IDEAS IN ACTION with Jim Glassman

The New Battle Field; Life After War for America's New Veterans

JIM GLASSMAN:
Welcome to Ideas in Action a television series about ideas and their consequences. I'm Jim Glassman. This week: after ten years in Afghanistan and with combat operations over in Iraq a new class of veterans will need to adapt to life back home. They're returning to a weak job market and a Veterans Administration that critics say isn't up to the task of helping them. Joining me to discuss this topic are; Colonel David Sutherland, special assistant to the chairman of the joint chiefs of staff; Paula Domenici, head of training programs at the Center for Deployment Psychology at the Uniform Services University of Health Sciences; and Rajiv Srinivasan, spokesperson for Iraq and Afghanistan Veterans of America. The topic this week: the new battlefield, life after war for America's new veterans. This is Ideas in Action.

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JIM GLASSMAN:
Since 2001, 2.3 million Americans have joined the U.S. military with many serving in Iraq or Afghanistan. As those conflicts wind down America's newest veterans are returning home. While some struggle with visible scars, others suffer from invisible, psychological wounds. How is today's generation of vets adapting to civilian life and what can Americans do to help? Colonel Sutherland 2.3 million Americans have fought in the most recent wars in Afghanistan and Iraq. What is unique about this new generation of veterans?

COL. DAVID SUTHERLAND:
Well I think that first off this generation of veterans are wired to serve. They just need a little help during transition and reintegration and they'll thrive. They've proven their fortitude, they've proven their capabilities time and time again on the battlefield and I've seen valor on the battlefield. The series of noble acts over a period of time under harsh conditions. And I've seen valor when they come home. They're the same series of noble acts over a period of time under harsh conditions. And sometimes it takes more than valor. It takes communities, and leaders in the communities, recognizing their potential for greatness. This generation of veterans, just like previous generations of veterans, have served with distinction. They're brave, they're disciplined, individually and collectively, and they're kind, and we see it over and over again. It's when they come home that those challenges-- the recognition and the assistance at the local level is so important.

JIM GLASSMAN:
Captain nearly 99% of Americans are not involved in military life and is this disconnect hamper veterans in transition, sort of-- maybe a lack of understanding?

CAPT. RAJIV SRINIVASAN:
You know the easy answer is yes. To say that because fewer people are serving then that's why military folks are having a harder time to transition. But I believe the right answer is no. The issue here isn't to get more people to serve. I don't think that would really help or hurt the situation. To me the issue is that we do not look at Veterans Affairs and the utilitarian argument for why it's important. Right now when you hear an argument for Veterans Affairs or an argument for veterans charities it's usually an argument that says oh of compassion, feel sorry for these vets, take care of them because they served their country. What we need to start doing is changing the argument. We need to realize that Veterans Affairs are important to this country for two reasons in my opinion; one it's an economic issue, we spend hundreds of thousands of dollars training these young men and women we need to make sure we maximize that utility when they come back home. To me the most important argument though is it's a national security issue, because every homeless veteran, every jobless veteran, every veteran without healthcare, is a walking billboard for our young leaders in high school today for them not to join the military. And quite frankly it's far stronger and louder when a young high school student sees a homeless or jobless veteran to realize that they could probably find welfare and a higher standard of living in another profession and our best and brightest won't join the service and our frontlines will be weaker for it.

JIM GLASSMAN:
Paula there's a recent Pew poll that says that reported rates of posttraumatic stress disorder are much higher than in previous wars. How have we progressed in helping veterans deal with this and other psychological conditions?

PAULA DOMENICI:
Well first of all I would actually disagree with that to some extent. We know the rates of PTSD range from about 14% to 30% depending on when you're looking at when they're surveyed; if they're in theater, when they come home, are they in veteran status, and those rates are not dramatically higher than other-- if you look at other wars. But irrespective of that I mean it's very important for us to address PTSD and where I work at the Center for Deployment Psychology what we are doing is disseminating evidence based treatments for conditions like PTSD that can actually get our soldiers and veterans better. Where they don't--

JIM GLASSMAN:
And what does that mean?

PAULA DOMENICI:
That they can stay in the mission. They can stay in the fight. They may not have to leave the service, that they don't need to be disabled, that they can be functional.

JIM GLASSMAN:
And Colonel Sutherland you don't really consider PTSD an illness right?

