By Bill Briggs, NBC News contributor on U.S. News

  • VA hits backlog goal in 3 cities: Hint of a fix or mirage?

    Evan Vucci / AP file

    Veterans Affairs Secretary Eric Shinseki testifies on Capitol Hill in Washington, on April 18, before the House Appropriations subcommittee on Military Constructions, Veterans Affairs, and Related Agencies hearing on the Veterans Affairs Department's fiscal 2014 budget.

    The U.S. Veterans Affairs department says it has hit a “tipping point,” cutting its monstrous backlog of disability claims by 74,000 since late April, yet agency critics contend that growing throngs of ex-troops waiting for injury compensation in America’s biggest cities show the VA is “over-promising and under-delivering.”

    Amid scrutiny from Capitol Hill and the White House, a top VA official reaffirmed last week the agency will meet its goal to process all disability-benefit claims within 125 days by 2015. Three of the VA’s 56 regional offices — St. Paul, Minn., Sioux Falls, S.D., and Providence, R.I. — have achieved that threshold, and VA officials told NBC News they will pluck lessons from those “pockets of success.”

    “We can get those best practices, (and) shine the light on some of our problem areas,” said Beth McCoy, who oversees 14 VA regional offices in the country’s midsection, including St. Paul, where benefit claims are typically processed in 100 days. 

    But those “problem areas” — where some duty-injured veterans wait 16 to 19 months for disability checks to stay financially afloat — are coloring the national mood regarding the VA.

    Jonathan Goodman, 29, a Marine veteran from Tulsa, Okla., and his wife, Shannon, say the delay in his disability-benefit claim has been putting a strain on their finances.

    “It's sad to see so many veterans come back and apply for this, and it just takes so long. It can send a lot of guys into a downward spiral,” said Jonathan Goodman, 29, a Marine veteran from Tulsa, Okla. who earned a Purple Heart Medal for wounds sustained in a 2004 suicide-bomb blast. He's been waiting 11 months for the VA to process his disability-benefit claim.

    “I just want to see guys get the (financial) help they've earned. I don’t want to see veterans put on the back burner," he added.

    Veterans in 12 cities now face delays of more than 400 days, on average, for their regional VA offices to handle their disability claims. One year ago, no cities posted VA backlogs surpassing 400 days, according to the agency’s online benefits dashboard.

    As of May 30 this year, the average backlog wait for veterans in New York City was 496 days, up 34 percent from a year ago, the dashboard shows. In Los Angeles, the average wait is now 568 days, up 63 percent since last year.

    In May 2012, the VA reported a national “rating claims processing time” of 250 days. As of May 30 this year, that national average was 302 days. 

    “VA has been over-promising and under-delivering for decades under both Democrat and Republican administrations,” said Rep. Jeff Miller, R-Fla, chairman of the House Committee on Veterans’ Affairs. “While VA leaders seem confident they’re on track to break the backlog by 2015, they haven’t provided us with any evidence to support that projection. That’s why the closer we get to 2015, the more I’m convinced that ending the backlog by then will require a commitment from the only person with the power to ensure VA lives up to its word: President Obama.”

    And veterans are challenging President Barack Obama to act. Iraq and Afghanistan Veterans of America (IAVA), which represents more than 200,000 men and women, posed five questions about the backlog to Obama on June 5. They asked, for example, how the White House is coordinating efforts between the Department of Defense and the VA to slash wait times.

    Other VA watchdogs want to know: Does the quick work executed at VA regional offices in St. Paul, Sioux Falls (where it typically takes 115 days to process claims) and Providence (117 days) foreshadow the dawn of a larger fix?

    “It’s worth looking at the leadership climate and the procedures used at those regional offices to see what they are doing differently,” said Tom Tarantino, IAVA's chief policy officer. “You also have to consider ... you only have 831 claims pending at the Sioux Falls office. When we solve those problems in L.A., then we will see progress.” 

    In Tulsa, where Marine veteran Goodman waits on a disability claim he filed with the VA in July 2012, life means managing wounds and ailments he sustained during two Iraq tours: a traumatic brain injury, back problems, and migraines plus memory and anxiety issues — all of which make working and going to school difficult, he said.

    While he appreciates the medical treatment he gets from his local VA hospital, he said, the job that best suits his symptoms is night bartending: dark and calm.

    The benefit-compensation delay, meanwhile, forced his wife, Shannon, to pull extra work hours. Goodman had to grab additional bar shifts.

    “It’s put a lot of stress on our marriage. It’s been rough financially. She works full time. I work nights. We spend a lot of time just seeing each other in passing,” Goodman said, adding that tax-free VA compensation for his combat wounds “would help us actually enjoy a normal life."

    As 30,000-plus troops return from Afghanistan by 2014, the VA is completing a wholesale transformation.

    Workflow is being redistributed to cities with available hands and reorganized from an “assembly-line system” to a network of “express lanes” for simple claims and “special-operations lanes” for complex claims like brain injuries, said VA’s McCoy. New employees are being trained to work more efficiently.

    And the biggest overhaul: VA is switching to digitized benefits claims, replacing “thousands of tons of paper on shelves,” McCoy said. The electronic system is considered the lynchpin to reducing all backlog waits to 125 days or less. Meanwhile, the VA says it has processed more than 1 million disability claims during each of the past three years. 

    “We have a sense of urgency,” McCoy said. “We don’t have the luxury of shutting down the shop, building a great system then opening the doors back up,” McCoy said. “We’re flying the plane as we’re changing it.” 

    Related: 

     

  • Gillibrand loses bid to strip military sex assault cases from chain of command

    The crisis of sexual assault in the military set up a political clash Wednesday that challenged allies and raised new questions as to how or if change can happen in the military. NBC's Kelly O'Donnell reports.

