evaluation explaining that the veteran was insane at the time of the misconduct. It doesn’t have to be a PTSD diagnosis and it doesn’t have to have caused the misconduct. However, if either is the case, this is an opportunity to make those claims.

Since disciplinary charges for misconduct pre-empt the medical disability retirement process, many vets end up with these “bad” discharges even after being recommended for military medical retirement for PTSD or another mental disability. The veteran may simply have given up on the military’s inadequate, inappropriate or nonexistent treatment and gone AWOL (Absent Without Leave). Misconduct involving drugs, alcohol or violence are also common. In addition, many veterans with PTSD are discharged for a “personality disorder” which the VA says is non-service connected. Once again a properly worded psychological evaluation can correct the diagnosis and the veteran can then get full VA benefits. It should be noted that many of these veterans have chronic medical conditions or illnesses that the VA will not treat until a favorable “character of service” determination is made.

We have “VA Claims Agents” accredited by the VA to represent veterans and their families in VA disability claims. They have the patience to deal with this population of veterans, the experience to write successful appeals and experience working with healthcare professionals in this specialized area. No other veterans group has a therapist on staff. This therapist, Hans Buwalda, does individual, couple, and group counseling for veterans and their loved ones. She also writes these psychological evaluations and trains volunteer mental health professionals, mainly from The Soldiers Project, which has 40,000 volunteers nationwide.

Our objective is to get these disabled veterans the treatment and housing that they so desperately need. For this to happen we need to make them eligible for benefits from the VA. Because the VA recognizes its limitations, they are funding non-VA, community-based service providers for healthcare, housing, job training and, most importantly, veteran-run peer-counseling. The actual number of such veterans and the cost savings to state, county and city budgets is a simple research task. These results may indicate that it would be cost effective for state and local healthcare providers to employ people in their facilities who can help these veterans win their claims for federal benefits.

Ray Parrish is the Benefits Director at VVAW’s Military and Veterans Counseling Service.

Article: Female veterans do battle for benefits at home

As more women serve in armed forces, the VA and other agencies gear up to meet their specific needs when they return home

Xatavia Hughes, an Iraqi war vet is looking for a safer neighborhood for herself and two sons. She is in her current home in the Englewood neighborhood on Nov. 6, 2013. (Nancy Stone, Chicago Tribune)

Dec 02, 2013

Chicago Tribune| by Annie Sweeney

When Xatavia Hughes, the granddaughter of a military man, went to serve in Iraq, she was prepared to prove herself to the male soldiers.

“My grandfather was tough and strong. That is how I was brought up: ‘Don’t let it get to you. Show them,'” the 28-year-old mother of two said.

And she did. It was only after she returned from a war zone to Chicago in December 2010 that Hughes began to feel tested.

A month after returning, Hughes found herself in an improbable spot: living in a dorm room at the Pacific Garden Mission, the sprawling homeless shelter on the city’s West Side, shielding her two sons from addicts and criminals.

“Often when I was in shelter there was a bunch of veterans,” Hughes said of her six months of homelessness. “When we get out, I thought we were supposed to be taken care of. And I was like, ‘Wow, this is how our life is going to be?’ I never felt that I would do so much good and then have to be pushed aside.”

Hughes was like so many women over the past decade who stepped up to serve as the country launched two wars. They saw it as a way to get ahead in life and forge a different future.Women have become the fastest growing segment of the veteran population, a trend that is expected to continue. Their return has posed several new issues for the Department of Veterans Affairs. Many are single moms. They have been adversely affected by the scandal of military sexual trauma that affects one in five women who serve. They report higher rates of mental health illnesses and homelessness. Many don’t feel comfortable in the male-dominated VA.

And though they already served in dangerous, life-threatening positions, the recent decision to allow women to fight in combat zones means even more are likely to return with complex and severe injuries that need attention.

Local VA hospitals have improved care and increased services for women vets, even down to their design and architectural elements. A new housing complex for veterans with families is scheduled to open next summer, offering some relief. The VA launched a hotline just for female vets in the spring.

