Unreserved support: Network helps state programs communicate
BURLINGTON, VT. — There are yellow ribbons and parades, sure.
But when National Guard and Reserve members return from deployment, many find themselves dropped off in the civilian world with not much more than a pat on the back and a thank you.
Without a military base like their active-duty counterparts, they disperse into the nooks and crannies of their state, settling back in with a community that cheers their homecoming but is largely unacquainted with the needs of the veterans and their families.
In most states, the flag-waving hasn’t translated into substantial long-term support for reservists. They are left on their own to make the tricky transition from combat to civilian life. Some are grieving combat losses, others face divorce. And some end up fighting the Army itself — Oregon guardsmen came home last month to find themselves labeled “weekend warriors” looking to milk the system by Madigan Army Medical Center at Joint Base Lewis-McChord, Wash.
But as the unprecedented reliance on reserve forces continues — they make up about half of Iraq and Afghanistan veterans — a few states are realizing more has to be done. The Pentagon and Veterans Affairs are betting that one state — Vermont — could become a national model.
Building a network
In 2005, Vermont shipped off about 400 guardsmen to Ramadi, Iraq, and almost immediately started experiencing the highest per capita losses of any state.
Lt. Col. Michael Heston can rattle off the names of those killed in the order they died.
“It just seemed like forever we were doing funerals right after one another,” he said.
Many were lifelong residents of Vermont. One was a local policeman whom Heston, a retired state police officer, had trained at the academy.
“It’s a community loss,” Heston said. “Not to diminish anything on the Army side, but the Army has a base and the base takes the hit and everybody feels it on that little base. But when a community member gets hit, it’s the whole state that feels it.”
The deployment started to adversely affect families. Divorce, for example, skyrocketed.
The Rev. Jim MacIntyre, Family Program and Readiness Center chaplain at the time, sought the help of the Veterans Affairs’ National Center for Post-Traumatic Stress Disorder in White River Junction, Vt.
They gathered at a conference and “the room full of camouflage” started peppering Center director Matthew Friedman with questions before he even got through the first point of his talk.
“We said: ‘Whoa. We’ve got a situation here,’ ” MacIntyre said.
It became very apparent that to really help guardsmen and their families, the state was going to need more than the typical efforts that “puff up and disappear.”
That realization turned into the Vermont Military, Family and Community Network, a grass roots endeavor to coordinate state services for military families.
At its most basic, the network brings together all the key players from across the state, forging long-term partnerships among health and human services, the Guard, the VA, state legislators, Vermont’s congressional delegation and the governor’s office.
Everyone works together to answer the question: “What are we doing today that works, and what do we need to do to make sure we have a system woven together so that no one falls through those cracks?” said Scott Johnson, director of field services for Vermont’s Agency of Human Services.
‘Web’ of communication
All involved said it was hard to overstate the power of a regular conversation.
“If we hit on an issue and have people at the human services level parlaying the message to the secretary, at the same time the lieutenant colonel is bringing it to the general, at the same time staffers are bringing it back to the congressmen, that’s pretty powerful,” Johnson said.
The network helps to avoid past situations where organizations knew only about what was going on in their department, and works to put servicemembers on the permanent agenda, according to Laurie Slone, a doctor with the National Center for PTSD who spearheaded the network.
“I was blown away,” she said. “We thought we were going to have gaps where we needed to come up with new services. No, we just needed to communicate.”
The players defined a common goal, saying “we own this problem together,” Johnson said.
“On some level I feel like I work for Lt. Col. Marc Goudreau,” he said about the Guard’s point person for the network. “If Marc says I need you, same as if my boss down the hall says I need you, I’d be there.”
The network can also prevent issues from escalating.
Take resources for traumatic brain injury, for example. Sitting at one of the quarterly network meetings it might come up as, “Oy vey, we just capped the TBI program because of budgetary issues and if the cap stays at that limit and we have this many returning soldiers estimated to have that certain type of disability, we’re short of the needed capacity by ‘X’,” Johnson said. “And that has to become a policy conversation. Someone has to pick up the phone and make sure the governor knows about it.”
The idea is that no matter how a servicemember or his family reaches out for help, there will be a knowledgeable person who can link them with the right resources.
Take Sgt. Mike Garcia, who discovered toxic mold in his basement shortly before deploying earlier this year. He was concerned about his pregnant wife and anxious about not being around to deal with the problem. Enter the network, which had a team meeting to see what could be done. Different agencies kicked in money to cover the costs, and within a few days a contractor was at Garcia’s house to take care of the mold.
“It’s very much like a spider web,” the network’s director, Marianne McEnrue, said. “You twang one part and the rest of the web vibrates.”
That kind of connection is especially important in mostly rural states.