    The Senate’s staunchest advocate for transferring military rape cases to independent prosecutors to contain a rape epidemic in the ranks said Wednesday she was distressed by the rejection of her proposal, saying, "The victims’ voices aren’t being heard."

    “To reverse this crisis, I do not believe it will be enough if we do not seize the opportunity and embrace the kind of systemic reform that will truly increase accountability," said Sen. Kirsten Gillibrand, D-N.Y., during a hearing of the Senate Armed Services Committee to consider amendments to the proposed fiscal 2014 military budget.

    For weeks, Gillibrand led what appeared to be rising movement on Capitol Hill to strip the investigations and prosecutions of serious military sex assaults from the military chain of command and instead hand such cases to independent military prosecutors. Her amendment had 27 co-sponsors, including four Republicans. But it was openly opposed at a hearing on June 4 by every branch commander, all of whom argued that unit leaders would consequently lose their authority to discipline sex offenders under their watch.

    "This is not a radical idea. It is a common sense proposal," Gillibrand said Wednesday. "... It is simply the right thing to do." 


    However, the chairman of the Senate Armed Services Committee, Sen. Carl Levin, D-Mich., on Wednesday replaced Gillibrand’s amendment to the National Defense Authorization Act of 2014 with his own plan: If unit commanders decide not to prosecute service members for alleged sex assaults, those cases would be required to undergo "an independent review by the next higher level of the chain of command." Further, Levin's amendment would make it a crime for service members to retaliate against victims who claim they were sexually assaulted.

    Levin's alternative plan — leaving sex-assault prosecutions in the chain of command — was approved by the committee in a 17-9 vote. 

    "We all know that we have a serious problem with sexual assault in the military. We have a problem with the under-reporting of sexual assaults," Levin said. "... However, I do not support removing the authority of command to prosecute sexual assault cases and putting that decision in the hands of military lawyers ...  

    "It is the chain of command that can and must be held accountable if it fails to change an unacceptable military culture. It his harder to hold someone accountable for their failure to act if you reduce their power to act." 

    The committee also accepted an amendment from Sen. Claire McCaskill, D-Mo., to prevent commanders from overturning jury verdicts.

    Sen. Kirsten Gillibrand, D-N.Y., says punishment should be harsh for those who commit sexual offenses while serving in the military.

    The clash between Gillibrand and Levin — and eight other senators who co-sponsored Levin's amendment — is not emblematic of a party-vs.-party split or a divide between genders. The co-sponsors of Levin's proposal included four Democrats and two women: Sen. Kelly Ayotte, R-N.H. and McCaskill. 

    "I know there will be those who think that Senator Gillibrand and I don't agree," McCaskill said. "But we agree on one thing: We are not giving up on focusing on this problem. We are not going anywhere.

    "One word of advice to the military: Don’t think this is over … because we‘ve just begun. We have just begun to monitor. We have just begun to hold your feet to the fire. We have just begun to hold you accountable. We have just begun to make sure this is a new day in the United States military when it comes to these horrific crimes."

    Levin's measure follows numerous calls for military-justice reform amid a recent barrage of sexual misconduct allegations in the ranks — including separate sex-assault charges against two branch leaders tasked with preventing rapes. In May, the Pentagon released an annual report estimating as many 26,000 military members faced unwanted sexual contact in 2012 — an increase from 19,000 cases the previous year. The numbers were based on an anonymous survey of military personnel. 

    Last week, a female midshipman who accused three U.S. Naval Academy football players of raping her last year said her client was actually disciplined for drinking while her alleged attackers went unpunished.

    Navy veteran Trina McDonald, who said she survived three rapes while serving in Alaska in 1989, called Levin's move "proposterous." In an interview Wednesday with NBC News, she predicted the military's sex-assault crisis will deepen because Gillibrand's plan was spiked and replaced by Levin's amendment. 

    "He’s not changing anything. He’s perpetuating the problem," McDonald said. "I’m just absolutely disgusted that, after all the (congressional) hearings that have taken place on this, he would come up with this decision — and that what Gillibrand is trying to do is going to be swept away."

    McDonald said that after the 1989 sex assaults she survived at age 18 — one allegedly carried out by a male Navy member and two more by a second male Navy member while a female Navy member held McDonald down — she felt she could not report the crimes. The reason: She would have been forced to file those complaints with the offenders — her superiors. (She left the Navy in 1990).

    For that reason, McDonald ardently supported Gillibrand's push to remove all such cases from the victims' chain of command. 

    "I think the number of assaults are going to increase as a result of this because it's sending a message to the perpetrators that you can do what you want to do because we are going to keep it in the chain of command," McDonald said. "It's telling them: Hey, see, you can get away with it." 

    Related stories

    Facebook shutters page that taunted lawmaker’s push to curb military rape

    Male rape survivors tackle military assault in tough-guy culture

    US military faces historic  tipping point on rape epidemic

     

  • A warmer welcome? Veteran unemployment rate down again: Labor Department

    Ian Horn / for NBC News

    New York National Guard Spc. Kyle Chen, center, meets potential employer Amrit Singh during the Hiring Our Heroes military job fair held in March in New York City.

    Younger veterans who served during the recent wartime era posted a 7.3 percent unemployment rate in May — down from the 12.7 percent rate recorded during the same month in 2012 — better news for a group that has struggled to find work since coming home, the U.S. Department of Labor reported Friday

    "This is an extremely positive step," said Tom Tarantino, chief policy officer for Iraq and Afghanistan Veterans of America (IAVA), which has more than 200,000 members. "It's the result of a lot of hard work by a lot of people both in and out of the government. But this isn't the time to take our eye off the ball." 