And in the latest recognition of the need for services, a long-standing community mental health organization, Thresholds, this year expanded its existing veteran services, assigning more case workers to connect with female vets struggling on Chicago’s streets.

Homelessness, isolation

The need to reach female vets was identified in a May 2012 VA report as “acute,” given the rapid growth of the population, not to mention that they are now suffering injuries similar to male soldiers.

The report cited higher rates of homelessness among women and lower access and enrollment in VA health care.

The Chicago office of Volunteers of America, a long-standing social service agency, already had recognized the new wave of younger veterans with children who were struggling with homelessness, said Nancy Hughes Moyer, president and CEO of the Illinois affiliate.

The organization began looking at the needs of women veterans in 2010 and plans to open a new housing complex for families next summer. The organization also offers gender-specific programming, something Hughes Moyer said is going to be critical as more women return with combat-related injuries, including post-traumatic stress disorder and high rates of anxiety.

“We know that is going to increase,” she said. “And they have dependent children.”

Thresholds secured a $350,000 grant to provide a range of services, from therapy to employment assistance, for an even more specific population: female vets with mental health issues.

“They have a lot more going on in their lives,” said Lydia Zopf, director of the veteran’s project at Thresholds, which is running the program. “They are more vulnerable.”

Thresholds offers gender-specific programming, including the option for vets to work with female staff.

Among the Thresholds clients is Hughes, who spiraled into homelessness about a month after returning home. Her $3,500 in savings went to expenses that included moving costs, winter clothes for her boys and “rent” payments to family members who offered her temporary and cramped spaces.

Meanwhile, her anxiety and stress was mounting. Fireworks on the Fourth of July sent her diving for cover. She mourned numerous losses in her unit.

“I was so happy to see my kids, my family,” she said. “But it was bittersweet because a lot of people didn’t get a chance to see their kids. … I felt guilty. I feel guilty.”

Hughes was able to secure a federal veteran housing voucher with the help of a caseworker at the Jesse Brown VA Medical Center in Chicago that let her get out of the shelters and into a Chicago home after about six months.

On a recent rainy afternoon, Hughes was feeling upbeat as she sat on her couch with Rebekah Pulju, a Thresholds social worker. On this visit, Pulju was checking in with Hughes on her current dream: a safer neighborhood for her children. She finds herself worried about the dangerous streets of Englewood and raising her children there. Pulju and others at Thresholds are trying to help find a better location.

“As long as it’s a nice neighborhood. If I find a nice neighborhood (for) my kids — that they can be able to play,” Hughes said. “I don’t even have to have a stove or a refrigerator. We can rent one. We can buy one cheap. Just as long as I have a big backyard.”

Barriers to service

For some returning female veterans, the challenges are especially daunting.

Back inside the Thresholds office on the North Side, Pulju meets with a 29-year-old Chicago woman who served in the Air Force and is currently covered 100 percent by the VA for PTSD. She can’t tell a reporter what happened, only that she knows the military changed her.

“It’s like I was alone,” she said. “I had my family. It felt like I didn’t know them. They didn’t know me anymore.”

Her goals, which she ticks off slowly to Pulju, seem simple yet tragically complicated at the same time.

“Being involved in more things. Getting out there meeting more people,” she said before hesitating for a long pause. “Stop being so isolated.”

In its 2012 report, the VA cited concerns that women were not accessing health care — something vets and experts here also have observed.

Jenny Garretson, the program manager for women veterans at Jesse Brown, said female vets can feel lost. “I can’t tell you how many times I have met a woman vet and she has told me, ‘When I got out of the military I didn’t know anything about the services that were available to me as a veteran or a female veteran,'” Garretson said.

Experts say a female vet who has experienced military sexual trauma would certainly find the busy, male-dominated hallways of a VA facility difficult, if not impossible, to navigate. But even without that type of traumatic experience, others simply don’t feel comfortable.

Inside a cheery Englewood library, Thresholds caseworker Shenetta Wilson, herself a vet, meets with client Francessca Phillips, 32, an Air Force vet and mother of two who has been homeless off and on over the past five years and suffered from depression after her service.

