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Will Iraq and Afghanistan be the wars that teach us how to take better care of our returning warriors?

January 2010By Comments

As I write this, stories about Major Malik Nadal Hasan’s rampage at Fort Hood have begun to vanish from the front pages of newspapers and the TV news, displaced by health care, the holidays, and Tiger Woods. It has not even been a month, but already the worst mass shooting at an Army base in U.S. history is old news. This won’t come as a surprise to anyone who’s fought in Iraq or Afghanistan. Civilians in America have been all too willing to let the wars in those two countries be something that happens to other people. Until tragedy strikes, most people avoid news about the military altogether, while a small number of Americans continue to put their lives on the line in desolate foreign lands for reasons that seem to have lost their meaning several years ago.

We still sing “God Bless America” at public events, but supporting the troops is mostly lip service. We learned from Vietnam to hate the war, not the warrior, but we have not learned any better than the Vietnam generation how to assimilate the returning troops into our midst. And though the casualties are far fewer than in Vietnam, the fighting in Iraq and Afghanistan has inflicted many soldiers with injuries that are not as obvious as, say, a missing limb. Multiple deployments have become a huge factor in the rise in the number of cases of post-traumatic stress disorder. Another factor is that the wars in the Middle East have no front lines: The enemy can be anywhere. The impact of improvised explosive devices—IEDs—can cause traumatic brain injuries that might not show up for years. Meanwhile, technology has made it easier to stay in touch, which means that a soldier can be stressed out in real time by a spouse’s inability to pay the bills or a child’s failing grades, all while he’s trying to remain vigilant at a market outside Baghdad or Kabul. Is it any wonder that the wars in Iraq and Afghanistan have shown an incredible spike in the number of veterans who commit suicide?

Even so, returning soldiers are still left mostly to fend for themselves, a fact that is doubly disturbing when you consider that some may have signed up to escape poverty or problems at home and may lack the emotional strength to survive battle stress and its aftermath. Uncared for, many of these veterans simply end up in prison; 10 percent of all adults arrested last year, according to the Department of Justice, had served in the military. Three hundred veterans are booked into the Harris County jail every month.

During the 2009 legislative session, Houston state senator Rodney Ellis began looking at ways to lower that number. Ellis knew that overseas, soldiers learned to carry weapons with them at all times and to barrel through traffic intersections to avoid potential sniper fire—not exactly skills that are advantageous in civilian life. What had been adaptive was now maladaptive, and veterans were being arrested and jailed for behavior that, in another setting, had kept them alive. Ellis also knew that nearly 20 percent of the soldiers who served in Iraq and Afghanistan suffered from PTSD or major depression but only slightly more than half were getting treatment. Since PTSD or a brain injury often makes it difficult to follow the intricate terms of probated sentences, veterans could stumble into stiffer punishments for relatively minor crimes by missing appointments or failing to report a change of address. And the number of vets in Ellis’s district was growing: Harris County now has the second-largest number of Operation Enduring Freedom and Operation Iraqi Freedom veterans in the country, second only to Los Angeles County.

Marty Gonzalez is one such veteran who nearly lost his way. At 29 he looks every inch the accomplished former Marine: He stands ramrod straight and answers questions with a level gaze and a crisp “yes, ma’am” or “no, ma’am.” He joined the Marines at 19, guarded nuclear weapons sites before serving in combat, and ultimately earned a Navy/Marine Corps Achievement Medal, three Purple Hearts, and two Bronze Stars. When he wears his uniform in public, strangers thank him for his service. But he could easily be sitting in prison right now, serving time for a felony.