    The promising May figures follow a federal report that showed the April jobless rate among post-9/11 veterans stood at a 7.5 percent — down from the 9.2 percent rate that group posted in April 2012.

    And far more telling: two straight months of welcome workforce news for younger veterans come on the heels of a comprehensive annual assessment by the Labor Department, released in March, that showed a steady downward dip in the unemployment rate for post-9/11 veterans between 2011 (12.1 percent) and 2012 (9.9 percent). 

    When viewed in sum, experts say, the chronically icy job market for veterans of the wars in Iraq and Afghanistan finally may be showing signs of a thaw. Overall, the pace of younger veterans on the job trail remained only slightly higher than the 7.0 percent unemployment rate in May for non-veterans, according to the latest labor figures. 

    "The good news is corporate America is improving its effort to educate itself. Businesses are training their hiring managers how to read a military resume. They're consulting veterans who are already on staff about hiring new veterans," Tarantino said.

    "This just reinforces that with a little bit of concerted effort by the public sector and private sector, we can fix the immediate problem," he added. "But it's going to take a much larger effort to solve all the structural problems that caused this in the first place: We still have to shore up how to translate military skills (into civilian jobs), and we still have to make sure that we're training veterans to enter the workforce properly."

    Ian Horn / for NBC News

    Ruty Rutenberg, a former U.S. Army medic, has two part-time jobs to pay the bills as he searches for his "mainstay career."

    A warmer reception among U.S. hiring managers coincides with a bevy of aggressive, veteran-employment initiatives launched during recent years within the private sector, the nonprofit world, and at the federal level. That includes first lady Michelle Obama's "Joining Forces" campaign, which has helped escort nearly 300,000 ex-military members from careers in uniform to civilian jobs, the White House reported April 30.

    "This is good. It's a positive trend," said Kevin M. Schmiegel, founder and executive director of the Hiring Our Heroes program at the U.S. Chamber of Commerce Foundation. Through hundreds of jobs fairs, that push has helped more than 18,400 veterans and military spouses find work. Schmiegel also lauds both Joining Forces and the JPMorgan Chase "100,000 Jobs Mission" for helping reduce the number of unemployed veterans. 

    "We have had a positive effect over the last couple of years. People should emphasize that," added Schmiegel, who served 20 years in the Marine Corps, reaching the rank of lieutenant colonel. 

    But winning the job war at home remains far from a rout for tens of thousands of veterans, especially for many who served in combat zones — like Ruty Rutenberg, an Army medic in Iraq. He's been searching for his "mainstay" career for about a year.

    Presently, Rutenberg fills his workweeks through a pair of part-time jobs: one hosting media events, the other doing outreach through a U.S. Department of Veterans Affairs program called "Make the Connection", which encourages veterans who need mental-health care to come forward and get it. 

    "I've got multiple outlets of part-time work that's helping me pay the bills but still nothing permanent," Rutenberg said. 

    "I do know a lot of veterans I've talked to are having a hard time getting work, especially if there's any type of medical situation attached," he added. "Even if it's a small injury. Or, let's say it's (Post Traumatic Stress Disorder) but it's a manageable amount: Employers are still afraid to take the initiative to hire those people. PTSD is very manageable if the veteran is actively getting counseling, taking meds, or if it's just not that high an amount (of anxiety symptoms)."

    Among veterans who served during the post-9/11 era and who have a service-connected disability, the unemployment during 2012 was 8.0 percent, the Labor Department reported in March

    But the veteran group scuffling hardest to land steady paychecks: men and women between the ages of 18 and 24 who, during 2012, posted an unemployment rate of 20.4 percent, according to federal figures. 

    And their ranks are about to swell exponentially, particularly as American troops exit Afghanistan by 2014. 

    "The fact is there are another million service members and their families who are getting ready to leave the armed forces over the next five years," Schmiegel said. "Many of them are going to be 24 and under, and many of them will have military spouses who also face high unemployment.

    "So even though we see positive trends year to year, we need to remain vigilant," he added. "We really need to push the programs that are working."

     

    Related:

     

     

     

     

     

    This story was originally published on

  • McCain: Cannot give 'unqualified support' for women joining the military until crisis resolved

    Senator John McCain addresses a panel of top military officials Tuesday on Capitol Hill regarding reports of sexual assaults in the U.S. military.

    Sen. John McCain, who built a potent political career on his record as a Vietnam veteran and ex-prisoner of war, on Tuesday told the leaders of every military branch he could not unconditionally advise women to join the service as the military grapples to contain and curb its sexual assault epidemic.

    "Just last night, a woman came to me and said her daughter wanted to join the military and could I give my unqualified support for her doing so. I could not," McCain, an Arizona Republican, said during a Senate Armed Services Committee hearing examining whether all serious sexual crimes should be removed from the chain of command. "I cannot overstate my disgust and disappointment over continued reports of sexual misconduct in our military. We’ve been talking about this issue for years and talk is insufficient."

    McCain also said: "At its core, this is an issue about defending basic human rights but it's also a long-term threat to the strength of our military. We have to ask ourselves: if left uncorrected, what impact will this problem have on recruitment and retention of qualified men and women?"


    The pivotal hearing follows numerous calls for a military-justice overhaul amid a recent barrage of sexual misconduct allegations in the ranks — including separate sex-assault charges against two branch leaders tasked with preventing rapes. In May, the Pentagon released an annual report estimating as many 26,000 military members faced unwanted sexual contact in 2012 — an increase from 19,000 cases the previous year. The numbers were based on an anonymous survey of military personnel. 

    And while he and his fellow four-star generals and admirals said they remain open to any idea to help stem the crisis, Army Gen. Martin Dempsey, chairman of the Joint Chiefs of Staff, maintained that discipline and punishment of sex offenders in the ranks must stay inside the chain of command. 