COL. DAVID SUTHERLAND:
I don't and in fact I won't use disorder associated with it. It's a sense of disconnection for me, my interpretation, I'm not a PhD or a doctor, my PhD's in soldiering. The understanding of that epidemic of disconnection when we come home and we don't feel like we fit in. Those sacred moments on the battlefield turn into secrets where we can't talk about these issues but-- the doctor's right. I mean the previous generation of veterans because of their challenges when they came home, especially our Vietnam veterans, we can now talk about our challenges and we can address them directly because we can talk about them. But understand-we're not victims, we're veterans. And we don't need a handout we need a hand up and it's not pity we're looking for but recognition of the potential. And when organizations do that-- RAND just recently released a study about the belongingness, the remedy to help deal with the effects of posttraumatic stress is a sense of belongingness, a sense of community, and how important that is to be able to talk about and feel like you fit in.

JIM GLASSMAN:
Yes.

PAULA DOMENICI:
If I could just add the other thing we're doing is training military providers to use evidence based practices in theater, in Iraq, in Afghanistan, for individuals on the field who have posttraumatic stress symptoms. So to intervene early and maybe pull them off the frontline but they're still downrange with their unit to some extent and so we're treating it earlier and sooner and not medivac-ing some of these folks home which we know often isn't good for their mental health.

COL. DAVID SUTHERLAND:
I think Raj will support me on this; we get asked three questions when we come home. Our friends will ask us what did we do over there. Our families will ask how do you feel about what you did. And we have to ask ourselves what did we accomplish. And discussing those and having the awareness on the battlefield we can do that because we have a built in peer-to-peer support network. It's when we come home and we lose that support network and that's why mentorship programs, peer-to-peer programs, at that local level, and family resilience. Our fam-- we can't discuss the service members without discussing the families.

JIM GLASSMAN:
So this community approach is that something, Captain, that DOD should be supporting or the Veterans Affairs Department, or is that for individual organizations and families? I mean, how do we get to this ideal that Colonel Sutherland is talking about?

CAPT. RAJIV SRINIVASAN:
Well I think he hit it right on the head it's about the community. It's about community organizations and---

JIM GLASSMAN:
So at the local level you're talking about?

CAPT. RAJIV SRINIVASAN:
Absolutely. To me in my opinion the issue isn't the availability of such programs. To me the supply side of this equation is actually not terrible in this country. To me it's the demand side that's really hurting and what I mean by that is when you come back as an Afghanistan or Iraq war vet we're soldiers, we're programmed to be self reliant, to take on any task on our own shoulders, and when it comes to the idea of asking for help I think a lot of us are more and more reluctant to seek out help. I think the demand for those programs on the soldiers' side is what-- is the missing side of this equation. I think it's going to take a lot of work to tell these soldiers that it's ok to go out and ask for help.

JIM GLASSMAN:
And you're saying it's ok to go out and help so it's not simply availability of information it is in some sense sort of psychological?

CAPT. RAJIV SRINIVASAN:
Absolutely and you know I'd add something that in my work with Veterans Affairs the most effective path to reaching the veteran isn't through veteran targeted marketing by any means it's actually reaching the veteran's mother, the veteran's father, the veteran's girlfriend, the veteran's sister; the family of influencers around the veteran that can really shape his or her decision making. I'm a great example of that. When I came back from Afghanistan I definitely needed to see a counselor. I had some posttraumatic stress issues that were definitely affecting my life but it wasn't until my mother and my girlfriend intervened that I went and actually took that first step into the counseling room.

JIM GLASSMAN:
And when you say affecting your life, if you don't mind, in what way?

CAPT. RAJIV SRINIVASAN:
I mean it starts out from anything from bad dreams that don't let you sleep at night, and abuse of food, I gained a lot of bad weight, neglecting, not to a point of huge noticeability, but neglecting my professional life and my personal health, where I just didn't feel good about myself.

COL. DAVID SUTHERLAND:
Not wanting to go into crowds.

CAPT. RAJIV SRINIVASAN:
Not wanting to go into crowds.

COL. DAVID SUTHERLAND:
Being hyper vigilant, re-experiencing the events over and over again.

CAPT. RAJIV SRINIVASAN:
And my temper. That was the one thing that really got out of control and how I-- when I really stood back and said I need to get help is when I saw how flaring my temper was when I came back.

