Post-traumatic stress disorder and the other “signature wound” of modern warfare, traumatic brain injury or TBI, are the source of problems for many veterans, even more when they descend into substance abuse with prescription or illegal drugs or alcohol. Left unchecked, these problems can increase a veteran’s likelihood for homelessness or suicide, as well as his or her chances of ending up in Carr’s court — or at Aleed Rivera’s door.
“One of the things we learned at the beginning is that there are a lot of issues with PTSD,” said Rivera, the bubbly, bilingual program director of Texas Lawyers for Texas Veterans, Tarrant County Bar Association chapter. “And because of that, it’s … likely that they will have run-ins with the police and the criminal justice system.” Rivera and her staff of volunteer attorneys, pulled from their private practices across Tarrant County, hold a legal clinic for veterans on the third Friday of each month at the North Texas VA’s new outpatient clinic on Southeast Loop 820.
Rivera’s volunteer staff is trained annually in post-traumatic stress symptoms. They learn, for example, to avoid confined spaces, which might make veterans feel anxious or claustrophobic. Rivera and her attorneys focus not on coddling vets but rather on restoring a supportive, strong foundation for them. A lot of time, she said, the vets just need advice on what to do, and then they can handle things on their own.
Her program has developed a national reputation. It began on a shoestring slightly over three years ago, with a measly $500 budget and a dozen attorneys working pro bono. (All veterans, of any era, get a free initial consultation. After that, services are still free if the veterans meet income guidelines.) Last year it won the National Conference of Bar Foundation’s “Partnership for Success” award for its model provision of services, today involving more than 10 percent of the Tarrant County Bar Association’s lawyers, an unheard-of level of participation.
“I’m always excited to tell people about our program,” said Rivera. “I want them to know, first of all, that we’re here. That [veterans] have an avenue for help. And also for other [lawyers] to get inspired by it, and say, ‘Hey, if they’re doing it, we can too.’ We don’t have to be a 10,000-attorney bar association in order to do this.”
The program draws from the ranks of solo practitioners as well as from large firms, which sometimes staff an entire legal clinic. Last year, the clinics served almost 1,100 veterans with consultations and representation.
Rivera said it’s hard to believe how fast the program has grown and how successful it’s been. “It’s because a lot of people care about veterans in this area, and a lot of attorneys are committed” to the program’s success and to veterans, she said. She estimated that 60 percent of the lawyers who started with the program are still involved with it.
Their clients come in all ages, including one World War II veteran in his 90s, but the largest group is from the Vietnam era. The cases run the gamut from traffic offenses and low-level criminal matters to family law cases, which can be very difficult. The tough cases, such as a divorce involving a custody fight, would ordinarily get rejected by a pro bono program because they take too many hours, but Rivera’s program frequently accepts them. They also handle landlord-tenant cases, employment law, and increasingly, personal bankruptcies. Veterans’ rates of bankruptcy and unemployment are significantly higher than those of the general population.
Texas Lawyers for Texas Veterans is a statewide program, but it’s the Tarrant County Bar Association chapter whose good work was cited in the national award. Beyond the robust involvement of the local attorneys, the chapter was lauded for handling some criminal matters (it may be the only chapter in the state that does so). And, it provides all veterans, regardless of income level, a “free, half-hour consultation with an attorney face-to-face, at the clinic.”
“It’s a ‘thank-you’ to veterans for their service,” said Rivera, the daughter and granddaughter of veterans.
Roughly a dozen attorneys show up for each clinic and handle a total of 50 to 60 appointments. Sometimes law firms provide snacks or give donations to help defray operating costs.
A Fort Worth businessman and veteran, Jeff Sandford of Juris Fabrilis, who is married to a lawyer, built the program’s custom database at minimal cost. Super-volunteer Michael Killam schedules all the appointments, and five or six law students from Texas Wesleyan University help veterans fill out applications over the phone, in advance, so that clinic time can be spent on pure consultation and not on what would otherwise be a “bottleneck of paperwork,” Rivera said.
The program clearly means a lot to the attorneys as well as to the people they serve.
