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From battlefield to street corner

Tuesday, December 14, 2004

From battlefield to street corner
Where the war intersects with our city's most polarizing political issue.

By Tali Woodward

WHEN WE THINK about the Vietnam War, we often think of the untimely deaths of U.S. service people, all their names etched into that granite wall in Washington, D.C., or of the political divide the war created at home, tearing apart communities and families and prompting widespread distrust of our political leaders.

But one of the most persistent reminders of the war is provided by the Vietnam veterans among today's homeless population. Just consider this astounding statistic from the U.S. Department of Veterans Affairs: the number of people who served during Vietnam and are now homeless actually exceeds the number who were killed in the conflict.

In San Francisco there are 2,400 to 3,000 homeless vets - up to one-third of the homeless population. Local vets and their service providers inevitably list homelessness as one of the most intractable veterans issues they confront. As the city continuously debates the compassion and efficacy of Mayor Gavin Newsom's plan to deal with homelessness, one has to wonder whether the latest war with Iraq is destined to inflate our homeless population for decades to come.

Robert Rosenheck, director of the V.A.'s Northeast Program Evaluation Center and a Yale University professor of psychiatry, has been studying homeless vets for 17 years. And while homelessness continues to be an extremely difficult challenge for vets, Rosenheck wants to correct the common assumption that combat - and the post- traumatic stress disorder soldiers often suffer - makes people homeless.

A 1996 survey by Rosenheck showed that those who served in the military between Vietnam and 1982, and were never in combat, were actually more likely to become homeless than their Vietnam counterparts. One of the reasons, Rosenheck explained, is that an all-volunteer army draws more heavily from the lower economic levels.

"It's not PTSD pulling people into homelessness; it's other risk factors, the same ones that pull other people into homelessness," he told the Bay Guardian, citing lack of education and substance abuse.

Vietnam vets fought hard to have their mental health problems recognized - and to make sure that service people suffering from PTSD would get disability payments. That program, which now has 100,000 enrolled, is probably keeping many from life on the street.

Still, finding work and housing can be difficult for soldiers now returning from Iraq, particularly those coping with PTSD.

Bobbie Rosenthal directs the V.A. Comprehensive Homeless Center at 13th and Mission Streets, one of the first programs of its kind in the country. She told us her staff has already seen about five people who have returned from fighting in Iraq. Some had housing and just came in for help finding a job, she said, but one or two of them were already effectively homeless. And according to new numbers provided by Rosenheck, nearly 1 percent of the homeless vets seen by the V.A. nationally since last August identified themselves as having served in the Iraq War. Rosenheck said this probably means there are already 1,500 homeless Iraq vets on U.S. streets.

That's pretty alarming, given that Rosenheck has found that it takes, on average, 12 years for a soldier to go from active duty to homelessness. And whenever they make that transition, they become a challenge for cities and counties.

"There's tremendous pressure on local governments to address this," said Michael Blecker, the director of Swords to Ploughshares, a San Francisco nonprofit founded in 1978 to help homeless and low-income vets. "As the federal government cuts back, it just increases the pressure on the local government."

Local V.A. spokesperson Gene Gibson and others told us that most of the people returning to San Francisco from Iraq have been in relatively good shape physically (which may be because those with more complex injuries are still in the nation's military hospitals). But PTSD is already shaping up to be a major issue for these vets.

Keith Armstrong, a social worker and UCSF psychiatry professor who works with the V.A.'s PTSD program, told us that 170 Iraq vets have been seen at San Francisco's V.A. Medical Center and its clinics. Of the 50 who have been evaluated by the mental health team, 90 percent have been diagnosed with PTSD. That's a rate "much higher" than the V.A.'s current national prediction, Armstrong said.

"We want to provide care as fast as possible, and the best care we can," Armstrong said. "We don't want to make the same mistakes we made with Vietnam."

E-mail Tali Woodward

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