It’s estimated one in five veterans of the wars in Afghanistan and Iraq suffers from traumatic brain injury, also known as TBI.
Two years ago Vermont received a $951,000 grant to help veterans suffering from TBI find jobs. But to date only a handful of vets have taken advantage of the program.
The reasons for this illustrate the challenges facing service providers and vets with brain injuries.
Joe Nusbaum is the TBI Grant Manager for the state of Vermont. It’s his job to use nearly one million dollars in grant money secured by Senator Patrick Leahy to help veterans with brain injuries find jobs.
This week, at the annual meeting of the Vermont Brain Injury Association, Nusbaum gave a talk with this provocative title: "Vets With Brain Injury Where Did They Go?"
Nusbaum’s message is that despite the state’s efforts to provide job services to veterans with TBI, few have come through his door.
Nusbaum says one factor is that many Vermont vets with TBI haven’t been diagnosed, compared to the number diagnosed with PTSD – Post Traumatic Stress Disorder.
He said, "From my perspective what I’ve seen is there’s a lot of institutional knowledge and awareness around PTSD and that’s identified much, much quicker than TBI."
Shortly after Nusbaum began his talk an Army veteran who asked to be identified only as ‘Pete’ spoke up. He was critical of the TBI diagnosis and treatment at the VA Hospital in White River Junction.
"Ultimately it’s a matter of culture at the VA that has to change," said Pete. "It’s a huge cultural problem."
In the past, other veterans have made similar complaints.
Early last year Senator Bernie Sanders’ office inquired about TBI care there and concluded that the hospital is providing the necessary care.
Ellen Duval is a clinical social worker and program manager at the White River VA hospital. She said the hospital has diagnosed many cases of traumatic brain injury.
"I would say that there’s no shortage of veterans I see diagnosed, who have TBI, who have concussion disorders," said Duval.
Other members of the audience, including the wife of a Marine with TBI, spoke in support of the VA.
They suggested there are other factors that keep veterans with TBI from seeking medical help or the other services available to them.
There are concerns about confidentiality and a belief in the so-called ‘warrior ethos’ – the fear they will seem weak in the eyes of their peers. Dan Moriarty is a combat veteran who now works at the White River VA.
Moriarty asked, "So why are they going to step up to the plate and say, ‘I need help’?"
Moriarty says the military has revised its protocols to improve the chances of detecting TBI and other problems.
As for why so few vets with TBI have taken advantage of the state program to help them get jobs, Moriarty suggests there’s a disconnect between the people doing the diagnosis and treatment at the federal VA hospital and Joe Nusbaum’s state program.
"From our perspective his program isn’t well defined for us, in terms of a resource," said Moriarty.
For his part Nusbaum says it’s been difficult to build a collaborative relationship with the VA.
He agrees there are many reasons why a vet might not seek out services, but he says he’s been able to use the TBI grant money to help non-veterans with brain injuries.
The problem remains, however, that the program has fallen short of its primary goal: helping veterans. The grant lasts through the end of next year.