Public Hearing - February 29, 2012
1 BEFORE THE NEW YORK STATE SENATE
STANDING COMMITTEE ON MENTAL HEALTH AND
2 DEVELOPMENTAL DISABILITIES
3 --------------------------------------------------
4 PUBLIC HEARING
5 TO SOLICIT INFORMATION ON
POST-TRAUMATIC STRESS DISORDER (PTSD)
6 IN VETERANS RETURNING FROM COMBAT
7 -----------------------------------------------------
8
Legislative Office Building
9 Hearing Room B - 2nd Floor
Albany, New York
10
February 29, 2012
11 10:00 a.m. to 1:00 p.m.
12
13 PRESIDING:
14 Senator Roy J. McDonald
Chair
15
16
17 SENATE MEMBERS PRESENT:
18 Senator Shirley L. Huntley (RM)
19 Senator Lee M. Zeldin
20
21
22
23
24
25
2
1
SPEAKERS: PAGE QUESTIONS
2
Christopher Delaney 9 21
3 President
9-1-1 Veterans
4
Dr. Yuval Neria 32 43
5 Director of Trauma & PTSD Program
Columbia University's College of
6 Physicians and Surgeons
7 John A. Javis 52 58
Director
8 Veterans Health Alliance of Long Island
9 Dr. Charles Kennedy 63 70
Clinical Director, PTSD Treatment Program
10 Peter Potter
Public Affairs Director
11 U.S. Dept. of Veterans Affairs,
Albany Station
12
Andrew Roberts 76 87
13 Director, Office of Military &
Veterans' Services
14 North Shore - LIJ Health System
15 Carol Davidson 89 98
Director of Veterans' Services
16 Samaritan Village, Inc.
17 Karin Moran 100 107
Director of Policy
18 National Association of
Social Workers - NYS
19
Jonathan E. Gradess 108 114
20 Executive Director
New York State Defenders Association
21
Command Sgt. Major Gary Flaherty 119 124
22 Director
Columbia County Veterans' Service Office
23
Thomas Ronayne 119 124
24 Director
Suffolk County Veterans' Service Office
25
3
1
SPEAKERS (Continued): PAGE QUESTIONS
2
John Richter 133 138
3 Director
Mental Health Association - NYS
4
Roger Ambrose 144 152
5 Director
Jefferson County Community Services
6
Katherine Maciol 144 152
7 Commissioner
Rensselaer County Dept. of Mental Health
8
Andrew Davis 156 161
9 Director
Saratoga County Veterans' Service Agency
10
Hatty Baldwin, R.N. 163 165
11 Fiancee of John Patrick Jennings
Resident of Suffolk County
12
L.W. Murphy 163 165
13 Chairman
Suffolk County Veterans' Advisory Panel
14
Dennis O'Donnell 170 176
15 Founder
Warriors' Circle Program
16
Joel Abelove 176 186
17 Attorney
OEF Veteran
18 ---oOo---
19
20
21
22
23
24
25
4
1 SENATOR MCDONALD: Okay, folks, I'd like to
2 take this opportunity to thank you for being here.
3 We're starting a program, to gather
4 information and all kinds of public input in
5 reference to a very serious topic, and that's,
6 post-traumatic stress, its relationship to the
7 returning men and women in our military who are
8 coming back to New York State, the relationship it
9 has to suicide, and so many other sad things that
10 have impacted these men and women who are serving.
11 It's not just in this war, but in previous
12 wars, and, what we can do to help them out. And
13 we're trying to gather that information, so we can
14 learn from it, so we can turn around and help these
15 folks.
16 We have this hearing. This hearing will go
17 to approximately 12:30.
18 We have several very prestigious speakers;
19 some people who have encountered these problems,
20 some professionals that deal with these problems.
21 And our objective is, here, to learn from
22 that.
23 This will be the first public hearing. We
24 will be doing public hearings in other parts of the
25 state, on this topic.
5
1 I am Roy McDonald, the senator who is the
2 Chairman of the Mental Health and Disabilities
3 Community -- Committee. Excuse me.
4 I am also a Vietnam Army veteran. And I'm
5 exceptionally proud to --
6 [Applause.]
7 SENATOR MCDONALD: Thank you.
8 I'm especially proud to introduce a new young
9 senator, Lee Zeldin, from Long Island, who not only
10 is a very bright, intelligent young man, but he's
11 also a very courageous man. He is an Iraqi War
12 veteran.
13 [Applause.]
14 SENATOR MCDONALD: At this time, I would like
15 to turn it over to Senator Zeldin, who will lead us
16 in the Pledge of Allegiance, and also talk about our
17 first speaker.
18 And the flag is, right here.
19 SENATOR ZELDIN: If everybody could stand.
20 (All recite, as follows:)
21 "I pledge allegiance to the flag of the
22 United States of America, and to the Republic for
23 which it stands, one nation under God, indivisible,
24 with liberty and justice for all."
25 SENATOR ZELDIN: If you don't mind, remain
6
1 standing for a brief moment of silence, and now
2 would be a most important time to say a silent
3 prayer to yourself, for all those that we've lost
4 for post-traumatic stress disorder as a result of
5 their service to our country.
6 (Moment of silence is held.)
7 SENATOR ZELDIN: Thank you. Please be
8 seated.
9 Well, thank you, Senator McDonald.
10 It's been a pleasure to serve as a member of
11 the Mental Health Committee since I joined the
12 State Senate last year.
13 It's also been an honor to serve in the
14 military. I still serve in the Army Reserves.
15 And, going back to my time on active duty, it
16 was one of the saddest -- one of the saddest
17 experiences, to have someone that you know, who
18 deployed, maybe multiple times, they come home with
19 the mental wounds of war. And, despite the fact
20 that they survive a deployment, unfortunately, those
21 mental wounds end up claiming their life afterwards.
22 When I returned home in 2008, I had the
23 opportunity to meet our first speaker.
24 His name is Christopher Delaney.
25 And told me a story of PFC Joseph Dwyer.
7
1 And as you see in front of you this famous
2 picture of PFC Dwyer, there was a picture in "Time"
3 magazine. All of you have seen this picture. And
4 he was -- he was almost, you know, a poster child of
5 everything right of what we were doing overseas.
6 He returned home with those mental wounds I
7 just discussed.
8 He had a wife, a young daughter. And,
9 unfortunately, PTSD ended up contributing to the
10 loss of his life after a very heroic deployment and
11 service to our country.
12 I wanted to work on some type of a program
13 with, you know, Senator McDonald, and my colleagues
14 here in the Senate and the Assembly, for us to
15 address post-traumatic stress disorder.
16 And, last January, when we were forming a
17 panel in the 3rd Senate District, to help develop a
18 legislative solution, someone that I was close with,
19 named John Patrick Jennings, unfortunately, lost his
20 life. And our panel went from being a
21 Veterans' Advisory Panel to the
22 John Patrick Jennings' Veterans' Advisory Panel.
23 This is something that doesn't get enough
24 attention in the media, throughout our state, and
25 throughout our country. There are veterans that are
8
1 deployed now that will return home with these mental
2 wounds.
3 There are -- there are veterans from wars
4 past.
5 Maybe we called it something different in
6 World War II or Korea or Vietnam, but, in our ranks,
7 there are members of multiple generations of people
8 that served our country that have post-traumatic
9 stress disorder today.
10 Our state and our country is not recognizing
11 this problem to the full extent as it needs to.
12 It's not addressing this problem to the full extent
13 that it needs to.
14 And Senator McDonald and I are not looking to
15 have a hearing, so that, for one morning, for
16 2 1/2 hours in Albany, we discuss this issue, and we
17 move on.
18 This is a start.
19 And we are going to fight as hard as we
20 possibly can to make sure that there are results, so
21 that New York State, and other states around this
22 country, do more to help with the diagnosis and
23 treatment of post-traumatic stress disorder.
24 I definitely say, thank you, to all of you
25 that traveled so far to be here, especially our
9
1 speakers.
2 It means so very much.
3 And, at this time, it's my honor to introduce
4 our first speaker, Mr. Christopher Delaney.
5 CHRISTOPHER DELANEY: Good morning.
6 My name is Christopher Delaney.
7 I am an Iraqi Freedom veteran, 2009 to 2010;
8 a VF Post 7279 member; and founder of
9 "HeroArmyPFCJosephDwyer."
10 I am currently the president of
11 9-1-1 Veterans, a small grassroots not-for-profit,
12 dedicated to helping our Long Island veterans who
13 fall on difficult -- who fall on difficult financial
14 times through no fault of their own.
15 I'm joined here today with Brian Dwyer,
16 brother of Private First Class Joseph Dwyer.
17 I was invited here today to testify on issues
18 regarding veterans with post-traumatic stress
19 disorder.
20 I would like to thank Senator Roy McDonald
21 and Senator Lee Zeldin for giving us this
22 opportunity to shed light on a disease which is
23 plaguing our returning combat troops.
24 Born into a family of police officers,
25 Joe Dwyer enlisted in the United States Army
10
1 two days after the September 11 attacks. Joe was
2 assigned to the Third Squadron, 7th Cavalry
3 Regiment, Third Infantry Division, a scout unit
4 described as "the tip of the tip of the spear."
5 In March of 2003, Operation Iraqi Freedom
6 began. As the first line of attack, Joe's unit
7 pushed powerfully through Iraq, securing river
8 crossings for the forces racing behind them to take
9 the Iraqi capital during the initial surge.
10 Out of the 21 days to get to Baghdad, only
11 4 lacked any combat.
12 On 25 March, 2003, "Army Times" photographer,
13 Warren Zinn, focused his camera on combat medic
14 Private First Class Joseph Dwyer as he whisked an
15 injured Iraqi boy to safety.
16 To those who saw the photograph on the cover
17 of the "USA Today" and "News Day", it symbolized
18 everything that was right about America.
19 One reader even wrote into the paper to say
20 that, "The photo explains, as no words ever could,
21 why so many Americans support this war."
22 This writer also thanked the soldier for
23 being the American many of us aspire to become.
24 PFC Dwyer was hailed a hero, but the Joe
25 I knew never understood the big to-do. Joe would
11
1 later say, "What you don't see in the picture is the
2 brave men who had my left and right flank. They
3 were protecting me. My rifle was slung."
4 Joe would return home to a hero's welcome.
5 Things people do not know about Joe, was he
6 was a kind, loving person who embraced life and had
7 a great sense of humor.
8 They also do not know that Joe volunteered
9 for this deployment because a fellow soldier, who
10 was also a medic, was supposed to go, was a single
11 mother. Joe insisted she stay home to take care of
12 her child, convincing her he would be okay.
13 Joe also told his parents and siblings he was
14 based in Kuwait, far from the battle, to put them at
15 ease.
16 When this picture emerged on the front page
17 of "News Day", with making mom proud, it did make
18 Joe's mom proud, but it also brought a sense of fear
19 to the entire Dwyer family.
20 Joe returned to the States, to his beautiful
21 wife, Matina, only a shell of who he once was. Joe
22 displayed all visible signs of PTSD.
23 He was diagnosed by the V.A., and yet we
24 failed him and his family.
25 We failed Joe and the Dwyer family, as a
12
1 community, a state, and a nation. We leave them to
2 bear the toll of the invisible wounds of war.
3 Joe's story started as a heroic tale, as an
4 American who wanted to bring the fight to our
5 enemies so that we can live in peace here.
6 He served his country with honor. He
7 returned home a hero, and then his story turns into
8 tragedy.
9 Now our mission is to turn Joe's story around
10 yet again.
11 Joe never wanted this attention, but accepted
12 it by saying, "If this photo can help a fellow
13 soldier from going through what I am going through,
14 well, I guess, then, it's worth it.
15 PFC Joseph "Doc" Dwyer, or as his family knew
16 him, "Joe," passed away from the side effects of
17 PTSD in June of 2008. Joe is survived by his wife,
18 Matina; daughter, Meagan; parents, and
19 five siblings.
20 We owe it to them to make this right; to make
21 a change on how we care for all our returning
22 service members.
23 I'm not here to talk you to about
24 post-traumatic stress disorder, or, "PTSD." Others
25 here will discuss that. But I do want to address
13
1 our neglect to our service members.
2 PTSD has been recorded as early as 480 BC,
3 all the way to our current conflicts.
4 PTSD has been called: Nostalgia;
5 survivor's guilt; anxiety disorder; battle fatigue;
6 combat fatigue; combat neurosis; shell-shock; and,
7 Post-Vietnam Syndrome -- just to name a few.
8 In 1980, the Psychiatric Association added
9 the definition of "post-traumatic stress disorder"
10 to their third edition of "The Diagnostic and
11 Statistical Manual of Mental Health Disorders," the
12 bible of psychiatry.
13 Most recently, PTSD has been redefined, yet
14 again, to "post-traumatic stress injury."
15 The first organized military system for
16 psychological treatment of combat fatigue occurred
17 during the Russo-Japanese War of 1904 to 1906, when
18 physicians were placed close to the front in order
19 to perform evaluations of traumatized soldiers.
20 This was known as "forward treatment." This
21 treatment was expanded upon and used effectively
22 during World War I.
23 At the beginning of World War II, we changed
24 to a pre-enlistment screening that was a complete
25 failure, and psychiatrists were no longer assigned
14
1 to combat divisions during the war.
2 As a result, many of the successful forward
3 treatments of World War I were forgotten.
4 Psychological casualties were 2.5 times greater
5 during World War II than the previous conflicts.
6 The American military had still not corrected
7 its deficiencies in treating PTSD when the
8 Korean War began in 1950. Initial PTSD rates were
9 three times higher than in World War II.
10 This trend continued for the next 62 years,
11 and continues now.
12 I am telling you this because, today, here,
13 we have an opportunity to make a real change in the
14 way we treat our service members. We need to make
15 the real changes, not just introduce a catchy new
16 phrase.
17 We are not here to point fingers and place
18 blame. We are here to change Joe's story back to a
19 heroic tale; to let this iconic photo of Joe serve
20 as a symbol, a reminder to all of us, to do what is
21 right for the brave men and women who defend freedom
22 and liberty.
23 We've noted 13 points that we feel can make a
24 significant difference in how PTSD is perceived and
25 treated.
15
1 First: We must you address the stigma of
2 PTSD.
3 We firmly believe that Joe never intended to
4 end his life. Although his actions resulted in his
5 death, it was clear to those that knew him, he was
6 only seeking a few moments of peace from the
7 battlefield he never left.
8 Joe's dying words, as he clasped a police
9 officer's hands, were, "I don't want to die. I have
10 a family, I have a daughter."
11 On Joe's death certificate, it states:
12 "Cause of Death: Suicide, due to the side
13 effects of post-traumatic stress disorder."
14 We need to classify to what truly is the
15 result of an invisible combat-related injury.
16 We need to establish a system where everyone
17 returning from combat gets some form of support.
18 Secondly: We need to stop overmedicating.
19 We suggest, instead of giving our service
20 members a cocktail of medications, we use other
21 alternate methods of treatment and therapies.
22 Also, authorization of medications used by
23 outside doctors that the V.A. does not cover.
24 During the demobilization process, upon
25 returning home, you are immediately given a
16
1 six question psychological screening test.
2 As all service members know, their answers
3 can delay their homecoming. Many answer these
4 questions falsely so they can get home to their
5 loved ones faster, and not fear the stigma
6 associated with PTSD.
7 We suggest, give a one-on-one physical and
8 psychological evaluation, anywhere from one to
9 three months after their deployment, as it sometimes
10 takes this long for PTSD to set in.
11 Fourth: When entering the military, we all
12 go through a military-entrance processing station.
13 To us, this is known as "MEPS."
14 Here, they conduct a full physical, and will
15 not accept you unless you are 100 percent; yet, we
16 discharge our service members who are not
17 100 percent, and return them to society and their
18 families.
19 We suggest that we do not discharge service
20 members who are at risk and not 100 percent.
21 Fifth: The number of veterans who are not
22 enrolled in the V.A. system is staggering.
23 We suggest, before a member can be discharged
24 from the military, they're required to enroll in the
25 V.A. system.
17
1 Sixth: The proper funding for the V.A.
2 The annual funding of the V.A. is a national
3 disgrace. Make Veterans Administration funding
4 mandatory.
5 Our seventh point is: The reduction in tour
6 length, and decrease the number of combat tours.
7 This applies to National Guard, as well as
8 Reserve units.
9 Our eighth point is: Force the Department of
10 Defense to follow its own regulations, that no
11 PTSD-diagnosed troops should be redeployed into a
12 combat zone.
13 Ninth is: To educate family members of the
14 signs and symptoms of PTSD.
15 Tenth is: To improve and streamline the V.A.
16 claim process.
17 Just as you do not want to sit and fill out
18 redundant forms at your doctor's office, veterans
19 who have health-care needs do not have the time or
20 the energy to devote to lengthy and redundant form
21 process.
22 Most certainly, they do not have the time to
23 wait months for a decision on their claim.
24 Number 11: We suggest training combat
25 veterans as social workers, or in some supporting
18
1 role.
2 Combat veterans share a bond. And although
3 devoted and dedicated, a civilian social worker who
4 never spent time away from their family in a combat
5 zone may only understand so much, and the veteran
6 might not feel comfortable speaking about his or her
7 experiences.
8 Our twelfth point is: To keep them with
9 their units, the units they share a bond with, until
10 they are ready to integrate to post-combat military
11 life or life after the military.
12 Our final point concerns the decompression
13 time.
14 Decompression time should be mandatory.
15 During our country's earlier wars, our
16 service members had time to decompress on a long
17 sail home, aboard a ship with their
18 brothers-in-arms.
19 Today, you go from Baghdad to your front door
20 in less than 24 hours.
21 We suggest starting the demobilization
22 process in places like Kuwait or Germany. Keep the
23 unit together in an area that is considered
24 friendly, to give the unit time to decompress.
25 Whether by suicide, accident, or enemy fire,
19
1 individuals who die while deployed are included in
2 war's casualty count.
3 Future memorials will include their names.
4 The nation they served will acknowledge their
5 sacrifice, and their bravery.
6 Stateside deaths, however, are not included
7 in official casualty counts, even if it clearly
8 stems from their military service.
9 The exact number of home-front deaths that
10 take place following combat deployment is unknown
11 because the Defense Department does not collect that
12 information.
13 I challenge anyone to find a memorial of a
14 soldier who passed away from the side effects of
15 PTSD.
16 With Senator Zeldin's help in 2008, we
17 honored Joe Dwyer, by renaming the street he grew up
18 on.
19 Joe ultimately died on a battlefield, but his
20 family has not been given that honor. Instead, they
21 are left picking up the pieces of a grieving family.
22 This is how we treat the brave men and women
23 who answer our country's calling.
24 We need to put our political issues of these
25 wars aside when it comes to how we take care of our
20
1 service men and women.
2 To this day, the military still denies a
3 relationship between PTSD and deaths away from the
4 battlefield.
5 We could try to look the other way and
6 pretend there is no problem, but we cannot ignore
7 the human suffering that arises from the personal
8 tragedies of domestic violence, homicide, and
9 suicide that emerge as our returning soldiers
10 attempt to reintegrate back into society.
11 I challenge all of you to do what is right:
12 To make the necessary changes so we don't lose any
13 more heroes in our own backyard. To show the nation
14 how we, here in New York, take care of our veterans.
15 Let them follow our lead.
16 Change Joe's story back to a heroic tale.
17 I came across a quote not long ago. I would
18 just like to take this opportunity to share it with
19 you.
20 "You can always tell how a government feels
21 about its people by looking at the way it treats its
22 soldiers."
23 Thank you for your time.
24 And if you have any concerns about the issues
25 raised here today, I would be very happy to address
21
1 them with you.
2 SENATOR ZELDIN: Thank you, Chris.
3 First, I just want to recognize
4 Senator Huntley, who is here; is also the ranking
5 member on Senator McDonald's Mental Health
6 Committee.
7 Senator Huntley.
8 SENATOR MCDONALD: Senator Huntley has been
9 very active in mental health issues for years now,
10 on this Committee, and we thank her for her service.
11 And she's also very sensitive to the
12 veterans, having been a big supporter for many, many
13 years.
14 So the comments that you've made are very
15 important.
16 I appreciate the written documentation
17 because, especially, the details, that I'm sure you
18 went into great thought, and the emotional issues,
19 that are very illustrative of so many of these men
20 and women.
21 And what a wonderful example, you know, this
22 gentleman was for the rest of the people.
23 And, hopefully, in his name, we can move
24 forward in doing some of these things, and hearing
25 from real people like yourself.
22
1 I was going to ask you a question, "In your
2 own words, what would you tell the family, and the
3 friends, of the veterans returning home?" -- but you
4 pretty much answered it, in this wonderful, precise,
5 concisive [sic] document.
6 So, I thank you.
7 CHRISTOPHER DELANEY: Thank you, sir.
8 SENATOR MCDONALD: You did a splendid job.
9 It's not going be easy for us to put all this
10 together, but you made it a little bit easier by
11 going into details.
12 SENATOR ZELDIN: Well, the one specific
13 question, Chris, that I wanted discuss, and ask you
14 about, was the concept of doing a peer-to-peer
15 mentorship program in the state.
16 One of the things that I have observed,
17 really, on the street, is, you meet someone with
18 post-traumatic stress disorder, and, they're on
19 their own. They're with their, maybe, family, or
20 friends, but, maybe those friends aren't combat
21 veterans. Maybe they don't suffer from
22 post-traumatic stress disorder.
23 And, one of the things that I wish we'd see
24 more of, in our state, and our country, would be a
25 mechanism, so that when you return to civilian life,
23
1 you would have access to like-minded individuals
2 that are going through what you've been through, so
3 you know that you're not alone.
4 And, if you wouldn't mind just commenting on
5 the concept of some type of a peer-to-peer
6 mentorship program.
7 CHRISTOPHER DELANEY: In a lot of the
8 dealings that we have on Long Island, and working
9 with our veterans, we're sort of in the trenches.
10 We deal with these guys when they fall on
11 hard times. And a lot of times, when they fall on
12 hard times, and -- it's not just the current
13 conflict that we deal with. You know, we help every
14 veteran on Long Island. And, we deal with a lot of
15 the Vietnam veterans as well.
16 But it seems like to be the one thing that
17 the veterans that are going through, they're
18 suffering from post-traumatic stress disorder, which
19 leads to an array of different problems, such as,
20 homelessness, them being arrested for drugs, and
21 domestic violence, and sometimes other crimes, that
22 are related with the side effects of the disease
23 that they're trying to battle.
24 When we actually can sit down and talk with
25 these guys, there's that level of sense of comfort,
24
1 because they know that we're not judging them. That
2 there's things that we've done, whether it be my
3 civilian job of working with the Suffolk County
4 Sheriff's Office, or through the military, we've
5 seen the same type of things.
6 And, they know that we're not going judge
7 them on their actions that they had to take, to
8 return home.
