Vet Center helps people with PTSD

Old and young veterans need help with their conditions

By Mac McLean / The Bulletin / @agingbeat

Roger Riolo can tell whether a person’s seen combat the second he walks through the door.

There’s a something about the way they carry themselves when they walk across the room, the 70-year-old Vietnam veteran said, and an unmistakable look combat veterans get in their eyes that he can spot from a mile away.

Riolo said he can also spot the signs of people with post-traumatic stress disorder. They often sit with their backs to the wall, they give short, one-word answers to questions and they are constantly looking around.

“You recognize these things because you have them yourself,” said Riolo, who was diagnosed with PTSD some 36 years after his service in Vietnam and now runs a support group dedicated to helping other veterans with PTSD.

Most of the people in Riolo’s support group, which meets at the Central Oregon Vet Center on Wednesday afternoons, fit a similar pattern: They dealt with the symptoms of their PTSD — which many of them didn’t even know what it was let alone that they had it — for decades until things got to be too much for them to handle and they finally got help.

“About 90 percent of our guys have PTSD right now,” said Gary Hunter, a licensed clinical social worker who manages the Vet Center as its team leader. He said the Vet Center’s eight PTSD support groups are equally divided between older veterans like Riolo, who may have had PTSD for decades, and younger veterans who are just now coming home from Afghanistan and Iraq.

The vets

Riolo was 24 when he was sent to what used to be South Vietnam to fly combat missions out of the U.S. Air Force’s Phu Cat and Da Nang airbases from 1968 to 1969. After the war, he spent about five years working for a San Diego-area parks and recreation department before he took a job working as a commercial airline pilot. He retired when he was 55.

Looking back on his career, Riolo said there were a number of times when he behaved inappropriately — he’d get too drunk at office parties and make a fool of himself, for example — that didn’t necessarily threaten his job but may have kept him from moving up the ranks to a managerial position with his airline’s corporate office.

“They had invested too much money in us to fire us,” said Riolo, who knew of several other Vietnam era pilots who worked for the airlines and had behavior issues. “We also knew what we were doing and that helped.”

But these behavioral issues spun out of control when Riolo left the airlines in 1999. He said they reached a point where his friends and family members felt compelled to hold an intervention and forced him to get help.

“When I retired, (my life) went to hell in a handbasket,” Riolo said, explaining he later realized that many of these behaviors — excessive drinking, quick temper, irritability — were a direct result of his PTSD.

Riolo joined a PTSD support group that met at the Veterans Affairs’ Bend outpatient clinic in 2005, which was about a year after his friends and family members held their intervention. This group and two others transferred to the Vet Center when Hunter’s facility opened in 2004.

The center

Hunter said he’s heard thousands of stories like Riolo’s through his 23 years of work with the Vet Center program, a network of 300 counseling centers across the U.S. that shares administrative functions with the Veterans Health Administration’s medical centers and outpatient clinics, but acts as its own entity.

“People work and work and then all of a sudden they’ve got time to think,” said Hunter, who ran across some World War II veterans who were starting to develop combat-related PTSD when he was working for the program in 1991. “They start thinking about their own mortality and then all of a sudden this world of PTSD symptoms comes along and it wipes them out.”

He said about 30 percent of the people who were deployed to fight the wars in Iraq and Afghanistan are coming back with some type of PTSD symptoms. He said the counseling center was swamped with people who needed help during the peak of the deployments, but it sees about one or two veterans each day now that both conflicts are winding down.

Hunter said most of the veterans who have PTSD can trace their illness back to a particularly violent situation they experienced while they were in combat. But others were traumatized by a more subtle experience like witnessing the poverty present in war zones — images of children playing in an open sewer, for example — that they didn’t realize bothered them until they came home.

He said sometimes the very act of coming home can exacerbate the amount of stress a veteran experiences at the end of their deployments and can lead to transitional issues that increase their chances of developing PTSD symptoms.

People often have to deal with situations where their spouses have taken over their household jobs — something that can ruin the veteran’s sense of place at home — or where their children may have grown up from being infants when the deployment started to being toddlers who do not recognize them or know who they are.

“It really messes our guys up,” said Hunter, whose center does almost as much work with veterans who are experiencing these transitional issues as it does with those who are suffering from PTSD. It also works with people who are the victims of sexual assault, Hunter said, which is a problem that affects men and women and may be more widespread than many think.

Hunter said the veterans who fought during the Vietnam War experienced similar transitional issues when they were deployed and when they came back to their homes, though there was one notable exception: The national unemployment rate was 3.7 percent when Riolo finished his tour of duty in 1969 — lower than what it is today — so people probably had an easier time finding a job and thus a distraction from their trauma and the stress it caused.

Riolo said the two youngest members of his group — a veteran who served in Afghanistan and one who served in Iraq — are unemployed, which doesn’t help their condition, because it gives them plenty of time to think.

But he’s worried that if these two people found a job, they might not be able to keep it for long due to their PTSD, and that could create a cycle of stress and depression that could worsen their symptoms.

“People have problems keeping jobs because of their PTSD,” he said.

Riolo also worries that the long wait times people experience when trying to get help from a Veterans Health Administration medical facility — which were brought to light this spring and eventually led to VA Secretary Eric Shinsecki’s resignation — might dissuade veterans from getting the help they need.

“Most people would just say screw it,” he said, explaining there are probably twice as many people trying to get into the system, where they can get access to the medical care they need, as there are who are in it. “They don’t have the patience to get into the system, and nobody’s really addressing that.”

Hunter said signing up for the Vet Center system — which is limited to people who have served in a combat zone — requires considerably less paperwork than the Veterans Health Administration’s system. He also has people on his staff who can help veterans cut through the VHA’s bureaucracy and get the help that they need.

“(Our outreach people) say ‘Come down to the Vet Center, have a bad cup of coffee, and check us out,’” Hunter said, explaining most veterans can find what they need through his office just by walking in the door. “That’s the one thing I can promise people, a bad cup of coffee. It may be Army coffee, it may be Navy coffee … It all depends on who makes it.”

— Reporter: 541-617-7816, mmclean@bendbulletin.com