    "The role of the commander should remain central. Our goal should be to hold commanders more accountable not render them less able to help us correct the crisis," Dempsey said. "The commanders' responsibility to preserve order and discipline is essential to effecting change."

    Under questioning from McCain, however, Dempsey acknowledged that the armed forces allow, albeit unwittingly, some people with histories of sexual bad acts to enlist and serve. 

    "There are currently, in my judgment, inadequate protections for precluding that from happening," Dempsey said. "So a sex offender could, in fact, find their way into the armed force of the United States, and in fact there are cases where a conviction (of a sex crime committed while in the service) wouldn’t automatically result in a discharge."

    "Obviously," McCain responded, "we have to fix that."

    Dempsey — again at the behest of senators — also agreed to launch an immediate change in how the Pentagon tracks sexual misconduct within the ranks by dividing its accounting of such offenses between rapes and sexual harassments. 

    Despite the Pentagon's own analysis that some 26,000 military members faced unwanted sexual contact during 2012, Sen. Claire McCaskill, D-Mo., said nobody at the Department of Defense can offer an accurate number on how many women and men in the service are raped. Her reason: in its annual report on sex assaults, the Pentagon combines criminal attacks and unwanted gazes in the same column of numbers. 

    "You have all mushed together two issues," McCaskill said. "You have two problems: one, you have sexual predators who are committing crimes and two, you have work to do on the issue of a respectful and healthy work environment. These are not the same issues.

    "'Unwanted sexual contact' (as the Pentagon report defines it) is everything from somebody looking at your sideways when they shouldn’t to pushing you up against the wall and brutally raping you ... We need to know how many women and men are being raped on an annual basis and we have no idea right now," she said. 

    Sen. Kirsten Gillibrand, a New York Democrat, put it to assembled leaders of the Army, Navy, Marines, Air Force and Coast Guard this way: "Not every single commander can distinguish between a slap on the ass and a rape."

    Sen. Carl Levin, D-Mich., chairman of the armed services committee, instructed Dempsey to have the Pentagon install a system that surveys and calculates sexual misconduct by both the frequency of rapes and of sexual harassments.

    Dempsey agreed. 

    "Here's how we got here," Dempsey said. "Ten, 12, 15 years ago, there was a conversation about whether we should separate these categories. Because in separating them, (some felt) you could encourage some to ignore the unwanted sexual touching or the sexual harassment and focus in only on the sexual assault.

    "It was our view 15 years ago, this problem was a continuum, not individual acts. I’m suggesting to you we didn’t get to this point by being stupid," Dempsey added. "We actually got to this point because we were trying to do the right thing. Looking back on it, it’s probably time to adjust it."

    Editor's Note: This story has been revised to clarify Sen. McCain's remarks. 

    Related:

     

    This story was originally published on

  • 'I don't forget': Memories of battles past stay forever with oldest veterans

    Brendan Hoffman / for NBC News

    Frank Stultz, a 91-year-old veteran of World War II, poses for a portrait at his home on Friday in New Carrollton, Md.

    On the day America remembers lost heroes, the memories of many of those who survived combat remain forever laced with the harrowing sights, sounds and smells of war — recollections still crisp and vivid many decades after the fight.

    For some, like Vietnam veteran John Hamilton, sensory triggers from past skirmishes can never be shaken, no matter how much he’d like to forget. When night falls, he sees the blackness as “a bad time, Charlie’s time,” a reference to his enemy 45 years ago, North Vietnamese communists. 

    For others, like World War II veteran Frank Stultz, the close calls in the South Pacific are recollections he refuses to surrender. He can close his eyes and put himself back inside his turret aboard the USS Biloxi, a Navy light cruiser, nearly 70 years ago, as Kamikaze pilots buzz above and his hands vibrate from the shells he’s firing into the blue sky.

    “I forget a lot of things, or so my wife tells me. But I don’t forget those things,” said Stultz, 91, from his home in New Carrollton, Md. “It was rough, in a way. I got through it. We did our job.”

    Whether it's 20-something Afghanistan veterans scratching out the progression of 2011 firefights in the dirt or men more than four times their age recounting battles in the South Pacific from 1945, there are stark parallels in their tales — similar noises, scents and visions, kindred feelings and emotions. War has a way of getting tattooed onto the brains of troops, no matter the conflict or the era, scientists say.

    John Hamilton/VFW

    John Hamilton served as a Marine Corps rifleman from 1968 to 1970, including a tour of Vietnam. Today, he is Commander-in-Chief of the Veterans of Foreign Wars. At left, Hamilton in Vietnam where he earned a Purple Heart medal.

    “There are commonalities with guys from World War II and Korea, or Afghanistan or Iraq, with what we saw and heard. They affect us all — forever. They affect your soul — forever,” said Hamilton, 62, a Marine rifleman from 1968 to 1970 who earned a Purple Heart in Vietnam.

    “To this day, if I’m walking through a city and see a tree line, I’m thinking: Don’t go that way; there are bad guys hiding there,” added Hamilton, who today heads the Veterans of Foreign Wars.

    Such permanent memories — and sensory triggers — are pure biology. The most indelible images usually are retained from our most horrific experiences or from our happiest days, said Dr. Sydney Savion, a Texas-based behavioral scientist and Air Force veteran who studies post-traumatic stress disorder.

    The centerfold in our mental scrapbook is the amygdala, an almond-shaped portion of the brain tasked with processing unique moments into long-term memory and choosing which emotional events get stored away for good.

    “When the brain experiences something, whether it’s beloved events or bad events, it assigns an emotional value to it. Those memories are imprinted,” Savion said.  

