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A national model
The Montana National Guard takes pride in the fact that its Yellow Ribbon Program does more than any other state to screen for and treat PTSD. In fact, federal legislation modeled after the program, pushed by Sen. Max Baucus and Rep. Denny Rehberg, is likely to reach President Obama's desk this month. Combined with the boots-on-the-ground work being done around Montana in vet-to-vet groups, the state leads the country in the fight against PTSD.
But Montana's success began with tragedy. On March 4, 2007, Chris Dana of Helena, two years after returning home from Iraq, shot himself in the head with a .22-caliber rifle. He was 23. As Dana's father collected his son's belongings, he reportedly found a letter from the National Guard indicating that Dana was being discharged under less-than-honorable conditions. He had skipped drills, a result of feeling isolated since returning from Iraq. The letter was in the trash, along with a Wal-Mart receipt for .22-caliber rifle shells.
"Before Chris' death the military didn't know how to effectively handle [PTSD]," explains Matt Kuntz, Chris' step-brother, who has since become a national advocate for advancing the treatment of PTSD and other mental illnesses with the Montana chapter of the National Alliance on Mental Illness. "I think a big part of it was they were trying to deal with it in an entirely voluntary manner. But the problem, when it comes to receiving health treatment in the military, is that nothing else is really voluntary, even something as simple as blisters. When you've completed a major road march...they require that everyone take off their boots and have a medic look at their blisters, then you're required to get them treated. And the reason they do that is because they think people will be too proud or won't recognize how bad it is until it's potentially disabling. Why can't we treat PTSD with the same level of care? I think that's where we're moving, and my focus has really been on trying to get help to the active duty personnel, because if we wait until they get out of the service the illness can compound, and it's also a lot harder to treat them, especially if they're in rural Montana or on the reservations."
The Montana National Guard says Dana's death brought about a reevaluation of how it reintegrates its service members into civilian life.
"When he took his life, and that was associated with PTSD, it really caused our state to step back and say, 'What are we doing, what should we be doing that we aren't doing, and how can we make the process better?'" says Col. Jeff Ireland, director of manpower and personnel for the Montana National Guard. "Because, obviously, we never want to have something like that happen again if we can help to avoid it."
The Yellow Ribbon Program requires soldiers to undergo counseling with behavioral health specialists and participate in workshops with each other and their families every 30, 60 and 90 days after returning home. The sessions are aimed at identifying mental health problems like anger management, stress management, substance abuse and depression. Thereafter, the Montana National Guard conducts medical assessments every six months out to the two-year mark. No other state requires such extensive monitoring.
"We're trying to help you understand," Ireland says, "that if you have problems sleeping, if you have problems with your temper, you're driving too fast, it isn't just you. It's those things that are normal things. So, when they happen, here are the things you can do and here are the resources that are available."
Between June and December 2008, according to data provided by Ireland, 40 percent of the 539 Montana National Guard service members who were evaluated by behavioral health providers were referred to a specialist. Of those, 49 percent reported anxiety, 46 percent reported problems with their marriage and family, and 40 percent displayed PTSD symptoms. Ireland believes many of them would have fallen through the cracks if not for the Yellow Ribbon Program.
Nationally, a recent study by researchers at the San Francisco Department of Veterans Affairs Medical Center and the University of California, San Francisco, found that 37 percent of Iraq and Afghanistan war veterans who enrolled in the veterans health system after 2001 received a diagnosis of a mental health problem, most often PTSD or depression. The study also revealed that the number of veterans found to have mental health problems rose steadily the longer they were out of the service.
Which is why Kuntz has worked so hard since his step-brother's death two years ago to ensure that as many soldiers as possible receive face-to-face counseling long after they return home. He appealed to then-Sen. Barack Obama, who later invited him on his post-inauguration train ride, which Kuntz says helped bring the issue national attention. Kuntz also worked with Baucus to draft the new legislation, and Sen. Jon Tester asked him to testify before the Senate Veterans' Affairs Committee.
"It's been a pretty amazing process, to be honest, to go from just one angry and sad family to hopefully really making a difference in a lot of lives on the national level," Kuntz says.
Just last Wednesday, Baucus and Rehberg's measure was included in the final version of the Department of Defense authorization bill. It passed the House on Friday on Oct. 9 and it's expected to pass the Senate any day now.
But more screening and counseling can only go so far in preventing soldiers from sinking into mental illness. Just look to Spokane, Wash., where it was revealed two months ago that, between July 2007 and July 2008, at least 22 veterans in the Spokane Veterans Affairs' service area killed themselves. Fifteen of them were being treated or had been treated at the city's VA medical center.
