ALBANY -- An elevator ride up from the busy whirl and steel-gray hues of the Stratton VA Medical Center lobby is a wing that seems worlds apart -- painted in buttery yellow and taupe, with an homage to women in the entrance hall and kid-size chairs in the waiting area.
The Women Veterans Wellness Clinic differs from the rest of the Albany VA by design. The medical center invested $829,000 to build it 18 months ago, with the realization that female veterans were not always comfortable coming in for annual physicals or gynecological exams in the male-dominated facility, said Jane Weber, women veteran's program manager. And for the estimated 22 percent of women vets who suffer from sexual trauma during their military service, the need for a soothing space designed for privacy was critical, she said.
"I love it," said 57-year-old Penny McInnis, a Gulf War vet who receives all her health services at the Albany VA, including therapy for military sexual trauma. The hallways on some floors, crowded with men like those who mistreated her, can trigger panic attacks for McInnis.
Like facilities throughout the Veterans Health Administration, the Albany VA has focused on creating a more welcoming environment attuned to women's needs, as the number of women returning from military service grows, their average age gets younger and the system steps up to address the growing problem of sexual trauma.
Yet many women veterans who are eligible for care still choose to go elsewhere, or don't get care at all, due to issues ranging from misinformation to mistrust, veterans and advocates said.
Overall, the VA's efforts to change its approach to offering services for women throughout the nation has been largely successful, said Greg Jacob, policy director for the Service Women's Action Network, a national advocacy group.
"Over the course of the past five years or so, the VHA has done an incredible job of responding to the needs of women veterans and sexual trauma," Jacob said.
The number of women patients getting medical care through the VA nationally nearly doubled in the 2000s to more than 300,000 in 2010. In Albany, about 70 to 80 women are seen at the new clinic each week, said Albany VA spokesman Peter Potter. That's an increase for the local VA, and the type of patients has changed too. The average age has gone from 60 to 40, Weber said.
Designers of the Albany women's clinic thought through many details to enhance women's feeling of safety and comfort, Weber said. Exam chairs face away from doorways, curtains are available throughout rooms for privacy, there's a room for breast-feeding or pumping milk.
All patients are screened for sexual trauma, said Amanda Kras, Albany VA military sexual trauma coordinator, at a public forum this month hosted by Community Cradle, an Albany nonprofit. To qualify for treatment, a vet need only say that she experienced sexual assault or harassment while in service. No proof is required, it doesn't matter how long ago it occurred, and it's OK if the veteran previously denied the experience.
When a vet reveals such an experience, Albany VA officials aim to get her to a counselor immediately, before she loses the courage to talk, Weber said.
McInnis, a Colonie resident, told a doctor there about her harassment experience almost 20 years after it happened. She'd started having panic attacks triggered by unexpected reminders of war -- at a gas station, an attendant pointing an air hose reminded her of a soldier pointing a weapon, for instance.
Within 20 minutes of disclosing her feelings, she was talking to a counselor, and has been receiving therapy since. She said it's helped tremendously.
"Because I never addressed this, it was always in the back of my mind," McInnis said.
Yet there are gaps in reaching women, VA officials and advocates noted. Some female vets have other options through private insurance plans. Other women think the VA is for men who experienced combat. Enrollment is not automatic at discharge; rather, veterans must actively sign up while they are handling the complexities of returning to civilian life.
In the case of women who were sexually assaulted during their service, and for whom that crime was inadequately addressed, their mistrust of the military may be transferred to the VA, Jacob said.
Sexual assault can leave permanent mental and emotional scars on victims, regardless of where it occurs. Aspects of military culture can exacerbate the trauma and erode a woman's trust overall, Kras said. Barriers to disclosing the problem and seeking help include a high value on loyalty and teamwork, and an emphasis on strength and self-sufficiency.
"The VA, even though it's not in the Department of Defense, the perception of it is still it's an extension of the institution," Jacob. He added that some female vets in Manhattan, for instance, must still walk through hallways of men who make rude comments, to get to an exam room.
"They're making a lot of improvement," Jacob said. "They've got a way to go."