really appreciate the opportunity to come talk to you today and was heartened to hear in the earlier meeting the yellow ribbons presence here the discussion about how you as a community can better support the returning veterans who are coming home they're going to need jobs they're going to need support some of them more than others and today we're here to talk about those who are really going to need a lot of support who are going to have brought their war home with them in many ways we're going to be struggling and we're hoping to learn from mistakes of the past made after past wars and do something differently with this new generation with the knowledge that we have today the presentation i'm about to give you is very condensed down from what is typically an hour to an hour and a half long slide show so i have pared it down but i've still got a lot of stuff in here i'm going to move through it quickly so forgive me if it seems like i'm moving that fast forward we've been fighting with two longest wars in our country's history simultaneously over the last decade and we've been doing it with the smallest military force we've ever field in a war time less than half of one percent of americans have served in the combat zones in iraq and afghanistan and the way that we've been able to accomplish this is by rotating our troops back into combat again and again and again like we've never done in our country's history so the weight of these deployments is falling on you shoulders compared to past wars and the troops are going to be coming home we expect are probably going to need more help on average than past generations of veterans as we begin preparing for the aftermath of iraq and afghanistan it's important to look back at the last in vietnam and the experience we had in the years after vietnam and what that looked like with think it will very much for shadow what we have coming ahead of us in the next decade or so court of the government's own statistics of the three and a half million americans that served in the vietnam theater of operations one to one and a half million suffered some long term psychological issues half of the veterans being treated for p t s d in the v a system by the mid one nine hundred eighty s had had some contact with the criminal justice system at least one arrest and of course the naam was an unpopular war and when our veterans came home it was a less than welcoming homecoming for most of them and when they acted out in ways that brought them in the criminal courts they were treated even more harshly often than had they been a civilian who had committed the same crime we didn't understand p t s d then we were scared of these folks we didn't know how to treat them and so we lock them up in huge numbers and the ramifications of that are still with us today forty years later even today government statistics show that hundreds of thousands of vietnam era veterans are still in prisons jails homeless or incarcerated across our country in fact a study done just this last year nationwide found a third of our nation's homeless population are veterans mostly of the vietnam era but now increasingly from iraq and afghanistan looking at the numbers from iraq and afghanistan and comparing them you see that they're starting to look hauntingly similar the rand corporation did a study a few years ago that found at that time one point seven million americans to serve in the combat zones in iraq and afghanistan that's now up at about two point five million but of the one point seven million rand determine that three hundred thousand had full blown traumatic or post traumatic stress disorder and another three hundred twenty thousand traumatic brain injury t b i is the signature injury of this war it's a new phenomenon we'll talk a little bit later in my presentation about why that is and what it means for us most significantly though less than half of the veterans identified with these injuries had reported their problem or saudi help for there's a big stigma within the fighting forces around psychological injuries that prevents these folks often from raising their hands and asking for the help that they need often their first identified as having a problem when they come into contact with the criminal court system and how we deal with them at that point  can have major ramifications on the rest of their life and long term public safety it's important to recognize that women have served in these conflicts like never before in fact over two hundred thousand american women have served in the combat and they're performing admirably and suffering in equal proportions as the men the v a estimates twenty percent of women who serve in the combat zones have p t s d roughly similar to the men a lot of us are concerned that the p t s d rates from this kind of these conflicts are going to top those of vietnam and primarily because of the multiple the point made issue i talked about before in vietnam in past wars we had a draft we drafted millions of americans from whom to draw our forces and the burden was spread much more thinly than it is today vietnam it was a twelve month you were and then you were done today we have a much smaller military force that we're recycling over and over again in today two in three combat tours are commonplace and within the active duty fighting forces three four five six seven even eight combat deployments have been documented by the department of defense we've never done this before we have no precedent and when they finally start coming home as the wars wind down you can bet that we're going to need some help military itself is now documenting that p t s d rates climb with each additional combat deployment this is an exposure injury the more you're exposed to the more likely you are to suffer from it and the strain on our military is like i said unprecedented i think this cartoon from a few years ago did a good job of symbolizing the strain that our military forces are under today and you see that strain in the the faces of these real life soldiers here the good news is we seem to have learned a lot of lessons from the post vietnam experience we recognize that no matter how we feel about the war it's not the troops fault its elected leaders who make decisions deploy troops into combat not the men and women in uniform who do to flee and selflessly carry out orders we support the troops now right at least that's what the bumper sticker say and our goal in this advocacy is to ensure that that mentality persists in the coming years as our troops come home and need real support and that support means more than bumper stickers and yellow ribbons around trees beyond the yellow ribbon is about going beyond that yellow ribbon and being there to support our troops and real substantive meaningful way it's not a hostile public that our troops come home to today like after vietnam as much as an apathetic and disconnected public public who has really been tuned out of the war to the extent that they were ever tuned in the words of drugs on and people have gotten tired of hearing about it and then less a major event happens it really doesn't even make the front page of the papers when it does make the papers you get a very sanitized version of the war we weren't even allowed to see flag draped coffins unloaded off the planes at dover air force base up until recently for fear that it would impact our support for the war and as a result americans are really disconnected from the ugly reality of what of a lot of our troops have seen and done in the combat zones that feeling among the troops is persistent and i hear it again and again they don't understand what we've seen and we've done one mural seen on a wall in iraq by nona miss marie and said america is not at war the us marine corps at war america is at the mall that's how they feel that's how they come home they don't know how to even begin talking about what they've seen because everybody's tuned out the next few photos i'm going to show you are going to give you a glimpse of what the real war looks like some of them are our graphic i'll warn you up front but it's community leaders i think it's imperative that you have some sense of the kinds of images our troops are seen in the combat zone that you're not seeing in usa today on c n n infantry troops coming back from their first tour in iraq reported that ninety four percent reported they had received incoming small arms fire they had been fired on directly by the enemy forty eight percent had personally killed an enemy combatant who was caught in the crossfire the veterans involved in these incidents bring in especially difficult burden the whole thing that they struggle with often sixty eight percent reported they have personally seen seriously injured or dead american soldiers and these are definitely not images you're going to see in the media if you think about the images you've just seen remind yourself that you're seeing them here in a safe environment not the hundred twenty degree heat of baghdad with the sounds of explosions and gunfire the screams of the dying in injured around you and you're only stop for a couple of minutes not day after day month after month deployment after deployment and you can start to understand how these problems would follow a true poll a lot of scholars are doing research now that we understand more about p t s d and going back into store caltex and finding clear evidence of p t s d as we now call it as far back as the greek classics homer's iliad and odyssey are now believed not to just contain lots of depictions of combat trauma to it in fact be about combat trauma that is the whole theme of both of those stories what we call p t s d today is gone by a lot of different names over the centuries such as nostalgia homesickness the spanish and seventeenth century europe called it a star roto to be broken by the american civil war we were calling it soldiers hearts and irritable hearts and by world war one it was shell shock by world war two it was combat fatigue it's all the same thing just by different names the turn thousand yard stare is often associated with combat trauma as well and it comes from this painting done by a time life war correspondent in world war two you see similar looks on the faces of many of our troops today it's important also to understand that p t s d has been a major issue in all of the wars our country has ever fought world war one especially is when we start to have an industrialized war with twenty four seven three sixty five warfare that created huge numbers of psychiatric casualties the british alone reported two hundred thousand completely disabled troops coming home from europe at the end of the war as we prepared for world war two we began to try to figure out ways to avoid it this time and we screened out people that we deemed either morally or mentally deficient from the draft before world war two thinking that would prevent these problems again but the statistics from the government show that over five hundred thousand american soldiers were discharged a psychiatric casualties over the course of the war i didn't hear that high school history class i don't know about you i also didn't hear the nine hundred forty three the american military was just charging psychiatric casualties faster than they could draft and train replacements to send to the front and i also didn't hear that of the troops who landed on normandy beach on d day and fought their way into france sixty days into that offensive those who were survived ninety eight percent were diagnosed a psychiatric casualties the two percent who weren't were diagnosed as either sociopath or psychopathic personalities there was something even more deeply wrong with them before the war audie murphy the great world war two hero went public twenty years after his war reporting that he had suffered from p t s d ever since his war and he went on an active campaign to remove the stigma around it for the fighting forces and to force the government to do more to treat the troops coming over vietnam at that time so how does this lead to criminal behavior it's pretty simple troops coming home without getting the help they need their self medicating with alcohol or drugs and doing self destructive reckless and sometimes biol and apps the bring them into contact with the criminal justice system sometimes you'll hear veterans with a flashbacks and relive a combat experience that can lead to very tragic consequences and we're also seeing potential ties between traumatic brain injuries and impulsive violence when the brain is damaged by a concussive shockwave from a blast it can do damage to the parts of the brain that govern your perceptions of threats and the way you react to them and this is an emerging area of medicine t b i is a new thing because our troops because of their body armor and awesome battlefield medicine are surviving blasts that would have killed them in past wars so they're coming home but they've got invisible injuries that we're just starting to learn how to deal with it's also important to realize that after every war we've seen waves of veteran committed crime the american civil war created a huge crime wave that lasted for at least five years after the war and the pennsylvania state penitentiary reported very detailed information about troops coming in and coming into the prison after the war who were incapacitated and shattered by their rule war one again a watershed event major numbers of psychiatric casualties and major crime waves documented in both europe and in the united states in the years after the war these are quotes from newspapers of the day talking about the epidemic of crimes of violence they were experiencing and we have a study done here in minnesota and other states in our area after world war two that showed a third of incoming inmates in the three years after world war two at prisons in these states were world war two combat veterans so just a huge wave came into the system in those regions post vietnam government statistics show that half of the veterans being treated for p t s d had been arrested at least once a third two or more times in the early twelve percent had been convicted of a felony in just the first ten years after their war we also have recent studies by the army that show ties between the intensity of combat trauma the length and the number of deployments and what they call negative outcomes so even the military just coming up to speed and realizing that there's a direct tie the military in the v a are ramping up their treatment for psychological injuries like never before there are effective treatments for these folks the biggest struggle is getting them to come in and get it because of the stigma that still is exists in the armed forces where is perceived as a weakness we're going to see a lot of troops coming almost survivor's guilt they've lost friends and they don't know if they deserve to get help and deserve to be happy and those involved in the deaths of innocent civilians burdened with guilt and shame over their acts here in minnesota we're leading the nation in the way that we're going to deal with these folks so we passed legislation in a way that makes us  second state in the country to encourage treatment over incarceration of the veterans who come into the system because of their psychological injuries they're given a chance to go to the v a and get help in the exchange get a break in their case maybe reduce jail time in many cases the chance to avoid a criminal conviction as long as they get back on track and stay there recognizing that a criminal conviction is going to be a further barrier to them ever getting back on their feet and being a productive member of their community and we have support from the u s supreme court who cited our statute the year after it was an apted in a landmark decision that overturned the death penalty of a korean war veteran because us attorney had not brought these issues up in the trial or the sentencing phase of the trial since then we have been used as a model for legislation in number of different states and we also have one of the best veterans courts in the country in hennepin county that's now being modeled in jurisdictions around the state including here in washington county where pete orbit has an act of the veterans diversion program and we'll talk about more of that about that in that question and answer phase at the end of this i'm going to turn the floor over now to hector modest to steal as as frank noted hacker is a former special operations veteran with thirteen combat deployments under his belt and p t s d that led in two thousand and four to an armed standoff with the police he got a second chance in his case and has made the most of it and i think that story exemplifies what's possible when a veteran is given that change it's thank you he was one of those guys that everybody looked up to when the stuff hit the fan as we used to say there was a guy the guy that you wanted to be around because you know they'd get you out of it or he was competent enough to be able to handle that he called down when things like this happened and you knew that you were to survive he instilled confidence in you and you wanted to be like him i remember we came back from an appointment and after we came back he disappeared a few days later we start to realize he was kind of rattling is going to order is going to rebel it was hard to be community hospital the mental health ward off we don't know that we're that rangers break we don't break raiders don't break rangers don't have mental health disorders we're not weakling because other guys are we just don't have these issues so you know what the heck is going on and we asked our squad leader to go visit him and he said yeah go ahead and visit him he said do me a favor when you get out from there and ask them we're trying to figure out what's going on inside his head we went we visited and we entered into the room where he was and he was sent in a corner totally dismissive of the fact that we were coming to visit him and i guess rangers didn't get a whole lot of visitation because even the nurse i know you guys just leave your own in a ditch when they when they break like this we don't see rangers here much and that was kind of disappointing because my ranger create says never shall leave a fallen comrade to fall into the hands of the enemy and here he was and this nurses tell me that we leave our fallen comrades and i didn't believe that nor does what we were there there might have been some shame stuff going on i don't know but at one point it was quiet and so we broke the awkward silence by asking a question so hey man you know we were all kind of wondering what's going on inside your head is the only time that he actually looked at us and he looked right at us and said you want to know what's going on inside my head my head is a place where butterflies cry and there weeping sounds like screaming i can't make it stop do you really want to go inside my head and i don't understand what that meant to much later because see it was a long time after that until i would realize that my head was a place for butterflies cry and i would understand what it meant to hear the weeping in the screaming and not be able to turn it off i served in the military for eighteen years and as i like to point out i served in some of the most beautiful places in the world i mean i've gotten to sit on top of the mountain tops overlooking triple canopy jungles with storm clouds coming in and waterfalls just flooded with water i've gotten to see the paramedics and right camelback near them i've stood in front of the sphinx and said what the heck is this thing all about anyway i've got an experience amazing things jump out of an airplane with a full moon above you and have the parachute come down and kiss you on the cheek i've seen and been part of the amazing things but some of the things that i've experienced led to some issues later on in life that which created the place for butterflies c for me i want to tell you about one of those missions that changed my life forever that sort of was a culminating experience for me and general twenty four two thousand and four i was involved in an organized operation with my ranger buddy and i wasn't building and so far everything was nice smooth speed a little bit of violence of action a lot of situational awareness and we're going to this building we entered and there was no enemy another side this was perfect it was great very quietly my ranger buddy comes out to the door because he was close to the door and he gives me the signal the stack on him which is basically comes the edge of the door and he's ready to come out and i have to come behind them push into him he pushes into me and i launch him up the door whatever direction he goes and i go in opposite direction and both of us go out that door in less than a quarter second we're ready to engage anything that's out on the street waiting for us well that evening something very odd happened so as i launched my out the door i didn't see which way he went i completely lost my situational awareness i had my pistols at the low ready which now meant that i couldn't come up at a high ready because what if i flagged him which means that the muscles of my pencils went over him and what if i accidentally fired on him and committed fratricide which means i shot my own b but then again what if this was an enemy that was coming up on me and i didn't shoot and then i went down so i sort of froze because i've never been in a situation like this you know listening to my one o'clock a shadowy figure with a pistol up towards me and advances on me and i remember thinking i have the rest of my military career to figure out what to do here and the rest of my life and then the drill came up on me i started posturing and i started yelling back at the center vigil put his weapons down tr trying to spanish trying german trying to narrate nothing was happening nothing was working an image will keep yelling at me and i could understand what it was saying i remember thinking of my had no sentimental should have fired upon me by now because i as a ranger would have ghost him by now is what we used to say i would have taken him down by now and moved on charlie my complete the mission continue with mission and it wasn't happening he wasn't taking me down i started thinking maybe this is like one of those movies when i was black and white movies you know where on one side of the trenches  are the allies and another side of the germans and they come out somewhere in between because there's a ceasefire it's christmas eve and they start making a fire they share some how to cocoa some coffee and then sing silent night by the end of the movie these big white fluffy snow folks come out of the sky maybe this was a big white fluffy snowflake moment but it wasn't the individual continued to posture but then started moving backwards and i started getting confused i remember thinking in my head who would move backwards if i have the drop on you i would continue to move through control and i remember shaking my head and opening my eyes as i heard in my head my head the sound that whoa whoa whoa whoa whoa on like i was trying to come back into the here and now and i remember the scene in front of me looks like those little speckles are going to treat you know the little frosting stuff with the little the rods and cones and that kind of thing all sorts of different colors black white yellow and i remember shaking my head a little bit more to try to clear up my vision and to my left when i look i thought i was looking at my one year old son thinking what the heck is going on in my head and there heard screaming in my rate shook my head some water and i thought i heard my ex wife screaming out into sunil's where so i looked in front of me to see what of mine might be screaming at and that's when it was very evident that i was not where i thought i was so i was facing off with police officers at gun point standing on the front lawn of my yard in my house i thought i was somewhere else ladies and gentlemen but this was not a one time occurrence this was just the deadliest occurrence this was my face to face time to accept the fact that there's something wrong with me this was coming up for years and years and years and i just decided to ignore it because as a ranger i don't have a disorder i don't want their four letter cuss word p t s d like brock said he had a client that one said it sounds like a venereal disease why would i want that don't want that why would a ranger and that weakness i'm not supposed to i'm supposed to take on more and more and more i was never given a class on how to ask for help i was given a class on how to take more and more responsibility that can do mentality well obviously a while i lost a lot that day but i want to share with you that i gained a lot again meaning towards what i was going through one of the biggest things that i that i heard throughout this whole event throughout all of that all of which happened afterwards