As one winds through Vermont, the land is forested and largely uninhabited. Then a steeple will pop into view, a landmark for the community of only a couple thousand that is typical for the state.
On a military base, “people understand TBI, PTSD and suicide and what have you,” Goudreau said, “Their support network is within a 5-mile, maybe 10-mile max, radius. And your neighbor is experiencing the same things you are.”
Not so in Vermont.
Earlier this year the state had its largest deployment since World War II, sending 1,400 soldiers to Afghanistan as part of the surge. They went to Camp Atterbury, Ind., to mobilize — and they’ll come home through there too.
That leaves quite a disconnect from the Army’s safety net.
“If there’s 100 percent connectivity on a military base, we’re probably lucky if we have 5 percent connectivity in the state,” Goudreau said. “And it’s not that they don’t care about us, it’s that they don’t understand the real issues that are associated with the deployment. They are willing to help and want to help, but what does that look like and how do you do it?”
A proactive community
The Military, Family and Community Network is focusing on educating the community.
“It can be as small as someone looking out their window on a cold February morning when 25 inches of snow has just landed and knowing that your neighbor has a deployed spouse and getting four children ready for school, and you take extra time to go snow-blow their driveway so they have one less stressor in their lives,” Goudreau said.
The network is also reaching out to the medical community.
For many guardsmen the nearest VA is more than an hour away. Maybe two. This means a returning guardsman is likely to get care from the local doctor in his community.
McEnrue said the network is trying to ensure that doctors are aware of screening questions they wouldn’t otherwise ask, understand the impact of military culture on treatment, and can recognize normal combat transition behavior and spot red flags for PTSD.
Soon questions related to TBI and PTSD will be added to the standard health questionnaire used in doctor’s offices.
It’s a part of the network’s ambitious plan to take the effort beyond a safety net to something more proactive. Earlier this year they started what they call the “Four Corners” project, which addresses education, employment, health care and financial issues.
“What can we do to mitigate [the soldiers] stepping off the plane and their foot hits the tarmac and not having any direction, or a job or college?” Goudreau said.
A few things are in the works: job fairs for January 2011 when the Vermont Guard soldiers are scheduled to come home; a standardized application to all the state’s colleges and universities; Web-based financial planning; and education for school counselors on the needs of children with deployed parents.
“It’s not rocket science,” Johnson said.
Most states don’t have anything close to Vermont’s program. Ohio, Rhode Island, California and Minnesota are a few with notable efforts.
In 2008, Congress legislated a national version of the Yellow Ribbon program started in Minnesota, which requires each returning Guard unit to gather as they mark 30, 60 and 90 days after deployment, to talk about reintegration issues such as mental health, substance abuse and financial planning. Families are encouraged to attend.
But the Pentagon dragged its feet on creating a national Yellow Ribbon template for all states to use, which was mandated by law. Robust state programs that go beyond the single-day events of the Yellow Ribbon requirements are rare.
Lt. Col. Barb O’Reilly, who is spearheading the charge in Minnesota, said it’s important that states take the lead rather than wait for direction from the Pentagon.
“Reservists are from communities,” she said. “They work in a community. Go to church in a community. Who better to support them than their own communities? They cannot be taken care of at a central level, we have to decentralize that.”
Like Vermont, Minnesota’s efforts have not cost the state any money.
“It’s not about creating a program,” O’Reilly said.
McEnrue agreed. Without a formal framework to confine the effort, “we don’t have to seek a whole lot of permission.”
The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury has recently created “Building Bridges,” a clearinghouse of information and resources. But mostly, the Pentagon is letting states take the lead on many of these issues.
Expanding the model
Will the Vermont concept work in other states?
The Defense Department awarded Slone, of the National Center for PTSD, a grant to find out. Last summer, the experiment began in Maine, and it closely mirrors Vermont’s network. Although Slone is pleased with the progress, she said Maine’s government hasn’t stepped up as much as is needed. In a few months, they will do surveys to evaluate the network there.
It’s yet to be seen whether the small state of Vermont — the number of babies born each year in California equals the total population in Vermont — is able to do what it does only because of its size. The governor, for instance, can attend a homecoming for five soldiers at 4 a.m. when there are no TV cameras to capture the handshaking. It also helps that some of the top positions in the state are held by guardsmen who recognize the need for the network and want to see it work.
The director of the National Center for PTSD doesn’t think size is an issue. For bigger states, the model could be regionalized, said.
That plan is working in Minnesota, where cities put together a community-based collaboration and earn the title of Yellow Ribbon City.
“It builds awareness throughout the state that this is not about something you just read on the front page on the newspaper,” O’Reilly said. “This is about your neighbors.”