    The most gruesome or most beautiful moments we experience cause the brain to become “awash with adrenaline,” she said. “That intensity over time, whether it’s graphic memories of the war or the birth of child, continues to self-perpetuate in memory.  

    “In these combat instances — in part because the veterans' brains have assigned such a high emotional value to them, they just can’t ever get these experiences off of their minds.” 

    Or, like nonagenarian Stultz, they simply don’t want to lose them.

    Even if they were downright frightful.

    There was the night be opened fire unknowingly on an American plane, which he was ordered to do because it was flying in from the direction of the enemy. A fellow sailor had to pound on Stultz's turret with a hammer to tell him to stop shooting. The plane and pilot were spared. 

    Brendan Hoffman / for NBC News

    A photo of Frank Stultz from his days in the U.S. Navy, as well as a diary he kept during World War II and a souvenir booklet from USS Biloxi, the ship on which he served.

    There was the day a shell dropped from a plane onto the Biloxi’s fantail. It struck 50 feet from Stultz’s turret. But it was a dud. Stultz and his shipmates were saved.

    There were days when Japanese suicide planes circled above, some hurtling down and crashing into nearby U.S. ships, including the USS West Virginia near Okinawa, killing four sailors. 

    "I could see them from the parascope in my turret. We were just shooting, shooting, shooting. They were all around our ship. We were just trying to put a shell right in front of them so they would hit it," Stultz said. "It was a good education for me. But I was young. 

    "When you're young, you don't worry about those things. I like to remember because we were taught to do the right thing and I think we did. If worst came to worst, well, that's the way it was." 

  • Unmasking the agony: Combat troops turn to art therapy

    Courtesy of the National Intrepid Center of Excellence

    For soldiers suffering from traumatic brain injury and the psychological effects of war, a Department of Defense art therapy program hopes to provide relief.

    The skull’s left corner is gone, leaving a jagged, diagonal edge drenched in red. The eyes are black and frantic. All of it resembles the Iraqi man who, in his final minute alive, stared up at Maj. Jeff Hall.

    For five years, that face tortured Hall, once a sharp Army leader later shoved to his own ragged edge. Not long ago, a woman handed Hall a blank mask, brushes and paints. She asked him to see what may emerge on the surface.

    “That image, seared into my mind, began leaking out of me,” said Hall, one of hundreds of active-duty troops who have created masks as part of an art therapy program at Walter Reed National Military Medical Center. “I almost needed to regurgitate it. To be honest, it helped me let it go.”

    Many more masks, some resembling Hall’s violent creation, some depicting abstract demons, adorn walls at the National Intrepid Center of Excellence (NICOE) on the Walter Reed campus.

    They reveal scars once carried and cloaked inside the minds of men and women back from war — troops diagnosed with mild brain injuries and secondary psychological issues, including post-combat stress.

    Hall, 43, who titled his mask “The Shock of Death,” served a pair of year-long tours in Iraq spanning 2003 to 2005. Ultimately haunted by violent events he saw and survived in Iraq, including the loss of friends, Hall eventually contemplated suicide and became more isolated. His commander noticed Hall's behavioral changes and guided him into counseling in 2008. Two years later, Hall was invited to seek treatment for a traumatic brain injury at then-new NICOE, a Department of Defense facility offering research, education and treatment focused on TBIs and psychological health. 

    When service members initially enter the art-therapy studio, their faces often are blank and unyielding, hiding unwelcome war souvenirs within — the mental cargo they’ve lugged home but can’t shake. On their masks, they expose that secret turmoil: vulnerabilities, anger, grief or, often, fragmented identities.

    “It’s intense. They get really invested in this. It becomes very meaningful for them,” said Melissa Walker, an art therapist who coordinates the masks program at NICOE.

    Participants at NICOE must be active-duty troops who are dealing with a combination of TBI and psychological health concerns. Typically, they are referred by their primary health care provider or their commander. A designated team at NICOE determines which service members are most appropriate to receive treatment there. Attendees participate for four weeks. Art therapy is just one of the tools offered and the service members usually make one mask — done during their first week at the center. 

    “I tell them: ‘Don’t worry about the finished product; worry about what you are symbolizing in the mask.’ That makes it more powerful to them. It gives them a way to express to us, visually, what they’re going through,” Walker said. “It’s a little less intimidating then handing them a blank piece of paper.”

    Art therapy has become a staple in the treatment of a wide array of traumas, from child abuse to PTSD. Making art can help people unlock dark emotions or memories that they can't yet vocalize, pulling those buried anxieties from their subconscious and placing them onto a canvass or into a lump of clay, said Donna Betts, a professor in the art therapy program at George Washington University.

    As a patients' pieces are taking shape, art therapists help them talk about what they believe they are trying to express in their creations, Betts said.   

    "It's especially effective in the treatment of trauma in service members. When trauma is experienced, it tends to be stored in the nonverbal part of the brain," Betts said. "This is why so many of them can't even put into words what they've been through. Art therapy helps them retell their story through art. It translate that trauma from the nonverbal part of the brain to the verbal part so they can start dealing with it.

    "They then become more aware of the trauma. This is where that healing starts to take place."

    After the paint is dabbed and stroked at NICOE, many of those papier-mache masks offer chilling accounts of what it is like to live inside the minds of combat veterans.

    One brown face with the mouth agape and with bloodshot eyes upturned is squeezed by a metal clamp that reads “TBI” on the left and “PTSD” on the right.

    Another mask is coated by small chunks of amber bark — two tiny holes remain for eyes — symbolizing the outer camouflage the maker felt is necessary to blend back into the civilian world.

    Some masks show mouths locked or sewn closed, whispering of an inability to speak of what they’ve witnessed. Many are divided down the middle — for example, one displays part of an American flag on the left and a skull on the right.