9 War isn't pretty.
10 We all sit down and we watch the, you know,
11 movies and the cinema, and Arnold Schwarzeneggers of
12 the world, and these big-movie action stars, and,
13 they make it like this glorifying thing.
14 But in the actuality of it, when you see what
15 the destruction of a .50-caliber weapon does; or the
16 weapon of a smart bomb, and what it does to the
17 area; and the people who get hit -- just like the
18 injured Iraqi child that Joe was bringing to safety,
19 he got hit with shrapnel -- it's, you're now seeing
20 a part of war that, you know, when you're done
21 playing your video game, you can turn off, and you
22 walk away, and there's nothing wrong.
23 So, it's the guys that see these things, that
24 are lucky enough to return home without a missing
25 limb, or that visible wound or that visible scar
25
1 that you and I can both see, these guys are left in
2 a shell to deal with it on their own.
3 And the military says: Oh, you know, let's
4 let these guys come forward.
5 But, we don't give them that opportunity to
6 come forward, because, when they do, there's a
7 stigma associated with it.
8 So when they run into us on the street and
9 we're in our regular clothes, and they see a veteran
10 speaking to a veteran, they kind of try to get --
11 they want to work with us. They end up showing up
12 at our events, because they feel a sense of comfort,
13 of being, I guess, back in that cohesive unit again.
14 Sort of like the unit that they shared a foxhole
15 with, or, you know, some of the experiences with.
16 So, the peer-to-peer is very important.
17 I don't want to rule out and say that
18 professional help also isn't important.
19 But that's why I said, maybe get that combat
20 veteran as part of the support role, in the
21 social-worker aspect. To have that professional
22 aspect of it, of someone who's trained in a
23 professional field; but, then, also bringing that
24 real-life experience, of somebody who can say, "You
25 know, hey, come with me brother into this other room
26
1 a minute. Cry on my shoulder for a minute. You
2 know, I'll embrace you."
3 I mean, my son, who is 6 years old, came up
4 to me the other day, and he goes, "Dad, I want to
5 shake your hand like you shake your friends' hands."
6 And he shook my hand, and he hugged me.
7 And I guess that's the bond that we share;
8 is, you know, we hug each other, because there's
9 that brotherhood, that relationship.
10 And that might be one of the links that makes
11 it easier for these guys to come out and talk about
12 their experiences, and know that they can come to us
13 and say: Hey, you know, I use drugs because I need
14 to get that moment of peace.
15 And they know I'm not going to say: Oh,
16 well, you know, what? You're using, I don't want
17 nothing to do with you.
18 That's not -- that's not how it is.
19 We're going to be there to get through that
20 problem, and then hopefully get you through the rest
21 of your problems.
22 SENATOR MCDONALD: Here's a question for you,
23 Chris: While you're talking, you're talking about
24 the mentoring program, I was thinking about our own
25 state, and how we're structured.
27
1 Obviously, Veterans Affairs is a national,
2 you know, division of Veterans Affairs' program that
3 the federal government runs.
4 I think each state tries to help that federal
5 program by being hands-on.
6 In our own state, each county has a veterans'
7 coordinator.
8 And, we have a piece of legislation that
9 Senator Chuck Fuschillo, another State Senator from
10 Long Island, had proposed, that would fund
11 educational programs, to help deal with these type
12 of people.
13 It's almost like localizing it. If we can
14 get down to the county level, and each county has
15 their own -- you know, I believe in grassroots.
16 Sometimes you get so far ahead of yourself, at a
17 state or a federal level.
18 And, we're not a small state. We're a very
19 large state of about 19 1/2 million people.
20 And what we're trying to do, is to bring
21 these types of services down to the personal level,
22 as opposed to just another mass number.
23 You know, and maybe that's something we
24 should explore with our county and our state, you
25 know, veterans' director and our county veterans, is
28
1 putting these programs together at a local level.
2 And then, when these returnees come in,
3 almost like have a caseworker, that we have some
4 sort of training, that we coordinate through our
5 county director of Veterans Affairs and our State
6 official in charge of Veterans Affairs.
7 So, if you've lived in a county, and -- say,
8 Erie County, you would be dealing with the
9 Erie County people. And, in this area, they would
10 be -- add a little background, a little bit of
11 training from us, what to work with. And then
12 coordinate with the Veterans Administration people,
13 if it's more serious, but we're localizing it.
14 So, the phone call's not coming from somebody
15 from another state, or, you know, or -- and in this
16 big state, another part of the state, but, it's
17 Erie County- or Columbia County-oriented, or
18 Brooklyn-oriented, so they can, not only deal with a
19 peer group, but a neighbor at the same time, that
20 could help them directly.
21 It's a very interesting premise.
22 CHRISTOPHER DELANEY: It's very interesting.
23 And I actually agree with you 100 percent on
24 that, because I'm not-for-profit. 9-1-1 Veterans is
25 a small grassroots not-for-profit, started in a
29
1 police-academy classroom, and started out raising
2 $8,000, of passing of a can; to, now, where we're
3 raising over $200,000 of it.
4 And, I never once solicited the county, the
5 government, or the state. We do everything through
6 private donations.
7 And, we take care of our veterans in our
8 backyard. And something, like: Oh, well, you won't
9 take care of this veteran?
10 It's not that I don't like the veteran that's
11 in New Jersey, or maybe in Manhattan. It's that we
12 know that we want to dedicate our time to the guys
13 in our backyard, and let people who will take the
14 role model of how we treat our veterans, and go
15 further.
16 Besides the fact, the way our
17 not-for-profit's set up, is, the money that we
18 receive in from our donors, now actually stays in
19 our communities.
20 So, we're helping a veteran who might be
21 waiting on that service-connected disability, for
22 PTSD, or for a visible wound of war. We might pay
23 his mortgage, which now, in turn, helps the
24 community that we're involved with.
25 So I agree that, keeping it close, keeping it
30
1 personal, is the way to go.
2 And I know, on Senator Zeldin's Advisory
3 Board, there will be a speaker today talking about
4 the -- I believe, the mentor-to-mentor peer
5 counseling that they want to set up on Long Island.
6 SENATOR MCDONALD: That, you know --
7 Senator Huntley, do you have any thoughts?
8 SENATOR HUNTLEY: In my district, I have, on
9 my staff, someone who is director of
10 Veterans Affairs, a gentleman by the name of
11 Lester Muse, who also has a Purple Heart, and who's
12 been very involved, for years, in my community.
13 So, we set up an advisory board for veterans.
14 We visit them on a regular basis.
15 In fact, the past two weeks, I have spent
16 most of my downtime in my district at the
17 veterans -- St. Albans Veterans' Hospital, where I
18 did a very huge clothing drive. Also,
19 Valentine's Day, because so many veterans have no
20 one.
21 So I am there on a regular basis.
22 And I think my part with veterans is, it hits
23 home with the family, because I come from a family
24 of veterans. My dad, my husband, my two sons, all
25 served their country. And not because they had
31
1 nothing else to do. Because they felt it was their
2 duty to do so.
3 So I'm very proud of what they will have
4 done.
5 And that's why I work so hard, because I
6 understand.
7 I understand the stress, the families.
8 I also understand, when veterans apply for
9 money, how the government drags its feet.
10 You know, we don't do enough.
11 We don't do enough on the federal level.
12 We don't do enough on the state level.
13 In fact, I think we're doing more now, since
14 Senator McDonald, and, Zeldin, who I'm also sure,
15 was in the service.
16 Am I right? You are a vet?
17 SENATOR ZELDIN: (Senator nods head.)
18 SENATOR HUNTLEY: Okay.
19 -- and I think that's why, now, we're doing
20 something like this.
21 You know?
22 And, whatever I can do, along with them,
23 working together, trying to make life better for our
24 veterans, we need to do that.
25 Because this country wastes a lot of money on
32
1 nonsense, when we can be helping people who need it.
2 Okay?
3 SENATOR MCDONALD: As you can see, folks, you
4 got some strong support here.
5 Now you got to help us, all of you, in all
6 the other public hearings that we do go to, pointing
7 us in the right direction, so we can do something.
8 But this is the beginning. Okay?
9 We'll be talking to you a lot, obviously.
10 You have your own senator, who's very
11 committed to this.
12 So, we want to thank you for your
13 presentation.
14 We're trying to keep a schedule.
15 And, if you can stay a while, we have just
16 such wonderful people here, gonna be talking.
17 Good for you folks to network with, and get
18 to know.
19 Thank you so much.
20 CHRISTOPHER DELANEY: Thank you, Senator.
21 I appreciate it.
22 Thanks, everyone.
23 SENATOR MCDONALD: We have now, an amazing
24 guest, that we're so grateful to make the trip up
25 from New York City.
33
1 He's the director of Trauma & PTSD Program at
2 Columbia University's College of Physicians and
3 Surgeons, one of our great universities that is in
4 this state, in the city of New York, who have led,
5 in so many different health-care areas, so many
6 different programs and services all over the place.
7 We're grateful to your university, and to
8 you, Dr. --
9 And help me with your the name.
10 -- Dr. Yuval Neria?
11 DR. YUVAL NERIA: Neria.
12 SENATOR MCDONALD: Thank you for being here.
13 Thank you for choosing to take your day to
14 come up to Albany. And --
15 DR. YUVAL NERIA: Thank you.
16 Thank you, Dr. -- Senator McDonald,
17 Senator Zeldin, and Senator Huntley, for conducting
18 this hearing. It's really timely.
19 My name is Dr. Yuval Neria.
20 I am the director of Trauma and PTSD at the
21 New York State's Academy Institute, and professor of
22 clinical psychology at the Department of Psychiatry
23 and Epidemiology at Columbia University.
24 I have worked with war veterans, as a
25 clinician and a researcher, for more than 20 years,
34
1 in treatment, and in research.
2 I also had some combat experience. Prior to
3 my academic and professional career, I served as a
4 commander of an armored company in the
5 1973 Yom Kippur War between Israel and Egypt.
6 I was injured, and awarded the Medal of
7 Valor, the highest medal awarded in Israel.
8 So what is the problem?
9 Recent and ongoing conflicts in the
10 Middle East have brought the psychological and
11 societal consequences of war to the forefront.
12 Apart from the devastating loss of life, and
13 physical wounds sustained in the tour of duty, a
14 significant number of returning service members,
15 upward of 26 percent, suffer from mental-health
16 problems, of which post-traumatic stress disorder,
17 "PTSD," is the most prevalent.
18 What is it, "PTSD"?
19 In order to be diagnosed with PTSD, an
20 individual must meet several specific criteria.
21 First: Requires a traumatic event to have
22 occurred; a traumatic event involved in
23 experiencing, witnessing, or being confronted with
24 an event that involves actual or threatened death,
25 serious injury, or threat to the physical integrity
35
1 of self or others.
2 Furthermore, the individual's response to the
3 event must include intense fear, helplessness, or
4 horror.
5 The second criterion requires a constant
6 reexperiencing of the traumatic event, including but
7 not limited to, recollections, nightmares, reliving
8 the event in one's mind, psychological distress, and
9 reactivity associated with exposure to the event.
10 The third criterion includes the avoidance of
11 trauma-associated stimuli and numbing of general
12 responsiveness.
13 Criterion D includes perpetually increased
14 arousal, resulting in insomnia, irritability, and
15 frequent anger bursts, difficulty concentrator,
16 hypervigilance, and exaggerated stutter response.
17 The duration of the aforementioned
18 disturbances must be longer than one month, and must
19 result in clinically significant distress or
20 impairment.
21 How prevalent PTSD is?
22 Among Iraq and Afghanistan veterans, rates of
23 psychological and neurological injuries are high,
24 and rising.
25 According to a similar 2008 Rand study,
36
1 nearly 20 percent of Iraq and Afghanistan veterans
2 screened positive for PTSD or depression.
3 Troops in Iraq and Afghanistan are also
4 exhibiting neurological injuries. Traumatic brain
5 injury, or, "TBI," has become the signature wound of
6 the Iraq war.
7 According to the Rand study, about 19 percent
8 of troops served reported probable TBI during
9 deployment.
10 These milder injuries are quite complicated
11 and difficult to identify, and they are not easily
12 distinguished from PTSD.
13 Importantly, combat-related mental health
14 problems are not limited to PTSD.
15 Rates of marital stress, substance abuse, and
16 suicide, as we heard, are all increasing.
17 Suicide behavior is a critical problem among
18 war veterans.
19 During the wars in Iraq and Afghanistan, the
20 U.S. Army suicide rate has increased, from 12.4 per
21 100,000 in 2003, to 18.1 per 100,000 in 2008.
22 Depression and PTSD increase the risk of
23 suicidal ideation, which is very highly correlated
24 with suicide attempts.
25 What about risk factors?
37
1 In the United States, the prevalence rates of
2 PTSD have been found to be significantly higher in
3 minority veterans, across different studies, and
4 different conflicts.
5 Yet, and importantly, studies focusing on the
6 current conflicts in Iraq and Afghanistan, however,
7 found no effect of race, ethnicity, on PTSD rates
8 among those military populations.
9 It is possible that the elevated PTSD rates
10 among minorities during the earlier wars, such as
11 Vietnam War, were influenced, at least in part, by
12 the widespread racial tensions that minority groups
13 had to endure at the time.
14 Importantly, among combat veterans, most
15 studies reported no gender effects, contrary to
16 civilian studies that found women to have double the
17 risk of PTSD as compared to men.
18 Level of exposure, severity of exposure, are
19 considered to be the most meaningful and enduring
20 factors in PTSD.
21 In studies where comparisons were made
22 between service members deployed to Iraq and
23 Afghanistan, or other locations, those deployed to
24 Iraq consistently present with higher PTSD rates.
25 Of the service members deployed to Iraq,
38
1 93 to 97 percent reported shooting or directing fire
2 at the enemy;
3 About 90 to 95 percent reported being
4 attacked or ambushed;
5 And, more than 94 percent reported seeing
6 dead bodies or human remains.
7 Of those deployed to Afghanistan, only 27,
8 58, and 39 percent reported such combat experiences,
9 respectively.
10 How about treatment?
11 Although screening for mental-health
12 problems, as we heard before, is conducted right
13 after deployment, and is gradually becoming the norm
14 in the U.S. military, and effective state-of-the-art
15 treatment options are available, there is still
16 considerable reluctance among military personnel to
17 seek professional care for mental-health problems,
18 unfortunately.
19 Of all the military-service members who
20 screened positive for mental-health disorder, less
21 than a half expressed interest in receiving
22 professional help.
23 Service members who's positive screen for a
24 mental-health disorder are also twice as likely to
25 be concerned about stigmatization, and other
39
1 barriers to mental-health care.
2 Even when service members do initiate
3 treatment, only a third receive minimally adequate
4 care.
5 What are the availability of treatments to
6 date?
7 For psychotherapy, exposure therapy is
8 considered to be one of the most effective
9 treatments for PTSD, and clinical practice
10 guidelines consistently recommend it as the first
11 diagnosing of treatment.
12 In the 2007, the Institute of Medicine
13 Committee conducted a detailed assessment of
14 evidence for available treatments of PTSD.
15 They found substantial number of randomized
16 controlled trial studies, comparing exposure
17 therapies to usual care or wait-list control, and a
18 substantial majority of which demonstrated
19 significant improvement of PTSD symptoms or loss of
20 diagnosis in groups who received exposure therapy.
21 The committee judged the over-quality of
22 evidence to be moderate to high, and conducted that
23 exposure therapy is an effective treatment for PTSD.
24 Pharmacotherapy: Selective serotonin
25 re-uptaking inhibitors, "SSRIs," are a class
40
1 anti-depressant that is currently the most
2 extensively studied pharmacological treatment for
3 PTSD; yet, efficacy of SSRIs are less robust as
4 compared to exposure therapy, suggesting that we
5 currently don't have a powerful enough medication
6 for PTSD.
7 What are the barriers for mental-health care?
8 A number of bills have been documented among
9 war veterans, including, fears of losing performance
10 edge or self-control, expectation of scorn or
11 negative career impact, shaming messages, myths and
12 lack of knowledge, feeling undeserving, and
13 logistical constraints and unavailability of care.
14 Much more efforts are needed to address these
15 barriers.
16 For instance: Initiative to legitimatize
17 acute care and early intervention might help to
18 reduce the barriers of shame and guilt.
19 Policymakers should address logistical
20 constraints and access to care by increasing the
21 number of availability of programs of war veterans.
22 So how to enhance mental-health care for war
23 veterans?
24 Currently, most of the mental-health
25 treatment for Iraq and Afghanistan war veterans is
41
1 provided in V.A. settings; yet, many war veterans
2 with mental-health problems may be reluctant to
3 enroll in V.A. programs.
4 For many, especially personnel of the
5 National Guard and Army Reserve, the V.A. may not be
6 the first choice.
7 Given the scope of mental-health problems
8 among returning military personnel, more
9 mental-health services for veterans should be
10 developed.
11 An evidence-based treatment for veterans
12 should be provided in multiple and diverse settings.
13 Moreover, previous studies have documented
14 the mental-health problems among children and
15 spouses of war veterans; yet, family members of
16 military personnel are not currently eligible for --
17 fully, for mental-health care in the V.A. settings.
18 Ignoring the needs of these populations is
19 unfortunate.
20 Treatment programs for veterans coming back
21 from the war should address the needs of family
22 members, and social support is critical for the
23 recovery process.
24 In addition, efforts to address the problem
25 of stigma, and other barriers to care-seeking,
42
1 should involve outreach, psychoeducation, and new
2 developed approaches to mental-health delivery.
3 In summary: Developing sustainable effective
4 treatment program for war veterans is a major, major
5 challenge.
6 Research has shown that war veterans, both
7 males and females, have a very good capacity to be
8 benefited from trauma-focused evidence-based
9 mental-health treatment when the treatment is
10 provided by well-trained, sensitive, and devoted
11 clinicians.
12 It is our hope that lessons from previous
13 wars, such as the importance of early intervention,
14 the need to address barriers to cares, and the role
15 of family members in post-deployment adjustment of
16 war veterans, will guide public-health efforts to
17 develop quality programs of new generation of war
18 veterans coming back from the war, anticipating to
19 receive safe and effective care for their
20 mental-health problems.
21 Thank you.
22 SENATOR MCDONALD: Thank you, Doctor.
23 I was informed that a recent study by the
24 Marine Corps suggests that feelings of guilt over
25 moral dilemmas, including survivor's guilt faced in
43
1 combat, are a leading cause of PTSD.
2 You, more or less, verified that in your
3 documentation.
4 DR. YUVAL NERIA: Yes. I mean --
5 SENATOR MCDONALD: We talked about early
6 intervention, and what's causing it.
7 The early intervention, you mentioned the
8 National Guard and the reservists.
9 It's not always the easiest, especially if
10 you're in upstate New York, the V.A. hospitals, say,
11 like down in New York City, where you can take a
12 subway ride and you can get there quickly.
13 They're spread out.
14 They do a good job, but they're spread out.
15 What thoughts do you have on that?
16 DR. YUVAL NERIA: Well, I have a number of
17 thoughts on that.
18 First of all, I think that the reluctance on
19 the V.A. is a major limitation for effective
20 widespread access to mental-health care, especially
21 in rural areas; but, not only, also in the cities.
22 Access is a problem, but also stigma is a
23 problem.
24 Going to the V.A. for post-traumatic stress
25 disorder shouldn't be a psychiatric issue. It
44
1 should be a normal care access.
2 You know, so, we should normalize care given
3 to war veterans.
4 We should, in order to combat stigma and
5 shame and guilt, the only way to do that is to
6 create, you know, a variety of services, on campuses
7 and universities.
8 I would recommend, you know, developing a
9 number of center of excellences, as done in -- for
10 other needs.
11 I mean, the community is large and diverse,
12 and channeling everybody to the V.A. seems to be,
13 certainly, I can understand it.
14 I think that's a major limitation for
15 effective and mental-health delivery, especially,
16 because, you know, the -- the source for
17 evidence-based treatment is not really coming from
18 the V.A.
19 The V.A. is educated by research programs,
20 such as, our research program at Columbia, or NYU,
21 or Mount Sinai.
22 And, the V.A. -- until the V.A.,
23 incorporating fully, you know, the knowledge about
24 treatment, it takes time and too much effort.
25 So I would say, let's open it up, let's make
45
1 it more diverse, and let's have the veterans have
2 more choices than the V.A.
3 SENATOR ZELDIN: Doctor, thank you.
4 The fact that Columbia University has a PTSD
5 program, it's something, that, it would be great if
6 it was replicated in every university and every
7 hospital across the country.
8 I'm starting to see with, law schools, are
9 starting to do veterans' programs.
10 And, it's just great that you even have the
11 program that you're directing.
12 And, thank you for being here.
13 The last speaker, I asked a question with
14 regards to a particular problem that I have
15 observed; that individuals just don't seem to have
16 access to others in their communities that share --
17 are going through the same experience that they are
18 with PTSD.
19 I'm just wondering what your thoughts are on
20 the idea of developing some kind of a peer-to-peer
21 program, where we can connect individuals who suffer
22 post-traumatic stress disorder, just so they know
23 they're not alone.
24 Maybe you can bring another perspective from
25 the medical side?
46
1 CHRISTOPHER DELANEY: Right.
2 I like the idea a lot.
3 In fact, I like ideas that involve informal
4 social support, and, to traumatized populations.
5 Could be disaster survivors, after 9/11, or
6 war veterans coming back from deployment.
7 It's a great idea.
8 And it should run in parallel to professional
9 evidence-based mental-health care, so you have a
10 system in which, for example, peer-based programs
11 have the capacity and the knowledge to refer
12 somebody who is at need, to a close-by mental-health
13 service program.
14 So you have -- and you have graduates of
15 treatment programs in those specialist centers,
16 coming back to the community and being benefited by
17 the availability of peer-based programs.
18 So, I think it's a great idea.
19 It's not either/or. It should be conducted
20 in parallel, and should be really tailored and
21 coordinated in a nice way.
22 So, I think, overall, it's a great idea.
23 SENATOR ZELDIN: My only other question I
24 actually have -- I can take up a couple of hours
25 asking you questions -- but, for the sake of today,
47
1 we, as a state, have more of an influence in the
2 say, with regards to interaction with our
3 National Guard unit.
4 When they're on Title 32 status, they belong
5 to the State. But the --
6 DR. YUVAL NERIA: Right.
7 SENATOR ZELDIN: -- when they're mobilized
8 and deployed, as well as the active duty and the
9 reserve components, when they're on Title 10 status,
10 it's really something that, hopefully, Congress can
11 do, and the Pentagon can do, a better job
12 addressing.
13 But, what can we do, as far as -- you're a
14 doctor; you're at Columbia University. You have
15 looked into post-traumatic stress disorder, I'm
16 sure, just so far beyond the norm.
17 Meanwhile, the best source of how to identify
18 the service member with the symptoms of
19 post-traumatic stress disorder is at the unit.
20 It is a specialist sergeant. You know, it's
21 the platoon leader. The company commander or first
22 sergeant.