Never the same again
Chris Poloynis sits in his small and dark living room in downtown Missoula when Chase Weston walks in. He's returning from facilitating the Spartans Honour vet-to-vet meeting for the first time.
"It was good. I was ready for it," Weston says.
"No you weren't," Poloynis interrupts, laughing, telling how Weston called earlier in the day trying to get out of it.
But Poloynis says Weston will eventually be ready.
"He came to vet-to-vet before all of this treatment and I couldn't hardly keep him in a meeting. But somehow him and I have connected like brothers, and just followed each other," says Poloynis. "We probably saw the same stuff. Different time, same intensity. Same wounds.
"The happiest day of my life the last few years," he continues, "was when he knocked on my door a few nights ago and said, 'I'm home, and I'm well.' That blew me fucking away. It put tears in my eyes."
Poloynis hopes Weston will continue to heal, and maybe even develop a sense of ownership over Spartans Honour and eventually become the primary facilitator. Today's the first step in that process. Weston, despite a long road to recovery still ahead, returned home dedicated to helping heal PTSD sufferers like himself. It's his new mission, but a familiar one, to make sure his fellow soldiers make it out alive.
"The honor is in living your values after you get out," Weston says. "So it took me some time to find my values, but sure as hell I'm making that time up right now. I'm taking every penny I own and every minute I have and giving it away to other veterans who want to get better."
But he and Poloynis both strongly believe that vet-to-vet groups and the state's once-every-six-month psychiatric screenings for National Guard service members, however innovative, aren't nearly enough. Combat veterans with PTSD need inpatient therapy, they say, like the therapy Weston received over the past year. The problem is that there are far too few resources for the countless soldiers in need.
"The program [in California] I just left had 30 beds," Weston explains. "It was for Iraq and Afghanistan veterans only. When I got in I was on the waiting list with 10 people. When I left, the waiting list was over 200...You have how many thousands of troops? Hundreds of thousands of troops are about to get out, are about to start to deal with PTSD, and unless you want to see crime rates go up, and jail rates go up, domestic violence go up..."
And no matter the level of therapy combat veterans receive, Poloynis and Weston say soldiers like them—trained to kill and dehumanized for combat—can never return to their pre-war lives. They can never fully reintegrate into a society that doesn't understand, and often doesn't appreciate, their sacrifice.
"It does not work. It will not work. It cannot work. And I know that sounds so negative, but it won't. It just cannot work," says Weston, stopping to bite his quivering lip. "Because there's no way that I'm going to be able to drive down the road and not see a trash bag and not think IED. Not see a dead squirrel or a dead fucking dog and think IED. Not watch everybody's fucking hands to make sure they're not in their pockets...I'm 26, and I'm fucked for the rest of my life."
"This is the cost of our freedom and liberties," Poloynis says, motioning to Weston and back to himself. "So the question is, 'Is it worth it?' For us to be able to have all these rights and to be able to live in a capitalist society and a democracy, so to speak, it takes this."
Are they bitter?
"My spirituality is helping others," Poloynis says. "And when I help Chase and scores of others, I sleep better. It's what I'm supposed to do. I could be bitter. I could be angry. But I chose this route. And that's why I try to tell these guys, you got to give of yourself. You have to give. Give, give, give. And that's how you get better."
"I'm more bitter about one thing than anything else," Weston says, "and it has nothing to do with the service. I'm so bitter at watching my mom weep all the time. Because she sees me walk up and down the stairs and have a hard time. She watches me have a seizure. She sees me frustrated, in tears, having a hard time, choked up like I am right now. And she just weeps."
Weston mentions Plato's "Allegory of the Cave," a fictional dialogue between Plato's teacher Socrates and Plato's brother Glaucon. Plato writes of a scenario in which people are chained in a cave all of their lives facing a blank wall, interpreting reality only from the shadows formed on the wall by the fire behind them. If a man is able to look at the fire, Socrates says, "wouldn't he be struck blind and try to turn his gaze back toward the shadows, as toward what he can see clearly and hold to be real?"
"In war you're bound by chains," Weston says. "You see the fucking light, and you're fucking blinded by it. And all you want to do is be back in the fucking cave. That's where I want to be. Give me five rounds, drop me in Iraq, and let somebody fucking kill me. It's so much easier than dealing with this shit. But I'm left to deal with it, and I know that now."