Every soldier has a wartime memory that aches deeper than the others. For Corporal Michael Stout, it was the first few minutes of a predawn raid that went terribly wrong.
Stout was a Marine Corps air support operator on his second deployment in 2013, directing coalition attacks and medevacs in Afghanistan’s battle-scarred Helmand Province. One morning just before 4 a.m., he safely guided a Danish Special Forces helicopter to its landing site at a nearby village. As the chopper touched down and the troops jumped out, one of them immediately stepped on an IED that tore off his left arm and leg. “It happened just like that,” said Stout with a snap of his fingers. “The situation shifts so quickly.”
The Special Forces team repeatedly radioed for a rescue, and a U.S Marine helicopter still circling the area confirmed over and over it was ready to swoop in. But the mission’s commander, “looking out for the lives of the marines on that aircraft — the multimillion-dollar aircraft — and the mission,” denied the requests, which Stout had to relay to the desperate men in the field. “The commander just kept saying, ‘No, no, no,’” remembered Stout, his eyes brimming. “It was just the saddest moment …” When marines transport a soldier killed in action, they announce they’re carrying an “angel.” That morning, Stout helped lead one angel back to base.
The memory still haunts him. So do many more moments of sudden death and violence. Stout coordinated daily gun runs and Hellfire strikes against the Taliban. “When there was downtime, I started to realize I played a significant part in killing people I didn’t know,” said Stout. It wasn’t enough that American generals and politicians said he was fighting in a justifiable war. “With what I felt, it was hard to reconcile,” he said.
Stout, 24, left the Marine Corps in May 2013 and enrolled in Santa Barbara City College. He jumped straight into his studies, met a girl, worked security at Dargan’s, and began a newswriting and photography internship with this paper, where I was his supervisor. In person, Stout was gracious and plainspoken with a wry sense of humor. He excelled as an intern. Something, however, was weighing heavily on his mind.
It was only later that I learned Stout was struggling with PTSD, post traumatic stress disorder. “I had a lot I wasn’t dealing with at the time,” he said. “I didn’t even have the words to ask myself the deep moral questions I had about my experience in Afghanistan.” Stout noticed he was becoming perpetually anxious. He began to worry about how much he was drinking, which, as the son of two addicts, was always a concern of his. He had nightmares of being shot at in a guard tower. His relationships suffered. He’d jump to full alert when a helicopter passed overhead. Hoping to numb this inner pain, he kept as busy and distracted as possible.
Then Stout read a description of PTSD and thought to himself, “Man, this is me.” This is when he reached out for help. It turned out to be relatively simple to schedule an appointment at the Veterans Affairs outpatient clinic on Calle Real, where a psychiatrist diagnosed him with the disorder. He was prescribed an antidepressant, but the medication left him groggy and uncomfortable. What he really wanted to do was talk to someone.
Booking the regular therapy sessions his VA benefits entitle him to, however, has proved exceptionally difficult — he’s had only two appointments since his screening three months ago. “I asked to be seen more often, but they said they didn’t have the staff,” he said. “I’d really like to see someone at least every other week.”
Stout echoes a complaint being voiced by an increasing number of Santa Barbara veterans troubled by extremely long wait times and frustrated with the VA’s often impenetrable bureaucracy. It’s a nationwide problem, especially as more public attention is paid to PTSD and suicide rates among soldiers. Santa Barbara’s vets stress clinic doctors and nurses are excellent and doing their best, but they don’t have the staffing or hours to help.
Grievances started climbing this summer after the Calle Real clinic lost some of its staff to attrition, lured away by less exhausting jobs with better pay. Because of the VA’s lengthy hiring process, it can take five or more months to find replacements. “Our office has had a noticeable uptick in complaints about VA care,” said C.J. Young, press secretary for Representative Lois Capps. “People are upset that their calls aren’t being answered and that their cases are being kicked down to Los Angeles.”
Dr. Joe Blum worked as a physician in the Santa Barbara outpatient clinic for more than three decades before retiring five months ago. He described the same problems — overtaxed caregivers hamstrung by a rigid system of checks and balances that drowns them in paperwork and keeps them from patients. “They’re very dedicated and feel honored to work for our veterans, to go beyond duty on all levels,” he said. “But for some reason, because of these administrative hurdles, they’re unable to take care of people in a timely fashion.”
In April 2014, a damning spotlight was thrown on the VA when CNN reported at least 40 veterans died while waiting for care at the Veterans Health Administration facilities in Phoenix. An investigation revealed that clinic records had been manipulated to meet performance goals, which kept more than 1,700 veterans off an official waiting list. Federal officials concluded the VA had displayed “significant and chronic system failures” within a “corrosive culture” of administrative misconduct. In the wake of the scandal, Secretary of Veterans Affairs Eric Shinseki resigned, and Congress passed a $15 billion bill to drastically overhaul the agency by increasing staff levels and improving access to non-VA medical centers.
But the department still struggles to manage patients’ schedules, according to a report issued Wednesday by the U.S. Government Accountability Office. A review of 100 cases nationwide found vets waited an average of 26 days from their first request for mental-health treatment to get an appointment. Some waited up to 279 days. Others were forced to go 57 days after their first assessment to begin treatment.
VA officials said they’re taking the report seriously. The department admitted individual clinics are having a hard time meeting demands but noted hiring goals have been reached at the national level. The VA hired 5,300 mental-health clinicians and administrative staff from 2012-2013, and increased mental-health staffing by a fourth between 2010 and 2014. Still, a federal audit released this August says the VA hasn’t been effective in its hiring opportunities or using existing personnel to improve access to timely care. The agency doesn’t have a good way of determining staffing needs at specific locations, and so 94 of 140 facilities are still short of psychiatrists. The deficit is exacerbated by a countrywide scarcity of psychiatrists in general.
Santa Barbara’s VA clinics — the Calle Real location and an office in Santa Maria — provide health care to 5,437 individual veterans. It has offered mental-health services to 2,487 vets so far this year, compared to 2,147 in 2010. Practitioners have held 12,252 appointments in 10 months this year, up from 9,969 in all of 2010. Those sessions include face-to-face encounters or meetings set up through what the VA calls “telemedicine technology.”
The mental-health team in South County currently consists of one part-time psychologist and two part-time psychiatrists. Three existing positions remain open and unfilled — for a psychiatrist, psychologist, and nurse. A new psychiatrist position will be created next year.
The North County clinic at the moment has three psychologists (who split their time with the San Luis Obispo office), one psychiatrist, three social workers, and a nurse practitioner. It is looking to hire two psychologists, two social workers, and an additional nurse.
By Courtesy Photo