“Everyone who gets involved in this program gets addicted to it, Rivera said. “Every time you … see that you’re making a difference in their lives, if they’re able to get housing or get a job, be a member of society, get back on their feet — it’s extremely rewarding. You just know it’s the right thing to do.”
She’d like to expand to other counties, perhaps through telephone conferences and Skype sessions. Attorneys who might not be able to get away from their offices for the Friday clinics could consult with veterans from their desks.
“I don’t know how it is in other places,” says Rivera, “but here in Tarrant County, it is very humbling to see that I don’t have a problem finding attorneys to take these cases for veterans.”
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Olson, the CEO at Grace After Fire, has a unique perspective on the women veterans who fall through the cracks.
“I don’t deal with women veterans who have great experiences with the VA, or any other source,” said Olson, who served as retired Army Gen. Jay Garner’s right-hand administrator in the early reconstruction of Iraq. “My team sees people who have been through a few things and are frustrated and are doing some not-good behaviors, or they won’t seek anybody’s help because they’re just so traumatized, and they need to be drawn out.”
She said women veterans have a unique set of issues and circumstances and consequently may need a slightly different set of services. Typically, she said, women “just get lost in the crowd of veteranism.”
Women represent an increasingly large share of the ranks of veterans –– they are about 15 percent of current, active-duty military personnel –– and are a unique demographic, Olson said. “The thing that you have to remember about our women veterans is that 60 percent of them are married to other military or veterans as their partners. So you’re dealing with not only their issues, but she’s taking on his too.”
Michelle Rosales-Kneubuhl is outreach coordinator for Grace After Fire in the Fort Worth area. She’s a 13-year Marine Corps veteran, married to a Marine, and has two young children. “I am who I serve,” she joked warmly.
“When everything’s going well,” the veteran experience is great, says Rosales-Kneubuhl, “but when it’s bad, it’s hell.” The women get little acknowledgment of their service from the public or from male veterans. So the chance to connect with other women veterans who understand their shared experience is priceless, she said.
The camaraderie is part of what Grace After Fire provides, at retreats for women veterans throughout the state and at “table talk” meetings, where women veterans get together to discuss their experiences, led by peer facilitators.
The group has branches in five big-city counties in Texas, with outreach to almost 40 counties. It served almost 1,300 women veterans in 2012. “If I can convince one” veteran to get help, Olson said, “he or she can then in turn convince two.” As veterans, she joked, “We are force-multipliers in ourselves.”
Peer-to-peer counseling for veterans is wildly popular in Fort Worth –– there are dozens of groups that meet weekly, with a blizzard of available meeting times and places. But just as at the VA, where many women veterans may not feel comfortable or initially welcome, counseling in a male-dominated group doesn’t always work for women, Olson said. So Grace After Fire offers a version modified to suit their needs.
“Women process trauma differently,” Olson said, “so the protocol for getting through it needs to be different. How [a woman veteran] reacts to the loss of a male comrade is going to be way different than how her male counterpart does.
“What women need,” she said, “is a safe place to go with other women who have had similar experiences. Not that you’ve had the same trauma, but you’ve had experiences in the military, you can nod your head and everybody understands without having to explain it.”
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Some experts think that the timetable for veterans “hitting a wall” is speeding up because of repeated deployments, perhaps for other reasons still not understood. That acceleration is adding to the demand for services.
Hansen has seen it. Her agency clients include those who served in “Gulf War, Desert Storm, Somalia, Africa — every war you can think of in the last 20, 30 years, going back to Vietnam.”
There are “three or four young vets, 23 to 24 years old, in Liberty House right now,” she said. “But I think they’re rare. I think most guys — and girls — get back from deployment and think they’re doing all right and try to pick up their lives and go on. And all of a sudden they’re drinking a little too much, or doing other [negative] things to comfort [themselves], to feel OK. And it kind of sneaks up on them. They probably don’t even think they have a problem until they’re right in the midst of a crisis.”
Michael Killam went through those stages. A Vietnam veteran, he was a client at Liberty House, after PTSD, drugs, and alcohol steered him into that wall. He has been clean and sober for six years, and today he provides peer services and drug and alcohol counseling to other veterans.“I have an office at Liberty House now,” he said, “where I used to have a bed.” He agrees that too many Vietnam vets delayed too long in asking for help. “We waited too late to come in,” he said, and he doesn’t want the same thing to happen to younger vets.
