It doesn't happen overnight. The effects of PTSD are insidious (according to Websters Ninth a: having a gradual and cumulative effect b: developing so gradually as to be well established before becoming apparent.) In my case it was 12 years before it finally hit home. Some of these people will live successfully despite the effects, and some will fall prey to it. Yes there may well be an alcohol abuse component, as well as drug use. There will also be a higher than statistically normal rate of transiency, divorce, domestic violence, anger issues, job loss, among many other long term effects. It is not a matter to be brushed off, trivialized, or neglected. If we expect these people to serve, then we damn well ought to be taking better care of them when they come home.
WASHINGTON, Nov. 7, 2000 More than 400 veterans of the Iraq and Afghanistan wars have turned up homeless, and the Veterans Affairs Department and aid groups say they are bracing for a new surge in homeless veterans in the years ahead.
Brendan Smialowski for The New York Times
Experts who work with veterans say it often takes several years after leaving military service for veterans accumulating problems to push them into the streets. But some aid workers say the Iraq and Afghanistan veterans appear to be turning up sooner than the Vietnam veterans did.
Were beginning to see, across the country, the first trickle of this generation of warriors in homeless shelters, said Phil Landis, chairman of Veterans Village of San Diego, a residence and counseling center. But we anticipate that its going to be a tsunami.
With more women serving in combat zones, the current wars are already resulting in a higher share of homeless women as well. They have an added risk factor: roughly 40 percent of the hundreds of homeless female veterans of recent wars have said they were sexually assaulted by American soldiers while in the military, officials said.
Sexual abuse is a risk factor for homelessness, Pete Dougherty, the V.A.s director of homeless programs, said.
Special traits of the current wars may contribute to homelessness, including high rates of post-traumatic stress disorder, or PTSD, and traumatic brain injury, which can cause unstable behavior and substance abuse, and the long and repeated tours of duty, which can make the reintegration into families and work all the harder.
Frederick Johnson, 37, an Army reservist, slept in abandoned houses shortly after returning to Chester, Pa., from a year in Iraq, where he experienced daily mortar attacks and saw mangled bodies of soldiers and children. He started using crack cocaine and drinking, burning through $6,000 in savings.
I cut myself off from my family and went from being a pleasant guy to wanting to rip your head off if you looked at me wrong, Mr. Johnson said.
On the street for a year, he finally checked in at a V.A. clinic in Maryland and has struggled with PTSD, depression, and drug and alcohol abuse. The V.A. has provided temporary housing as he starts a new job.
Tracy Jones of the Compass Center, a Seattle agency that has seen a handful of new homeless each month, said she was surprised by the quickness in which Iraqi Freedom veterans are becoming homeless compared with the Vietnam era. The availability of meth and crack could lead addicts into rapid downhill spirals, Ms. Jones said.
Poverty and high housing costs also contribute. The National Alliance to End Homelessness in Washington will release a report on Thursday saying that among one million veterans who served after the Sept. 11 attacks, 72,000 are paying more than half their incomes for rent, leaving them highly vulnerable.
Mr. Dougherty of the V.A. said outreach officers, who visit shelters, soup kitchens and parks, had located about 1,500 returnees from Iraq or Afghanistan who seemed at high risk, though many had jobs. More than 400 have entered agency-supported residential programs around the country. No one knows how many others have not made contact with aid agencies.
More than 11 percent of the newly homeless veterans are women, Mr. Dougherty said, compared with 4 percent enrolled in such programs over all.
Veterans have long accounted for a high share of the nations homeless. Although they make up 11 percent of the adult population, they make up 26 percent of the homeless on any given day, the National Alliance report calculated.
According to the V.A., some 196,000 veterans of all ages were homeless on any given night in 2006. That represents a decline from about 250,000 a decade back, Mr. Dougherty said, as housing and medical programs grew and older veterans died.
The most troubling face of homelessness has been the chronic cases, those who live in the streets or shelters for more than year. Some 44,000 to 64,000 veterans fit that category, according to the National Alliance study.
On Wednesday, the Bush administration announced what it described as remarkable progress for the chronic homeless. Alphonso R. Jackson, the secretary of housing and urban development, said a new policy of bringing the long-term homeless directly into housing, backed by supporting services, had put more than 20,000, or about 12 percent, into permanent or transitional homes.
Veterans have been among the beneficiaries, but Mary Cunningham, director of the research institute of the National Alliance and chief author of their report, said the share of supported housing marked for veterans was low.
A collaborative program of the Department of Housing and Urban Development and the V.A. has developed 1,780 such units. The National Alliance said the number needed to grow by 25,000.
Mr. Dougherty described the large and growing efforts the V.A. was making to prevent homelessness including offering two years of free medical care and identifying psychological and substance abuse problems early.
One obstacle is that many veterans wait too long to seek help. I had that pride thing going on, Im a soldier, I should be better than this, Mr. Johnson said.
Kent Richardson, 49, who was in the Army from 1976 to 1992 and has flashbacks from the gulf war, said, when you get out you feel disconnected and alone.
Mr. Richardson said it took him two years to find a job after leaving the Army. Then he became an alcoholic. He now stays at the Southeast Veterans Service Center in Washington, awaiting permanent subsidized housing.
Joe Williams, 53, spent 16 years in the Army and the Navy, including a deeply upsetting assignment in the mortuary at Dover Air Force Base in Delaware, where the dead from the gulf war were taken for autopsies.
For the past three years Mr. Williams has lived in a bunk bed in a Washington shelter. He was laid off, his car and house were repossessed, and his wife left him. He moved to Georgia, where he lost another job.
Broke and depressed, he walked from Georgia to a V.A. hospital in the Washington area, where schizophrenia was diagnosed. Now, after three years of medication and therapy, he feels ready to start looking for work.
I have a mission Ive got to accomplish, Mr. Williams said.
Sean D. Hamill contributed reporting from Pittsburgh, Michael Parrish from Los Angeles and J. Michael Kennedy from Seattle.
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