Special Report

A year before Gary Silcott was deployed, he never could recall upon waking what he had dreamed during the night.

That all changed after the Alabama National Guard member returned from Iraq.

Now, the 22-year-old Brookwood native wishes he could forget.

In particular, there’s one recurring dream that has him in an exploding truck. That dream causes him to break into a cold sweat and wake with a knot in his stomach.

“Being home has been strange,” Silcott said. “Not having to wear a uniform every day, not having to eat at a certain time, being able to sleep as much as I want is just different. I’m slowly starting to get over it.”

The Department of Veterans Affairs is bracing for an influx of soldiers like Silcott. As the war in Iraq gets longer, the VA — already reeling from scandal at Walter Reed Medical Center and long processing times at state claims offices — must ready itself for the second phase in battle: recovery.

Calhoun County VA officials say they’re prepared for when the rush hits home. They have seen barely a ripple so far.

Indeed, Silcott is the exception rather than the rule when it comes to seeking health care, according to a survey of 420 Alabama National Guard members conducted by the Knight Fellows in Community Journalism at the University of Alabama and The Anniston Star.

Reader response

Tell us what you think about this project

More than 60 percent of those surveyed said they had sought no medical treatment in the past 48 months, with nearly 80 percent reporting that their health was “excellent or good.”

Learning from the past

Jerry Bynum, a psychologist at the Anniston/Oxford VA Clinic, said it’s not uncommon for veterans to be diagnosed with a variety of mood and thought disorders, such as post-traumatic stress disorder, anxiety and bipolar disorder.

With all they’ve seen and experienced, it should be expected. But that wasn’t always the case. Only in recent years have the Department of Defense and the VA improved mental health services for veterans.

Because of the unconventional fighting style of insurgents in Iraq, these agencies see a greater need for medical services for veterans with serious brain injuries.

Bynum said the ongoing war has triggered undiagnosed disorders in older veterans from previous wars, causing many of them to finally seek services.

“We’re seeing a lot of Vietnam veterans who have symptoms triggered,” he said. “Many of these guys are 50-something, and they’re now seeing their sons and daughters off to war. The older ones are getting the younger ones in here a lot of the time.”

Eddie Huggins, a psychiatrist at the clinic, said there is still a stigma associated with having mental health problems, but veterans erode that attitude with peer-to-peer support.

Tom Johnson, a social worker and mental health counselor who also works at the Anniston/Oxford clinic, said when it comes to mental health problems most veterans’ concerns are practical. Many of the veterans that the clinic serves work at the Anniston Army Depot, and they want to know whether admitting to a mental health problem jeopardizes their security clearances and their jobs.

It’s a concern many Guard members have, too, Johnson said.

“There is often some element of denial and a reluctance even of admitting that they are having a mental problem, because they believe it will have a negative impact at their job,” he said.

Bynum said if he could tell veterans returning from this war anything, it would be to seek help early.

“The success rate of treatment is better when we get you early,” he said.

Former U.S. Marine Mike Tyree said he would tell new veterans they’re not alone. He would tell them it’s never too late to get help.

He should know. The 59-year-old, who served in Vietnam, didn’t seek help for nearly 30 years for post-traumatic stress.

“I couldn’t talk about the war,” he said. “I get chills when I talk about it now.

“Back then I just wanted to work and blend in like everything was normal.”

Everything was normal, or at least it appeared that way, until a tornado destroyed Goshen United Methodist Church, where he served as a chairman. That tornado killed 20 people in 1994, and it opened a floodgate of flashbacks from Vietnam that shook Tyree to his core.

“I wound up with a lot of anger,” he said. “I couldn’t sleep, I was emotional. But what I found was that I wasn’t the only one with these problems.”

Tyree said he understands that young veterans might not want to confront what they experienced. But he firmly believes they will have to eventually.

“They should talk about everything they did and get it out of their system,” he said. “It will never leave you completely, but you can deal with it.”

A better safety net

As the Operation Enduring Freedom-Operation Iraqi Freedom clinical case manager at the Birmingham VA Medical Center, Tracey Daniell is one of the first people veterans see when they return home. More than 2,000 veterans from this war are registered with the hospital.