23 And many of them, you know, they're not
24 doctors. They don't have the experience and the
25 depth of knowledge that you do.
48
1 So, what's the best way that we could be
2 doing a better job to prepare those leaders to help
3 with the diagnosis and treatment of post-traumatic
4 stress disorder?
5 DR. YUVAL NERIA: Right.
6 And two comments on that.
7 I think that, overall, there is a nice
8 progression. I think there is more consciousness.
9 And I think, army personnel, military
10 personnel, overall, is very much educated about
11 post-traumatic stress disorder, about the effect of
12 exposure.
13 So I think, overall, there's recent progress.
14 The problem is, really, reacting in a timely
15 manner to a distress of a fellow soldier, or fellow
16 veteran; and, who will do that.
17 And I agree with you that, friends, and
18 platoon commanders, and sergeants, are those who
19 will be the first to notice that there is a
20 deterioration of mood. That there is some issues;
21 somebody's closed, somebody doesn't feel right.
22 And then, you know, if -- if barriers of
23 stigma and shames are removed, you know, there
24 should be a quick referral to a mental-health
25 specialist.
49
1 The problem with Reserve and V.A., especially
2 National Guard units, is that they don't have the --
3 they're under-resourced, in terms of medical
4 personnel.
5 You know, Reserve are a little bit better,
6 but I think National Guards suffer from, kind of,
7 unavailability of mental and medical personnel.
8 This should be discussed, and considered.
9 And I think, perhaps, you know, our discussion today
10 can kind of facilitate that.
11 It is very -- availability is really the name
12 of the game: Availability of peer-based program,
13 availability of mental-health professionals,
14 availability of friends, availability of a spouse,
15 that noted something is not all right.
16 And this is only way, really, to intervene,
17 and to intervene on time.
18 And it's a process.
19 And it's a process of education.
20 SENATOR ZELDIN: Well, it's a -- definitely
21 an interesting challenge to pass your knowledge down
22 to the average person.
23 You're very informed in your testimony.
24 Thank you for being here, Doctor.
25 DR. YUVAL NERIA: Thank you.
50
1 SENATOR ZELDIN: Senator Huntley.
2 SENATOR HUNTLEY: Yes, Doctor, what type of
3 outreach do you use for your program?
4 For instance: A veteran who lives in the
5 south Bronx, east New York, I mean, how do they know
6 about your program?
7 DR. YUVAL NERIA: Right.
8 So, I can talk a little bit about my
9 Trauma and PTSD program at Columbia.
10 We are located as the medical campus of
11 Columbia University.
12 We have a big trauma program that is funded
13 by the National Institute of Mental Health,
14 primarily.
15 You know, a little bit by -- a little bit by
16 private foundations.
17 We have never received, for example, funding
18 from the State, but we are funded to do research.
19 Now, our research programs are about
20 treatment.
21 We are testing new treatments. We are
22 pushing the envelope, really to understand better
23 why some people react to treatment, and others don't
24 react to treatment.
25 We are, pretty much, successful in bringing
51
1 in civilian population with PTSD.
2 We are not successful, unfortunately, of
3 bringing in war veterans with PTSD.
4 And, believe me, we are doing our best.
5 You know, we are going to the Bronx. We are
6 going to -- we are going Harlem. We are going to
7 downtown New York.
8 We have -- there is a certain reluctance of
9 veterans with PTSD to seek civilian help. And, the
10 availability is there.
11 There is no-cost treatment available for
12 them, and there is -- still, there is a gap in
13 access, that we should do everything in order to
14 bridge it, actually.
15 SENATOR HUNTLEY: Now -- okay, now, with your
16 research, does that include people of color also?
17 DR. YUVAL NERIA: Oh, yeah. Yeah, yeah,
18 yeah.
19 We are doing very well with minority
20 populations. At least half of our patients are
21 Hispanics and Blacks.
22 And, actually, we are obliged to make our
23 patient samples as representative as possible. And
24 we are working very hard on that.
25 SENATOR HUNTLEY: What are the numbers, in
52
1 terms of male and female, that --
2 DR. YUVAL NERIA: About 60/40 percent.
3 60 percent females, and 40 percent males.
4 SENATOR HUNTLEY: Thanks.
5 DR. YUVAL NERIA: So, a slight elevations for
6 females.
7 SENATOR ZELDIN: Thank you so much, Doctor.
8 DR. YUVAL NERIA: Sure.
9 Thank you.
10 (Senator Huntley leaves the hearing
11 room.)
12 SENATOR ZELDIN: At this time, I would like
13 to call Mr. John Javis.
14 John is the director of the Veterans Health
15 Alliance of Long Island.
16 Mr. Javis, thank you.
17 At this point, for the sake of time, and all
18 of our speakers know, we're going to try to cover
19 everyone within a 5-minute time frame.
20 I'll keep --
21 JOHN A. JAVIS: Of course.
22 SENATOR ZELDIN: -- the big challenge for you
23 are the -- becomes the questions from us, because
24 you're probably all better at sticking to
25 5-minute timelines than we are.
53
1 But, thank you for being here.
2 JOHN A. JAVIS: Okay, I'll make it brief.
3 I'll cut it down.
4 So, I'm here to advocate for peer support as
5 a valuable tool to help veterans deal with
6 post-traumatic stress disorder.
7 In 2011, the New York State Health Foundation
8 and the Rand Corporation released a study of
9 New York State veterans from Iraq and Afghanistan,
10 that showed that 22 percent of those veterans met
11 the criteria for PTSD or depression.
12 Unfortunately, only about one-third of those
13 individuals actually sought help for their
14 condition.
15 One major reason cited for not seeking help,
16 was that veterans had no one to encourage them or
17 assist them navigating what can be a very complex
18 system of care.
19 Those of us who have served in the military
20 know the importance of the buddy system.
21 It is known by various names, such as,
22 "your Ranger buddy," "your battle buddy" or
23 "your wingman."
24 Buddies are responsible for keeping each
25 other safe.
54
1 In a combat zone, it might mean providing
2 covering fire for your buddy.
3 After deployment, it might mean driving your
4 buddy home after he's had one too many drinks at the
5 bar, or bringing to him see the chaplain if he's
6 talking about suicide.
7 A few years ago, the U.S. Army developed a
8 concept called "Battle Mind," to help soldiers and
9 family members deal with issue of deployment and
10 reintegration.
11 The "B" in "Battle Mind" stood for "buddies."
12 It reminded veterans to have friends, or buddies,
13 when they returned home to civilian life.
14 What was happening to these individuals, felt
15 that could only trust the buddies they served in
16 combat with, and would not share their feelings with
17 their spouses, family members, or anyone else, for
18 that matter.
19 It was these suppressed feelings that led
20 some to suicide.
21 Battle Mind taught veterans that buddies who
22 would care for each other were also necessary in
23 civilian life.
24 In the civilian mental-health context, the
25 New York State Office of Mental Health encourages
55
1 the use of peer specialists, and highlights the role
2 of them.
3 A "peer specialist" is an individual that is
4 a current or former user over mental-health
5 services. They are open about disclosing this, and
6 they share the secrets of their recovery, in an
7 effort to help others.
8 The roots of mental-health peer support
9 actually come from AA and other 12-step support
10 groups.
11 In the mental-health world, peer support is
12 not meant to replace traditional mental-health
13 services. It is intended to come complement other
14 services.
15 People who may not want to partake in
16 traditional services, because of stigma, might be
17 inclined to try peer support.
18 At a later time, peer support leaders may be
19 able to encourage the individual to seek traditional
20 services if appropriate.
21 A model of veteran-specific peer support
22 already exists, called "Vet to Vet," that was
23 started by a Vietnam veteran by the name of
24 Mo Armstrong.
25 Moe Armstrong was a medical corpsman in
56
1 Vietnam, and has written extensively about his
2 battles with trauma and substance abuse after the
3 war.
4 Complete manuals about starting Vet to Vet
5 groups are available online from the "Vet to Vet"
6 website.
7 I feel that this model can be easily brought
8 to New York State.
9 At the MHA in Nassau County, we are in the
10 process of starting a pilot of peer support, in both
11 group and individual sessions, in collaboration with
12 the Mental Health Association of New York State,
13 using a grant from the Bristol-Myers Squibb
14 Foundation.
15 I would urge that the Office of Mental Health
16 be provided with funds to put out an RFP for
17 non-profits to hire one full-time veterans' peer
18 specialist in each of the five OMH regions.
19 These individuals would be responsible for
20 outreaching and engaging veterans in their area, for
21 leading peer-support groups, providing individual
22 peer support, and developing volunteer leaders who
23 could run their own peer-support groups, again, much
24 in the manner of AA.
25 The estimated cost for this would be about
57
1 $400,000.
2 In conclusion: After the media coverage of
3 the Walter Reed and V.A. scandals in 2007 brought
4 nationwide attention to the poor treatment given to
5 veterans, people, like myself, have been advocating
6 that New York State have a comprehensive
7 mental-health policy in regards to veterans.
8 And, to date, we have not seen any new
9 funding or new initiatives in this regard.
10 During the same period, we have seen massive
11 regulatory changes in the mental-health system, such
12 as, PROS, clinic reform, and health homes.
13 These new initiatives are designed to save
14 money.
15 Would it make sense, then, for some of these
16 savings to be reinvested to assist veterans with
17 mental-health concerns?
18 Our veterans are paying the price for
19 inactivity.
20 There's a little secret out there that won't
21 show up in any statistics or research study.
22 There is a pool of veterans from Iraq and
23 Afghanistan who have dropped off the radar.
24 They live at home with their parents and
25 relatives. They're not going to the V.A., they
58
1 don't go to work, they don't go to school.
2 They spend their days in isolation, using
3 substances, and playing on-line video war games.
4 Some have concurrent drug and alcohol
5 problems, PTSD, and traumatic brain injuries.
6 Many of them have caring families who
7 desperately want, and encourage them to get help.
8 We feel that peer-support encouragement from
9 a fellow veteran who has been there might be the
10 method to assist these individuals to reengage in
11 our community.
12 Thank you.
13 SENATOR ZELDIN: Mr. Javis, first, as a
14 senator on Long Island, I just want to say,
15 thank you, because I see your activity around the
16 Island, and your interest, just in helping veterans.
17 And that's really something to be applauded.
18 Thank you for traveling up here from
19 Long Island, for this, and speaking specifically
20 about the peer-to-peer mentorship concept.
21 And the idea of the -- you know, the
22 proposal, I guess, with regards to OMH, which we'll
23 look more closely at.
24 Senator Huntley had a question before she
25 left, which has been a topic of conversation between
59
1 us, and the Veterans' Advisory Panel out in Suffolk.
2 It was a question of, you know, she has
3 constituents in her Senate District. And, here we
4 have a director of, you know, PTSD for
5 Columbia University.
6 And one of, I think, the challenges that face
7 mental-health providers, maybe you could speak to it
8 on Long Island, is, making sure that everyone knows
9 where these services are available.
10 So, if maybe you can speak to your experience
11 there, and how we might be able to be helpful.
12 JOHN A. JAVIS: I think we need two
13 approaches.
14 You know, one is a high-tech approach; one is
15 a low-tech approach.
16 You know, and so we know, that, for many
17 younger veterans, the Internet is probably the way
18 to go.
19 You know, they're all computer-savvy. They
20 grew up on the Internet. And, so, you know, some
21 kind of a website, or some kind of an interactive
22 web page, would be, you know, the way to attract
23 those folks.
24 However, if you're an older veteran, you
25 know, a veteran who's struggling, bordering on
60
1 homelessness, you're not going have a wireless
2 router or a smartphone or, you know, a laptop
3 computer. That, you need the low-tech approach.
4 That's the peer-support person that, kind of,
5 boots on the ground, would be identified as the
6 person who would be able to do that outreach
7 engagement. You know, visit people in the
8 community.
9 I think you need both approaches: both a
10 high-tech approach, as well as a low-tech, "boots on
11 the ground," approach.
12 SENATOR ZELDIN: Thank you.
13 SENATOR MCDONALD: I'm sorry. I had to step
14 out for a moment, to talk to some people, and I
15 missed part of your dialogue.
16 I'm sure we're going to be talking, though,
17 individually.
18 I too want to thank you for what you've done,
19 what you're doing, and what you hope to do in the
20 future in this area.
21 The one common thing that I've been hearing
22 since we started picking into this topic, is a
23 mentoring program; whether it's vet to vet, or buddy
24 to buddy -- whatever -- wingman, I see the different
25 terminologies.
61
1 It seems to be a logical way to do that; to
2 have somebody caring, but also to have somebody who
3 has some basic knowledge that we help provide,
4 whether it's on a regional basis; or, if it's -- you
5 know, if you're in the metropolitan New York City
6 area, delivering services and people, it's a little
7 bit easier than if you're in the upstate New York
8 area, where you go from a small urban area to a
9 rural area, quite quickly.
10 And some of these folks don't have that kind
11 of transportation capacity, or knowledge. And you
12 start talking along miles, to get from one place to
13 another.
14 JOHN A. JAVIS: Well, again, I think a
15 thought there: Again, if you had one person, if
16 they could develop volunteers in little areas --
17 SENATOR MCDONALD: Volunteers. And, of
18 course, I go by the county concept in upstate, which
19 provides so many well-needed services.
20 But it is the general premise, in speaking
21 generally, is that's an amazing way to go; to enlist
22 this corps of volunteers, get them trained, working
23 for, you know, a full-time professionals, our county
24 veterans' directors and coordinators, along with the
25 State.
62
1 We don't want to duplicate what the federal
2 government's doing. We want to help the federal
3 government deliver the services.
4 And if they can't get to everywhere as
5 quickly, the State's already got, you know, veterans
6 on the ground, if you will, in the county.
7 And, certainly, in every county in the state,
8 there's a variety of veterans who live there.
9 So, I mean, this is an issue that's not going
10 away.
11 Too often, people think these wars end, and
12 the official ending of the -- what was it, the Iraq
13 War, December 15th, or something, of last year?
14 I mean, it doesn't end on December 15th for
15 the soldiers, the men and women who served there,
16 and their family structure.
17 And a parade is nice, and the yellow ribbons
18 are nice, but these folks are looking at hard-core
19 issues; whether it be, jobs, education, housing,
20 health care, mental-health care.
21 And not just for them. We've got family
22 structures.
23 And, you know, the one thing that amazed me,
24 from the difference between the military, when I was
25 in the Vietnam Era, to the military today: When I
63
1 went to Vietnam, young guys, don't have that family
2 structure yet. Don't have, in many cases, they
3 were, you know, full-time military people.
4 Today, they're older people, with, you know,
5 a family structure, children, commitment to their
6 community, jobs that are needed, and all the
7 emotional baggage that goes along with this.
8 And, so, you know, if we're sending them off
9 to fight for us, we have to take care of them when
10 we come back.
11 And we start with the emotional problems.
12 Thank you for your time.
13 JOHN A. JAVIS: Thank you.
14 SENATOR MCDONALD: Next, we're honored to
15 have with us, Dr. Charles Kennedy, clinical
16 director of PTSD Treatment Program at the
17 U.S. Department of Veterans Affairs, right here in
18 our own local Albany Stratton V.A. Hospital, which,
19 I think, if you're a local person, like myself, you
20 know very well.
21 They treated my father who was a World War II
22 veteran, as well as me, and my uncles and relatives
23 who actually spent much time in there.
24 And with you, Dr. Kennedy, would you
25 introduce your guest.
64
1 PETER POTTER: Peter Potter. I'm the public
2 affairs director.
3 SENATOR MCDONALD: Peter Potter, is public
4 affairs director.
5 First off, we thank you for coming. It's a
6 shorter distance, but I know you've got a busy
7 schedule.
8 DR. CHARLES KENNEDY: Senator McDonald and
9 Senator Zeldin, thank you very much for inviting us
10 to come share with you our experience serving our
11 veterans, and, to seek your partnership in helping
12 us care for what is a huge number of folks that
13 deserve our help: our veterans; but, most
14 especially, their families, as well as our veterans.
15 And if we help their families, we, in turn,
16 will be helping them.
17 They'll help a veteran access treatment, and
18 overcome stigma, the kind of things that we've heard
19 from the previous speakers. Mr. Delaney,
20 Dr. Neria, Mr. Javis, all highlight very, very
21 important issues and obstacles to our veterans
22 accessing treatment.
23 Approximately 3 million people have now
24 served in Iraq and Afghanistan.
25 Of that 3 million, 1.75 million have
65
1 completed their military service.
2 Of those completing military service,
3 48 percent are presenting to the V.A. with problems,
4 with post-traumatic stress disorder, major
5 depression, and substance-abuse problems.
6 Many of these people are isolated. And in
7 that isolation, they are in danger of taking their
8 own lives.
9 We need everybody we can access, to reach out
10 to the folks that are isolated, because it is the
11 isolation and the avoidance that is potentially
12 lethal.
13 All the previous speakers noted how difficult
14 it is to come to the V.A.
15 Imagine, if you will, what it's like to say:
16 Geez, I've got something wrong with me. It's
17 unmanly, this thing that I have wrong with me. And
18 then I got to go into the V.A., to seek services.
19 And, in our case, if you push the number "10"
20 in the elevator, everybody on the elevator knows
21 you're going to the mental-health floor.
22 So, you're revealed, especially if you're
23 sensitized to this.
24 We are especially struggling to help connect
25 with the youngest cohort, those from 19 to 26.
66
1 They'll come, and they'll go.
2 They'll come, and they'll go.
3 So, as Dr. Neria said, we don't need to
4 have enclaves of treatment. We need to push
5 treatment out into the community, onto our college
6 campuses, into our community colleges, and out into
7 the areas, up to the border, for us.
8 And we are making efforts to do that, but we
9 need all of the help we can get to do it.
10 We have 11 community-based outpatient
11 clinics, from the Canadian border, down to
12 Dutchess County.
13 We have, in the PTSD program, 5 of the 11 of
14 us have telemental health equipment.
15 And much to my surprise, this is a wonderful
16 way to reach people in Plattsburg, and out in Utica.
17 There are issues that one -- the clinician
18 needs to be concerned with, to ensure safety, but at
19 the same time, we're able to offer psychotherapy,
20 based on the empirically supported treatments, to
21 people as far away as Plattsburg.
22 So, we're making some headway, that way.
23 Soon to come out of our research at the
24 Stratton V.A., which is actually one of the homes of
25 the PTSD diagnosis, Dr. Larry Kolb, a
67
1 psychiatrist, was instrumental, in the '70s, in
2 bringing to the attention of the mental-health
3 community, the fact that there was this thing, which
4 we were then to call "post-traumatic stress
5 disorder," which had been deleted from the
6 "Diagnostic Manual" in 1952.
7 So, when Vietnam veterans returned from
8 Vietnam, when Korean War veterans returned from
9 Korea, there was no diagnosis to describe what was
10 happening to them, and to suggest what the
11 treatments might be.
12 So, it was not until the late '70s, and
13 Dr. Kolb and others' work, that led us to have
14 this "post-traumatic stress disorder" diagnosis.
15 I also want to add, and tell you about the
16 local situation.
17 I've been with the PTSD program for 24 years
18 now.
19 When I started, there were two of us.
20 When I started, we couldn't get anybody to
21 show up and come for treatment.
22 In 2000/2001, that fiscal year, we had
23 194 combat-veteran participants.
24 In 2004/2005, we had 253 combat-veteran
25 participants.
68
1 In -- from April of 2010 to April of 2011, we
2 had 716 participants.
3 I had predicted for this year that we would
4 exceed 900. I'm afraid we're going to reach
5 1,000 this year, of folks that we'll be treating in
6 the PTSD program here.
7 Interestingly, about 51 percent of those that
8 are presenting for treatment at the Stratton V.A.,
9 are Iraqi and Afghani veterans.
10 Fully, 43 percent of brand new referrals,
11 first-time people seeking treatment, are Vietnam
12 veterans coming in for the first time. As they hit
13 retirement age, as they lose a spouse, as they have
14 physical problems, their PTSD comes back full-blown
15 after they've led successful lives.
16 I guess what I'm trying to say is, we need
17 all the help we can get from everybody we can get it
18 from, who are knowledgable and caring about the
19 issues of veterans.
20 Let me say one other thing: Many folks have
21 commented on how important, for those in need, to
22 be -- have connection with veterans.
23 And that's very true.
24 I remember, as a young psychologist, a combat
25 veteran saying to me, "You young buck, what are you
69
1 doing? How can you help me? You have not been to
2 war."
3 And, of course, I would have to say, "No, I
4 have not."
5 And there seemed a real face validity to
6 their criticism, and I felt at a loss to be helpful,
7 because of my lack of experience in the military.
8 But over the years, the veterans that I've
9 worked with taught me some things that were very
10 special.
11 One: My ignorance was a valuable tool,
12 because, not only were the veterans presenting for
13 treatment right, I didn't understand what it was
14 like to be in the terror and horror of combat, but
15 they didn't understand what was happening to them.
16 They did not have words to explain these
17 things, where, they were trying to talk to their
18 wife or to their son, and they would have such a
19 powerful, vivid, intrusive experience, of back in
20 Vietnam, or over in Iraq, or in Afghanistan, that
21 they would not be able to concentrate on the remarks
22 being made to them by a loved one.
23 And they would feign, that everything was
24 okay, and that they were doing just fine.
25 And on and on, these intrusions would come.
70
1 And, in order to avoid embarrassing
2 themselves, they isolated in the basement, playing
3 the video game, or abusing marijuana, or something
4 like that.
5 So, I learned to, with a genuine authentic
6 ignorance, help them find the words to tell me, as
7 best they could, what was going on for them.
8 And, in that way, they began to understand
9 themselves, and be able to communicate, not with
10 just other veterans, but with people they cared
11 about; and reconnect, and reinvest, in the civilian
12 world, as well as have that special connection and
13 bond to their fellow veterans.
14 I'll conclude my remarks with that, and take
15 any questions that you have.
16 SENATOR ZELDIN: If -- right now, as we're
17 here, one of the beauties of Facebook and the
18 Internet, that people are watching this exchange.
19 So, if there's anyone out there that wants to
20 get help from their V.A., if you wouldn't mind just
21 sharing some information of where they can go.
22 DR. CHARLES KENNEDY: Well, absolutely.
23 Simply call the "626-5000" number, at the
24 V.A., and get routed to the PTSD program. Or, to
25 immediate help, up in the mental-health clinic, if
71
1 that's the case.
2 There is a Veterans' Suicide-Prevention
3 Hotline.
4 I don't have that.
5 Do you have that with you now, Peter?
6 PETER POTTER: I don't have the hotline.
7 But, if you go to our website, and that's,
8 AlbanyVA.com;
9 We also have our Facebook page, which is
10 "VAalbany," simply;
11 And, you can connect, for any of that
12 information, for the suicide hotline, for enrolling
13 for veteran services, both for benefits and health
14 care.
15 SENATOR ZELDIN: We have a veterans'
16 crisis-line phone number here, for the V.A., of
17 1-800-273-8255.