COL. DAVID SUTHERLAND:
What you get from the community level to go back to what Raj is saying is you get information and options. There is a desire to want to help, there-- across the nation. I've now been to 300 communities in the past year and there is a desire to want to help. The American people know what we are but they don't know us and therefore-- and when I saw what we are we're a military, we're at war, we're fighting. Each one of us is unique and individuals. Although I can talk through his symptoms and he can talk through mine we still have different ways of dealing with that and what we find at the community level is flexibility, innovation, and a horizontal network as opposed to a vertical network that's policy driven. Having that flexibility comes from the local levels.

JIM GLASSMAN:
This is a very important point so how, Paula, do we-- is there a way to kind of de-stigmatize the asking for help?

PAULA DOMENICI:
I think it has to be a top down and bottom up approach within the military. The culture is shifting and you know has shifted a great deal but there still remains a lot of stigma. So I think both from leadership as well as the average battle buddy everybody along the continuum needs to know the importance of one's wellbeing and mental health to the resilient soldier-- that that's going to actually help the mission.

JIM GLASSMAN:
But the resilient soldier-- but in many cases these are returning soldiers, they may not be soldiers anymore. So does that mean that the kind of intervention has to come in at the time they're on the battlefield? Just you know remember if you have problems when you get back--

PAULA DOMENICI:
I think it needs to start throughout the deployment cycle, you know pre-deployment, during deployment, after deployment. It's not a message that can only be there when someone steps off the plane after having served in a war zone.

JIM GLASSMAN:
Rajiv.

CAPT. RAJIV SRINIVASAN:
I'd like to talk-- I'd like to take your step one point further Paula is that I don't think transition begins during deployment, doesn't begin after deployment, transition for the solder begins when he signs on the dotted line in my opinion. Just to give you a glimpse during the pre-deployment timeline for a soldier moves very fast. You spend a vast-- especially for a combat-armed soldier you're spending weeks if not a month in the field and spending a lot of time away from your family. When the few days that you have back on post in Garrison on your main day to day life of post you're trying to get in do your job and get home because you know you're going to be away from them for a year. And then of course during deployment it's 365 days, 24 hours a day you're on call. And then when you come back it's the same thing, you know you want to be with your family. And all these tasks like making us go to PowerPoint briefings or these mandatory one to two hour counseling sessions they seem like distractions. The way you have to fix that is the minute the soldier, sailor, airman, marine, the minute they sign on the dotted line we have to think what's the next step for this person. To me it's a holistic approach that is not associated at all with the deployment but is associated with the flag that he or she wears on his shoulder.

COL. DAVID SUTHERLAND:
It's a specific leadership at the local level, what Paula's talking about, what Raj is talking about, it's leadership. And it's our responsibility when they're in to say there is no stigma. You've got an army captain who served in Afghanistan and an army colonel who has served multiple tours in different locations saying I've got post traumatic stress and what's important is your quality of life long term and that quality of life comes from looking for options that best suit you to deal with this vileness that you've just experienced.

PAULA DOMENICI:
And if I could just add an important part of our training is to get to all sorts of individuals that will interface with a service member or veteran whether it's a primary care doc who might be their first entryway into talking about sleep problems or a minister or a priest, chaplains also may be a good segway. In addition using things like telemedicine. So I think we need to be creative and know there's a lot of different access points and that all of those individuals if they can be trained up to look for and help service members with problems that they then may be able to refer them on.

JIM GLASSMAN:
You know Paula the VA estimates that 18 veterans commit suicide everyday and that number may well be underreported. Can something be done specifically to address that problem?

PAULA DOMENICI:
Well I actually think a lot of good things are underway regarding suicide in the military from the DOD side specifically. Most of-- all the branches have prevention efforts that are very good. There's a large multiyear study underway that's looking at risk and protective factors for Army specifically. The VA has a hotline and suicide coordinators. Suicide is a very complicated condition. There's many variables that are at play. We can't say that it's only linked to deployment. It's hard to predict suicide. So I think education and awareness about the signs and symptoms again among everybody that will interface with the veteran or service member is really important.