Her position was created for them, and she has counterparts at VA medical centers around the country.

“Some of them are OK,” she said. “A lot of them aren’t.”

The injuries, both physical and mental, caused by multiple deployments and extended tours of duty, make having access to health services crucial for soldiers.

Members of the Guard are less likely than their active duty counterparts to pursue these services, according to Rick DeFilippo, the Global War on Terrorism outreach representative for the Birmingham VA Medical Center.

When invited, DeFilippo speaks to U.S. Army Reserve and National Guard units preparing to deploy to war zones and those just returning.

He tells them about the two-year time frame during which they must enroll in the VA to receive free care for injuries or illness connected to or aggravated by their service.

He tries to assuage any fear of the bureaucracy that can come with seeking care from the VA.

As a retired Navy Officer, he knows there is a good chance he will be tuned out. Soldiers preparing to deploy to war zones want to focus on the mission ahead, not the possibility of returning home injured. Those who have returned home are concerned with getting to their families.

So he speaks to them from a perspective he knows they will understand: the perspective of a military man and veteran enrolled with the VA.

He doesn’t get as many invitations as he would like, but that doesn’t stop him from trying.

Because most Guard members have non-military jobs, they’re more likely to have access to insurance through their employers, or their spouses’ employers.

But DeFilippo said having access to VA services could make a significant difference if a Guard member has a life-changing event, such as a major illness or losing a job.

“Once you’re in the system, you’re in,” he said. “Personally, if given the choice between my monthly retirement check and VA health care, without hesitation I’d choose the health care.”

The young ones

For young Guard members like Silcott, who are more likely to be in school or in lower-paying jobs that don’t offer insurance, access to VA health care is the difference between seeking medical treatment and not.

And Daniell worries about the young people in the military, particularly those who’ve had multiple trips to a combat zone. They remind her of her own two sons who are in their early 20s.

“Some have problems talking with girls, and they can’t get out and mix and socialize like they used to,” she said. “They’re changed to their core by this experience.”

Silcott knows he’s changed. He said gaining access to VA services for physical and mental health problems has been easy. It’s the waiting and rescheduling appointments that annoy him.

“I really feel in-between about the level of services,” he said. “The problem is that the VA in Tuscaloosa doesn’t have as many options as the Birmingham VA.”

The Birmingham VA Hospital is an acute, tertiary medical and surgical center, which provides more specialized and consultative services. The Tuscaloosa VA Hospital has a greater focus on primary care, long-term care and mental health services.

DeFilippo said waiting comes with the territory. But veterans can often see multiple doctors and specialists in a single trip, without scheduling new appointments. Any co-payment for a service typically covers the entire visit, regardless of how many doctors or tests have been called upon.

Jo Pike, whose husband, Billy, served in the U.S. Army for 26 years, said sometimes she believes the services her husband receives from the VA are better than what non-military people receive in the private sector.

“I typically have to keep up with my own appointments,” she said. “When he needs a follow up, they contact him.”

Rick Freeman, a Piedmont native and the newly elected junior vice commander of the state branch of the Disabled American Veterans, served in the U.S. Army and the Alabama National Guard for 22 years. He said he’s seen the VA evolve, and for the most part medical services are better than they used to be. DAV often helps new veterans navigate the VA system and apply for not only health benefits, but also disability claims.

Waiting for services is the one constant. And veterans can be impatient, he said.

In the meantime, local providers such as those at the Anniston/Oxford VA Clinic wait. They wait to see whether there will be an influx of soldiers, and they wait to see if they’ll get more resources to accommodate them.

Who's seeking VA care?

• According to the Knight Fellows in Community Journalism survey, fewer than 8 percent reported that they had sought help for psychological problems. Another 27.7 percent said they’d sought treatment for physical and psychological problems.

• Just under 35 percent sought care from the VA.

• Of those surveyed who sought health care from the VA, 64 percent reported that their treatment was excellent or good, and 78 percent said access was easy.