18 Apparently, press "1," and you'll get --
19 PETER POTTER: That's to talk, yeah.
20 SENATOR ZELDIN: -- get some help.
21 Thank you very much for being here.
22 Senator McDonald.
23 SENATOR MCDONALD: Yeah, we were talking with
24 some of the previous speakers, and the difficulty in
25 a state like New York.
72
1 You would think the difficulty would be, that
2 some of the public officials would say, in this day
3 and age, the hard economic times, we don't want to
4 do anything.
5 That's not a difficulty. It's just the
6 opposite.
7 The difficulty of us, now, is we're united to
8 do something, and we're willing to do what has to be
9 done, but we want to capture the bureaucracy of
10 everything.
11 This is a very large physical state.
12 If you're talking to somebody from Indiana,
13 they think everybody lives between 150th Street and
14 the Bowery in New York City. Them don't realize
15 it's such a big and wonderful state.
16 And some of the state is more metropolitan,
17 or congested, in a sense, where the population
18 lives, and you can deliver services much easier.
19 As you go beyond Poughkeepsie, and you start
20 spreading out into our great state, and you folks
21 know it firsthand, because Albany Medical, or
22 V.A. Hospital, services more than just the people,
23 say, in the city of Albany or Albany County.
24 It's a great capital region that goes up to
25 the Canadian border, to the New England, and goes
73
1 quite a bit west.
2 And the issue is, is that a lot of these
3 folks are in the rural areas, and getting the word
4 to them.
5 And, you start out, in your first statement,
6 saying, "partnership."
7 And that's what we're looking for.
8 We're not looking for any kind of a
9 criticisms or adversarial relationships, you know,
10 saying: We don't think that you're doing what
11 you're supposed to.
12 It's a tough issue.
13 It's come a long way since the Korean War or
14 the Vietnam War, and we want to be sure that we
15 capture that, okay, that good feeling of the public,
16 and the public officials.
17 So, put some thoughts on to us, as, how do we
18 communicate?
19 It certainly is important, when you have
20 1-800 numbers, and things like that. But I'm into,
21 sometimes I think people want to see one face
22 looking at another face, and talking to a human
23 being, and expressing, that only -- only you can do
24 that, individually, the emotions, the problems that
25 they have, that they don't want to share over the
74
1 phone. They want to sit there, and they want to
2 have that kind of emotional attachment.
3 And, we have been -- talked about
4 partnerships, and we're talking about mentoring
5 programs, and working with our counties, and the
6 State Division of Veterans Affairs, and you folks,
7 the Veterans Administration.
8 So, I don't know if there's any kind of
9 special programs that you see throughout the
10 country, that you might have in a smaller state, or
11 any state, that might be applicable, that we
12 customize.
13 We're open to any suggestions that you might
14 have, and what your organization is doing in, Texas
15 or Minnesota, or whatever, because we're going to
16 review it, and anything that makes your life easier,
17 delivering that soldier, and their family structure,
18 to professional help.
19 DR. CHARLES KENNEDY: In Arizona, there's a
20 Dr. Michael Marks, who is a psychologist --
21 clinical psychologist, Vietnam veteran. He is the
22 chief of psychology and the PTSD team leader.
23 He and a colleague have put together a
24 program at the University of Arizona, called
25 "Scholars in Camo."
75
1 SENATOR ZELDIN: What was that? "Scholars
2 in," what, now?
3 DR. CHARLES KENNEDY: Excuse me?
4 SENATOR MCDONALD: "Scholars in"...?
5 DR. CHARLES KENNEDY: "Scholars in Camo."
6 SENATOR MCDONALD: Oh, okay.
7 DR. CHARLES KENNEDY: In, like, "camouflage."
8 SENATOR MCDONALD: Yeah. Yep, yep.
9 DR. CHARLES KENNEDY: It is a cohort program,
10 in which they bring veterans into the university,
11 together. They have three or four courses that all
12 of the veterans take together.
13 And they have increased the successful
14 completion of the bachelor's degree, from what was
15 3 or 4 percent in some returning veterans with PTSD,
16 up to, 90, 95 percent.
17 This is the kind of resilience,
18 non-mental-health-stigmatizing approach that we
19 should try to find ways to do everywhere.
20 At our community colleges, at our state
21 universities, at Columbia -- everywhere we can -- we
22 should try to identify, and invite, our veterans to
23 form a community. And then, to help them in that
24 community, within the context of the university, to
25 succeed.
76
1 SENATOR MCDONALD: I think that's the new
2 words that we're going to talk about: Mentor
3 programs and partnerships, and partnerships with
4 education.
5 Whatever we can do.
6 And we're very grateful of your time here,
7 and what you've done.
8 I know your hospital, because of so many of
9 my relatives being there, and they were always
10 treated well.
11 Thank you.
12 SENATOR ZELDIN: Thank you.
13 DR. CHARLES KENNEDY: Thank you for the
14 opportunity.
15 SENATOR ZELDIN: Our next speaker is
16 Mr. Andrew Roberts.
17 Mr. Roberts is the director of the Office
18 of Military & Veterans' Services,
19 North Shore - LIJ Health System.
20 While Mr. Roberts comes up, just some
21 additional information that we have.
22 There's a website at: VeteransCrisisLine.net.
23 This also belongs to the U.S. Department of
24 Veterans Affairs.
25 "VeteransCrisisLine.net."
77
1 You can also text to 838255, to receive free,
2 confidential support, 24 hours a day, 7 days a week,
3 365 days a year.
4 Although, I guess this year would be 366 days
5 a year.
6 And, Mr. Roberts, with that, thank you for
7 being here.
8 SENATOR MCDONALD: Mr. Roberts, before you
9 start, first off, I want to thank you. You have a
10 very impressive resume. A West Point graduate.
11 We're honored that you're here.
12 We're trying to keep on schedule, to get
13 everybody to talk. So, we're trying -- sometimes,
14 people like me and Lee like to talk.
15 And, you're an Iraqi War veteran as well.
16 Thank you.
17 And thank you for being the director of
18 Military & Veterans' Affairs Liaison Services for
19 the North Shore - Long Island Jewish Medical
20 School -- Center. Excuse me.
21 Thank you.
22 ANDREW ROBERTS: Thank you very much.
23 Thank you both for your service, as well.
24 So, I'm Andrew Roberts. I'm a West Point
25 graduate, and a former Army captain.
78
1 I served in Iraq from 2003 to 2004, and was
2 in command of a unit of about 90 American soldiers.
3 When I was putting my testimony together, I
4 was originally going to talk about a few incidents
5 that I actually had, where I was engaged with -- by
6 the enemy, but I realized it really wouldn't
7 accurately reflect the majority of the time that I
8 spent in Iraq.
9 The reality is, that most of time that I was
10 there, I was on the ground, working with my soldiers
11 and the Iraqi people, to help them to build their
12 fledgling democracy.
13 I admit, I was constantly aware that I could
14 be attacked, and greatly concerned for my safety and
15 the safety of the men that I was responsible for.
16 And actually feel that I had fairly positive
17 experiences over there; and, yet, I was still
18 intensely impacted by my experiences.
19 I've been working with veterans now for over
20 five years. And, I can say that, based on my own
21 experiences, compared to many others that I've seen,
22 my troubles were probably on a scale of about 3 out
23 of 10.
24 And I'm going to talk a little bit about some
25 of any experiences. And, I'd like you to think
79
1 about how my -- you know, someone going through what
2 I went through, and how that could impact somebody's
3 family.
4 When I came from home from Iraq, I left the
5 Army and moved to California.
6 I used to drive to work, scan the hilltops,
7 looking for the silhouettes of enemy heads that I
8 was always looking for when I was in Iraq.
9 I occasionally wondered if the vehicles that
10 I was driving next to had weapons in them.
11 I had a very high startle response.
12 Once, my girlfriend at the time stepped on
13 some bubble wrap in the living room.
14 And, I didn't realize what had happened, and
15 it sounded as though she had crept up behind me and
16 fired an M-16 right behind my back.
17 To say that it startled me is an extreme
18 understatement.
19 A startled response caused by combat
20 deployment, triggered by an unexpected noise, is an
21 awful, uncontrollable visceral reaction that shoots
22 through your entire body.
23 I saw an animal get electrocuted on TV one
24 time, and its physical reaction to the high voltage
25 is similar to how I felt inside of my skin when that
80
1 happened to me.
2 I don't have kids, and I didn't at that time
3 either, but, I can only imagine how my actions might
4 have impacted them if they had to experience
5 somebody that was going through that.
6 I felt very alone when I was back in America.
7 I felt like I was in a country that no longer
8 understood me, and that I no longer understood.
9 I remember standing in an airport one time,
10 and feeling as though everybody in that airport was
11 together, and I was alone.
12 I hated my job, and I was unhappy with the
13 relationship that I was in.
14 So, there was a lot of stress in my life at
15 that time, but I realize now, that the majority of
16 it was directly related to Iraq. It just didn't
17 seem that way at the time.
18 I never had a nightmare or a flashback. And,
19 as it's been referred to a number of times here,
20 although I had some bad days in Iraq, I really
21 wasn't involved in the combat that I grew up
22 watching on TV, and that I had seen on the movies.
23 So, really, in my own mind, I never connected
24 what I was experiencing when I came home, with my
25 experiences in Iraq or my service in Iraq.
81
1 I felt normal, and that's how I felt in Iraq
2 for a long time. And, it felt normal to me to feel
3 the way that I was.
4 The one thing I was aware of, was that I was
5 unhappy.
6 I felt as though my job was meaningless. And
7 compared to life-or-death decisions that were being
8 made on a regular basis in Iraq, it's just how I
9 felt.
10 I ended up quitting my job, moved back east.
11 For six months, I was unemployed, and lived
12 with my parents. I was 30 years old, West Point
13 graduate, and unemployed.
14 I was a miserable person.
15 I eventually got a job and moved to
16 New York City, but it was three years after I came
17 home before I finally got help.
18 Although my startle response had been
19 reduced, basically, to nothing, I was still very
20 angry. And nothing really felt better than to get
21 extremely angry and upset about things that were
22 going on in my life.
23 My dad even mentioned at the time,
24 "Maybe this has something to do with Iraq"; which
25 is, now, it's very obvious that it had everything to
82
1 do with my service in Iraq. But at the time, again,
2 I still just wasn't making that connection.
3 I went through a period of time, trying to
4 figure out, over a weekend, of whether or not I was
5 actually going to seek help.
6 And what inspired me to get help, was that I
7 wanted to serve other veterans. I wanted to be an
8 advocate.
9 And I knew that the first question that any
10 other veteran was going to say to me, if I asked
11 them to get help, was going to be, "Well, did you
12 go?"
13 And I knew I'd have no credibility if the
14 answer was no to that.
15 So, I did; I seeked -- I sought therapy, and
16 it gave me a chance to -- what I describe as:
17 Gave me a chance to step outside of myself, and see
18 how I was actually behaving.
19 I believe it's very hard to do this without a
20 professional, trained, and evidence-based therapies.
21 And that's exactly what I needed to do in order to
22 learn from my experiences, and to understand why I
23 was still suffering.
24 I feel that I have come out of therapy
25 stronger than I was before.
83
1 And I think it is worth mentioning, that I
2 didn't go to the V.A. for help, although, I've
3 worked with many people from the V.A., and admire
4 and respect many of them.
5 It's, just, I didn't feel, at that time, that
6 that was something that was for me. I didn't want
7 to bump into anybody that might know me.
8 And, I just want to let you know, that that's
9 how I found my therapist, was on a website for
10 people looking for therapy in New York City, which I
11 then sort of realized, also, that almost everybody
12 in New York City is getting some type of therapy.
13 [Laughter.]
14 ANDREW ROBERTS: So, it wasn't as big of a
15 deal as I thought, but it was extremely hard for me
16 to ask for help.
17 And I even asked myself, at one point, if I
18 was mentally ill.
19 And, that is that stigma that is so heavy --
20 weighs so heavily.
21 And I'm a person that would have believed, or
22 recommended somebody else go for therapy. I just
23 didn't think that I needed it.
24 And it was very challenging for me to go.
25 So, I went five years ago.
84
1 I had a family that enabled me to get back on
2 my feet, and I've become an advocate for veterans.
3 I worked for the Iraq and Afghanistan
4 Veterans of America;
5 I was formerly a deputy director for the
6 New York State Division of Veterans Affairs, here;
7 And now I'm the director of the Office of
8 Military & Veterans' Liaison Services for
9 North Shore - LIJ Health System, and part of my
10 role, is administrator of the Rosen Family Wellness
11 Center.
12 And I just want to briefly discuss this
13 example of behavioral health as a potential
14 community partner.
15 But working for the Rosen Center, we treat
16 law enforcement, military veterans.
17 Senator Zeldin came to visit us about a
18 couple of months ago.
19 But, I realized how much PTSD can impact a
20 family, which we haven't heard a lot about that
21 today, but it really can.
22 We've treated parents of family members,
23 dealing with their children that are suffering.
24 We've dealt with the brother of a veteran --
25 or, correction, the -- yeah, the brother of a
85
1 veteran who lost his leg in Iraq, and the child was
2 emotionally impacted by the experience.
3 We've dealt with wives that are nearly
4 crippled with anxiety, due to the deployment of a
5 loved one.
6 And, of course, we've treated many veterans,
7 and other military members.
8 And we view ourselves as a supplement to
9 V.A. care. And we're proud to be able to provide
10 services that the V.A. just isn't really designed to
11 provide.
12 And, we'll also be opening Unified Behavioral
13 Health Center, for military veterans and their
14 families, in Bay Shore, New York. And this is going
15 to be a collaboration with the V.A., where,
16 North Shore - LIJ, and staff from the V.A., will be
17 operating, side by side, under one roof. And, we'll
18 be able to treat the families; the V.A. will be able
19 of treat the veterans.
20 Both of these organizations are providing
21 care at no cost.
22 And I think these are examples of public and
23 non-profit partnerships that are critical to care
24 for the veteran and his or her family.
25 Now, from my experience, I know that is very
86
1 hard to ask for help. But, I also believe that you
2 could be, basically, handing out $100 bills at your
3 organization, and, if it doesn't get -- the word
4 doesn't get out to the right veteran, they're not
5 going to come.
6 It goes against everything that our service
7 sort of trains us to do, to ask for help, but, it's
8 also not fair to just look at one organization, like
9 the V.A., or the Department of the Defense, to
10 handle all of these issues.
11 And I believe, you were talking about it
12 earlier, this concept of working with communities.
13 And I think that's critical, because, sometimes
14 veterans just aren't even aware that there could be
15 a service right in their backyard. They wouldn't
16 even know to look.
17 I don't think I would have known to look in
18 my county for help, when I got back.
19 I haven't worked with the State.
20 I see it as a tremendous resource, and it is
21 right there in the community.
22 And I just want to encourage that.
23 I think we can all do more to serve those who
24 serve us.
25 Communities are usually aware of these small
87
1 local resources, sort of like the Rosen Center that
2 exists.
3 There should be a net of services, to catch
4 any veteran that comes home from war, to ensure that
5 they and their family are aware of them, and how to
6 go about accessing them.
7 It's challenging to gets veterans to come in
8 for treatment, post-operational stress conditions,
9 but, it's a critical step. And, the sooner they get
10 treatment, the faster they can get back on their
11 feet.
12 I'll take any questions.
13 SENATOR ZELDIN: Just one comment, is: Going
14 forward, any ideas that you have, where we can be
15 helpful, Senator McDonald's office, my office.
16 There are -- many of our colleagues have
17 served. As Senator Huntley mentioned, you know,
18 that have loved ones who have served.
19 And we do have a speaker, later on, to
20 testify from the family perspective.
21 You know, our first speaker, Chris Delaney,
22 you know, talking about his best friend, and brought
23 up PFC Joseph Dwyer's brother.
24 And, we definitely realize the impact on the
25 family.
88
1 We're looking forward to soliciting more
2 testimony.
3 And, for that sake, I'll just turn it over to
4 Senator McDonald at this point.
5 SENATOR MCDONALD: Andrew, we really liked
6 that concept of the partnership with the Veterans'
7 Hospital administration down there.
8 We're probably following up on that.
9 ANDREW ROBERTS: Okay.
10 SENATOR MCDONALD: It's a great illustration
11 to do, as we go across the state, getting as many
12 organizations working together, including, in many
13 cases, for instance, the county I live in, in
14 Saratoga County, mental-health services for the
15 county is actually located in the local hospital.
16 So, we're partners in so many other things,
17 and this would -- we got to continue to explore this
18 partnership, and deliver that service.
19 And I thank you for your service.
20 Thank you.
21 SENATOR ZELDIN: Thank you for your service
22 as well.
23 ANDREW ROBERTS: Thank you both, very much.
24 SENATOR MCDONALD: Next we have a wonderful
25 guest, senior director of Veteran Services,
89
1 Samaritan Village, Inc., Ms. Carol Davidson.
2 Hello.
3 CAROL DAVIDSON: Thank you.
4 Good morning.
5 SENATOR ZELDIN: And for all the speakers
6 that will be testifying, if we don't end up asking
7 as many questions as we'd want to, please, just
8 understand that it's for the respect of the other.
9 witnesses to follow, to make sure we get everyone
10 in.
11 CAROL DAVIDSON: Good morning,
12 Senator McDonald, Senator Zeldin.
13 Thank you both for your service, and, welcome
14 home.
15 Thank you very much for inviting me to
16 participate in this meaningful dialogue about the
17 psychological, emotional, and spiritual impact of
18 combat service on our military-service members; and
19 the ways in which we, as a community, can assist our
20 veterans in homecoming, healing, and successful
21 reintegration.
22 It is my privilege today to represent the
23 president of Samaritan Village, Tino Hernandez.
24 And, it is my hope that I can contribute to
25 the discussion, from the perspective of a dedicated
90
1 community-based agency that has been providing
2 specialized programs and services to veterans for
3 the past 15 years.
4 There are well in excess of 1 million
5 veterans living in New York State. And, there are,
6 currently, as many as 10,000 veterans coming home
7 from active duty to New York every year.
8 Veterans are a diverse group of men and women
9 who embody the richness of American culture.
10 They personify the spirit of patriotic
11 service, leadership, courage, and sacrifice.
12 They are resourceful, resilient, and
13 motivated.
14 The warrior ethos that they live by is based
15 on core commitments: To place the mission first, to
16 persevere against all odds, and to take care of one
17 another at all costs.
18 These service members and veterans are
19 real-life heros.
20 Sometimes we forget that they're also
21 real-life human beings whose lives are changed
22 forever as a result of their experiences.
23 The wounds of battle are not always visible,
24 but the impact of trauma, grief, guilt, and horror
25 can be as debilitating as any other catastrophic
91
1 injury.
2 The writer Paul Fossil described
3 post-traumatic stress disorder, when he said, that
4 he joined the Army to fight the war for its
5 duration, but, discovered that he would have to
6 fight it every day and night for the rest of his
7 life.
8 The Committee's interest in this compelling
9 issue, and willingness to create a forum for public
10 education, discourse, and collaboration, will
11 benefit, both, our veterans, community, and our
12 provider network.
13 If I may, I'd like to begin my comments by
14 just telling you a little bit about
15 Samaritan Village, and our work with veterans.
16 Samaritan Village is a non-profit
17 social-service provider in New York State, with a
18 history of 50 years, and a thriving continuum of
19 services.
20 The current roster of services includes,
21 both, outpatient and intensive residential programs
22 for chemical-dependency treatment, shelter and
23 transitional housing programs for the homeless,
24 health and mental-health services, vocational
25 rehabilitation for our program participants, and an
92
1 active senior center.
2 Our facilities are located throughout
3 New York City and in Ulster County, and serve over
4 3,000 clients annually.
5 The treatment programs are licensed by the
6 New York State Office of Alcoholism and Substance
7 Abuse Services.
8 We administer three residential facilities
9 for military veterans who is have substance-abuse
10 disorders, and the spectrum of life problems that
11 are associated to chemical dependency, including
12 specialized services for the treatment of trauma and
13 PTSD.
14 Our programs include a 48-bed --
15 I see a typo to there.
16 -- 48-bed residential program for male
17 veterans in Manhattan; a 50-bed program for male
18 veterans in Queens; and, 25-bed residential program
19 for women veterans in Ulster County, which I'm very
20 proud to say is the first program of its kind in
21 New York State, funded by OASAS.
22 In 2011, Samaritan Village was awarded a
23 grant, for the first time, directly from the
24 U.S. Department of Veterans Affairs, to develop a
25 Supportive Services for Veterans' Families program,
93
1 which is designed to assist homeless veterans and
2 their families who may be at risk for homelessness.
3 Samaritan Village began to develop treatment
4 services for veterans over 20 years ago, when the
5 clinical staff identified a subculture of Vietnam
6 veterans within the existing treatment programs.
7 Those veterans often had histories of
8 previous treatment failure, and had been unable to
9 stay sober for any significant period of time.
10 Most of the treatment options that were
11 available during that era focused exclusively on,
12 either, of the substance abuse problem or the PTSD.
13 Samaritan Village developed an integrated
14 clinical model for simultaneous treatment of
15 substance abuse and co-occurring mental-health
16 disorders, including PTSD.
17 Our first veterans' program opened its doors
18 in 1996, and we have continued to work diligently
19 since that time on creating a clinical culture that
20 honors veterans, builds on their inherent strengths,
21 and offers pathways to personal healing, that are
22 grounded in trauma-informed care, mutual self-help,
23 and evidence-based clinical practice.
24 Samaritan Village veterans range in age, from
25 their mid-20s, up into their late 60s, and include
94
1 both combat and peacetime veterans who represent
2 every era.
3 We have begun to see an influx of
4 Operation Iraqi Freedom and Operation Enduring
5 Freedom veterans over the past few years, and we
6 certainly anticipate that we'll see many more in the
7 years ahead.
8 In 2011, the Rand Corporation prepared a
9 "Needs Assessment of New York State Veterans" report
10 for the New York State Health Foundation.
11 The highlights of the report indicate, that,
12 while about 20 percent of combat veterans screened
13 positive for symptoms of PTSD, less than half had
14 received any mental-health services in the prior
15 year.
16 In addition to combat-related trauma,
17 veterans may also develop PTSD in response to
18 incidents of military sexual trauma, which occur
19 with a alarming frequency.
20 The U.S. Department of Labor - Women's Bureau
21 released a recent report, that estimates a range of
22 20 to 48 percent of women in the military experience
23 some form of direct sexual assault.
24 I will not attempt to address these issues in
25 any real depth within the scope of my comments
95
1 today, but, I will summarize a few key points that
2 reflect my experience of working with veterans at
3 Samaritan Village.
4 Less than 1 percent of Americans have borne
5 the full burden of military service in the wars in
6 Iraq and Afghanistan.
7 The nature of guerrilla warfare, shifting
8 mission objectives, multiple deployments, and the
9 particularly harsh conditions faced by our current
10 service members create conditions that are likely to
11 result in high rates of PTSD and other mental-health
12 problems among this generation of veterans.