JIM GLASSMAN:
I'm wondering-- Colonel Sutherland used the term vileness and I'm just wondering whether you Colonel or Captain-- is there something about Afghanistan and Iraq that's different-- COL. DAVID SUTHERLAND:
Yeah I think that first off war is vile no matter where.

JIM GLASSMAN:
Right.

COL. DAVID SUTHERLAND:
It is the most vile thing you can think of with the exception of why we fight. Holding a five-year-old girl in my arms who'd been shot in the face because her father was trying to enforce a rule of law and not Sharia law is why we fight. Going into a torture house and in one corner are arms and another corner are legs, another corner torsos, and another corner heads of seventy different men, women, and children, that were brutalized because they would not succumb to Zarqawi's view of the world is why we fight. But that affects you and you come home and it's the same effect in Vietnam, the same effect in Korea, and WWII. I met a gentleman yesterday who fought in the Battle of the Bulge that says he still wrestles with his demons and we can talk about this now and that's part of the goodness. But when you're used to accomplishing the mission on the battlefield and you come home and you can't get a job that power of humiliation will overwhelm you. Or it's difficult to stay in a classroom because you've got two tours in Iraq and one in Afghanistan and the kid sitting next to you is 18 years old and just out of high school and giggles every time the door slams and you jump and he's got-- he's texting and doesn't have the same level of discipline-- that feeling of fitting in. So what we find are veteran resource centers at universities that make a difference and connect the veterans to one another. Or in the workplace a veterans network or a mentorship program and sponsorship program geared towards the veterans. That makes a huge difference--

JIM GLASSMAN:
That brings up a good point, which is about unemployment. I mean I don't think there's any doubt those of us who know military people who have fought in these two wars that the level of talent is tremendously high-- dedication, talent, ability-- and yet the Bureau of Labor Statistics in October showed that veterans between the ages of 18 and 24 have an unemployment rate of 22%. Do you think that the bill that was just passed by congress helping veterans through tax credits to employers-- will that help? Are there other things that could help?

CAPT. RAJIV SRINIVASAN:
I do think it'll help. I think it'll help for several reasons; one there's nothing more fulfilling than leading soldiers in combat and so when you transition back and you're in a 9 to 5 job your tendency is to slack off. Your tend-- you're not 100% in because your heart and your mind are somewhere else. What I believe that tax credit does to the employer is that it serves as a credit to say hey thank you for taking a risk on this person that's coming back. Thank you for taking a risk on him. We understand that there may have been other people who are more qualified, had prior experience, but you're taking a risk on a veteran. We understand the sacrifice that you're making and we hope that you'll keep him onboard because we want to make it financially beneficial to you to make sure you're taking care of our veterans. I believe it's a good thing and I do think it will help.

JIM GLASSMAN:
Is there a problem Colonel Sutherland in the talents, the skills, the jobs that are-- that people use when they're in the military not being readily transferable?

COL. DAVID SUTHERLAND:
No I think they are transferable. When you understand risk and how to mitigate it and you understand showing up for work on time and not minding working on weekends or holidays-- but more importantly you understand the decision-making, the leadership making a positive difference on a daily basis. And then the other aspect is what they bring in decision-making and what they bring in talent and fortitude is phenomenal because I don't see hiring a veteran as a risk-- as a risky proposition. What I see as they want to be part of a winning organization and they want to take it to the next level. The challenge is that we've got organizations out there saying we want to hire veterans, we can't find them. And part of it is they're coming to us, to government, to find them. They're in your local community.

JIM GLASSMAN:
So if somebody's watching this program and says you know I'm convinced I really want to hire veterans there's not one place that such a person would go right?

COL. DAVID SUTHERLAND:
Exactly. They're migrating to the trades. They want to continue to do what they did but we've made it difficult because of licensing and credentialing requirements at the state level. Where somebody that's been a medic on the battlefield comes back and has to go through EMT training from day one with a kid just out of-- an 18 year old. And so we have to recognize their skills at the civil level-- civil society-- and adjust to them as opposed to the service member and veteran coming back and adjusting to civil society.