    “There is a split sense of self. They feel like they’re one person when they’re deployed and one person when they return home,” Walker said. “Or, they do a really strong, warrior exterior with a vulnerable inside but they don’t feel like they can express that.”

    The troops who come to NICOE for therapy can take their masks home. But many purposely leave them to hang from the walls to speak to — and perhaps even soothe — incoming troops trying to cope with the same thoughts and impulses.

    The creations give service members a format “to say what they can’t say out loud — because it’s too painful or because we just don’t feel like anybody really wants to hear it,” said Hall, who remains on active duty, stationed at Rock Island Arsenal in northwestern Illinois.

    “I absolutely believe it is a method to calm your mind.”

     

  • Rebirth after the big storm: How one small town dug out, spruced up and lived on

    Barry Gutierrez / for NBC News

    Limon librarian Lucille Reimer holds a historical photograph of the town bank destroyed by a 1990 tornado. The building was reborn as a library. See images of the town then and now.

    One generation after a 206-mph tornado pulverized and vacuumed away most of the historic downtown and damaged one-third of the homes in Limon, Colo., librarian Lucille Reimer has a small hitch in her voice when she describes the initial dawn after the storm, the first day of revival.

    “The most amazing site. The sun was coming up. People were just starting to move around. And I saw them — hundreds of police cars, all coming in to help,” recalled Reimer, who was a reporter for the local newspaper, The Limon Leader, when a June 6, 1990 twister nearly scraped away the little village of about 2,000 people in eastern Colorado, injuring 17 people, displacing hundreds, yet killing none. "Seeing all those flashing lights arriving, well, it still gives me shivers." 

    Over the past 23 years, Limon has reinvented its look, retained much of its population and reclaimed its status as a stout plains anchor where stranded travelers find friendly shelter when white-out blizzards close the nearby interstate highway. The town has returned to its reputation as a plucky refuge after enduring a short spell as a place in desperate need of extra hands.   

    The same ragged roadmap — reconstruction and resurrection — has been followed repeatedly in towns slashed or decimated by house-chewing tornadoes. They’re still rebuilding in Joplin, Mo., where on Wednesday residents paused in silence to mark the second anniversary of the twister that claimed 161 people. And they’re mourning again in Moore, Okla., which lost 36 people in a 1999 twister and where searchers this week combed the carnage from Monday’s tornado that took another 24 lives. 

    Looking back, some parallels can be seen when comparing the early renaissance of Limon and the ongoing recovery in Joplin. One year after the catastrophic storm struck Joplin, officials there had erected a new hospital to replace a destroyed medical center. Thirteen months after the Limon tornado, workers had built a new town hall and a new fire station. 

    But there are difficult contrasts as well. Joplin received $1 billion in federal aid to help reassemble. Limon — which sustained $25 million in damage — did not receive a similar federal disaster designation despite its near destruction. Why?

    "Nobody got killed," said Joe Kiely, Limon's assistant town manager. After the storm, he drove to Limon from his home in Fort Morgan, Colo., 80 miles to the north, to volunteer in the cleanup for one weekend. He stayed for three weeks and later was offered the job of Limon's recovery director. "We used primarily state money, insurance dollars, and donations from the public." 

    The big rebuild
    More than two decades later, much of Limon barely resembles its pre-storm form. Small trees, planted along the downtown sidewalks during the early 1990s, now are fully mature and starting to leaf out for summer. Limon’s new town hall was constructed with a modern flair. In all, some 350 building permits were pulled there in the months after the big winds. 

    Barry Gutierrez / for NBC News

    Joe Kiely, 60, stands in front of the new town hall that replaced the old one destroyed in the 1990 tornado in Limon, Colo.

    At his town hall office, Limon town manager Dave Stone scans an old photo of the four-block downtown sector taken before the twister. He counts nine buildings that today are gone, including a bank, two restaurants, the local newspaper's former office, a corner gas station, a vintage hotel, the fire station — and the old town hall.

    "The downtown area is drastically different," said Stone, who grew up there. Leaving after the tornado, he adds, "never crossed my mind." 

    "I wanted to make sure that town did sustain itself," Stone said. "I don’t know that anybody picked up and left town. Essentially, they stayed here and worked together to reconstruct the community." 

    Like any town, Limon has had its comings and goings, its births and deaths during in the past 23 years. But U.S. Census figures back Stone's point: In 1990, there were 1,831 residents; in 2010 there were 1,880. 

    While memories of an eerie aftermath remain thick for many folks — the brick rubble, the contorted metal sheets sheered from dozens of mobile homes, the odd chill that filled the darkness after the super cell passed — it is the warmth of what followed that locals prefer to recount.

    The launch of the big rebuild seemed to be signaled by that incoming parade of squad cars witnessed by Lucille Reimer. They came from Colorado cities and little burgs to the west, south and east. They followed the twister’s precise path, right down Main Street, where many of the town's businesses, about 80 percent of the local commerce, were ruined or heavily impacted.

    'Not one homeless person'
    With security re-established by visiting cops, food became the next necessity. The twister hit just after 8 p.m. on a Wednesday. Normally, trucks pulled in on Thursdays to replenish the local grocery’s shelves. A grocery store in the neighboring town of Hugo, Colo., offered to let those same rigs offload their perishables in its backrooms there so that Limon’s hungry residents could drive over to restock their pantries.

    But restoring city services — including hooking up utilities and finding temporary headquarters for the police department, ambulance service, government offices and the post office — quickly became priority number one. Simultaneously, anyone with a spare bedroom took in some of the hundreds of people who had lost their homes. In all, 228 of Limon's 750 dwellings were damaged

    “On Monday morning, when FEMA came to town, there was not one single homeless person,” Reimer said. “Because people took care of their own.”