13 No one returns from war unchanged, and no one
14 hates war more than the warriors who have lived it.
15 A PEW Research Center report cites that
16 98 percent of post-9/11 veterans are proud to have
17 served, but 51 percent describe that readjustment
18 has been difficult; and, fully, 49 percent admitted
19 that they had some degree of post-traumatic stress
20 reaction.
21 PTSD is a disorder of both memory and
22 meaning.
23 Service members can withstand enormous
24 amounts of adversity and trauma, but, they're prone
25 to derive meanings from their experience that
96
1 involve irrational self-blame, that erodes character
2 and self-esteem, and engenders self-destructive
3 behaviors.
4 Readjustment problems, including PTSD, create
5 a cascade of consequences that may include,
6 addiction, health problems, marital and family
7 problems, vocational dysfunction, loss of housing,
8 criminal-justice involvement, and, in the worst case
9 scenario, suicide.
10 Some of the barriers to effective service
11 delivery for our veterans include their own
12 reluctance to seek help, because, they perceive it
13 as a sign of weakness, or they fear being
14 stigmatized, they have concerns about taking
15 medications, and, have various challenges and doubts
16 about accessibility to competent care.
17 The U.S. Department of Veterans Affairs needs
18 significant support from community-based providers
19 to deal with the numbers of combat veterans who are
20 on their way home in next few years.
21 Providers need training to develop necessary
22 clinical competencies.
23 The course curriculum for most mental-health
24 professionals does not include any content about
25 military-cultural competence, trauma-informed care,
97
1 or evidence-based practice for PTSD.
2 Effective treatment for PTSD includes the use
3 of evidence-based practices, like prolonged exposure
4 therapy, eye-movement desensitization and
5 reprocessing, cognitive-processing therapy,
6 et cetera, that is delivered within a context of
7 respect for military service, and provides an
8 opportunity for the veteran to connect with a
9 support network of his or her peers.
10 Finally, it is the moral, social, and
11 practical imperative for American society to
12 mobilize all necessary resources across multiple
13 systems, systems to assist our OIF, OEF, OND,
14 veterans, as well as veterans of all eras.
15 The responsibility for war, and its
16 aftermath, is rightfully shared by a whole culture.
17 In closing: I would like to reference a
18 young OIF veteran named Billy, who talked about the
19 difference between, coming back, and, coming home.
20 It's perfectly normal for human beings to
21 have profound emotional responses to horrific
22 war-time experiences.
23 Our warriors possess incredible resources
24 that they will utilize to benefit society, if only
25 we'd work together to assist in their healing, and
98
1 help them to rediscover a sense of meaning and
2 purpose, and a place in the community as rightfully
3 honored veterans.
4 Thank you for allowing me to share my
5 observations.
6 SENATOR MCDONALD: Carol, we think highly of
7 your organization.
8 CAROL DAVIDSON: Thank you.
9 SENATOR MCDONALD: We would like to know more
10 about it.
11 You mentioned something about, down in
12 Ulster County --
13 CAROL DAVIDSON: Yes.
14 SENATOR MCDONALD: -- you have a new
15 facility.
16 I think I would like to visit some of those
17 things.
18 We're moving our schedule along because we
19 want to make sure that we get everybody in.
20 CAROL DAVIDSON: Okay.
21 SENATOR MCDONALD: Okay?
22 But you're going be hearing from us.
23 And, first off, I want to thank you for what
24 you've done so far for these folks.
25 CAROL DAVIDSON: Thank you very much.
99
1 SENATOR MCDONALD: It's obvious that
2 non-profit organizations have a role in what we're
3 doing here. And they've already established some,
4 you know, really great programs.
5 CAROL DAVIDSON: If I could add just one
6 point that hasn't been mentioned yet?
7 And, you know, again among kind of
8 unspeakable things, that, there are some incredible
9 war heroes/veterans of these conflicts, and all
10 eras, who, for one reason or another, and including
11 reasons that may be associated to PTSD, end up with
12 bad discharge status that disqualifies them from,
13 you know, accessing services at the V.A.
14 And, so, it's --
15 SENATOR MCDONALD: Well, we're going to be --
16 CAROL DAVIDSON: -- another reason --
17 SENATOR MCDONALD: -- these are things -- we
18 do have limitations, and the federal government does
19 supercede us, but we certainly are going to try to
20 personalize the New York State veterans, so we know
21 them as a person, not a number.
22 CAROL DAVIDSON: Thank you very much.
23 SENATOR MCDONALD: Thank you.
24 Next we have another wonderful guest,
25 Ms. Karin Moran, who is director of policy,
100
1 National Association of Social Workers in
2 New York State, which already sees a great deal of
3 emotional trauma on regular basis.
4 We are trying to keep, Karin, a schedule, so,
5 please help us out.
6 Now, we do know some of the stuff you do, and
7 we do know that there's an overlap.
8 KARIN MORAN: Yes.
9 SENATOR MCDONALD: So --
10 KARIN MORAN: Thank you.
11 SENATOR MCDONALD: -- and you don't have to
12 read the whole thing.
13 Highlight, if you will, some of the areas
14 that you feel that haven't been covered, that you
15 are unique in.
16 KARIN MORAN: Okay.
17 Thank you, Chairman McDonald, and
18 Senator Zeldin.
19 My name, as you mentioned, is Karin Moran,
20 and I am the director of policy for the
21 New York State Chapter of the National Association
22 of Social Workers.
23 As such, I have spent a considerable amount
24 of time, over the course of the last several years,
25 working on veterans' issues; specifically, the
101
1 preparedness of the mental-health workforce in
2 relation to meeting the needs of returning service
3 members and their families.
4 I would like to thank you for providing this
5 opportunity to address a critical area of concern
6 regarding veterans and the care available to them.
7 As you are acutely aware, the state of
8 New York, and the country at large, are facing
9 formidable challenges in serving the mental-health
10 needs of our veterans returning from active duty in
11 Iraq and Afghanistan.
12 Since 2001, 2.6 million American service
13 members have deployed to the combat theaters of Iraq
14 and Afghanistan.
15 It is estimated that New York alone, has, to
16 date, assigned over 85,000 troops to
17 Operation Enduring Freedom, Operation Iraqi Freedom,
18 and Operation New Dawn, many of whom have been
19 assigned to multiple deployments.
20 With each deployment, our service members
21 encounter extreme strains on their physical and
22 mental health, which, in many cases, has resulted in
23 unprecedented rates of health and mental-health
24 problems, most notably, post-traumatic stress
25 disorder and traumatic brain injuries.
102
1 Equally alarming are the numerous reports
2 that I have -- that have identified PTSD and TBI as
3 risk factors of suicide.
4 And, reportedly, individuals with traumatic
5 brain injury are 1 1/2 times more likely than a
6 healthy individual to complete suicide.
7 Other risk factors include, PTSD, depression,
8 chronic pain deployment to combat, and substance
9 abuse.
10 As evidenced by a number of reports,
11 including a landmark study in "The Journal of
12 American Medical Association," post-traumatic stress
13 disorder rates are, reportedly, as high as
14 24 1/2 percent for National Guard and Reserve troops
15 serving in Iraq.
16 In addition to high rates of PTSD, providers
17 in the mental-health community have reported
18 increased cases of TBIs sustained in Iraq and
19 Afghanistan theaters of combat, due in large part to
20 the use of improvised explosive devices.
21 Also disturbing is the rate at which TBI has
22 been misdiagnosed as PTSD.
23 Numerous reports have told the stories of
24 soldiers returning from Iraq and Afghanistan with
25 brain trauma, but because visible head wounds and
103
1 symptoms -- because there are no visible head
2 wounds, symptoms, such as memory loss and confusion,
3 are often mistaken as indicators of PTSD.
4 In addition, the Department of Defense Task
5 Force on Veterans' Mental Health has reported
6 elevated rates of major depression and substance
7 abuse, while post-deployment health reassessment
8 data show that, up to 38 percent of soldiers, and
9 31 percent of Marines, are suffering from negative
10 psychological symptoms.
11 Hence as service members return to New York,
12 they and their family members are often in need of
13 expert mental health-care; yet, there continues to
14 be a short supply of mental-health professionals who
15 are adequately trained in veteran-specific
16 mental-health issues.
17 In addition, providers need to be well versed
18 in the unique context of mental health within the
19 military culture.
20 The recent Rand Corporation needs health --
21 "Needs Assessment of New York State Veterans,"
22 released January 2011, confirms such, as they all
23 clear for increasing the number of providers trained
24 in the provision of evidence-based treatment.
25 In response to such an identified workforce
104
1 issue, NASW partnered with the New York State
2 Psychiatric Association and the Medical Society of
3 the State of New York, each of whom have
4 representatives here today, in the development and
5 the facilitation of the Veterans' Mental-Health
6 Training Initiative, a multi-year comprehensive
7 training project focused on increasing the number of
8 community mental-health professionals knowledgeable
9 about the assessment and treatment of mental-health
10 issues specific to veterans and their families.
11 One of the initiatives was funded through a
12 legislative grant, and delivered in five separate
13 locations throughout the state.
14 In addition, the New York State Office of
15 Mental Health utilized the model to train their
16 workforce, cumulatively resulting in over
17 1,000 mental-health providers statewide.
18 While this is indeed a tremendous feat, and
19 even far exceeded our initial expectations, the
20 number of returning veterans, and the derth of
21 mental-health professionals specifically trained to
22 meet the needs of continued -- to meet their needs,
23 continue to be documented in study after study, such
24 as the Rand "Needs Assessment," the Department of
25 Defense's Task Force on Veterans' Mental Health, and
105
1 many others.
2 Building upon the success of year one, we
3 moved forward with two year of the project funded
4 through a grant by the New York Health Foundation,
5 expanding the project to reach -- to include higher
6 levels of clinical skill-building, in addition to
7 PTSD and TBI introductory curriculum.
8 This project is currently underway, and to
9 date, we have completed 1 of 4 training institutes
10 for 150 mental-health participants.
11 With an eye toward the future; and, yet,
12 additional identification of needs surfacing, we,
13 again, work in partnership with the New York State
14 Psychiatric Association, The Medical Society of the
15 State of New York, to expand the breadth and scope
16 of the project, to include training -- a training
17 track specific to primary-care physicians.
18 As evidenced in recent reports by the
19 Veterans Administration, "The Journal of American
20 Osteopathic Association," the Department of Defense
21 and Division of Psychiatry, and Behavioral Sciences
22 at Walter Reed Army Institute, just to name a few,
23 public-health authorities anticipate that many
24 returning soldiers will initially consult their
25 primary-care physicians regarding health problems;
106
1 however, the diagnosis of PTSD is often missed in
2 primary-care settings.
3 NASW and its partner organizations believe
4 our veterans deserve access to a comprehensive
5 system of care, one that is staffed with the most
6 highly qualified individuals, and as such, we are
7 dedicated to our role in assuring that New York's
8 health and mental-health workforce continue to lead
9 the nation in preparedness to meet the needs of our
10 veterans.
11 It is with this in mind that we thank you,
12 Senator McDonald, and Senator Zeldin, in addition to
13 numerous other members of your House, with a special
14 note of appreciation to Senator Fuschillo, who's
15 initiative you referenced earlier, and,
16 Senator McDonald, for being such avid champions,
17 both past and present, of our initiative, as well as
18 inviting us to speak today, about our work, our
19 ongoing efforts, to promote continuation of this
20 final project.
21 Thank you.
22 SENATOR MCDONALD: Thank you.
23 It would seem, as we've been talking to the
24 various groups, that one what major role for
25 New York State could be the coordination of all of
107
1 the different services, so we can cut that
2 bureaucracy.
3 The social workers, and I had experienced at
4 a local county level, as a member of a county
5 legislature in Saratoga County, are there, in many
6 sad situations. And some of time, these sad
7 situations overlap.
8 Your organization, and your membership, can
9 be very helpful, helping us to identify, when
10 they're talking to some of these folks that have,
11 you know, financial problems.
12 And we all know, social services, more than
13 finance, it's a -- dysfunctional families, and
14 things of that nature, as well, that gets
15 highlighted, that we could become -- have them also
16 become part of our team, where they're able to help
17 us, and say: There's a dysfunctional situation, and
18 it happens to involve a military family.
19 For them to be on the alert, and, more so now
20 as these men and women come back.
21 So, the challenge for you folks is to help us
22 out.
23 And our challenge is to get this bureaucracy
24 manageable, so we can get it down to that individual
25 level: the name, not the number, of the person.
108
1 KARIN MORAN: Absolutely.
2 And it was actually the field that started
3 contacting us, five years ago, which was part of the
4 impetus of this project, because, we had social
5 workers calling us, whether it be from county
6 mental-hygiene offices --
7 SENATOR MCDONALD: Right.
8 KARIN MORAN: -- or, in a private practice
9 somewhere, that said: We have a freshman combat
10 veteran sitting across from us, and we have no
11 specific training in how to meet these needs.
12 SENATOR MCDONALD: That's what
13 Senator Fuschillo's bill calls for.
14 And that's what Lee and myself, and the rest
15 of us, are going to be pushing this year.
16 Thank you so much.
17 KARIN MORAN: Thank you.
18 SENATOR ZELDIN: Thank you.
19 SENATOR MCDONALD: Next we have, as our
20 guest, Jonathan Gradess, who's executive director of
21 the New York State Defenders Association.
22 Another sad reality about returning veterans,
23 and PTSD, and these type of issues, is some of these
24 folks, not only have the emotional problems that you
25 get from serving in combat, in the military,
109
1 economic problems, but, you know, family problems,
2 but they also have legal problems.
3 And, there's no justification for breaking
4 laws and doing criminal activity, but there's
5 certainly an understanding that some of these men
6 and women are under undue pressure.
7 And for us to highlight them before they do
8 that, where they help them, so they don't do
9 anything worse than, you know, the original crime
10 they're arrested for.
11 And, Jonathan is the executive director of
12 Defenders Association, which I believe is all of the
13 county defenders in the 62 counties that make up
14 New York State.
15 Jonathan, we are working on a time issue --
16 JONATHAN E. GRADESS: I understand.
17 SENATOR MCDONALD: -- but I know you talk
18 fast.
19 JONATHAN E. GRADESS: I've been editing as
20 quickly as I could.
21 I want to tell you a story about a soldier,
22 who was driving in the North Country, down the
23 middle of the road at night, followed by an unmarked
24 police car, who comes to a stop sign, and quickly
25 turns around it, without stopping. There's a
110
1 6-pack, or a 24-pack of beer on the front seat, and
2 a shotgun.
3 And a confrontation that occurs in a case
4 like that, with shots fired, results in a charge of
5 attempted murder of a police officer.
6 What I'm here to talk to you about, is how to
7 translate that experience when I happens, if it
8 happens, into a defense for combat veterans who are
9 suffering from the experience of combat, and bring
10 it home with them.
11 And I want to share with you the background
12 of that story, but I want, first, to say one thing:
13 What I'm going to talk about is, in no way,
14 applies to every veteran. And it's important, for
15 your listening audience, and for everyone, to
16 appreciate that.
17 But, there is a small segment of people,
18 growing segment of people, who, suffering from TBI
19 and post-traumatic stress disorder, from suicide
20 risks, and from depression, from alcohol and drug
21 addiction, from the things that attach like
22 barnacles in service to their lives.
23 That class of people can find themselves in
24 the criminal justice system, and it's that class of
25 people that we're seeking to talk about.
111
1 The history of this, for me, is, in part,
2 personal, and somewhat longstanding.
3 43 years ago, I worked in the criminal courts
4 of the City of New York, and I watched the class of
5 combat veterans from Vietnam who found themselves
6 enmeshed in the criminal justice system, poorly
7 treated, in my opinion, by the lawyers who
8 represented them; not so much because they -- I
9 think there was a cognitive dissidence.
10 It was before the findings of PTSD. It was
11 back in the late '60s and early '70s. It was a
12 decade before we recognized the defense, but the
13 mitigating circumstances that could have been used
14 in those cases were often missed.
15 And we now have a gigantic cohort of Vietnam
16 veterans in the State prison system. It's our
17 largest, our Vietnam-Era veterans.
18 So as we approach the Iraq and Afghanistan
19 War, the Defenders Association, having had that
20 experience personally, we wanted to be ahead of the
21 wave of Iraq and Afghanistan returnees.
22 We had also handled the very first PTSD
23 defense in this state, in 1980. And it was -- or
24 assisted with it, I should say. It was handled by
25 Steve Wax, who's now the federal defender for
112
1 Portland, Oregon.
2 That client is still serving time in prison.
3 That defense was not easily recognized at the time.
4 And, today, we have a system in which the
5 public defense lawyers who represent poor people in
6 the 62 counties of this state, are radically
7 underfinanced, are without investigative support,
8 have very little access to experts.
9 And, so, you could imagine a veteran who does
10 not want to reveal and disclose their situation,
11 coming in contact with a defense lawyer who does not
12 have the time to explore that situation. You can
13 imagine how those people can be wrongly propelled
14 into the state's criminal justice system if we don't
15 do something to interdict that.
16 About five years ago, we received a small
17 planning grant, to try and do some planning around
18 that, for public defense services. We wanted to set
19 up a military and veterans' defense unit.
20 We ended up really spending more time
21 learning how much we didn't know; and being in touch
22 with some of the witnesses who were here today, and
23 some of those issues, learning about the barriers,
24 learning about the unreliable identifications,
25 learning about the real institutional resistance to
113
1 reporting.
2 And, some of that data, which in my written
3 testimony, I'm not going read it again, is
4 absolutely flabbergasting, when you put up that
5 against non-reporting, non-disclosure concerns,
6 stigma, up against lawyers who are not trained to
7 look for, find, and defend in these cases, you have
8 a real calamity about to occur in our state.
9 And that's really what I'd like us to
10 address, is, as we talk about "providers," we mean
11 lawyers who will represent clients, who have been
12 combat veterans, who have a story that needs to be
13 told to juries, who have issues that need to be
14 presented to prosecutors, who need to be diverted
15 from the system, who need to have the kind of care
16 and concern that every client should have, but,
17 particularly, people who -- many of whom, have had
18 inculcated in them, specifically because of their
19 combat experience, issues, which, if translated into
20 criminal behavior, are very hard to explain.
21 They seem incongruous.
22 You heard a witness earlier today, who I want
23 to talk to, who said: Driving along the Long Island
24 Expressway, or wherever in Long Island, looking for
25 silhouettes; or, responding to bubble wrap;
114
1 Or, the reason you turn past the stop signs,
2 is because that's habitual behavior, after not
3 stopping at corners;
4 That, I think, Senator, is something that
5 happens in combat. And, it's happened in Iraq.
6 Those kinds of things need to be explained.
7 But, if you have a client who is unemployed,
8 or homeless, on drugs and alcohol, and in denial
9 about that, or maybe not in touch with it, it's a
10 very real task.
11 So we're hopeful, that, together, we can work
12 to help continue the training of defense lawyers,
13 and develop some of the issues that we think could
14 help solve these problems.
15 SENATOR MCDONALD: I have a question right
16 now, and then I'm going to give it to my colleague.
17 JONATHAN E. GRADESS: Yes.
18 SENATOR MCDONALD: That would be an excellent
19 proposal that your organization can make us in a
20 more detailed fashion.
21 JONATHAN E. GRADESS: We would love to do
22 that.
23 SENATOR MCDONALD: We have veterans' courts,
24 as you know.
25 JONATHAN E. GRADESS: Right.
115
1 SENATOR MCDONALD: They're popping up in
2 different locations, that are special courts for
3 returning veterans.
4 And, you know, the training might be
5 something, that we might be able to go to the local
6 bar associations. Each county has a bar
7 association. New York State has a bar association.
8 And if I'm correct, they're are required to do a
9 certain amount of, you know, charity-type work, if
10 you will.
11 But, we have somebody sitting right next to
12 me, who's not only a combat veteran of Iraq, but
13 also an attorney.
14 Do you have any thoughts on that, Lee?
15 SENATOR ZELDIN: Well, my question actually
16 was: When you're talking about, to be able to
17 explain this story to the jury, are you focusing
18 primarily on the liability end of the case, or are
19 you talking about mitigation during sentencing?
20 JONATHAN E. GRADESS: Well, I'm talking
21 about, in criminal, I think there's three classes of
22 cases that we're interested in.
23 The veterans courts are a good example, and
24 I'm glad you raised it.
25 There are four of them operating now, and
116
1 there's about thirteen in the hopper, for this
2 state.
3 We actually have a little bit of concern
4 that -- that not all focus should be on those courts
5 because they are dealing with lesser cases,
6 important cases.
7 They're working well. The mentoring process
8 is excellent.
9 We're talking, in part, about very serious
10 cases which go wrong, which are going to be charged
11 as felonies, that are going to be brought into court
12 and prosecuted, in which defense lawyers are going
13 to need to have an entire array and repertoire of
14 understanding of these cases, of understanding of
15 what the combat situation was of a then-defendant
16 combat and military record, they're going to need to
17 have access to experts and diagnostic treatment, and
18 to be able to explain the circumstances in
19 mitigation, to prosecutors, to juries, as to why
20 lesser punishments, or even acquittals, should
21 occur.
22 Very complicated, but it has an analogue in
23 mitigation work that is done every day in very
24 serious cases.
25 But it is a problem in New York, because
117
1 people are so underfunded and so overwhelmed, that
2 it isn't going to come naturally unless we intervene
3 to make it happen.
4 SENATOR ZELDIN: Yeah, I would absolutely
5 agree on the -- you know, the mitigation point, that
6 someone's service to our country, and the mental
7 wounds that they bring home, and how that
8 contributes to the act that they committed.
9 While there may be a need for a guilty
10 verdict, and to hold them responsible for what
11 happened, maybe it should be considered, in certain
12 cases, as far as mitigation.
13 So, I would agree with that.
14 SENATOR MCDONALD: You know an enlightened
15 legal system of what we've got here, and it's been
16 said several times: You send men and women off to
17 war. You think you send them off individually, you
18 don't, because they have some kind of -- hopefully,
19 some kind of friendship and family structure behind
20 them. So that means they're going to war with them.
21 And when they come back, the war isn't over
22 on a particular time or a date or a year, for them.
23 And they're going to be -- you know, it's a
24 different world on the other side of the world, when
25 you're in combat. And they're going to have to
118
1 adjust to that.
2 Now, we don't justify any crimes. It's
3 America; you pay the price.
4 But we have to turn around and recognize that
5 these men and women have got to be defended, with
6 the understanding that they came from a place --
7 JONATHAN E. GRADESS: And the --
8 SENATOR MCDONALD: -- that was barbaric.
9 JONATHAN E. GRADESS: -- I think there needs
10 be an understanding for all of us, on the difference
11 between, accountability for behavior, and, the
12 nature of what then happens, to send someone, for
13 example to prison, who's in a state already of
14 hypervigilance, where that hypervigilance is going
15 to be increased in prison, and they're going to
16 learn survival skills there that are like combat;
17 but, then, come home, break up their family to do
18 so.