PAULA DOMENICI:
And I think we need to educate employers that-- about not having stereotypes about our veterans that they all have PTSD, they're all going to go over the edge and be aggressive, etc. It's just not true. The majority of our service members and veterans are resilient and you know they have reintegration challenges but they don't have PTSD. So we need to break those stereotypes through education, through training groups like the one where I work. And we need to get--

JIM GLASSMAN:
And you see-- and that's a real problem that's not just something-- that's not just conjecture--

PAULA DOMENICI:
I mean you've got organizations that want to hire, you're describing, and they don't know quite how to connect but I think you have a group of corporations and organizations that do think it's a risk and are concerned they're going to have the one person who goes over the edge and does something and their place is going to hold liability. And so we need to give them education and let them know that these men and women have great skill sets and values that's going to truly benefit their organization. We just need to help them understand how they're transferable.

COL. DAVID SUTHERLAND:
We had an individual in Phoenix the other day that just his workspace was not conducive for his issues. Every time he was in a cubicle, every time someone walked behind him, he flinched, he jumped. Not that it was disruptive to anyone else but it affected his productivity. The leadership of that company engaged with him, looked at his workspace, they put up a rearview mirror, his productivity went off the chart.

JIM GLASSMAN:
Great story. And let's just conclude, I want to ask all of you-- polls show that Americans very much support this newest generation of veterans and-- but they often don't know what they should do to show their appreciation. What can Americans do just to show military people who are returning from Afghanistan and Iraq that they really appreciate their service to the United States. Rajiv.

CAPT. RAJIV SRINIVASAN:
I think the baseline answer is to get involved. It's one thing to reach out your hand and thank me for your service but I want to know what you're doing to really thank the guys that are coming behind me. I want to see people at the YMCA. I want to see people in their church reaching out to those in their community who they know are vets. The hard part about the community effort is that if you take the total number of Iraq and Afghanistan war vets and divide them amongst the 3,000 plus counties in the country you're talking maybe a handful per country. They're few and far between and so that means when you find one in your community you really invest in them. You show them that you're thankful, you keep your eye out for them as if they were your neighbor, your friend, and see what you can do with your own dollar, with your own time, to make that veteran's transition the easiest it can be.

PAULA DOMENICI:
And I want to just add to that. I think a big issue is the moral injuries that service members sustain which goes to the fact that they're incredibly compassionate and they have to make these split second decisions about incredibly hard things about you know the baby that's going to die or running over somebody and so they come home with these moral and ethical challenges that just eat up their soul. I mean that's what I hear about in my clinical sessions and that's hard work and we need to be thankful for what you're describing.

JIM GLASSMAN:
And what about this appreciation question? What can people do to show appreciation?

PAULA DOMENICI:
I mean I think what you're saying obviously is really important. Joining up in any type of volunteer group. I think probably one of the most important things also is if you interact with a veteran to listen, to listen to their story, and if they don't want to talk that's fine too but to be there and just listen.

JIM GLASSMAN:
Colonel?

COL. DAVID SUTHERLAND:
I would say recognizing that there are just some things that government can't do. That independent organizations working together and leaders in communities coming together, solution focused as opposed to problem focused, and what I mean by that is there are cities where we've got up to 1500 unemployed veterans in one city from Iraq and Afghanistan and so these black holes for transition and reintegration services can only be solved by that conduit coming together focusing the good will. Mentorship programs keep them in school, being a mentor for a returning service member. University of Arizona-- every veteran at the University of Arizona that wants one has a mentor from the Tucson community. Look at linking your employment efforts to those groups but recognizing that trades are people too. The trades-- the truck drivers, the pipe fitters, the crane operators, they all participate in this as well and so providing internships while they go to school enables these service members and that's where you find them.

JIM GLASSMAN:
Thank you Colonel Sutherland, thank you Captain, and thank you Paula.

PAULA DOMENICI:
Thank you for having us.

JIM GLASSMAN:
And that's it for this week's Ideas in Action. I'm Jim Glassman, thanks for watching. Keep in mind that you can watch Ideas in Action whenever and wherever you want. To watch highlights or complete programs just go to ideasinactiontv.com or download a podcast from the iTunes store. Ideas in Action because ideas have consequences.

ANNOUNCER:
For more information visit us at ideasinactiontv.com. Funding for Ideas in Action is provided by Investor's Business Daily. Every stock market cycle is led by America's never ending stream of innovative new companies and inventions. Investor's Business Daily helps investors find these new leaders as they emerge. More information is available at investors.com. This program is a production of Grace Creek Media and the George W. Bush Institute, which are solely responsible for its content.