    Some merchants had extra, empty commercial space located away from the ravaged town core, and they offered their storefronts or unused locales to friends and colleagues whose businesses had been blown away, Reimer said. 

    Soon, the Army National Guard thundered in to knock down rickety buildings then shovel up and haul away the massive stacks of debris. Before winter 1990, Limon was free of loose bricks, splinters and metal shards.   

    'All kinds of progress'
    Compare that to Joplin, Mo., where the 2011 tornado took out 553 businesses in a town of about 50,000 people. One year after that storm, 446 of those businesses had re-opened. Today, road signs ripped from the ground have been replaced. Three new schools are being constructed.

    "We've made all kinds of progress, just phenomenal progress. I've never seen anything move so fast in my life: new buildings where the old buildings used to be, and businesses, homes, apartments where the old ones all used to be," said Aaron Miller, who owns Midwest Storm Shelters, a local company that constructs residential tornado shelters and safe rooms. His crew has installed at least 600 such units in Joplin since the devastating storm. 

    "But there's still empty lots. Being a lifetime resident, I can say it's not the same. It doesn't look the same. Besides the buildings being different, the trees are gone. Joplin was just beautiful for its big trees (before 2011). Now, you might pull up to what used to be a nice shady intersection that had trees growing over the road, and there's just a street light there."

    Joe Raedle / Getty Images file

    The top photo of this composite image shows family members salvaging what they can from a home after it was destroyed when a massive tornado struck on May 22, 2011, in Joplin, Mo. The bottom photo was taken one year after the tornado, and shows the destroyed buildings and rubble have been removed and new homes have been built.

    Unlike Limon, Joplin sustained mass casualties. And those missing friends and family members cast a personal shadow over Joplin that may take generations to fade, that no physical rebuilding boom can begin to pave over or replace. 

    "We've put storm shelters in for people who have lost family members. We'll put a storm shelter in, now and then, for somebody that has lifetime scars, where you can tell they were in the tornado — scars on their arms, their legs, even their face. They'll tell you: We were in the tornado," Miller said. "We've had a catastrophic loss of life." 

    'A new sense of pride'
    Limon’s full re-emergence took about five years, estimates Reimer, now the head librarian and treasurer of the chamber of commerce. 

    Local contractors who for years had doggedly competed, trying to outbid and out-hustle each other for jobs, began working side by side to ensure the fastest possible restoration, including resurrecting Limon's grocery store. The overriding spirit on the ground, Reimer said, was marked by "looking out for one another." 

    “It all just gave our community a new sense of pride to kind of change an old town to a new look, a perk up,” she said. "Small towns just take care of themselves like that. But we also had a lot of generous help.

    “Limon always had a reputation of being there when people needed us — whenever they closed the highway (Interstate 70) during the blizzards, when the wind is blowing and people have nowhere else to go. So people here just take them in. It’s what we do," she said. "But after the tornado, they came in and they took care of us.”

    Related:

    Full coverage of the Oklahoma tornado tragedy on NBCNews.com

    While Oklahoma staggers, Joplin marks 2 years after its own tornado

  • One every 18 hours: Military suicide rate still high despite hard fight to stem deaths

    Amid a raft of Pentagon initiatives to slow its suicide crisis, a new Army report Thursday showed the pace of self-inflicted deaths among soldiers — and all service members — has barely budged so far this year from the record rate the military suffered during 2012. 


    Through April, the U.S. military has recorded 161 potential suicides in 2013 among active-duty troops, reservists and National Guard members — a pace of one suicide about every 18 hours. The Army, the largest contingent of the armed forces, sustained 109 reported suicides during the first four months, according its latest report.

    Last year, when self-inflicted military deaths outstripped the number of troops killed in combat, there was one suicide every 17 hours among all active-duty, reserve and National Guard members, according to figures gathered from each branch. 


    "We are still continuing to fight this problem with the same intensiveness," said Cynthia O. Smith, a Pentagon spokeswoman. "We are still focused on preventing suicides from occurring in the Department of Defense. We are doing everything we can to ensure that service members are getting the proper health care they need to prevent this type of event from happening. 

    "It concerns us deeply." 

    The number of suicides the military has suffered in recent years has brought new initiatives and programs aimed at stemming the epidemic. But advocates fear the rate will climb in coming years as more troops are drawn down in Afghanistan.

    And research published last week has experts concerned that American troops who survived multiple nearby IED blasts while in Afghanistan and Iraq now are at greater jeopardy for harming themselves.

    People who have suffered numerous mild traumatic brain injuries — or concussions — carry a higher suicide risk, according to the first study to make that connection

    "We’re starting to see now: It’s the build up, it’s the accumulation of brain injuries that increases the risk for suicide,” said Craig Bryan, the study’s lead author, assistant professor of psychology at the University of Utah, and associate director of the National Center for Veterans Studies.

    The research team made that correlation by surveying 161 troops who served in Iraq, were evaluated for TBIs — some reporting as many as 15 — and who acknowledged later enduring suicidal thoughts or behaviors, according to the study, published last week in the medical journal JAMA Psychiatry.

    Courtesy of Jeremy Lattimer

    Marine Sgt. Jeremy Lattimer, far left, stands with members of his squad in Iraq. Lattimer received a mild TBI from an IED blast. He has not struggled with suicidal thoughts but he is working through the symptoms of his TBI at a military hospital.

    One in five surveyed veterans who had sustained more than one TBI also experienced thoughts about — or preoccupation with — suicide, the study found. For patients who received one TBI, 6.9 percent reported having suicidal thoughts. And the soldiers surveyed who never were diagnosed with a TBI reported no suicidal ideations, the study showed.