19 When, in Minnesota and California, we already
20 have statutory schemes, which we'd also like to
21 share with you, that are diverting veterans for this
22 reason.
23 So we'll --
24 SENATOR MCDONALD: I see this, though, we'll
25 work together --
119
1 JONATHAN E. GRADESS: Great.
2 SENATOR MCDONALD: -- but, please get us
3 back, with some detailed comments --
4 JONATHAN E. GRADESS: We'd be happy to do
5 that.
6 SENATOR MCDONALD: -- on what the training
7 would be.
8 JONATHAN E. GRADESS: Very happy to be --
9 SENATOR MCDONALD: Much like the -- and who
10 are the non-profits that we could utilize, such as
11 the bar associations, and things of that nature.
12 Thank you.
13 JONATHAN E. GRADESS: Thank you very much.
14 SENATOR MCDONALD: Next we have,
15 Command Sergeant Major Gary Flaherty.
16 And we have been talking about county
17 veterans, county veterans' directors, and the State
18 program.
19 And, Gary is the director for the
20 Columbia County Veterans' Service Office.
21 And we're lucky to catch him in, because he's
22 a gentleman that spends less time in the office, and
23 more time going out to see the men and women, and
24 their families, that need him.
25 Thank you, Gary.
120
1 SENATOR ZELDIN: And, Senator McDonald, and
2 Mr. Flaherty, if you wouldn't mind, Mr. Ronayne,
3 Tom Ronayne, is here.
4 Would you mind just coming up, as well?
5 Tom is the director of the Veteran Services'
6 Office for Suffolk County, who has been advising --
7 advising me and my office as well.
8 SENATOR MCDONALD: Fine.
9 And we have a third one, but we'll get to
10 him, from Saratoga.
11 This is, what in the Army we called,
12 "the ground troops." The grunts, they see the real
13 things.
14 Thank you.
15 And your name again, sir?
16 THOMAS RONAYNE: Thomas Ronayne.
17 SENATOR MCDONALD: Nice to meet you, sir.
18 Thank you.
19 We'll start with Gary, then we'll go over to
20 Thomas.
21 COMMAND SGT. MJR. GARY FLAHERTY: Senators,
22 thank you for the opportunity for me to appear
23 before you today.
24 I gave a lot of papers, the background
25 information, so I'm -- with your permission, I'd
121
1 like to go off script, and tell you about the
2 successes we've had in Columbia County.
3 When I went down and took over the director
4 of Veterans' Services at Columbia County, the office
5 was more of a walk-in. If you needed veteran
6 services, and you walked in and asked for them, and,
7 they did what they could for you.
8 I turned all that around, and started an
9 outreach program. And, my outreach program includes
10 doing mail-outs to veterans.
11 I get a list out of Washington once a year,
12 that has every veteran who was discharged during
13 that year, and I send them a already letter,
14 welcoming them home. And, also, giving my cell
15 phone, my home phone, my e-mail, asking them, if
16 they need services, to call me.
17 I do not spend very much time in my office.
18 I make house calls, day and night.
19 We've been very successful in linking our
20 services with the V.A. services.
21 And, in particular, with post-traumatic
22 stress syndrome, TBI, for all areas of the wars.
23 I spent my time in Vietnam, and suffered
24 many, many years with post-traumatic stress syndrome
25 myself.
122
1 And I thank God, and I thank the Albany V.A.,
2 or I probably would not be setting before you today.
3 We've also started a program, as directed by
4 the -- Judge Teresi (ph.) in Albany, and called the
5 "Veterans' Justice Outreach Program."
6 And, we coordinate with a coordinator at the
7 V.A. We work with all of our legal people at the
8 V.A. -- at the county level: the district attorney,
9 the sheriff's department. The -- Judge Nichols
10 oversees the program.
11 Most places, they have a drug court; which we
12 have a drug court. And they put us into the
13 drug-court program.
14 However, we're in the process of working a
15 model, where it would -- we would have a separate
16 time that Judge Nichols would hear the cases of only
17 combat veterans, or veterans, who have committed
18 non-violent crimes.
19 This past year, we've been successful, that
20 we were able to keep eight veterans out of prison,
21 and get them into treatment.
22 Judge Nichols, instead of sentencing them
23 back to jail, he'll direct them to work with me, to
24 get into mental or physical health, as needed.
25 Oftentimes, I'll get a call from the
123
1 sheriff's department, that they picked up somebody.
2 And when I go to visit the veteran at the sheriff's
3 department, they ask me two things:
4 "Did you ever serve in a war zone?"
5 And, "Did you have any effects after being in
6 combat?"
7 And, once you establish that role, they
8 immediately open up to you.
9 And, I've had 24 people this year, and in
10 every case, it's become more of a friendship,
11 mentoring program, than it has, "go get help."
12 And our -- the other part of our outreach
13 program is, we brought all the department heads
14 together in Columbia County.
15 And, our chairman directed that they, on
16 their intake form, they change it, to ask the first
17 question, "Did you ever serve in the military?"
18 rather than, "Are you a veteran?" -- because, a lot
19 of people who previously were in the Reserves or
20 National Guard don't consider themselves veterans.
21 And, when they ask that question --
22 SENATOR ZELDIN: That's changed.
23 COMMAND SGT. MJR. GARY FLAHERTY: Pardon me?
24 SENATOR ZELDIN: That's changed.
25 COMMAND SGT. MJR. GARY FLAHERTY: That's
124
1 changed, yes, correct.
2 But when they -- if they answer "yes," then
3 they're to be directed to our office for help from
4 us, from a veteran standpoint, rather than
5 social services, or Office of the Aging, or
6 whatever.
7 SENATOR MCDONALD: Let me ask you a question,
8 Gary.
9 We were talking about partnerships.
10 And I think you, and your colleague sitting
11 next to you from Nassau County, and your colleague
12 from Saratoga County who will be speaking in a
13 little bit, getting this one-on-one mentoring
14 program --
15 Some of these non-profits already have it.
16 We heard hospitals, and different groups.
17 -- it really is important, in upstate
18 especially.
19 You're a small county of about 60,000 people.
20 And if we can do that, in using Senator Fuschillo's
21 bill as a springboard to getting a little training
22 money, it would seem to me that this is tailor-made,
23 especially in upstate, for our county governments.
24 Would you agree with that?
25 COMMAND SGT. MJR. GARY FLAHERTY: I totally
125
1 agree.
2 And I feel that, you know, as we would say in
3 the military, "If you don't have the boots on the
4 ground," you know --
5 SENATOR MCDONALD: Right. It's easy to talk
6 to all the agencies in a small county. It's
7 tougher, obviously, Nassau County's bigger than some
8 states, obviously, in population.
9 COMMAND SGT. MJR. GARY FLAHERTY: But we were
10 able to train 13 mentors, and besides myself. And I
11 oversee all of them. And if I get veterans -- and
12 some of them are females. If I get a veteran that I
13 want to refer to another mentor, then I have the
14 veterans --
15 SENATOR MCDONALD: Well, I think you bring up
16 a good point.
17 COMMAND SGT. MJR. GARY FLAHERTY: -- trained,
18 standing by.
19 SENATOR MCDONALD: With so many female
20 veterans, it's important that we recruit mentors for
21 females too, whoever they're comfortable with.
22 COMMAND SGT. MJR. GARY FLAHERTY: But I -- I
23 would -- in the interest of time, I would tell you,
24 that our program has been so successful, that the
25 judge in Greene County calls on me to come to his
126
1 court.
2 I've now been called to court, down in
3 Ulster County, to help veterans down there.
4 And, last night, as an example, I -- we did
5 have one veteran this year end up, before they
6 called me, and he had already made an arrangement,
7 or a deal, with the DA, and a public defender, that
8 he would take 1 1/3 to 3 years' probation.
9 But after I talked to the judge, the judge
10 wrote a letter, saying, give him an early parole
11 hearing.
12 And I received a call from him last night,
13 and he already has it, after a month and a half, and
14 will be getting out in -- the 2nd of July.
15 And, he called me back a half hour later, and
16 said: I've been talking to the officer in charge of
17 our block, which is all veterans. There's
18 60 veterans in that block. And he wants to know if
19 you'll come out to the prison near Rochester, and
20 present your program to us.
21 SENATOR MCDONALD: You have such a good
22 program, I'm going to personally visit you. It's so
23 close to the capitol.
24 And I'm so grateful that you're here, and I'm
25 grateful for your service.
127
1 COMMAND SGT. MJR. GARY FLAHERTY: Thank you.
2 SENATOR ZELDIN: Thank you, Gary, for your
3 service as well.
4 And, Senator McDonald, just by way of
5 introduction, Tom Ronayne, last name spelled
6 R-O-N-A-Y-N-E, has been running the
7 Veterans' Service Office in my home county of
8 Suffolk for a few years, and has served our
9 community very well.
10 And something to offer up to the Committee
11 is -- is a program called -- it's called the
12 "Baghdad to Brentwood in 24 hours" program.
13 And I represent the Brentwood community,
14 which, the program involves Suffolk County police
15 officers, who, before going from -- before getting
16 their firearm back, and going right back to the
17 street on a patrol, they go back to the academy for
18 retraining and screening.
19 And if -- Mr. Ronayne, if you wouldn't mind
20 giving us the abbreviated 2-minute version of the
21 program, and any additional thought, for sake of
22 time, though.
23 I appreciate the last-minute invitation.
24 THOMAS RONAYNE: Before you do,
25 George Basher, I just want to -- I didn't have a
128
1 chance to just recognize him.
2 He's the former director of Veterans Affairs
3 for New York State.
4 Thank you for being here. We're going to be
5 talking to you later, to get your input.
6 GEORGE BASHER: Yes, sir. Thank you.
7 SENATOR MCDONALD: Thank you, George.
8 I'm sorry, sir.
9 SENATOR ZELDIN: Thank you, Mr. Ronayne.
10 THOMAS RONAYNE: Thank you, Senator.
11 The program that Senator Zeldin refers to, we
12 affectionately refer to it, in Suffolk County, as
13 "Baghdad to Brentwood in 24 hours."
14 And --
15 SENATOR MCDONALD: Doesn't sound like a train
16 I want to be on.
17 COMMAND SGT. MJR. GARY FLAHERTY: Well,
18 much --
19 SENATOR MCDONALD: Or, maybe on, but going
20 the other direction.
21 THOMAS RONAYNE: Much to the credit of the
22 leadership in the Suffolk County Police Department,
23 they recognized, a number of years ago, that the
24 issue of police officers, who, in many instances,
25 were National Guard members, were returning from
129
1 their military duty.
2 Upon arrival home, they could, effectively,
3 immediately report for duty; pick up their ID card,
4 pick up their weapon, and return to patrol.
5 It was recognized that maybe this wasn't the
6 best way of approaching the issue.
7 And what they did was, they designed a
8 program, wherein, when the police officers return
9 from combat duty, before returning to regular patrol
10 assignments, they would go back to the police
11 academy, which makes a great deal of sense, not only
12 for the issue of the delay in returning the weapon,
13 but, allowing them to be retrained in issues of all
14 that may have occurred during their absence, and so
15 forth.
16 But as a part of their retraining, they would
17 also be invited to participate in a psychological
18 screening.
19 One of the components that I find most
20 beneficial in this program, is that it is not
21 intended only for the police officer. The
22 psychological evaluation, the counseling, and the
23 ability to come in and speak with the individuals
24 involved, extends to that police officer's family as
25 well.
130
1 And we all know, and we've heard excellent
2 testimony here this morning, that the family
3 members, the loved ones, those closest to these
4 veterans, are, very often, the first ones to
5 recognize that these issues may exist at all.
6 Certainly, far sooner than, in many of our cases,
7 ourselves.
8 SENATOR MCDONALD: This is an excellent
9 illustration of what we can do.
10 One of the problems you have, is, when some
11 of these -- if you're in the police department, and
12 you're coming back to Suffolk County, people are
13 gonna know who you are, and they're going to have
14 some background.
15 We get people discharged in our communities,
16 we didn't even know they lived in our communities.
17 Some of these communities are bigger, and maybe
18 their family members moved. And, all of a sudden,
19 and we can't -- freedom of information, okay, won't
20 get you that material from the federal government.
21 They're protecting their privacy.
22 So it's a never-ending issue, how do you get
23 somebody who doesn't have that network?
24 And, certainly, every police department I've
25 ever seen has a network of discipline and
131
1 responsibility and affection for their colleagues.
2 How do we get these people, coming out?
3 Because we're not going to get a list,
4 generally speaking, from the federal government.
5 Or -- and I think that's -- that's the
6 never-ending issue of your jobs, is, they come -- if
7 somebody says, go see you, okay, then your jobs
8 become more relevant, not less relevant, okay, as
9 they war returnees come back.
10 COMMAND SGT. MJR. GARY FLAHERTY: There is a
11 computer base that I found in Washington, that
12 provides the name and address, last address known,
13 of every veteran, on an annual basis, that is coming
14 out of the service.
15 And that's what I use as -- for my outreach
16 program.
17 SENATOR MCDONALD: Okay.
18 THOMAS RONAYNE: We also subscribe to it. It
19 is referred to as the "RONA List." The, R-O-N-A,
20 List.
21 It is available to governmental agencies.
22 And it, essentially, is a list of those service
23 members separated from service during the previous
24 year.
25 It is something that is only released to
132
1 governmental agencies, and a few others. It is done
2 by request.
3 It's extremely helpful. It's a wonderful
4 resource. But we have found that the return rate,
5 the information is not always already current.
6 SENATOR MCDONALD: Sure.
7 SENATOR ZELDIN: I want to personally thank
8 both of you for your military service.
9 And I think this illustrates the need, going
10 forward, for us to communicate with all of the
11 Veterans' Service Offices of all of the counties of
12 the state, because we allow diverse ideas of how to
13 connect to different levels of government to help
14 our returning veterans.
15 So, thank you for being here.
16 SENATOR MCDONALD: I think you guys are the
17 infrastructure that we need to reach out to the
18 grassroots, and we just have to put all the pieces
19 together.
20 Thank you, each of you.
21 SENATOR ZELDIN: Thank you.
22 COMMAND SGT. MJR. GARY FLAHERTY: Well, I
23 look at it, as you know, command sergeant majors
24 took care of their troops.
25 Now I feel it's my obligation to take care of
133
1 our veterans.
2 SENATOR MCDONALD: Thank you.
3 THOMAS RONAYNE: Thank you for this
4 opportunity, and Suffolk County is never more than a
5 phone call away if we could be of service.
6 SENATOR MCDONALD: I appreciate it.
7 Thank you.
8 Next we have, Mr. John Richter, director of
9 Mental Health Association - New York State.
10 And I would also appreciate, it's not that
11 we're trying to get you through fast, but, we tried
12 to get as many people, and we would love talking to
13 them, but we have to keep on our schedule.
14 JOHN RICHTER: Understood, Senators.
15 SENATOR MCDONALD: That's all right.
16 And we're grateful for what you do.
17 JOHN RICHTER: Thank you for introducing me.
18 I don't need to do that job now.
19 And thank you both, Senators, for your
20 service in the military, and, particularly for
21 calling attention to this -- the particular issue
22 that you chose to focus your attention, I think is
23 so important here, because, what we've been
24 learning, I think, and seeing today, is that PTSD,
25 although there's a lot that can be said about
134
1 causality, it seems to be the culprit in so many
2 different issues and problems that veterans and
3 families struggle with.
4 So, zeroing in on that, I particularly --
5 SENATOR MCDONALD: Yeah, you don't have to
6 read the whole document --
7 JOHN RICHTER: I'm not gong to.
8 SENATOR MCDONALD: -- but if you can hit
9 that, you know, what to do, and how -- you can help
10 us.
11 JOHN RICHTER: Sure, I'll cut right to the
12 chase, in terms of where we come at this from.
13 We're looking at untreated PTSD and
14 under-treated PTSD, in particular, and the
15 disconnects for why that occurs;
16 And, then, how military families, as been
17 alluded to already, can play an important role in
18 overcoming some of the barriers that exist.
19 So, with that said, I will get right to the
20 focus.
21 You've heard already, a lot about the other
22 comorbid things that go along with PTSD, that what
23 it -- the havoc that it wreaks on families and
24 communities when it's unchecked, when it's
25 untreated.
135
1 We've talked about -- you've heard about, you
2 know, the incidence of PTSD. You've heard about,
3 that anywhere from a third to a half, as far as we
4 know, of cases of PTSD go untreated.
5 That that untreated PTSD is costly to
6 society, costly to families. It takes its toll on
7 the family, in marriages, in substance abuse, and
8 other mental illnesses that can occur as well, not
9 only in the veteran, but also in family members.
10 So, you know, we're -- we want to focus in on
11 the clear disconnect between the illness and the
12 treatment; and that's where we come at this from,
13 and, how do we overcome some of the barriers.
14 A lot of those have been discussed today.
15 Stigma is a big barrier.
16 We all face that in trying to -- with
17 mental-health services.
18 Veterans, I believe, have probably a more
19 intense, perhaps, stigma, that owes itself to
20 military culture, and other norms, and things like
21 that, but, nonetheless, they're stepping into a
22 situation, where, when they do come home, that
23 their -- that stigma is a big issue that keeps them
24 from getting treatment.
25 Fears of negative career implications, for
136
1 how they answer on some of the screens that are
2 already in place, it can be a problem that keeps
3 them from it.
4 And, finally, the difficulty navigating
5 barriers to service, that we all have to negotiate
6 when we decide we need help.
7 Okay?
8 SENATOR MCDONALD: Right. Yep.
9 JOHN RICHTER: So, there's those things.
10 Overcoming those, even if we have the most
11 advanced and sophisticated treatment system you can
12 imagine, that unless -- for the people who don't
13 overcome these barriers, it's kind of meaningless.
14 So, to focus on mitigating some of the damage
15 that occurs when PTSD goes untreated, the approach
16 that we've taken, is to work with families while --
17 while the military folks are still deployed, when
18 they've been deployed, when they come -- and when
19 they come home, to give them tools, to equip them
20 with everything, from recognizing some of the signs
21 and symptoms of PTSD, where to get help, how to get
22 help, but, perhaps, more important, how to stay
23 engaged in recovery; how to keep with the program,
24 so to speak, until you've made it through recovery,
25 and the family's got their feet back on the ground
137
1 again.
2 You know, we -- again, we believe that
3 through these trusted relationships, families and
4 friends are the strongest allies in overcoming these
5 barriers.
6 You know, and I ask you to bear in mind,
7 these things, as we present a particular approach
8 to -- that we've already started in two counties in
9 this state, to address this with military families,
10 to give them the tools that they need, and equip
11 them, for, basically, the battle that they face when
12 their loved ones come home.
13 And I know that has been alluded to already
14 today enough, and I'll get right to the project.
15 This project that we've been engaged in with
16 2 of our MHA affiliates -- we have 31 MHA
17 affiliates, total -- they reach into 54 counties.
18 And that is, very much, I think directly goes
19 to Senator McDonald's point, about, how we engage
20 folks in their communities.
21 And because our MHAs have been doing --
22 providing services in their communities --
23
24
25
138
1 SENATOR MCDONALD: We don't want to
2 duplicate.
3 In fact, we want to do something just the
4 opposite. We want to highlight, and maximize the
5 impact that, already, our mental-health community,
6 because we have an established mental-health system
7 in our counties, in our state.
8 Now we're just asking them, which is a big
9 ask, and I recognize that, just to help us out, and
10 highlight these possible issues with the PTSD.
11 And, you know, PTSD, we're talking about the
12 military.
13 And, we had a gentleman from Suffolk County,
14 it even occurs in police departments and the fire
15 departments.
16 And, so, you know, we just don't say, we're
17 helping the soldiers. That's highlighted it,
18 because so many are coming back, and so many are
19 having problems with these types of issues.
20 But on a day-to-day basis, you have other
21 people who are impacted, which is traumatic events
22 in the course of their occupation, like a policeman
23 or a firefighter.
24 So we're trying to do the right thing.
25 And, we want to work closer with the
139
1 mental-health entities, because we really want to
2 show the public that we need this kind of support in
3 our society.
4 JOHN RICHTER: And we absolutely do
5 believe --
6 SENATOR MCDONALD: Yeah, and we're going to
7 have --
8 JOHN RICHTER: -- that families are a glue.
9 And they're the conduit, we believe, through which
10 we overcome these barriers, and connect people with
11 services.
12 So, we're doing this in Jefferson County,
13 we're doing it in Nassau County, under a grant
14 through the Bristol-Myers Squibb's foundation.
15 SENATOR MCDONALD: Sure, yeah.
16 Jefferson, of course, is the home -- is that
17 the home of, uh --
18 JOHN RICHTER: National Guard? Or -- oh,
19 Fort Drum Airbase.
20 SENATOR MCDONALD: Yeah, yeah.
21 JOHN RICHTER: Fort Drum military base, yes.
22 SENATOR MCDONALD: So you have got --
23 JOHN RICHTER: And a disproportionately
24 number of deployments --
25 SENATOR MCDONALD: Well, I was just going to
140
1 say --
2 JOHN RICHTER: -- as compared to other places
3 of deployment in the country.
4 SENATOR MCDONALD: -- well, and just a large
5 percentage of the total population is
6 military-oriented.
7 JOHN RICHTER: Absolutely.
8 And many of their families live on the base.
9 SENATOR MCDONALD: What a great learning
10 process for us --
11 JOHN RICHTER: Absolutely, sir.
12 And Nassau County, of course, has one of the
13 highest levels of veterans living there, in the
14 state.
15 So, two counties that make sense to really
16 cut our teeth in this pilot.
17 What's really important about the pilot, is
18 the specific tools that we try to give to families.
19 And we start work -- again, we start working with
20 them while their loved one is deployed.
21 And these include, peer supports, and peer
22 groups, these -- that was alluded to earlier,
23 this -- the notion of a mentor.
24 We include wellness tools, and training for
25 the families themselves.
141
1 These are tools that help them to manage
2 their own difficulties that may come up with mental
3 illnesses; PTSD, in particular, in this case.
4 Advanced directives; trauma-informed care;
5 trauma-recovery tools; and, Safe Talk, which is a
6 suicide-prevention program.
7 So this is what we're trying to impart on
8 families, you know, to give them some tools, to know
9 what to recognize.
10 When someone comes home -- the last thing
11 that I think a veteran needs, when they come home to
12 their family, is that their family is just as
13 misinformed about all of these issue as the rest of
14 the population; and, yet, they are -- they have --
15 they hold the keys to overcoming some of the stigma,
16 and some of the --
17 SENATOR MCDONALD: Yeah, and it's been that
18 way forever.
19 JOHN RICHTER: And, so --
20 SENATOR MCDONALD: John, what we need from
21 you --
22 JOHN RICHTER: Yes, sir?
23 SENATOR MCDONALD: -- is to be a part of our
24 team as we put these programs together --
25 JOHN RICHTER: Absolutely.
142
1 SENATOR MCDONALD: -- and working with one of
2 our staff -- Dr. Carpinola [ph.], for instance --
3 so we can turn around and coordinate, and help those
4 folks at the baseline.