Phillips, who returned in 2004, waited five years before going to the VA. She acknowledges she felt some bitterness about her service — she didn’t get along with her bosses. But she also said it never really occurred to her to seek services at the VA. And then once she did, there were leering men who called out remarks like, “Hey girl, hey hot thing.”

Wilson, who served in Kuwait in the early 2000s, nodded.

“Ladies have been mistreated in different ways, anything as serious as (military sexual trauma) to just the sexism, the rampant sexism,” Wilson said. “It’s a part of the culture. That is not going to change overnight, and most of us accepted that. But when you get out … I have heard a lot of ladies say, ‘I am not a soldier anymore.’ They close that door. They don’t feel like a vet.”

That women have not served in official combat roles — though they are often impacted along with male soldiers — might also explain why they and others are less likely to see themselves as veterans.

“I was never deployed. I never saw any of the Iraqi Freedom action, but it created issues,” said Air Force vet Tessa Clark, 28, who served at Dover Air Force Base in Delaware in 2003 when so many war dead were returned there. “It was hard for me to be in a lot of the veteran places. They are not friendly when you haven’t seen any action.”

Don’t Call Me Mister

Today there are numerous public education campaigns to remind those inside the VA hospitals that women serve too: Pink camouflage bags were passed out at Jesse Brown during breast cancer awareness month. A “Please Don’t Call Me Mister” poster campaign is a gentle reminder to staff not to assume that every surname on a doctor’s patient list belongs to a man.

Rochelle Crump, who served during the Vietnam era in the Women’s Army Corps and who has been an advocate for decades, is pleased to see these efforts by private agencies and the VA.

But Crump still worries.

Crump said she will continue to advocate through her National Women Veterans United organization, which holds information-sharing events for female vets and also recently formed what she think is the only all-female color guard in the state.

“We hold events so that women can feel proud of their service, so they know they are a veteran,” Crump said. “We write ourselves out of history when we don’t.”

© Copyright 2013 Chicago Tribune. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

CVO and the VA Budget for 2013 by Bruce E. Parry, CVO Chair

The Obama Administration Budget proposed for 2013 for the VA is $140.3 billion. $76.3 billion is for mandatory benefits such as disability compensation and pensions. The remaining $64 billion is for discretionary spending, primarily for medical care.*CVO and VA Budget

The discretionary spending amount represents a 4.5% increase from the current year. This is more than $4 billion less than the major veterans organizations call for in The Independent Budget. Of particular note is the “minuscule” increase in medical and prothetic research of $1.6 million and in VA facility construction, according to the VFW.*

The CVO position on this budget is that all medical costs ought to be done by formula and counted under the mandatory spending, just as benefits and pensions are. This is what we mean by Full Mandatory Funding of VA healthcare benefits. The formula should be:

(The Number of Veterans to be Treated) x (The Average Cost for Treating a Veteran) x (A Factor for Increased Cost of Medical Care from Year to Year) = (Total Medical Care Allocation in the Proposed Budget)

CVO also demands for full eligibility for VA healthcare for all veterans. This means that the number of veterans to be treated in the above formula, should take into consideration how many veterans would use the VA healthcare system if all veterans had free and unencumbered access to the VA.

If there was full eligibility for VA healthcare, the humiliating and despised Means Test—by which veterans are segregated into different “Priority Groups” based on their income and other factors—could be completely eliminated. In fact, the Priority Groups themselves could be eliminated.

The VA was established as a healthcare system to serve all veterans. This promise has been continually eroded. Thousands of veterans are still excluded from even applying for VA healthcare benefits. This is a travesty and a disgrace in a country where nearly 50 million people have no healthcare. Veterans need healthcare and further burden the public sector when it is denied by the VA. Veterans have already paid for their healthcare through their military service.

CVO calls for Full Mandatory Funding and Full Eligibility for all Veterans of VA healthcare. We ask you and your organization to join us now!

* Source: VFW Magazine, May 2012, Washington Wire.