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CONFRONTING THE UNSPEAKABLE -- An innovative Minnesota

National Guard program helps newly returned soldiers bearing

psychological wounds from combat in Iraq.

Nick Maurstad has intense memories of his combat duty and has turned to writing to find solace. The 22-year-old works on "Bristols Bastards," a book about his time in Iraq with the Minnesota National Guard. (photo: BEN GARVIN, Pioneer Press)

For more about this Minnesota National Guard program, use the VA Watchdog search engine...click here...
http://www.yourvabenefits.org/sessearch.
php?q=minnesota+national+guard&op=ph

Story here... http://www.twincities.com/ci_7297381?source=most_viewed

Story below:

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-------------------------

Confronting the unspeakable

An innovative Minnesota National Guard program helps newly returned soldiers bearing psychological wounds from combat in Iraq.

BY JEREMY OLSON
Pioneer Press

Chaplain John Morris stood in a Minneapolis auditorium and faced 500 Minnesota National Guard members, mostly quiet, attentive and indistinguishable in their camouflage fatigues.

"There's somebody here with a bleeding artery," he told them at the Oct. 13 assembly. "I just can't see it."

It's been two months since 2,600 Minnesota Guard members returned from an unprecedented 16-month tour in Iraq, and Guard leaders and veterans' organizations are paying close attention as the celebrating wears off.

It's the "golden hour" of reintegration, Morris said, when most returnees re-enter civilian life - and a few show signs of depression, anxiety or post-traumatic stress disorder.

"You can see it in their eyes," he said. "It's that loss of hope."

The prevalence of combat stress and mental disorders among returnees from Iraq and Afghanistan has been a growing concern for military and veteran leaders. It's a particular concern for Minnesota Guard members, whose extended tour stretched their marriages, exposed them to further trauma and made life back home that much more foreign.

It's also a concern borne by those who served in Vietnam, who remember the lack of help they received and how it deepened their stress and anxiety.

"The Vietnam veteran was driven to silence, he was driven to embarrassment, he was driven to not talk about it," said Maj. Gen. Larry Shellito of the Minnesota National Guard.

Guard leaders expect that a majority of Iraq returnees will experience mild adjustment problems - from feeling nervous when commercial planes fly overhead to struggling with the return to civilian freedom. However, they expect far fewer to have diagnosable mental disorders.

SLIGHTLY HIGHER RISK

Research suggests a slightly higher risk of psychological problems for local Guard members, who spent more time in Iraq than any other U.S. active or reserve unit. In June, the Department of Defense Task Force on Mental Health reported psychological symptoms
in 49 percent of returning National Guard and Reserves members, compared with 38 percent of Army soldiers and 31 percent of Marines.

An Army mental health assessment in 2006 found deployment length to be an important risk factor in addition to the intensity of combat exposure.

The exact toll for the Minnesota soldiers will be clearer in the coming weeks as they complete post-deployment health re-assessments and report psychological symptoms. A study at the Minneapolis VA Medical Center will eventually provide precise data on the rate of post-traumatic stress disorder among these returnees as well.

In the interim, the Guard and veteran organizations are using a variety of strategies to keep tabs on all returnees from the 1st Brigade Combat Team. The military health insurer TriWest is placing counselors in Guard armories. The Guard has created the Beyond the Yellow Ribbon program, a mandatory series of conferences to teach returnees about their risks.

Part of the Guard's strategy is simply getting soldiers back together - knowing they bonded in Iraq and will identify problems in one another first. Many won't ask for help on their own, said Morris, a lieutenant colonel and the Guard's deputy state chaplain.

"We teach resiliency in combat - suck it up and drive on," he said, "and now it's OK to ask for help?"

MOVING ON

Nick Maurstad spent a night drinking earlier this month with a fellow member of B Company and noticed something different. It wasn't the amount of alcohol his friend drank but rather the angry edge he took on. Maurstad called the man's wife later and said her husband should consider seeking help.

Maurstad lost three friends in Iraq, and a friendly demeanor belies his own frustrations. He has intense memories, such as disarming an insurgent who was raising a handgun to shoot while in bed with his wife and children.

Back home, the 22-year-old has been trying to find his place. Maurstad took a limo trip with friends from northern Minnesota but felt distanced from them. He helped his father with the fall sugar beet harvest. Now, he has a book deal and hopes to find solace in writing.

"It really is helping me quite a bit to move on from that place," he said.

He's not alone in feeling strange at times.

Howard Johnson is among the many returnees who feel nervous in commuter traffic, after being trained to steer clear of potentially hostile vehicles in Iraq.

James Heinecke said it's an adjustment to simply cook and do laundry again.

Paul Bramsen misses the adrenaline that came with his "counterfire" duties to repel insurgent attacks.

"I haven't replaced it with anything," he said.

WHAT'S NORMAL, WHAT'S NOT

Morris said it is important to distinguish these various reactions to combat stress, which are normal after war, from severe mental health problems.

Part of the challenge is getting returnees to overcome the fear that they will be viewed as weak if they seek counseling. Studies by Dr. Charles Hoge at the Walter Reed Army Institute of Research have found gaps between returnees who show psychological symptoms and those who seek help.

It's possible that soldiers report mild, temporary symptoms in the initial screenings that never meet the criteria for mental disorders. A formal PTSD diagnosis, for example, requires symptoms to last at least a month and to impair daily living. Typical symptoms include flashbacks, emotional numbness and withdrawal from society.

It's also possible that soldiers are refusing help, which for some can turn acute mental disorders into long-term, chronic problems.

"Hopefully, it will be less than in Vietnam," Hoge said, "when mental health issues weren't addressed until years or decades after they returned home."

VIETNAM INFLUENCE

Shellito urged the creation of the Guard's reintegration program after seeing early returnees act just like he did when he came back from Vietnam. The Guard's adjutant general said he still has vivid memories about the friends he saw killed and thinks about the allies left behind when the U.S. withdrew from Saigon.

However, some veterans' officials worry that all the focus on mental health risks might create a stereotype about returnees - potentially repeating a problem that occurred after Vietnam.

"We all got stereotyped as having drug and alcohol problems, when it was only 10 percent of Vietnam veterans that had that problem," said Steve Lindstrom, director of Ramsey County Veterans Services.

"I'm afraid of that (happening again)," he said.

Shellito disagreed. Guard members may grumble that they don't need the Yellow Ribbon events, but he separates them in two groups.

The first probably doesn't need to be there, but "therefore they should be looking their buddy in the eye and taking care of their buddies," Shellito said. "Then there's the other group who, as soon as they say that, I immediately start looking at them in the eye because they may be at the other extreme, too, of self-denial."

The Guard's program has showed early success.

The first meetings identified five soldiers who needed intensive care for suicide threats and more than 60 who wanted immediate counseling.

TESTIMONIAL

Andrew Qualy wishes the help had been available when he returned home to Shakopee in January, after being injured in Iraq by an explosion that caused his vehicle to roll over. Qualy felt like he had no purpose away from his unit and became depressed. He drank heavily, lost his girlfriend and ended up in jail in March after driving drunk and crashing his car.

"In a month and a half, I did a lot of damage to myself and others," he said. "I'm the poster child for what happens when you don't get that" support.

Qualy now tells his story at the Yellow Ribbon events, which weren't available when he first came home, so others know they aren't alone.

Maurstad thinks he's going to be OK, returning to college after writing the book. His mental hurdle for now is visiting the graves of the friends he lost. Others from B Company have gone, but he can't. He thought it would be the first thing he'd do back home.

"It turns out," he said, "I'm not really looking forward to that as much as I thought."

Jeremy Olson can be reached at jolson@pioneerpress.com  or 651-228-5583.

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Larry Scott  --

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