    Marine Sgt. Jeremy Lattimer, 26, who earned a Bronze Star for his 2009 actions in Afghanistan, can count at least three concussions he’s sustained through sports and combat — moments when he briefly lost consciousness. 

    Military doctors believe he sustained a mild TBI in 2005 during an IED detonation. Six years later, he developed speaking, hearing and sleep problems often affiliated with mild brain injuries. A brain scan later confirmed that Lattimer had suffered a past TBI, he said.

    But some of “the biggest blasts” that he and his fellow unit members experienced in combat came from their own outgoing rockets, added Lattimer, an outpatient at Walter Reed National Military Medical Center where he’s receiving TBI treatment and therapy.

    Courtesy Jeremy Lattimer

    Marine Sgt. Jeremy Lattimer, right, receives the Bronze Star in 2011. He earned the award for his 2009 actions in Afghanistan: While under machine gun fire, he maneuvered his squad in a position to help other troops escape an enemy ambush.

    “They put out a tremendous blast wave. One (firing episode) was close enough to ring my bell more intensely than the IEDs that went off in my vicinity,” Lattimer said. “To get back into my train of thought, to read my GPS, it took a minute or two before my brain kicked back in. It’s like you’re in a daze.”

    The Pentagon’s own tally shows 266,810 service members received a traumatic brain injuries between 2000 and 2012. More than 80 percent of those TBIs were not deployment-related cases. Many occurred amid crashes of privately owned cars and military vehicles. 

    In March, more than 50 members of Congress formally asked Defense Secretary Chuck Hagel to investigate whether mild TBIs sustained in American troops may be fueling the military’s suicide crisis.

  • Facebook shutters page that taunted lawmaker's push to curb military rape

    A "direct threat" against a U.S. congresswoman — posted on a military-oriented Facebook page that graphically belittled her and her efforts to stem sexual misconduct within the branches — has been referred to U.S. Capitol Police for investigation. 

    The threat was made last week against Rep. Jackie Speier, D-Calif., and her husband shortly after Speier sent a letter May 8 to Defense Secretary Chuck Hagel informing him of the Facebook page which, according to Speier, helped "contribute to a culture that permits and seems to encourage sexual assault and abuse." U.S. Capitol Police have asked Speier and her staff not to divulge the nature of the threat.


    Before that page was taken down Friday afternoon by Facebook, Speier's staff was able to confirm that several active-duty Marines had posted messages on the page, which disparaged the congresswoman and made numerous sexual jokes about women in the military. At least three people who had "liked" the page — and who had posted comments there supporting its content — list themselves as active-duty service members on their personal Facebook pages. As of Friday morning, the page — called "F*** You Jackie Speier — was active and had 182 "likes."

    Speier's staff has not been able to determine the identity of the person or people or who created the Facebook page — or several earlier versions of the same page (with other names) that contained the same content, commentary and photos. Those previous iterations were also dismantled by Facebook. 

    In her May 8 letter, also sent to Gen. James Amos, commandant of the Marine Corps, Speier said it was her "understanding that not only is the Marine Corps Inspector General aware of this page and monitoring it, but they have been doing so for over three years." 

    Speier has authored three bills aimed at transforming the military justice system’s treatment of sexual assault cases. Those include the STOP Act (HR 1593), which seeks to take all cases of sexual assault outside of the chain of command by creating an independent office within the military to handle the reporting, investigation, and prosecution of such crimes. The bipartisan bill has 122 co-sponsors but has not been placed into consideration for a House vote. 

    Before the anti-Speier Facebook page was removed, it displayed a banner photo of a topless woman holding up her middle fingers as well as multiple posts and pictures making fun of military rape, including an image posted Friday morning with a caption that joked about raping a pregnant woman.

    In addition, there were photos posted mocking Jewish concentration camp prisoners, African Americans, and President Barack Obama, shown with a rope around his neck. But the page's primary theme involved deriding women in the military, particularly those within the Marines. The administrator posted pictures titled "this is my rape face," and "I can 'bang' even when I'm not on my back!!" atop the image of a woman holding a gun in her camouflage uniform.

    Courtesy Facebook

    A screen grab shows one of the photos posted on a page about Jackie Speier.

    There also was a picture of Speier, photoshopped with a black eye. One poster — whose personal Facebook page lists his occupation as "Military infantry" — wrote of Speier: "I still firmly believe someone needs to struggle snuggle the s*** outta her."

    The Pentagon acknowledged that it is aware of the Facebook page.  

    "Secretary Hagel made clear that sexual assault is a despicable crime and one of the most serious challenges facing the Department of Defense," Cynthia O. Smith, a Pentagon spokeswoman, said Friday in reaction to the page. "Leaders will be held accountable for preventing and responding to sexual assault in the ranks. The Secretary will respond directly back to Congresswoman as appropriate."

    "Unfortunately, we cannot offer comment," added Shennell Antrobus, spokesman for the U.S. Capitol Police. "As a matter of Department policy, we do not discuss information relating to the security of Senators, Members of the House, or the Capitol Complex."

    Facebook declines to comment on individual pages within its network but it does list a strict set of "community standards" that govern allowable content.

    "We maintain a robust reporting infrastructure that leverages over 1 billion people who use our site to keep an eye out for offensive or potentially dangerous content," said Alison Schumer, a Facebook spokeswoman. "This reporting infrastructure includes report links on pages across the Facebook site, systems to prioritize the most serious reports, and a trained team of reviewers who respond to reports."

    Facebook, which also lists its "law enforcement guidelines," has been known to cooperate with police agencies with active investigations that may delve into a suspect's Facebook accounts and activity. 

    Related: