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Dulling the Impact of War

Last November, just before Veterans Day, a sobering statistic was released at the annual meeting of the American Public Health Association: Approximately 25 percent of the first 100,000 returning Iraq and Afghanistan veterans were given mental health diagnoses by the Department of Veterans Affairs (VA). The message was crystal clear: With the total number of troops deployed exceeding 1.5 million and VA facilites already swamped, the situation can only get worse.

Here in Buffalo, a dedicated group of people is trying hard to improve the lot of local veterans—especially those who may have slipped through the cracks of the sprawling VA healthcare system—by mobilizing a veterans assistance network that consists of local courts and community-based service providers. And with any luck, next week they’ll have the opportunity to show the rest of the nation how to do it when Crisis Services hosts a conference entitled “The Impact of War: Community Mental Health Responds to Returning Combat Veterans.” The conference, which will run from Tuesday through Thursday, is an attempt to build on the success of the recently founded Buffalo Veterans Court.

The Veterans Court, viewed as the first of its kind in the country, held its first sesssion January 15, with the noble mission of intercepting troubled veterans before they could become mired in our imperfect, overwhelmed justice system. The court is the brainchild of Western New York Veterans Project co-founders David Mann and Jack O’Connor, who saw that many returning veterans, particularly combat veterans, had problems readjusting to civilian life and weren’t being well-served by the traditional court system.

In fact, according to Henry Pirowski, project director for City Court, 323 veterans entered the local criminal justice system between January 2006 and June of 2007, for charges ranging from loitering and begging to disorderly conduct, petit larceny and domestic violence. “But jail’s not the answer,” says Pirowski. “Nobody gets helped by going to jail.”

And getting help is the key, according to Pirowski. While their problems are myriad and include Post Traumatic Stess Disorder (PTSD) and other psychiatric problems, substance abuse and problems with violence, many of them don’t seek out help of their own accord. “Many of these folks have a warrior’s mentality,” Pirowski says. “They have these ideas like ‘treatment is for the weak’ or ‘I can take care of this on my own.’ As a result, things can get out of hand for them rather quickly.”

Pirowski would know, being a former Marine himself. And, nationally, the stats back him up.

Take post-traumatic stress disorder (PTSD), for example. While estimates suggest that between 12 to 20 percent of all veterans suffer from PTSD, only 52,000 veterans of Operation Enduring Freedom and Operation Iraqi Freedom have been treated for PTSD by the VA—or roughly three percent of troops deployed.

Many factors play into the soldiers’ silence. According to Mann, a lieutenant in the Buffalo Police Department, “If they’re active duty, they just won’t go to the military if they’re having any kind of problem, for fear of damaging their military careers. And with these multiple deployments, we can expect that a lot of them are having problems.”

Some veterans undoubtedly end up getting in trouble, and that’s how they wind up at Veterans Court on a Tuesday afternoon, standing before Judge Robert Russell. The court is set up to help meet the special needs of troubled veterans, not only by sparing them jail time or probation but by connecting them with veteran mentors who, in turn, help enroll them in community-based programs that offer the kind of counseling that can help turn their lives around.

John Rudy, an Army veteran, is one of the nearly 20 volunteer mentors in Veterans Court. “I think that there’s an instant rapport when a veteran talks to another veteran,” he says. A supervisor and former counselor in the New York State Division of Veterans Affairs, Rudy says his own 23-year-old son is a combat-wounded veteran. “You go through something like that and you’re changed forever. There’s no getting away from that—they are changed forever. It’s just a matter of trying to get them help when they’re young versus what we see on the other end of the spectrum where there are guys whose whole lives have been messed up.”

Besides talking to them and referring them to services, the mentors—whose backgrounds include mental health experience, VA healthcare experience and work in various veterans affairs organizations—find them safe, stable housing if they’re homeless (a 1999 report showed that 23 percent of America’s homeless are veterans), and get them into education and job training programs at Erie Community College.

In its first six weeks, the Veterans Court has already taken on and is actively handling 27 cases, most of which involve nonviolent substance abusers who also have some kind of psychiatric disorder. The word “active” is important to what the court does. The vets are judicially monitored, which means they return to the court every week. “Judge Russell knows exactly what they’re doing,” says Pirowski, “he knows when they’re doing it and how they’re doing it. It’s the most stringent form of community supervision there is.”

They receive urine tests three times a week, visit their case manager twice a week and are rigorously breathalyzed. But, most important, their needs are met. They get counseling and a clean record rather than a long rap sheet.

“Make no mistake on this,” Pirowski says. “It would be easier for these guys to go to jail and do their time. It’s not a soft on crime thing at all. They’re under strict community supervision and they’re held to a high standard.”

It’s a model that produces results. The recidivism rate for a substance abuser coming out of the Drug and Mental Health Court (also one of the first of its kind in the nation when it was started), on which the Veterans Court is based and what it’s modeled after, is a meager 17 percent after three years. Compare that to the national average of 60 to 75 percent.

The Western New York Veterans Project’s work to help veterans won’t stop with the Veterans Court—that’s where next week’s conference comes in. Mann describes it as the “next step in this ongoing process.” After setting up the court, he and O’Connor met with local VA officials as well as local managed care providers to talk about the Veterans Court. “We were basically trying to get community-based services in the game of providing treatment and support for veterans,” Mann says, “and using the VA to train them on the issues that are specific to veterans.”

That education, begun in September during a one-day training session, will continue at the “Impact of War” conference, where VA officials and doctors, combat veterans and military experts will get a chance to present to nearly 100 community-based service agencies.

They’re also hoping that those services—Crisis Services, Child & Family Services, Jewish Family Services and many, many more—will be able to take cases from the VA, should it experience capacity problems. “So the community could probide support to the VA when they need it,” Mann says. “It’s to get the community involved in supporting the VA, and the VA more involved in educating the community, so we have a more cohesive response to the troubles faced by our veterans.”

Mann continues, “All of these agencies—the Buffalo Police, the mental health agencies, certainly the addictions agencies, the domestic violence agencies—we’re all dealing with the aftermath of combat experience and trauma, but we’re just not recognizing it as such.”

The conference will be a showcase for the local model, including the Veterans Court (Judge Russell and Hank Pirowski will be presenting), since William F. Feeley, the VA’s Deputy Under Secretary for Health, will be in attendance.

“We’ve got a lot going on here fairly quickly,” Mann says. “So it could lead to some good things locally, but I think it will be helpful on a much broader scale, too.”

Pirowski, considering his military days and reflecting on the situation of the veterans now returning from war, sums it up this way: “We used to seek and destroy, now it’s our turn to identify and assess. We need to find them and put them into the programs that will help them.”