Gonzalez fought in Iraq. On a cold, gloomy December day in 2004 in Fallujah, his platoon came under fire. With another soldier, Gonzalez stormed a house to retrieve the body of one of his men. An insurgent threw a grenade down the stairwell as Gonzalez was ascending. Caught in the explosion, Gonzalez still managed to retrieve the dead Marine and pull his buddy out of the wreckage, all while having suffered a concussion and other brain injuries. The fighting continued through the night, and the next day Gonzalez was shot in the elbow at close range. He barely survived and, after being seen at several hospitals in Europe and the U.S., was shipped home to the veterans hospital in Harris County, where his father, a Vietnam veteran who worked in housekeeping, looked out for him. Over the next few years, Gonzalez endured nine or ten surgeries and almost lost his right arm. But that was nothing compared with his emotional injuries. “When Marty came back, he was different,” his father, Tomas, says. He was angry, distracted, and felt that he couldn’t talk about his experience with anyone. Gonzalez couldn’t adjust to civilian life, which meant that he couldn’t hold down a job. His marriage collapsed. In severe, constant pain, he began taking medications for relief. Gonzalez was suffering from PTSD, but he didn’t recognize the symptoms. Then, in April 2007, he was arrested for driving under the influence; he was loaded up on painkillers. Because his infant son was in the backseat at the time, he was charged with endangering the life of a child, a felony.

Facing a prison sentence of two to ten years, Gonzalez got his first lucky break. His defense attorney, Darryl Spiller, looked over his military record and concluded that Gonzalez’s condition—and his crime—was a result of what had happened to him overseas. At first, the judge on his case saw nothing more than an irresponsible 27-year-old. “I thought, ‘Good luck,’ the day his package was presented to me,” says Judge Marc Carter, of the 228th Criminal District Court. But the more he read of Gonzalez’s file, the more he softened. He was also a veteran, from a family of veterans, and he had seen too many soldiers like Gonzalez end up in prison. Gonzalez was asking for a two-year pretrial diversion. “I realized that because of one bad decision, one bad day, Marty could be a felon,” he says. He agreed to Gonzalez’s request.

The case prompted Carter to look for concrete ways to smooth the way home for other veterans. He soon teamed up with Ellis, who was then proposing a jail diversion program in the Legislature. Only a handful of such programs exist in the U.S., and most of them simply provide mental health services and treatment for alcohol and drug abuse. Ellis wanted more: a program that would not only keep veterans out of the criminal justice system but also help them get job training and claim their benefits (simple as it sounds, some veterans, especially young ones, don’t do this). He and Carter, along with a number of local veterans, including Patrick F. McCann, the former president of the Harris County Criminal Lawyers Association, put their heads together, enlisted still more allies, and finally, after some eleventh-hour negotiating, got a bill passed that established the first veterans’ courts in Texas: courts specifically designed to pull military personnel with combat-related PTSD and other injuries out of the criminal justice system and into treatment.

The logical place to house such a program was at Houston’s Michael E. DeBakey Veterans Affairs Medical Center, the largest health-care facility in Texas and one of the largest in the nation. At the same time that Ellis was working the Legislature, forensic psychiatrist Andrea Stolar and her colleagues had begun to develop a rehabilitation program that could offer not just drug and alcohol treatment but care for medical problems like PTSD and traumatic brain injuries. The program was also designed to provide help with military benefits and, for the growing number of homeless vets, assistance with finding a place to live. In other words, the goal was to truly bring soldiers home again. “A successful jail diversion program has coordinated care,” Stolar explained. “The VA is the only system we have that provides that. All you have to do is get them in the door.”

Several more months of negotiations followed. The Harris County district attorney’s office would have to approve all transfers from the criminal court to the veterans’ court; in most instances, those with violent histories would not be eligible. Soldiers charged with misdemeanors or felonies would have to have a diagnosis of a brain injury or mental illness from the VA. On Veterans Day the last hurdle was cleared for the establishment of a six-month pilot program, the first in the state with VA services. Depending on the case and their plea, vets who successfully complete the two-year program can have all charges expunged from their records.

The first session of the veterans’ court took place on December 9—the same month Marty Gonzalez completed his probation—with a docket of five people and Judge Carter presiding. (Competition for the slots was intense; just about every day a criminal lawyer lobbied Carter for a slot on the docket for his client.) Those who worked to make the court a reality express a relentless optimism. “We will save lives,” Adam Walmus, the director of the VA hospital, promises.

Every war teaches us something. Let’s hope this is the one that teaches us that we can no longer ignore the mental and emotional tolls that are the hidden scars of battle in modern warfare. As Walmus told me, “It’s the right thing to do.”

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