was that you can only lead as far as you've gone and once you've led your way out of this as one chaplain said you believe others back through it i had a psychologist who looked at me in the throes of my pain and suffering when i was the most suicidal out of a minute my life and he said to during the surge my highest peacetime award is a meritorious service medal and if i want to go back to the military to retire i can but i'll be honest with you i'm pretty happy as a psychotherapist i'm pretty happy that i don't have to pick up a rifle anymore and if i had to i would i would do it in a heartbeat because it's still in me i'm still a warrior i want to share with you that i'm not a victim i was never a victim i volunteered and i love everything that i did in the military i even love the fact that i went through things that most people wouldn't go through because i know that most people couldn't go through it i'm glad that it happened to me and i'm glad now that i get the opportunity to talk to you about this because if it wasn't for eight little police officers who didn't pull the trigger of which any one of them could have and probably see my five beautiful boys get up in the morning argue to get out of the house my wife was a former marine and in the rain and her comes out when the ranger me comes out believe me we have beautiful battles and just this past week i was invited not not that i'm actually was the one seeking it but i was invited to apply for a doctoral program at the university of minnesota to do some research on how to help military families through psychological interventions i've been invited to so i have a pretty good future ahead of me and if it wasn't for that incident that night of course there are probably a lot less obstacles in my life but i'm happy the fact that i'm here to tell you today about those obstacles you're going to see veterans coming to your communities that may end up being that extreme that i was and that everybody is going to be like me and hopefully none of them are i am an extreme case but this is where you actually get the put to the fire your sense of wanting to be going beyond that beyond beyond the l ribbon this is where you get the show ok i have to take an extra step into this matter and this is where where you get to prove that you're there for that matter in i'm happy that you're beyond the yellow ribbon community now because we need more communities like this means that you went through a very long process of going to that i commend you and i salute you and mostly i thank you i thank you not only for the step you taken us but also for the fact that you came here in your will innocent you were willing know we purposely fast forwarded through this to allow some time for questions and we're told that this is a very active question asking audience so fire away come on back up actor not all  but you took a big step today in coming here in inviting us to present hopefully leave today with a better understanding of the context of what's coming and the kinds of issues our veterans are going to be bringing home with them so that you can have more empathy and you can have a more intelligent conversation with them about what's going on and maybe a breakthrough maybe you can help them get help that they themselves don't feel that they need or that they don't deserve we also have a stream the high unemployment rate in  returning veterans it's up in the mid twenty's percent one of the worst in the country believe it or not is a good many good things as we're doing on the criminal justice front for veterans our employment rate for returning veterans is one of the worst so get  work remember not every veteran who comes back is going to have p t s d a lot of them are going to come back stronger for their service i know i did but even those who are struggling can get help and come back and be valuable assets to their community they have incredible amount of experience and wisdom that they're bringing back from their their experiences in the military that can be put to work for you get involved support the you beyond the yellow ribbon program and and just be aware because we've got a busy next our presentation today they don't get that in boot camp they're told they're invincible they're told p t s d doesn't exist they're told you know that they're superman and i find myself with a lot of clients educating them on the horrid storable context of what they're going through in fact that they're not the first soldier to come back from or deal with these problems and that can really help overcome that stigma and get them to open up and agree that ok maybe i do need to get some help the help is out there and it is a fact of exposure therapy is the a are doing a really really promising and veterans can make dramatic turnaround  sir beyond the l ribbon program would be a great start right here in your local community and through them they can wire you up with a lot of other stuff that's going on feel free to contact either of us as well and we can arrange to have our contact psychology is really in its infancy and it's but it is made great progress even in the last few years we've had a lot of trouble veterans to work with and figure out what works those exposure therapy programs at the v a i talked about are incredibly effective it requires the veterans to dig up their traumatic memories though and process them and talk about them and talk about them which is itself a difficult thing to do for them and and sometimes the criminal justice contact provides us with leverage to do an intervention with a veteran that might not otherwise be willing to go and sit through that treatment and get to the other side where they're actually going to be better and so it's all about working collaboratively using the v a as a partner with the criminal justice system and within the community but but yeah we've spent decades and decades honing the psychological conditioning that we put our troops through to prepare them to go into the combat zone and kill and perform their mission under extreme situations we're just starting to figure out that gee we need to do more on the back side and together as a as a society i think we're going to be dealing with that for the next decade to come anybody else thank you so much