Older veterans now helping vets of Iraq and Afghanistan

William Rider had never seen the young stranger standing in his office doorway. But as a Vietnam veteran who'd spent decades helping himself and other vets struggling with psychological injuries, he knew that face.

"I saw a look in his face like terror. He didn't know what he was going to say or if he was going to be judged," says Mr. Rider, who cofounded American Combat Veterans of War (ACVOW), a volunteer group that counsels and advocates for combat vets diagnosed with psychological injuries. "He sat down and started telling us about his combat trauma and he was there for over four hours.... He's been coming back ever since."

Using veterans who have recovered from psychological injuries to help others through the healing process is a novel, even a controversial approach. But there's growing evidence of its effectiveness, and it's now gaining greater acceptance in the US and abroad.

The approach is both simple and profound: Providing a safe, nonjudgmental place where someone who's "been there" can simply listen.

"There is this enormous chasm of understanding between people who have been to war and civilians," says Jonathan Shay, an author and psychiatrist who treated psychological injuries during a 20-year career with the US Department of Veterans Affairs (VA).

Rider's group is one of many formal and informal government and civilian efforts helping a new and growing generation of veterans recover from psychological injuries that disrupt their lives and, at a growing rate, end them.

ACVOW's 20 volunteers lend an empathetic ear for hours on end; pull veterans on the brink out of bars, jails, or fights at home; and give briefings to groups returning from war. As fellow warriors, ACVOW members believe they can earn the trust of troubled young veterans who are wary of civilian care providers and convince them to get help.

One concern is that without such help, today's combat veterans might experience the difficulties that continue to trouble many Vietnam vets.

Army suicides hit record in 2007

Last year saw the highest rate of suicide among soldiers on record, according to Army data. That year also saw rates of post-traumatic stress disorder (PTSD) diagnosed by the Army jump 50 percent. There have been 172 suicides among all branches of active-duty military while they were assigned to operations in Iraq or Afghanistan as of May 3, according to the Department of Defense.

The Department of Veterans Affairs counted 144 suicides among veterans of the Iraq and Afghanistan wars being helped within the VA system. But that count is only through 2005, and there is no nationwide tracking of suicides among all veterans.

More than 35,000 troops who served in those wars have been diagnosed with PTSD, says the Office of the Surgeon General (see chart). But a RAND Corp. report estimates that some 300,000 of them are experiencing PTSD or major depression, both considered factors in suicide. RAND reports that another 320,000 may have sustained a traumatic brain injury (TBI), usually caused by an explosion and associated with memory loss and personality changes.

Repeated and extended deployments to Iraq and Afghanistan are driving psychological injuries upward, say military and civilian doctors, despite a spectrum of new government programs aimed at preventing and treating them.

With the advent of the wars in Iraq and Afghanistan, the Army started programs to teach soldiers how to identify signs of PTSD, prepare mentally for combat, and remove the stigma of seeking help.

The VA recently announced the creation of a panel to advise the agency on improving its suicide-prevention effort. Last year it created positions at each VA medical center to oversee suicide prevention and started a suicide hot line.

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