The government needs to broadly improve its services and flow of information to the growing ranks of veterans suffering debilitating mental ailments from their war experiences, according to a chorus of voices inside and outside government.

Larry James, dean of the Wright State University School of Psychology, predicts that post-traumatic stress disorder will be to this generation what HIV/AIDs was in the ’70s and ’80s. “I’m very worried about it,” he said. “If people think that PTSD was a challenge in the post-Vietnam era, just wait.”

The stigma of mental health treatments is one of the biggest barriers to healing, James believes: “People are afraid to seek help because they think it might end their careers.” It would help, he added, if a healthier message came from the top. “There are only two conditions for which you can’t win a Purple Heart: PTSD and hearing conditions,” he said.

The rate of military suicides is much higher today than during World War II, and James believes that behavioral scientists should explore why that is happening.

Getting treatment, benefits

Charles Hooker, 55, of Hamilton, said it took more than five years for him to obtain the full government benefits to which he was entitled under his diagnosis of post-traumatic stress disorder. Hooker, who travels to the Dayton VA Medical Center for treatment, said his questions to a local VA office were often referred to offices in other parts of the country, without explanation.

Hooker said he was unable to keep a job in the civilian sector because of the mental trauma he blames on his experiences serving on the flight deck of a U.S. Navy aircraft carrier that helped to evacuate U.S. forces from Vietnam during that war in the 1970s. He said he didn’t begin receiving his full allotment of benefits until he asked for help from U.S. Sen. Sherrod Brown, D-Ohio, a member of the Senate Veterans’ Affairs Committee.

More must be done to address the backlog of veterans’ claims for critical services, U.S. Rep. Steve Austria, R-Beavercreek. From 1999 to 2010, the number of veterans receiving VA compensation for service-connected PTSD increased by 222 percent, he said.

The VA could do more to inform veterans of benefits available to them, said Mark Hawk, 53, of West Milton, an Army and Army Reserve veteran who served in the Persian Gulf War. Hawk said he eventually found out only from another veteran that he could have requested reimbursement from the VA for his costs of travel to the Dayton VA Medical Center to attend meetings of a PTSD support group.

Veterans Service Organizations exist in all 88 Ohio counties, but many veterans or their caregivers are unaware of those offices or how they can assist veterans with paperwork to file for benefits, Brown said.

Improving the process

The U.S. Government Accountability Office, auditing and investigative arm of Congress, said the Defense Department and VA must improve the performance of the Integrated Disability Evaluation System, which they began jointly operating in 2007 to replace the previous separate disability evaluation processes for each department.

The time needed for processing those cases has increased each year, the GAO reported last week to the Senate Veterans’ Affairs Committee. In 2011, the average processing time had reached 394 days for active-duty service members and 420 days for reservists, well above the government’s stated goals of 295 days and 305 days respectively, the GAO noted.

The VA has increased resources for evaluating veterans for service-related disabilities and the Army is hiring more staff for its medical evaluation boards, the GAO reported.

The VA has committed to hire 1,900 additional employees to improve veterans’ access to mental health care. The VA is seeing more patients, in part because the department has made it easier for veterans to submit disability claims for PTSD, Veterans Affairs Secretary Eric Shinseki told Congress this spring.

Claims backlogs are growing. In 2011, the VA processed 1 million claims from veterans, but 1.3 million new claims were submitted.

As of March, Ohio veterans were awaiting decisions on 25,226 pending claims for benefits. Seventy percent of those claims had been pending for more than four months. The state Department of Veterans Services projects that the backlog will increase by 17 percent in the next four months alone.

The Dayton VA Medical Center said in April that it routinely schedules appointments within 14 days for veterans new to the mental health services clinic in its outpatient clinic. As a whole, the VA nationwide reported that 95 percent of veterans who contacted the department received a full mental health evaluation within 14 days.

But the VA’s own inspector general criticized the department’s data as “not accurate or reliable.” Most veterans waited approximately 50 days before evaluation, the inspector general found.

The inspector general recommended that the VA revise how it measures wait times for mental health services and do an analysis of whether mental health staff vacancies was undermining timely access to mental health treatment for veterans.

Making changes

Bill Wall, program manager for the Freedom Center, took the recent suicide of Curt Fike very much to heart. Not only did Fike work at the National Center, but also he sought help at the Freedom Center, the Dayton VA Medical Center’s post-deployment clinic. “He was one of my guys,” Wall said.

Medical Center Director Dr. Glenn Costie has recently proposed a number of initiatives in the aftermath of Fike’s suicide.

As a result of Merrill’s recommendations, a veterans’ suicide survivors group is being put together. “Suicide is grief on steroids,” Wall explained. “Survivor guilt is in a special category. It’s a very ambiguous loss, forcing survivors to ask themselves, ‘Why did it happen and what could have been done to prevent it?’ It’s very hard for survivors to make sense of that kind of death after their loved ones survived Iraq and Afghanistan.”

The VA’s Freedom Center conducts a 10-step screening, known as intake, of each returning veteran, looking for signs of PTSD or other health problems. Many problems don’t develop until much later, Wall said, and that’s why families are such a critical resource.

The Freedom Center also will offer training sessions for patients’ families and emergency contacts. Each veteran, at his or her intake session, will be asked to complete a “release of information” form so the staff can speak openly with specified family members. “This gives our staff free access to talk about the patient’s care and medical records, and for family members to share concerns ... .”

Merrill applauds that move: “Curt suffered and I mean suffered each and every day from those dreadful invisible wounds. If we would have only known what he went through, ... we would have been able to do so much more to help him.”

Staff writer Barrie Barber contributed to this article. Contact this reporter at (937) 225-2242 or jnolan@DaytonDailyNews.com.