Hawaii Soldiers Coming Home
For many soldiers getting back from Iraq or Afghanistan, the battle has just begun.
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It’s always been a tenacious and hard-to-treat disorder, but, in recent years, a number of new therapies have been empirically shown to alleviate symptoms. There’s no 100 percent effective cure yet, but, whereas doctors in the past were forced to guess at the effectiveness of counseling and medication, today, treatments with names like “Seeking Safety” and “Acceptance and Commitment Therapy” come with research studies showing statistically significant results.
Hirsh’s program, an intensive nine-week residential clinic designed for soldiers and veterans suffering from severe PTSD, uses several of these evidence-based treatments, including “Desensitization in Vivo.” Patients take group outings to experience situations that might trigger their anxieties: movie theaters, driving on the freeway, a visit to Ala Moana Center.
They also spend hours every day in group psychotherapy sessions, unwrapping the paranoias and fears that keep them from functioning normally. “You can’t just change your emotions by wanting them to change,” Hirsh says. “But you can modify your thought processes, by evaluating their validity. And that can change your emotions.”
Not everyone needs a rigorous program like this. Hirsch says PTSD occurs in a wide range of severity. “It’s more like hypertension in that respect, rather than pregnancy, where you either are or are not,” he says. Patients with milder symptoms can be treated on an outpatient basis.
But, realistically speaking, the limiting factor is space, not need. The current ward has room for just 12 patients at a time, and there’s a constant waiting list of veterans and active-duty soldiers hoping to get treated. The overflow is forced to find help elsewhere.
Finn was one of the ones who couldn’t get into the residential PTSD program at Tripler. He remembers asking his VA psychiatrist to be referred, as his anxiety attacks and nightmares grew worse, but got the thumbs down. “He said, You’re not bad enough. We’re reserving that for the extreme cases. So what do I do in the meantime?”
The answer for Finn, and for many other veterans not finding the help they’re looking for, has been to turn to independent organizations in the community.
The outpatient therapy programs at Tripler Hospital for substance abuse and PTSD did Finn some good, but more helpful, he says, were the counseling sessions at the Honolulu Vet Center. “The approach is basically to talk it out, expel the demons, express your feelings. It worked for me for quite a while. But when I stopped, the symptoms started coming back.”
Things came to a head in June when he was arrested for a suspected DUI and for resisting arrest. The DUI charge was dismissed, but Finn lost his pool attendant job at the Moana Surfrider, and says his life started spinning out of control.
The turning point came this past October when, after the loss of his place forced Finn to live out of his car for four days, he moved into a shelter at Barbers Point, run by nonprofit organization U.S. Vets. The shelter is a residential work reentry program devoted to helping veterans transition into normal civilian life.
“People were telling me about U.S. Vets and how it helped them, and it sounded really appealing,” Finn says. “A free place to stay, three meals a day, regular sleeping times, that comfortable military setting, at least parts of it. It’s given me a stable platform, and peace of mind.”
At the moment, the majority of the veterans living at the shelter fought in the Vietnam War, but U.S. Vets outreach counselor Marko Johnson says he’s starting to see more and more Iraq and Afghanistan veterans out on the streets. The difficult task facing U.S. Vets and other independent veterans nonprofits in Hawaii today is publicizing their existence to this new wave of veterans.
Noe Foster, founder of theStrategist, a local health care advisory firm, and consultant to Mental Health America of Hawaii, says, “What we’re learning is that younger veterans aren’t raising their hands and identifying themselves as veterans. For the soldiers coming back from Iraq and Afghanistan, I think the term ‘veteran’ is more associated with Korea or Vietnam.”
The challenge is even bigger when it comes to female veterans, who, as Foster points out, experience a disproportionate amount of ill effect from wartime service. “The VA estimates one in three women who have been deployed to combat since 9/11 have experienced sexual trauma or rape, and 90 percent of these incidents go unreported,” she says.
Women are three times more likely than men to get a divorce while they’re deployed, Foster adds, which leads to child custody issues, financial hardships and other complications. “Many of these issues are common to men as well, but we’re finding that women, in particular, are not navigating the processes and programs that are already available to them. There’s a wealth of resources available to veterans returning home, but the women are often going it alone.”
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