5 And the baseline is, I'm beginning to see
6 more and more, the grassroots --
7 And it goes, from the grassroots, right up to
8 the federal government.
9 -- is, the county governments and their
10 mental health and their veterans and their social
11 services.
12 And so many of these people have got so much
13 experience already, and such big hearts, and that it
14 could be very helpful.
15 So, we're going to review your policy, but
16 we're going to get back. And think of that role
17 that your team of members that you have can play
18 with us.
19 JOHN RICHTER: Yes.
20 SENATOR MCDONALD: And think of a diagram
21 that we can present to our colleagues in the
22 Assembly and the Senate and the Governor's Office,
23 so we can see, how, instead of working from the top,
24 down, we're working from the bottom, up.
25 So, my sensitivity, is that, that family,
143
1 whatever county, your community, in New York State
2 throughout, they don't feel like they're part of the
3 masses.
4 JOHN RICHTER: Yes.
5 SENATOR MCDONALD: They feel that we know
6 their name, it's not a number. And that we're going
7 to talk to them the best way we can.
8 Now, we know it's not going to be an easy
9 task, and we have a big bureaucracy. But we need a
10 path through that bureaucracy, to the individual
11 family or individual veteran, with the help.
12 You guys are going to be very critical,
13 because you've already -- you folks have already
14 been trained in this area: the sensitivity, the
15 understanding of it.
16 And, it might be helpful as we talk to them.
17 So, we're going to need your help, John.
18 JOHN RICHTER: Yes, sir.
19 And we're prepared, and we're right there
20 with you.
21 SENATOR MCDONALD: Thank you.
22 JOHN RICHTER: Whatever we learn from this
23 project, we want to share. And we certainly look
24 to, hopefully, replicate it.
25 SENATOR MCDONALD: You put thoughts on it,
144
1 get back to us. As we go around, we've got some
2 other communities we have to do this in.
3 And I just want to make sure I get through.
4 There's, some of these people, we tried to
5 put the ones that traveled the farthest away, up
6 front.
7 JOHN RICHTER: Understood, sir.
8 Thank you, both, Senators.
9 SENATOR ZELDIN: Thank you.
10 SENATOR MCDONALD: Thank you, John.
11 Okay, Roger Ambrose;
12 And, Kathleen Manasio [sic],
13 Rensselaer County person, just as we...
14 KATHERIN MACIOL: Yes, sir.
15 SENATOR MCDONALD: Roger is director of
16 Jefferson County Community Services;
17 And, Katherine is the commissioner of
18 Rensselaer County Department of Mental Health.
19 I want to thank you both for being here.
20 I want to thank you for what you're doing.
21 We just talked to your colleague John, head
22 of the Mental Health Association - New York State.
23 And, you can see where we're going.
24 KATHERIN MACIOL: Yes.
25 SENATOR MCDONALD: You had a lot of patience,
145
1 sitting through some of the dialogue.
2 KATHERIN MACIOL: Yes, sir.
3 SENATOR MCDONALD: We're looking for
4 partners; we're looking to extend that helping hand
5 to these young -- not so young. Men and women of
6 all ages who are our veterans, and their families.
7 KATHERIN MACIOL: Great.
8 SENATOR MCDONALD: Roger.
9 KATHERIN MACIOL: Well, thank you.
10 ROGER AMBROSE: Thank you, Senator.
11 KATHERIN MACIOL: I'll begin.
12 First of all, I'd like to say, that, I'm also
13 here as a daughter of a World War II veteran.
14 And my father, John Maciol, was a
15 Marine Infantry, and he was stationed in the
16 Philippines during World War II.
17 And, my father is watching this, and he says
18 to you, sir, "Semper Fi."
19 Good morning, Senator McDonald,
20 Senator Zeldin, other esteemed members of the
21 Senate.
22 And I'd like to thank you for having us here
23 on, behalf of the Conference of Mental Hygiene
24 Directors.
25 One of the challenges in writing this
146
1 testimony today, I think, actually speaks to the
2 larger system, and -- larger problem meeting the
3 needs of veterans at the local level, as I hear you
4 talking a lot about.
5 That has been some of the systems set up for
6 veterans and returning service members that have not
7 been effectively integrated with or channeled
8 through counties.
9 For example: While counties contract
10 State-aid dollars for mental health, substance abuse
11 and developmentally disabled service providers,
12 there is little or no involvement of the directing
13 of funds or programmatic development for
14 veterans-specific services.
15 While the Veterans Administration has
16 moved -- been moving at break-neck speed to increase
17 capacity in services in their systems, we do not
18 have the corresponding growth and planning for
19 veterans taking place in our local systems.
20 That is something that we would like to see
21 changed.
22 We do not mean to say that veterans cannot or
23 should not be served in existing county systems;
24 but, rather, that these existing systems need to be
25 enhanced in their ability to meet some of the unique
147
1 needs of our veterans, and incorporated in the
2 larger statewide, and even national, planning
3 process for meeting the needs of our veterans in the
4 future.
5 I'm now going to turn the microphone over to
6 my colleague, to get into some more detail on the
7 challenges he sees every day in Jefferson County.
8 ROGER AMBROSE: Good morning, Senator.
9 As you mentioned, Jefferson County is the
10 home of Fort Drum, which is an incredibly large
11 military Army base, and houses about 19,000 troops.
12 We also have the privilege of having most of
13 those families living in our community, but that
14 does present us with challenges as well.
15 In terms of veterans and PTSD, many of the
16 newly discharged veterans stay in our community, and
17 they face a lot of challenges as they're
18 reintegrating into our system, including, housing,
19 which is usually the very first issue they face.
20 And not all servicemen plan for the financial needs,
21 to provide housing for themselves as they're
22 discharged.
23 Also, employment issues are a challenge.
24 In our county, going back to the housing
25 issue just for a moment, housing is incredibly
148
1 expensive, and rare. There's just not enough
2 housing.
3 We have buildings going up all the time, but,
4 to try to meet the demand is a challenge.
5 And, also, providing employment.
6 Those are two factors that we know are
7 protective factors for people with PTSD, as well as
8 other mental-health issues.
9 So those are issues that we really want to be
10 able to provide adequate coverage of.
11 And, our systems, I have to say, on the
12 mental-health side of things, are overwhelmed at
13 times.
14 The deployment schedules of our troops makes
15 it very difficult to keep up with what kinds of
16 capacity needs we're going to have, from time to
17 time. So, we're consistently challenged.
18 And we work very closely with the
19 Department of Defense. We work with the V.A., and
20 the V.A. Center in our community. They're all very
21 helpful, they're all very cooperative, but it's
22 still a challenge, on the private sector -- or, the
23 public sector, excuse me, to meet the needs, not
24 just for the service member, but also the families.
25 The Mental Health Association project that
149
1 was just mentioned, we had a -- I'm on that advisory
2 board for Jefferson County. And it does reach out
3 to families, which, a lot of times, are -- is going
4 to be our access to the individual who may be
5 actually suffering post-traumatic stress disorder,
6 or experience a TBI while in combat.
7 That's what's going to bring them into the
8 system, so that project is very valuable to us.
9 I think -- I tried to summarize here, so that
10 I wouldn't take up too much time.
11 We do have 19,000 troops. And in the spring
12 of this year, we expect most of those 19,000 troops
13 to be home, for the first time, all at one time,
14 which means their family members are going to be
15 there as well.
16 So, anything that we can do. We certainly
17 want to partner with the state organizations, as
18 well as our community organizations, do their very
19 best to work together, to try and make sure that
20 we're meeting all the mental needs of our community,
21 as well as those of our military population.
22 It can be a challenge.
23 And, then, also working with the V.A., the
24 vet centers, and, you know, making sure that we're
25 not overlapping services, but making sure that we're
150
1 not missing anything as well.
2 So --
3 KATHERIN MACIOL: In addition to what Roger
4 had to say, there's two key areas that I'd like to
5 leave you with, and those are: our service capacity,
6 and our program expertise.
7 Now, in 2010, and it was through your office,
8 Senator, that there was a study done in
9 Rensselaer County, and, they looked at families and
10 veterans in Rensselaer County.
11 And, about 30 percent of those interviewed in
12 these focus groups identified mental health as a
13 primary need in access to mental-health services.
14 The issue of -- that Roger mentions, are
15 definitely not unique to Jefferson County.
16 Veterans have a -- should have a choice where
17 they want to receive their services. However, our
18 local mental-hygiene systems do not always have the
19 appropriate training materials for their staff, and
20 the demands on clinicians, at this point, the
21 productivity levels are very high.
22 And we're very reliant on insurance payments
23 for our reimbursement to keep on functioning.
24 As you know, the major insurance
25 reimbursement for those in the military, at least
151
1 for the first five years upon discharge, is TRICARE
2 insurance.
3 TRICARE is for active duty also.
4 And, the rate paid by TRICARE does not cover
5 the rate that it costs to deliver that service.
6 The other issue is, that TRICARE is -- has
7 very high criteria for who though will reimburses.
8 For example: Most clinics have licensed
9 mental-health professionals; however, they have to
10 meet a certain level of licensure that is not
11 often -- it's very expensive, number one, and
12 they're in very high demand.
13 So, in order to be reimbursed for those, we
14 have to have those licensed professionals on staff.
15 We run a mental-health clinic in
16 Rensselaer County.
17 I pulled the statistics on TRICARE for
18 recipients in our county, and these are families and
19 children. And we found that we were not paid for
20 half of the services through TRICARE.
21 And when we were reimbursed, it was about
22 $50 per session, which is less from the Medicaid
23 going rate.
24 So, that is a big issue for us.
25 And, that they also do not license clinics
152
1 overall. They license individuals.
2 Many insurance companies will license you as
3 a clinic. So, when someone comes in, they can pick
4 the clinician they'd like to have.
5 We have to assign a clinician, who might not
6 always be available to service that family.
7 So, it really limits the range of services
8 that the military -- the veterans, active military,
9 but most, also, of their family members, their
10 children.
11 So, I guess I'd just like to say, that, you
12 know, on behalf of the conference -- my colleagues
13 at the conference, to thank you, to thank all of our
14 veterans, for your service.
15 And, I really, we really, look forward to
16 working with you, and bringing those services to the
17 local level.
18 SENATOR MCDONALD: Well, I appreciate that.
19 We're going to have very serious objectives,
20 and you're going to be a major part of it.
21 So you got to talk to me, not now, but in a
22 white-paper type of thing, a memo, about the details
23 of the training that you need, and about the
24 financing. You know, where do we get to pay the
25 bills?
153
1 Will it be the federal government, or the
2 State? -- since, obviously, we can't pass on undue
3 expenditures to the local county governments. At
4 this point in time, they can't afford them.
5 Okay?
6 It's not reasonable.
7 So, if you could highlight that, for the
8 organi- -- you know, the people you represent, and,
9 you know, with the gentleman who was just sitting
10 here earlier, John, that could be very helpful.
11 Think of this as a program that's going to be
12 a macro program, starting with the feds.
13 Now, obviously, most counties are not like
14 Jefferson, where you have a gigantic military base
15 that has a variety of program services and
16 employees.
17 Most of them are going to be, you know, not
18 that closely associated to active duty, but more
19 associated to actual veterans.
20 So put some thought on that.
21 And if you have any statistics, Roger, on
22 what you're seeing, overall, when these troops come
23 in, like, P -- you know, post-traumatic stress, and
24 some of other issues, criminal issues, things of
25 that nature, and, we'd be interested in seeing those
154
1 statistics.
2 That might not be able to illustrate it for
3 everybody, but it certainly is something that we --
4 all of those numbers are educating in the long term.
5 Now, if you work with your association
6 organizations, maybe in a month or so, if you guys
7 come into Albany, for whatever --
8 I'm talking about, across the state, and I
9 know they do, on regular basis.
10 -- we'd like to start talking to these
11 people.
12 And this is -- we're putting a team together.
13 We're putting our other military operation together,
14 and people are going to have particular roles.
15 And you guys are going to have a major role,
16 along with the county veterans' coordinators, and
17 the State Division of Veteran Affairs, and, of
18 course, the federal government, and the individual
19 military operations, and such.
20 ROGER AMBROSE: We'll do that for you.
21 SENATOR MCDONALD: Thank you.
22 KATHERIN MACIOL: Thank you.
23 ROGER AMBROSE: We'd love to have you come up
24 to Fort Drum sometime.
25 SENATOR MCDONALD: Well, actually, let me
155
1 tell you a true story.
2 About five or six years ago, Joseph Taluto,
3 the two-star general who was the head of the
4 42nd Infantry Division, invited me up, and they were
5 getting sent to Iraq.
6 Now, I was in Vietnam, in an air-mobile
7 Infantry unit. And when I got out of there, I said
8 I never want to see helicopters and rifles -- I
9 don't like jumping out of helicopters -- ever again.
10 One of my staff person, at the time, was a
11 retired Army colonel, who spent a couple tours in
12 Vietnam, and we went out there. And it was quite
13 a -- you know, an observation, on my part.
14 I'm much older now; a father, grandfather.
15 And all these young men and women, and
16 they're getting ready to ship out to Iraq.
17 And I asked the general, who I think very
18 highly of, I said, "What can I do for you? I feel
19 frustrated. As an old soldier, what can I -- how I
20 can help out?"
21 And he said: He had lots of issues.
22 The biggest issue, of course, was going to
23 Iraq in about two weeks, with all of his people.
24 But the other issues were, that he felt the
25 most significant thing that I could help him out in,
156
1 is with the emotional problems of the family
2 structure and the soldiers, and all the...
3 I was thinking in terms of something else,
4 but it was the emotional problems.
5 And the first thing I thought: What a great
6 general this man is, to care that much about his
7 troops, and their own personal lives;
8 And, the second thing is: That we got to do
9 something about this issue.
10 So help us to fulfill his requests.
11 ROGER AMBROSE: Thank you.
12 SENATOR ZELDIN: Thank you.
13 KATHERIN MACIOL: Thank you, Senators.
14 SENATOR MCDONALD: I'm proud to now introduce
15 my director of Veterans Affairs for Saratoga County
16 Veterans' Service, Andrew Davis, who is also an
17 Army, Iraqi War veteran.
18 Andrew, thank you.
19 ANDREW DAVIS: Thank you, Senator, for having
20 me today.
21 I'm here, as not only a client and patient at
22 the V.A., but also a three-time combat veteran,
23 having served in both Afghanistan and Iraq as an
24 Army Ranger.
25 I've been the Veterans' director in
157
1 Saratoga County for two years. Been a congressional
2 staffer. And, I've seen these issues, from the
3 federal level, down to the local level, and I
4 appreciate the chance to be here.
5 You have my testimony; you have some details
6 I think are important.
7 I'm going to just gloss over a couple
8 important items, and save time for you.
9 The issues we're looking at here, with this
10 population, are ever-changing.
11 We have a more geographically dispersed and
12 mobile veterans' population, a more married
13 veterans' population, and a population that needs to
14 be served in their local communities.
15 We, as citizens, sent our veterans to war.
16 We need to bring them home from war.
17 It's not a V.A. program or government
18 program; it's a community program, and it's what
19 you're speaking to.
20 I challenge the folks, like you, to look at a
21 program that I would like to call "Veteran-Friendly
22 Communities."
23 And that's a program, where we can go out to
24 the individual communities, train every interested
25 party, on a "no wrong door" referral process, for
158
1 veterans to gets the care they're entitled to
2 receive.
3 I want to give you an example of what we're
4 looking at in Saratoga County, where we have the
5 Saratoga Veterans' Resource Initiative.
6 We have, in Saratoga County, 16,870 veterans,
7 as of September of 2011. And we serve, in my
8 office, about 7,000 of those veterans.
9 The State serves an additional 3,000, and a
10 remaining 7,000 seek no services whatsoever.
11 My office accounts for 41 1/2 percent.
12 Of that 41 1/2 percent, of the total
13 population, we've done 237 claims for post-traumatic
14 stress disorder since 1994, which translates into
15 about 3.3 percent of the population filing those
16 types of claims.
17 That does not mean, how many folks have PTSD.
18 That means, how many folks have pursued it,
19 officially, with the V.A.
20 That is in line with what the V.A. will tell
21 you they can track.
22 And we can only track what's been officially
23 diagnosed, not what's been surveyed.
24 Across the board, 2.3 million veterans.
25 About 740,000 in this country seek care with the
159
1 V.A.
2 So, we have a big gap in who's entitled to
3 things, and who gets it; and the county and the
4 local community is what starts that process.
5 Veterans who attempt get to care, at any
6 level, encounter a group of systems and
7 bureaucracies, that, by all appearances, are several
8 cars, on separate roads, driving towards the same
9 destination.
10 That system has to stop.
11 It needs to be, no matter what door you walk
12 in, you end up getting the same care, and the same
13 referral, no matter where you go.
14 By all appearances, V.A. realizes this, but
15 is not staffed to do proper outreach, and depends
16 upon the folks in the grassroots, like us, and like
17 you.
18 So, to close: I believe, we, as veterans'
19 advocates, serve an important role in this process.
20 And, all told, we, as a nation, and state,
21 must stand committed to ensuring that the
22 sustainable, quality supportive services exist in
23 our communities.
24 V.A. can lead this charge, but lacks
25 geographical dispersement [sic] and resources, and,
160
1 many times, we can fill that gap.
2 The V.A. can't be blamed solely or be solely
3 responsible for integrating our veterans fully into
4 our communities.
5 We, as citizens, sent our young men and women
6 to war, and we need to bring them back from war.
7 We need to continue to break the stigma of
8 asking for help, for what can be summed up as a
9 normal reaction to an abnormal situation; or, PTSD,
10 in my opinion.
11 However, we need to do it carefully, by
12 acknowledging fact-based figures that do not harm a
13 population that is already finding it difficult to
14 gain meaningful employment and assimilate back into
15 society.
16 We cannot continue to only stress the harmful
17 and negative effects of war, or we will have the
18 potential of causing great harm to those who are not
19 affected by these disorders.
20 There's no better example of that, Senator,
21 than your generation of Vietnam veterans who came
22 home to a country much less supportive than this one
23 is now, and now lead our great institutions, like
24 the New York State Senate, Fortune 500 companies,
25 and other political bodies.
161
1 So I thank you again for this Committee's
2 time.
3 I know we're getting to the end, it's snowing
4 outside, but I wanted to make sure we get the point
5 across.
6 We in Saratoga County are ready to do the
7 local things you're asking. We're already trying to
8 do it.
9 I just need some help in training some of the
10 other agencies out there.
11 SENATOR MCDONALD: Andrew, you're very
12 succinct, and I appreciate it.
13 I also appreciate it as a citizen of
14 Saratoga County, and a veteran, what you do for us.
15 The training's gonna come.
16 And I like your attitude, to take anybody who
17 wants to help.
18 We'll train those volunteers, people who
19 care.
20 And, fellow veterans talking to each other,
21 that seems to be the vet-on-vet, whatever
22 terminology, in incorporating every entity that we
23 can to become a partnership.
24 And that will spill over. People have become
25 more aware of mental-illness problems with veterans
162
1 and post-traumatic stress disorder.
2 They'll also become more aware that
3 human beings are not, all, always going on
4 100 percent. Sometimes some of our family members
5 and friends need some assistance.
6 And it may not be post-traumatic stress, it
7 may not be veterans, but we're here to serve all the
8 people in New York State, and to highlight the
9 mental health is a legitimate concern.
10 And not only, we'll help those people, but in
11 case there's any kind of sad reactions, incidents,
12 hurtful situations, we'll try to eliminate that.
13 And we don't want just people walking down
14 the street, with no hope, and their family structure
15 falling apart, ripped apart, by it all.
16 Going to be a lot of work. I know you're up
17 for the task.
18 I appreciate it.
19 We've had three great county directors here
20 today: one from Suffolk County, one from
21 Columbia County, and yourself.
22 And I know the rest, some we asked couldn't
23 be here, but the rest of them had the heart.
24 All of a sudden, the mental-health services
25 of our counties, the Veterans' Services of our
163
1 counties, just to look at two, the spotlight's going
2 to shine on you folks.
3 You've become very important to us, and I'm
4 grateful that you're here.
5 Thank you.
6 ANDREW DAVIS: Thank you, Senator.
7 SENATOR ZELDIN: Thank you for your service.
8 SENATOR MCDONALD: Our next speaker --
9 SENATOR ZELDIN: Actually, Senator McDonald,
10 if I can steal your thunder on this one --
11 SENATOR MCDONALD: Okay.
12 SENATOR ZELDIN: -- Hatty Baldwin is someone
13 that has been very special for our
14 Veterans' Advisory Panel down in Suffolk County.
15 She's coming up with L.W. Murphy, who's been
16 the chairman of our Veterans' Advisory Panel.
17 Earlier in my introduction, I spoke of
18 John Patrick Jennings, who passed away, and we named
19 our panel in honor of. And when John passed away,
20 Hatty was John's fiancee.
21 Obviously, a very different and important
22 perspective that Hatty can share with us this
23 morning, as a loved one.
24 SENATOR MCDONALD: And we apologize for
25 rushing you along, but we've got snow, which is
164
1 unusual in Albany at this time of the year, this
2 year.
3 But it finally caught up with us, and I got a
4 lot of folks that got to get to other meetings.
5 Thank you so much.
6 HATTY BALDWIN: Well, I will skip everything
7 about everything that everyone else has spoken
8 about.
9 I'll just tell my story, and John's story.
10 When I met him, initially, he was a
11 law-school graduate. He looked like he was doing
12 great.
13 He did tell me that he had PTSD, and that he
14 was in treatment.
15 And, as a nursing student, I thought: Well,
16 that's fine. I can -- we can fix this.
17 And, he continued to go on, and he did very
18 well. He made a lot of friends.
19 He was a very charming guy.
20 Senator Zeldin knows him.
21 You know, he did, and he -- there was a
22 disconnect between what he needed and what he was
23 able to find. He couldn't find the services that he
24 needed.
25 The V.A., he got care from them, but it
165
1 wasn't enough. He needed more, and we didn't know
2 where to find it. We didn't know where to look, we
3 didn't know where to start.
4 He started to go downhill the last year of
5 his life.
6 And, finally, at the time of his death, he
7 was on over a dozen medications. All prescribed,
8 nothing recreational. Just what he needed to get
9 through the day.
10 And he -- when I came home from work, he was
11 unresponsive, and not breathing. And --
12 SENATOR ZELDIN: Hatty, Senator McDonald, and
13 anyone else who's here, one of -- maybe the best
14 point that I can -- I can provide the entire day,
15 while we do this hearing, and beyond, was, I had
16 spoken to a newspaper reporter. I won't mention
17 what newspaper, but I spoke to a newspaper reporter
18 while John was alive, because he was doing a story
19 on post-traumatic stress disorder.