Delays in seeking services don’t just affect veterans themselves. If they have problems that are going untreated, those problems are also probably affecting their families.
The VA, that quasi-benevolent elephant in the room, doesn’t serve veterans’ families, but only the veterans themselves. The Vet Centers, a more informal part of the VA, often run by veterans themselves, do see the families. There’s a tremendous trickle-down effect, noted by researchers from the Vietnam era, who proved that PTSD could be passed on to succeeding generations of veterans’ families.
Debra Kaplan, a licensed social worker and marriage and family therapist in Plano, sees veterans and family members as part of her private practice. She also sees the impact of deployment on the family.
“The parents may feel they’ve got it under control by having gone to the VA, etc., but the children –– it’s almost like they have these emotional antennas, and they pick things up,” she said. “What begins to happen is, the children begin to pick up the symptoms of the parent.”
The kids of parents who’ve been deployed “may come in with a lot of rage or nightmares or bed-wetting, or any of those behaviors,” she said
Julian has seen similar effects among the families of veterans suffering from PTSD and other psychological maladies. “We’re dealing with a whole generation of people who are going to become parents” and who are “visiting their illness on their children, and [whose] children will visit it on their children,” she said.
“If we’re going to send troops into these wars, then we have an obligation to give them the best of care when they get back.”
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Thanks to a concerted effort on the part of the federal government, the Obama administration, and the VA, homelessness among veterans is dropping. Nonetheless, the figures can still be shocking. Nationally, at least one in seven homeless people in this country are military veterans.
According to a recent comprehensive study by the U.S. Department of Housing and Urban Development, veterans are 50 percent more likely to become homeless than other Americans, and if they do end up on the streets, they remain homeless on average for close to six years, compared to the general average of slightly less than four. Minorities have an even tougher time. And, according to information from the YWCA, women veterans are twice as likely as their male peers to become homeless.
When veterans with families show up at homeless shelters, they, like other families, are usually separated into different facilities by gender. Hansen said she has one male veteran at Liberty House whose wife stays at the Presbyterian Night Shelter with their children.
Liberty House provides temporary transitional housing for up to two years, for homeless veterans with PTSD, as well as job training, budgeting advice, and mental health and substance abuse counseling. It’s the only Fort Worth shelter set up specifically for them. There has been talk about establishing a “Lady Liberty House” in Fort Worth for women veterans and their children, but Hansen said the VA “hasn’t issued another capital grant since 2010.”
Many of those who work in veterans services locally said there is a real need for more help to keep veterans from becoming homeless in the first place.
Olson isn’t opposed to programs for the homeless, but she’d like to see the intervention come earlier, with prevention programs. “Because that’s where you’re going to get the most bang for your buck,” she said. “We know who are high risk among our vets for being homeless, and you should fund that because they’re still in stable housing. Once you hit the streets — particularly a female vet, in this day and age?” She let the sentence trail off.
“It’s a long climb [back] once they’re reached that point,” she said, “because they’ve exhausted all their friends, all their support structure. They’ve lost their job, all their money. And we think, ‘Oh my God, if we could have gotten to you a year ago.’ ”
Olson said the structure set up to help homeless female veterans is inadequate. Shelters for male vets are often set up next to drug rehab centers, she said, because substance abuse is the problem that usually drives them to the streets.
For women vets, though, the issue is much more likely to be sexual abuse — about 78 percent of them have experienced it while serving in the military. “What she needs is counseling around [military sexual trauma], and, oh by the way — she’s got kids in tow. And most homeless shelters won’t let you have children there.”
“I ran into a woman vet like this at the VA,” Olson said. “She was living in her car at Wal-Mart. She had a job, but when she was deployed, her husband ran through the money, their house was foreclosed on, and she had nothing to come back to” when her duty tour was over.
Women veterans “don’t need a bed and a place to sleep” so much as an “an all-encompassing place that’s an apartment, where they have child care, where they have job training, where people come in and do counseling, where there’s nutrition, and where they have all these things right there on site,” Olson said. “What we need is a mini-base.”
