“There’s something to be said for burning up some shoe leather and going to find these people,” Boyd said. “They may not answer the phone or an e-mail, but if you knock on the door, 99 times out of 100, veterans will talk to you, and you’re going to find out what’s going on.”
In Vermont, officials have seen the effectiveness of using combat veterans as outreach team members, Boyd said. “Our program has observed that using fellow veterans helped allay anxiety some soldiers felt when first contacted,” he said.
The program has a goal of contacting all reserve component veterans of Iraq and Afghanistan in Vermont. Outreach specialists focus on ensuring that veterans are receiving benefits, including early diagnosis and treatment of post-traumatic stress disorder and traumatic brain injury.
In many cases, outreach specialists drive veterans to Vermont VA medical facilities for their first few visits, Boyd said.
“Unlike their active-duty counterparts, Guard and reserve veterans must transition from their civilian life and employment, to active-duty military service, and back again,” said committee chairman Sen. Daniel Akaka, D-Hawaii. “Despite VA’s best efforts to conduct outreach to this population, it seems clear that some are still unaware of all that VA has to offer and how to access those services and benefits.”
Army Reserve Maj. Cynthia Rasmussen, combat stress officer for the 88th Regional Readiness Command, said officials need to keep in mind that active-duty members separating from service may also need support when they come home to a rural area.
She said VA staff workers must be “culturally competent.”
“You don’t have to wear the uniform, but you have to understand why we do what we do and why we think the way we do,” she said.
Vet Centers are an excellent place for outreach, said Joseph Scotti, a licensed clinical psychologist and professor of psychology at West Virginia University. At the Morgantown, W.V., outreach center, for example, “they do a tremendous job, but they are overwhelmed.”
“A room full of 50 vets and one counselor … calling it group therapy — it’s not,” Scotti said. “They need more help. They’re still overwhelmed” with older veterans of Vietnam and other wars.
Veterans in rural areas have been a longstanding concern. Veterans from rural counties in West Virginia had greater combat exposure than those from urban counties, according to the initial results of a study resulting from a survey mailed to West Virginia veterans of Iraq and Afghanistan, conducted by Scotti and his colleagues.
Results of the study also indicate:
• Veterans who served as members of the Guard and reserve are experiencing more problems with psychological and daily functioning than active-duty personnel.
• Veterans from rural counties are experiencing more problems with psychological and daily functioning than those from urban counties.
• While about 80 percent to 90 percent of veterans are aware of services and support available to help them deal with these issues, one-third to one-half are not using professional or VA-related services. And only about half the veterans reported that a service they used was helpful to them.
Still, progress is being made. Maryland Army National Guard Sgt. Roy Meredith said he saw significant improvement in the way VA accommodated him after he returned from his first deployment in early 2006 compared to when he got back from his second deployment earlier this year.
After his first deployment, he said he got little information from VA at his demobilization site, and VA later erroneously ruled his injuries form a roadside bomb in Iraq as not combat-related.
Two years later, VA counselors and claims processors were at the demobilization site to help troops. He was given e-mail address contacts, office numbers and even personal cell phone numbers of supervisors, and contacts for hospitals and clinics.
“Supervisors called me to follow up,” he said. “It was 180 degrees difference. No longer do I wonder if I’ll be taken care of for wounds seen and unseen.”