20 And I shared John's story, and it was very
21 interesting. And the newspaper reporter met with
22 John, for hours. Took pages and pages worth of
23 notes, but never wrote a story, because it wasn't
24 sexy enough for a print.
25 And then John passed away.
166
1 And he revisited all of his notes, and the
2 phone conversation, and the meeting, and now he had
3 a story.
4 There was no story to tell while John was
5 alive and suffering of post-traumatic stress
6 disorder, but there was when he had passed away.
7 And, I think that, maybe our mission up
8 here -- and we all have the mission that we're
9 sharing, but I feel, as part of my mission, here in
10 the State Legislature, is making sure that the
11 stories of John Jennings are told before that person
12 passes away, not after it's too late.
13 HATTY BALDWIN: Yeah, the -- one of the
14 things that was the hardest about going to the
15 committee, was, after all of the time of going back
16 and forth to the V.A., and admissions, and
17 everything else, when I went to the committee, the
18 first time, I was handed a stack of paper.
19 And on that stack -- in that stack of paper
20 was all of the resources that I didn't know about,
21 and all of things we could have --
22 SENATOR MCDONALD: Well, that is the problem
23 we've got: It's a shotgun approach, as opposed to a
24 rightful approach.
25 And, even though we can't bring the gentleman
167
1 back, what we can do is, in the future, try to, you
2 know, bring it down to the personal level; that
3 we're dealing with human beings, okay, and try to
4 have a support network that people in that
5 community, not necessarily the State Capital, or the
6 federal capital, or the big city that's closest,
7 whatever that community is, that we'll have that
8 awareness, that we can turn around, and try our best
9 to get him to somebody that can help him, and
10 somebody that cares.
11 And the constant thing we have to say, as Lee
12 alluded to, they didn't want to talk about
13 post-stress. They talk about, you know, it wasn't
14 hip enough, till somebody dies.
15 Well, we're not going to wait for that
16 moment. Okay?
17 And just out of the frustrations of my own
18 life, it was very difficult watching people that I
19 served in the military with, in a war that lost
20 almost 60,000 soldiers. You know, Airmen, Marines,
21 Navy.
22 That's a whole bunch of people.
23 That's more than we lost in World War I, in
24 Vietnam, and nobody really cared.
25 Unless you had a good family structure at
168
1 home -- a mother, a father, which is unique today,
2 by the way, extended family, siblings, the whole --
3 nobody cared.
4 Well, I think America's changed dramatically
5 since then. I think the American public does care,
6 and we have their blessings to go out and do
7 something.
8 So, I think we have to take advantage of
9 that.
10 So, you guys become more important.
11 But in the memory of your friend, and as a
12 friend of the veteran, as the way that you were
13 described, they have -- we have not forgotten, and
14 we will go forward.
15 This will not be an issue that's Republican
16 or Democrat. It's not New York State; upstate,
17 downstate. It's not the southern part of the
18 country, the northern part of the country.
19 Because, all those soldiers you read about
20 dying over there, they're from all of over America:
21 All different colors, all different backgrounds.
22 So, thank you.
23 We're not going stop now. We just started.
24 SENATOR ZELDIN: And, thank you, L.W., who is
25 a fellow Vietnam vet.
169
1 L.W. MURPHY: Yes.
2 SENATOR ZELDIN: Very active with the
3 Patriot Guard Riders, and a lot of veterans' causes,
4 Disabled American Legion.
5 Gary Vertichio, who's here from the Disabled
6 American Legion as well.
7 And, for being a very close friend of John's,
8 as well as I know that you were.
9 L.W. MURPHY: I'm going to give you a
10 10-second reply.
11 John was a very close friend, and I was
12 devastated when he passed.
13 But, the reward is, that when this committee
14 was put together, this panel was put together, and I
15 asked the Senator to let me chair it, I have seen an
16 enormous amount of increased involvement and
17 interest in PTSD. Resources that could choke a
18 horse.
19 SENATOR MCDONALD: we got to public behind
20 us --
21 L.W. MURPHY: If the goal is to put it all
22 together, and make it all work, I'd be gratified
23 till the day I die.
24 SENATOR MCDONALD: They you, both.
25 SENATOR ZELDIN: Thank you, L.W.
170
1 And, thank you, Hatty.
2 SENATOR MCDONALD: Thank you, Hatty.
3 Our next guest is, Mr. Dennis O'Donnell,
4 founder, Warrior Project member, of the Patriot
5 Guard Riders, which has received a lot of attention,
6 and we're grateful for it.
7 They have some of those folks up here, if I'm
8 correct.
9 DENNIS O'DONNELL: Outstanding.
10 SENATOR MCDONALD: We have our own chapter.
11 And when they say "Patriot Guard Riders,"
12 they mean just that: they guard.
13 Dennis, please understand that we're --
14 DENNIS O'DONNELL: Absolutely.
15 Thank you for the introduction.
16 Thank you for the invitation.
17 Aside from my pride in volunteering with
18 Wounded Warrior Project, Patriot Guard Riders
19 "Ride to Recovery," I'm proudest of being a parent
20 of an active-duty United States Army Infantryman,
21 Specialist Sean O'Donnell.
22 I'm here, largely as a parent, to describe,
23 briefly, my frustration, and my activity; my
24 frustration with the inability to help my son, and
25 his brothers, upon returning from combat.
171
1 Sean came home from Iraq, after nine months,
2 and was demonstrating all of the typical signs of
3 post-traumatic stress.
4 He is with the Florida National Guard. I was
5 here. And, as is with most of our -- most parents,
6 our children are just beyond our reach when they
7 come home from war.
8 They're adults now, and you respect the fact
9 that they're warriors, so, you give them their
10 space.
11 However, I was frustrated by the inability of
12 finding non-military, non-governmental resources to
13 direct him, for help with his PTSD.
14 Born out of that, and through my volunteer
15 work with the Wounded Warrior Project, and the
16 Patriot Guard -- I'm sorry -- and, "Ride to
17 Recovery," I do physical programs with them.
18 We put warriors on bicycles, and take them on
19 long-distance trips.
20 But, by "warriors," I mean injured warriors:
21 amputees, PTSD victims, and the like.
22 So I began to ask them: What do you need?
23 What are you lacking, and, what would you like?
24 What could you use?
25 And to a man, for two years, every single one
172
1 of them have told me the same thing: The
2 professional help is wonderful, but we need time
3 with our brothers. They're the only ones who will
4 understand, and to whom we can speak about what
5 we've been through.
6 The healing occurs during those sessions.
7 I've witnessed it myself on the cycling events.
8 I've gotten my son involved with
9 Wounded Warrior Project, and he's breaking out of
10 his shell.
11 So, I believe it's a balance of government
12 resources, mental-health resources, military
13 resources, and, non-affiliated grassroots
14 organizations.
15 And from that frustration of not being able
16 to direct him, I created my own program.
17 It is designed, and is being implemented. It
18 is based on the organization, the meeting format, of
19 Alcoholics Anonymous, of which I'm a member.
20 It seems to suit the format -- the anonymity,
21 the privacy, the mentorship -- that we've all been
22 speaking about all day long.
23 So, I'm using that as a basis.
24 I was introduced to Alcoholics Anonymous
25 through the good people of New York State, 17 years
173
1 ago, when I needed help.
2 I'm calling today on the State to take the
3 lead, in encouraging -- in taking the issue of PTSD
4 as an illness, as an ailment, and increasing public
5 awareness of it, and professional awareness of it;
6 To remove the stigma that's attached to it,
7 as the State did, through the Department of Health,
8 with alcoholism, and HIV infection.
9 It was successful then, it can be successful
10 now.
11 It will help draw -- I believe it will help
12 draw those warriors who have been -- who slipped
13 through the cracks at demobilization, who have not
14 yet found themselves in a precinct, a courtroom, or
15 a hospital, based on their PTSD behaviors, and
16 perhaps draw them out of the shadows of the living
17 rooms and the basements that have been alluded to;
18 that, living in isolation and fear of being
19 discovered, and thought less of, or weak as a
20 warrior.
21 I believe, if we remove the stigma, with the
22 State taking the lead, and the various agencies that
23 are presented here, professionals and the like, in
24 partnership with grassroot organizations that
25 provide a safe haven, a safe place, an anonymous
174
1 place, for these warriors to go, and partner, and be
2 with their brothers, share their experience,
3 strength, and hope, especially the Vietnam veterans,
4 who have found a way to survive all these decades.
5 I look at among -- at my Warriors' Circle
6 program is just one of many organizations,
7 grassroots organizations, non-professional, around
8 the state that would benefit from, and could use the
9 professional support and leadership of the
10 peer-to-peer mentor trainees that I've heard spoken
11 of in various counties and situations.
12 I look for that partnership to occur.
13 So I'm asking for that.
14 I'm asking for the State to take the
15 leadership role in increasing public awareness.
16 Training, on the law-enforcement level, I've
17 heard it mentioned in one county, and one instance,
18 where, when a -- when called to a domestic-violence
19 situating, or other situation, that the warrior was
20 questioned: Are you a veteran? Have you seen
21 military service?
22 And then redirect, accordingly, and away from
23 the criminal justice system.
24 I don't want to take much more time, but I
25 wanted to add something that I haven't heard
175
1 mentioned yet: You're looking for ideas.
2 I mentioned that I work with Wounded Warrior
3 Project "Soldier Ride," and another group called
4 "Ride to Recovery."
5 Okay?
6 It's cycling. It's a physical challenge for,
7 both, physically and mentally and spiritually
8 challenged warriors and veterans.
9 I implore you to look into, and include, them
10 in your conversation.
11 The benefits that I have observed, and that
12 been documented, from physical challenges, and the
13 comrade -- camaraderie that comes from getting out
14 there on the open road, or doing a physical
15 challenge, with their brothers-in-arms, is enormous,
16 and they should be part of the conversation.
17 It's not just about mental health. As we all
18 knowing, mental and physical health go hand in hand.
19 So, I would suggest that we do that.
20 In closing: I would like to thank, again,
21 the State of New York for their leadership.
22 You gentlemen, for taking the lead here.
23 And, I'll do everything I can to help.
24
25
176
1 SENATOR MCDONALD: I'm going to call you on
2 that, Dennis.
3 Lee's going to work with you down in
4 Long Island, and all of these non-profit groups,
5 we're going to learn.
6 And instead of trying to duplicate them,
7 we're going to make them part of our teams.
8 Because, you know, most of what I've seen
9 with these non-profit groups, they start out with
10 somebody who cares a great deal. And then they
11 realize they're up against a big issue, and we're
12 going to be there to help them out with the big
13 issues.
14 SENATOR ZELDIN: Couldn't agree more.
15 SENATOR MCDONALD: And tell your son, thank
16 you.
17 Thank him for his service.
18 DENNIS O'DONNELL: Thank you all.
19 SENATOR MCDONALD: We care.
20 SENATOR ZELDIN: Thank you, Dennis.
21 SENATOR MCDONALD: I want to thank everybody
22 for being patient, and I want to invite our final
23 guest, a local attorney, Joel Abelove, who is an
24 Iraqi War veteran.
25 He might be an Afghanistan War veteran as
177
1 well.
2 And, we thank him for his service.
3 And, he came in a little later, but we're
4 looking for all of the good folks who are attorneys,
5 because there was a nice presentation earlier about
6 defense.
7 Joel, we're fighting the snow and the time
8 and other meetings. We've been here since about
9 quarter of ten.
10 We're so grateful that you spent the time.
11 JOEL ABELOVE: I understand.
12 And, thank you for having me, Senator, and
13 inviting me, Senator Zeldin, I appreciate the
14 opportunity to come and address your Committee.
15 I know I'm going last, and people are looking
16 to probably get out of here, and beat the weather.
17 And I appreciate your patience, and bearing
18 with me.
19 As you said, my name is Joel Abelove. I'm an
20 Afghanistan War veteran. I did not serve in Iraq.
21 And I would like to share with you some of my
22 experiences.
23 I am an attorney, with nearly 17 years of
24 experience as a prosecutor. I consider myself
25 fairly educated.
178
1 I've got degrees in, history, and political
2 science. I'm married with two wonderful children.
3 I've got an extensive family support system.
4 And I'm currently in my 17th year of service
5 with the New York Army National Guard.
6 I spent 8 years as an enlisted soldier in the
7 Military Police Corps, and then I rejoined the Guard
8 after 9/11, as an officer in the Judge Advocate
9 General's Corps.
10 In January of 2008, I mobilized with the
11 27th Infantry Brigade Combat Team, and deployed to
12 Kabul, Afghanistan, as part of Task Force Phoenix.
13 And, I have PTSD.
14 It's one thing to know what PTSD is, and what
15 symptoms are generally associated with it.
16 It is quite another to experience those
17 symptoms yourself.
18 I need not delve into the clinical aspects of
19 PTSD, as I'm sure other individuals who have spoken
20 with this Committee are eminently more qualified
21 than I to do so.
22 Rather, I would like to share my experiences
23 and my perspective on how I came to have PTSD, its
24 effects on me and my family, and how I'm dealing
25 with it.
179
1 Prior to my tour in Afghanistan, I had never
2 served in combat. And like many others new to the
3 experience, I had own expectations of what to
4 expect.
5 I had spoken with those who had gone before
6 me, I had attended countless briefings, and
7 undergone months of pre-deployment training.
8 I learned how to spot and react to IEDs; how
9 to perform first-aid on an open chest wound; how to
10 interact with local population, given their
11 particular customs.
12 I read books and manuals, to prepare for my
13 job, and I made a list of important phone numbers
14 for my wife.
15 I spend time with my young children, and hope
16 for the best.
17 But, it wasn't enough to avoid PTSD.
18 Even with all the training, nothing prepares
19 you for the unexpected.
20 Nothing prepared me for my boss,
21 Lieutenant Colonel Jim Wiley, committing suicide
22 during our tour.
23 I didn't anticipate having to disarm one of
24 our own enlisted soldiers who, overwhelmed by
25 stress, sought out a superior, intent on causing him
180
1 harm.
2 I wasn't prepared for the seemingly endless
3 memorial services held on our base for the dozens of
4 service members killed in action.
5 Each service included a short biography of
6 the soldier or Marine, his military experience, and
7 his family left behind.
8 Each time, it concluded with a salute, and
9 then immediately back to work.
10 We were losing multiple men at once, so that,
11 one day, the chaplain's assistant came into my
12 office, asking whether anyone had an extra pair of
13 boots that could be used for the ceremonies.
14 I gladly gave up an extra pair or mine, and
15 watched as my boots repeatedly appeared beneath the
16 rifle and helmet of our fallen comrades.
17 After redeploying, I hadn't given those boots
18 another thought. But months after returning home, I
19 found the motivation to unpack my duffle bag.
20 Suddenly, I pulled out a pair of brand new
21 boots, and a pair of blank dog tags spilled out,
22 with a clank on the concrete basement floor in my
23 house.
24 I felt like I had been hit in the chest with
25 a sledgehammer.
181
1 I immediately knew their significance, and
2 suddenly a wave of emotions flooded my head.
3 This was, as I was to learn, called
4 "a trigger."
5 For Reservists and National Guardsmen, the
6 challenges of returning home and reintegrating into
7 society presents unique challenges.
8 One day, you're spending every minute with
9 your fellow warriors, eating together, working
10 together, going on patrols and convoys together;
11 And the next day, you're home, and you don't
12 see them much at all.
13 You're back to your family and friends, none
14 of whom can be expected to understand what you've
15 been through.
16 And after two weeks of being home, I went
17 right back to my civilian job, where I suspect I
18 appeared to resemble a zombie for a number of
19 months.
20 One day, I'm scanning traffic for suicide
21 bombers, and the next, I'm waiting for an elevator
22 in the Corning Tower.
23 When I came home, everything was different,
24 because I was different.
25 I looked at the world differently. I looked
182
1 at people differently.
2 I didn't care about things that used to
3 concern me.
4 Having endured 120 degree heat in full battle
5 gear, it's hard to listen to people complain about
6 the weather.
7 Having seen injured soldiers anxious to get
8 back to their units to perform their mission, I
9 scowled at civilians who contemplated calling out
10 sick because they had a stuffy nose.
11 I learned that the behaviors that worked for
12 me overseas, that kept me alert and alive, worked
13 against me here at home: hypervigilance, distrust of
14 those around me, skepticism, and emotional
15 separation from the human condition.
16 I longed for a return to a world that I knew,
17 where my feelings and behaviors seemed to fit.
18 After about 25 hours of travel, that took us
19 home through Kurdistan, Ireland, through Maine, we
20 landed at Fort Bragg, North Carolina, to undergo our
21 four-day demobilization.
22 The briefings and paperwork came fast and
23 furious, and most of us just wanted to be done with
24 it, and get back to our waiting families. But, we
25 listened to a representative of the V.A. at
183
1 Fort Bragg.
2 I don't recall anybody from the
3 New York State Division of Veteran Affairs, or my
4 county Veterans' Agency being there, or contacting
5 me to let me know how they could help.
6 Since the civilian workers on post couldn't
7 work late, I ended up spending Christmas Eve at
8 Fort Bragg, which had completely emptied out for the
9 holiday.
10 I finished my out-processing the next day.
11 After a flight to Syracuse, and a 3-hour bus
12 ride back to Latham, I was finally home.
13 But while my body was home, my mind wasn't
14 where I wanted it to be.
15 The dreams, the hypervigilance, the anxiety,
16 the anger, the stress of readjusting to a life that
17 kept going while I was gone, quickly became a
18 problem.
19 My wife and family immediately noticed how I
20 had changed, but, I was lucky, because I noticed it
21 too.
22 Fortunately, for me, I have a great support
23 system of family and friends. I availed myself of
24 the V.A.'s resources.
25 It helps, but it hasn't been easy.
184
1 And aside from the personal challenges of
2 dealing with PTSD, I believe there still exists
3 institutional and bureaucratic impediments to
4 helping service members who suffer from it.
5 First, and foremost, PTSD is, figuratively,
6 still a four-letter word.
7 It carries with it a stigma that discourages
8 those who have it from seeking help.
9 This is especially true in military culture
10 which necessarily cultivates the warrior ethos:
11 A warrior is strong, unaffected by battle, and
12 immune to the inhumanity of war.
13 Conversely, PTSD is a sign of weakness, to be
14 denied and stuffed away in the deepest recesses of
15 one's mind where it cannot affect the warrior's
16 ability to fight on.
17 The problem with this tragedy is, that while
18 one can discipline one's self to compartmentalize
19 these thoughts and feelings, they do not go away.
20 They fester like an infection that is
21 ignored, becoming ever more malignant, until
22 eventually overwhelming their host and causing an
23 inability to function normally.
24 Still, many veterans will try to suppress
25 their symptoms because of their belief that society
185
1 finds them distasteful; and, because, to admit one
2 has a problem, is to admit that which is most
3 distasteful to a warrior: weakness.
4 But before we were warriors, we were
5 human beings.
6 Veterans need to be encouraged, from all
7 circles, to seek help.
8 They need to know that PTSD is a normal
9 response to abnormal circumstances;
10 They need to be informed of every resource
11 available to help them, from every federal, state,
12 and local agency;
13 And, they need to know, that without that
14 help, they will have difficulty continuing the
15 mission.
16 There are numerous individuals who have
17 dedicated their professional lives to helping
18 veterans who suffer from PTSD.
19 I believe that, as legislators, it is your
20 responsibility to ensure that they have the
21 staffing, the training, and the resources to
22 accomplish their mission.
23 Without them, we, as warriors, cannot
24 accomplish ours.
25 I appreciate you bearing with me, gentlemen.
186
1 I just sort of wrote that from the heart
2 because it's how I feel about my own personal
3 situation.
4 I know everybody's experiences are different.
5 I appreciate your service to our country.
6 And, certainly, I greatly appreciate your
7 willingness to utilize this Committee, and its
8 resources, to help those veterans who need the help
9 that we desperately need.
10 It's my hope, that all these efforts, and
11 I've heard from many of the speakers today, there
12 are certainly enough people who want to get the job
13 done.
14 And I feel as though, all it takes is the
15 resources, because we have the will.
16 SENATOR MCDONALD: Joel, your presentation
17 was outstanding.
18 JOEL ABELOVE: Thank you, sir.
19 SENATOR MCDONALD: And we're grateful for
20 your service.
21 And, you and myself and Senator Zeldin, and
22 so many people here, are military people.
23 Sometimes, when you speak up, they get you to
24 volunteer, whether you like it or not.
25 We're volunteering you to help us out.
187
1 You're a local person that lives, literally,
2 across the river from here.
3 JOEL ABELOVE: Yes, sir.
4 SENATOR MCDONALD: So this is something --
5 and I know you have to make a living, and all that
6 kind of stuff, but this is something that you,
7 obviously, have your heart in the right place.
8 And, like Senator Zeldin, you're a young
9 veteran that -- a recent veteran.
10 So, we're going to come back and utilize that
11 heart, and that brain, to help out these veterans
12 today.
13 JOEL ABELOVE: I hope so, sir. I look
14 forward to it.
15 SENATOR ZELDIN: I think, not only your
16 testimony is a fitting way to end this hearing, but
17 your last couple of sentences were a fitting way to
18 end the hearing.
19 You're saying that you believe, that, as
20 legislators, it's our responsibility to ensure that
21 there's a staffing and training, resources, to
22 accomplish this mission. And without them, the
23 warriors cannot accomplish it.
24 So, I think that it's really the duty.
25 There are 212 legislators here in Albany, and
188
1 a governor. It is our duty, to do what we can to
2 help.
3 And, thank you, as well, for your service.
4 JOEL ABELOVE: Thank you, sir.
5 SENATOR ZELDIN: I want to say, thank you, to
6 everyone that traveled from Suffolk County.
7 Suffolk County is actually the home of the
8 single highest population of veterans in the entire
9 state of New York.
10 We're very proud of our veterans.
11 And, I'm very honored, and proud, of the fact
12 that so many traveled so far to be here.
13 For all of you watching at home, that last
14 public service announcement, if anyone ever needs
15 any help, the phone number is: 1-800-273-8255.
16 Press "1."
17 Maybe you're calling for yourself, a loved
18 one, a business associate.
19 There's a website for the V.A., at:
20 VeteransCrisisLine.net.
21 You can also text it to: 838255.
22 We're here, not only to help you,
23 individually, but, to figure out what we can do as a
24 state, to finally address post-traumatic stress
25 disorder.
189
1 So, thank you, everybody, for your
2 participation.
3 SENATOR MCDONALD: Thank each and every one
4 of you.
5 Drive carefully. It's snowing out.
6 Help your neighbors.
7 There's nothing better than to help your
8 neighbors.
9 Thank you.
10 [Applause.]
11 (Whereupon, at approximately 1:20 p.m.,
12 the public hearing, held before the New York State
13 Senate Standing Committee on Mental Health and
14 Developmental Disabilities, concluded.)
15
16 ---oOo---
17
18
19
20
21
22
23
24
25