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Lurking just under the surface of any discussion of veterans’ mental health issues is the specter of suicide –– a seemingly intractable problem that, despite determined efforts by all the military branches, just keeps getting worse. Military suicide figures are higher than for civilians and still increasing.
Carr is a believer in the effectiveness of timely intervention. He keeps an album of photos of all the veterans who’ve gone through his program. “It’s gotten very thick,” he said.
But he never forgets those for whom the help wasn’t enough. He recalled one young man who’d gone through extensive trauma in the war zone. The veteran successfully completed Carr’s program but killed himself eight months after graduating.
“I was at the funeral. It was a tear-jerker,” the judge said. So many from his unit had been killed, and “this kid felt incredible survivor’s remorse, but he’d made such progress.” In the end, despite everyone’s best efforts, the young man “got back into his dark places, and it just finally caught up with him.”
Even in a place with as many resources for veterans as Tarrant County, more help is still needed.
One of the things that Kaplan and others think would aid veterans tremendously would be a lessening of the stigma surrounding PTSD from combat.
“Who wouldn’t come back traumatized?” Kaplan asked. “Who wouldn’t come back needing some kind of support … to reintegrate into society and into the world?
“Veterans and their families need support to integrate the experience of being away from one another, and how people in the family have changed during that separation,” she said. “And then coming back together and seeing that they can still be a very loving, functional family — and that there are certain traumas that need to be addressed, without stigma, almost as if they’re an expected response to one of life’s challenges.”
Hansen sees the same need on the practical level. Her crisis line fields up to 50 calls a day from veterans and their families needing help. She wishes there were more emergency funds available to bridge the gap and keep those who are barely making it from becoming homeless.
“This economic squeeze … has really been hard on young couples and especially military vets who … can’t always transfer what they learned in the military to the outside world,” she said. “And then something [bad] happens, and they’re stuck. They end up in a homeless shelter. They’re just at the breaking point.”
Several of the people interviewed for this story talked about how many veterans just need that extra bit of help — advice on how to get their legal affairs in order, a push to get them back on track in some other part of their lives, and, just maybe, a roadmap and a reminder of how capable they really are.
Sometimes they just need advice,” Rivera said. “They don’t [necessarily] need representation in court. They just need someone to tell them, ‘Hey, these are the steps. This is what you need to do.’ And then they do them! They’re perfectly capable.”
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Support on the Homefront
A partial list of organizations providing services to the approximatly 127,000 veterans in Tarrant County.
Government/Medical
VA North Texas Health Care System, Outpatient Clinic
Medical, surgical, and mental healthcare for veterans, with proof of military service. (817) 335-2202 / (800) 443-9672
Fort Worth Vet Center Individual, group and family counseling for veterans with proof of military service. After veterans register, their families can also get help. (817) 921-9095
Private/Nonprofit/Charitable
Liberty House Transitional housing for up to two years for homeless veterans with PTSD, as well as job training, budgeting advice, and mental health and substance abuse counseling. (817) 569-4540
Bring Everyone in the Zone Peer-to-peer counseling offered by military veterans for veterans and their families, at multiple Fort Worth locations. Website (www.bringeveryoneinthezone.org/sharing.html) includes locations and phone numbers as well as a list of other service providers.
Grace After Fire Peer-to-peer counseling for women veterans.
(800)362-6477 / (817)682-6694
Legal/Judicial
Veterans Court Diversion Program Provides appropriate treatment in lieu of criminal justice punishment for veterans with brain injury or mental illness who commit nonviolent offenses.
Judge Brent Carr (817) 884-3225.
Program Manager Courtney Young (817) 884-3754.
Texas Lawyers for Texas Veterans, Tarrant County chapter. Legal clinics on the third Friday afternoon of most months, at the VA’s Outpatient Clinic. Handles criminal as well as civil matters.
Other
TexVet.com offers a comprehensive list of veteran-related events and counseling sessions. The Veterans Coalition produces a resource guide available at many locations in the Fort Worth area.
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Lily Casura is a longtime journalist with a strong interest in veterans issues . She is the founder and executive director of HealingCombatTrauma.com.
