Charities Scramble to Provide Housing and Health Care to Veterans

Even if the conflicts in Iraq and Afghanistan ended in the next few months, the needs of veterans

would persist for at least a generation, say leaders of nonprofit groups that care for returning members of the military. Drug and alcohol abuse, homelessness, post-traumatic stress disorder, and other troubles are almost certain to cause problems for a large number of veterans for the next few decades, they say.

Veterans groups need only look at the problems that continue to affect veterans of the Vietnam War, they say, to see what could lie ahead for the newest generation of soldiers.

Many Vietnam-era problems are “recurring in huge numbers,” says Bill White, president of the Intrepid Fallen Heroes Fund, in New York. “These unmet needs will in 20 years create a huge health-care and financial problem set for the American people, because it’s already happening.”

Gaps in the Safety Net

Leaders of veterans groups have been lobbying the Department of Veterans Affairs to do more, but they still expect charities will fill in the gaps to take care of needs the federal government is unable to handle.

Paul Rieckhoff, an Iraq veteran and founder of Iraq and Afghanistan Veterans of America, in New York, has advocated for better mental-health screening, more Veterans Affairs Department mental-health professionals, and an overhaul of the VA and Defense Department disability systems, among other measures. “There’s a hole between what the VA is doing and what the VA needs to be doing,” Mr. Rieckhoff says.

Charities say the federal government is especially unprepared to deal with mental-health problems.

Thirty to 40 percent of returning veterans will develop mental-health problems like depression or post-traumatic stress disorder, according to estimates from the Department of Veterans Affairs. Hundreds have come to department-run homeless shelters; many more may already be living on the streets. At least 40,000 have sought substance-abuse treatment from the VA.

“We are overwhelmed, and it’s only going to get worse,” says Joseph Bobrow, a clinical psychologist and founder of the Coming Home Project, in San Francisco.

Bureaucracy, he says, has made it difficult for the Veterans Affairs and Defense departments to collaborate with grass-roots mental-health networks like his.

“The thing we need most is to work together, and it’s the thing that’s happening least,” Mr. Bobrow says.

Two of the biggest concerns are the large numbers of soldiers experiencing post-traumatic stress disorder and traumatic brain injury.

“Those two disabilities can affect every aspect of your life,” says Steven Nardizzi, deputy executive director of operations for the Wounded Warrior Project. “They are going to be the most difficult to address.”

The Department of Veterans Affairs estimates that 6 percent to 11 percent of Afghanistan veterans and 12 percent to 20 percent of Iraq veterans will develop post-traumatic stress disorder, though some experts believe the numbers will be much higher. (Approximately 30 percent of Vietnam veterans experienced the disorder, according to the department.)

“The key is always early intervention,” Mr. Nardizzi says. “You never want somebody living with these difficulties, not realizing there’s help, and going five or 10 years without assistance.”

Despite stepped-up screening measures from veterans affairs, advocates worry that many cases are going undiagnosed.

Traumatic brain injury, which can result from roadside bombs or mortar attacks, has emerged as the “signature injury” of the war, Mr. Rieckhoff says.

It can cause a host of debilitating symptoms, like confusion, lethargy, unending headaches, and the inability to wake from sleep. In severe cases, veterans suffer permanent brain damage and will require long-term care.

Repeat deployments also increase the risk of mental-health problems, according to research by the Army, and the increasing strain on military families may have long-term emotional impacts, says Michelle Joyner, communications director of the National Military Family Association, in Alexandria, Va.

“We have not had sustained, multiple deployments like this before as an all-volunteer force,” Ms. Joyner says. “It used to be that the Marine Corps would deploy for six months and then be home for 18. Now they might deploy for six or seven and be home for six or seven.”

Financial Woes

Battlefield injuries can trigger financial crises, says Meredith Leyva, founder of Operation Homefront, a charity in Santa Ana, Calif., that provides emergency assistance to military families.

Spouses often have to leave work for extended periods and travel to the wounded soldier’s bedside, draining their savings. They may have to pay for a hotel, and the service member may be on a reduced salary during recovery.

“You can imagine how the debt accumulates,” Ms. Leyva says.

Compounding the problem is the fact that it can take months or even years for wounded soldiers to begin receiving disability benefits from the Department of Veterans Affairs.

In 2007, the department had a backlog of 392,000 disability claims, according to the U.S. Government Accountability Office. The average time to process a claim was 132 days.

“It’s just taking too long,” says Mike Cash, founder of Operation Family Fund in China Lake, Calif., who says he has spoken to veterans who had to wait two years for their disability claims to be approved. His and other groups help veterans cover expenses during that time.

In 2004, the Wounded Warrior Project worked on the issue by lobbying for traumatic-injury protection as an add-on to the Servicemembers’ Group Life Insurance. The new coverage, which was made retroactive to the start of the current conflicts, pays $25,000 to $100,000 depending on the severity of the injury. Thus far, veterans have received $250-million in benefits, Mr. Nardizzi says.

Employment Help

Some Iraq and Afghanistan veterans are at risk of homelessness. Twenty-six percent of homeless people in America are veterans, according to the Homelessness Research Institute, in Washington. And approximately 8 percent of veterans who have served since 2001 pay more than half their income in rent, according to the institute. Mr. Cash estimates that 10 percent of the applicants to his organization are facing eviction or foreclosure.

Veterans 20 to 24 years old have much higher rates of unemployment than their older counterparts, according to the Department of Labor.

In December, Dan Caulfield, a gulf-war veteran and an entrepreneur in Carlsbad, Calif., started a nonprofit organization, Hire a Hero, to help returning veterans overcome what he calls “the military-service penalty.”

The problem, Mr. Caulfield believes, is that employers who didn’t serve in the military or have close connections to service members tend not to hire veterans.

His solution is to set up social networks that help veterans find military-friendly opportunities. “We have to pay attention to people when they leave the military and make sure they’re connected to people in their hometown,” he says.

Other groups have also started offering employment services. The Wounded Warrior Project’s year-old Warriors to Work program, for example, provides job training, career counseling, help finding internships, and other assistance.

Mr. Nardizzi says he hopes that instead of just looking at whether veterans have avoided homelessness and unemployment, the question will be whether they own their homes and have found rewarding careers. It is an ambitious goal, he admits.

“Our measure of success is going to be whether or not service members achieve the same success in life we all want,” Mr. Nardizzi says. “We’re here to raise that bar.”