WMC News & Features

Demanding better for women veterans

A woman in military service who was gang-raped while on active duty seeks counseling at a Veterans Administration (VA) hospital. Without seeing a therapist, she finds herself admitted to a locked, co-ed psych ward where she is diagnosed with “severe post-traumatic distress disorder” and advised to retire from the military because she is “very ill and not likely to get better.”

An active-duty servicewoman is violently raped by another soldier during the Iraq War. When she tries to report the rape, she is told by her commanding officer there’s a war on, and she should “get over it.” Later, as a veteran, she seeks help from the VA, but it is not forthcoming. An advocate with a similar past experience contacts a TV reporter on her behalf. The station is warned by military officials not to air the story.

These examples seem extreme, but cases like these are not uncommon. Veterans’ advocates are calling attention to the fact that VA services often leave much to be desired when it comes to responding to women in need of appropriate mental health care and support, especially if they are survivors of sexual trauma.

Col. (Ret.) Kathy Platoni, Ph.D., was a U.S. Army psychologist for more than three decades. She now serves as a colonel in the Ohio Military Reserve while maintaining a private practice, working with victims of military sexual trauma. She calls the VA “a scary place for most people,” citing problems such as hostile physicians and violations of HIPAA privacy regulations. VA care can be particularly difficult for women because the system isn’t designed to fully meet their needs, especially following sexual assault.

Susan Avila Smith, who served in the Army for four years, during which time she was sexually assaulted, is now a successful advocate for women who’ve suffered rape and other forms of sexual abuse in the military. She has won 100 percent of the various benefit claims she has filed on their behalf. “It’s always the same story,” Smith says. “Women get raped, report it, and the perpetrators go free. Maybe he gets a fine or has to pick up cigarette butts, but nobody helps the women. They’re all screwed over because the military is a man’s world.” This kind of outcome can increase women’s post-abuse trauma, making appropriate mental health support more urgent.

Smith has done advocacy work for 20 years. The stories she hears are chilling. For example, one woman told her that while on a co-ed psych ward at a VA facility, she was forced to watch a New Year’s Day football game with a group of male patients. When they cheered their team, she screamed in fear, reminded of when she was raped by a serviceman. She was then strapped to a gurney, legs spread, and left alone in a quiet room instead of receiving appropriate care and support.

Change is slow in coming, but advocates have succeeded in getting some treatment protocols changed or added. For example, while most VA psych wards are still co-ed, shower rooms are not. Referral to outside vendors for psychotherapy is in place in some VA settings, although getting a referral to an off-site provider remains challenging, and many of those providers know little about military service. There are now women’s clinics in 55 percent of the 150 major VA hospitals, according to Geri Lynn Weinstein Matthews, a clinical/medical social worker and advocate for victims of military sexual trauma, but some problems persist; a rape survivor is still unlikely to feel safe on a co-ed psych ward. And while good providers exist within the VA system who share patients’ and families’ frustrations about the quality, timeliness, and accessibility of appropriate services, many fear retribution if they speak out. “There are some great providers in the VA,” says Matthews, “but it’s still flawed and limited at best.”

Matthews and other advocates believe that clinical staff need to understand the trauma of rape in the military and to be better trained to respond to it. Many advocates say more peer counselors could help in avoiding hurtful, inappropriate responses. And some join Matthews in pushing for the VA to establish more “process groups” where survivors can talk about what happened and share support and coping mechanisms. She also worries about hiring practices, pointing out that someone who has committed a sexual assault on active duty could be employed at a VA facility upon military retirement because most perpetrators are never convicted.

Col. Platoni agrees that non-veteran providers can foster a “huge distrust factor” and need to be adequately trained to deal with situations that may be new to them and can be hard to comprehend. She believes that every veteran who enters the VA system should be assigned “an advocate to walk them through the system, help get what’s needed, and ensure that they are not silenced, threatened, or retaliated against.”

Military sexual assault is not solely a female experience, but women are more likely to be assaulted. According to the Pentagon, female service members account for about 15 percent of the armed forces, but 46 percent of military sexual assault victims. Worse, according to a 2015 report by Human Rights Watch, 62 percent of victims who reported attacks said they’d been retaliated against professionally and socially for reporting those crimes. And it is estimated that fewer than three out of every 100 sexual assaults in 2012 were prosecuted.

A VA response to this story was hard to come by, but psychologist Magret Bell, Ph.D., national deputy director of the VA’s Military Sexual Trauma Support Team, said stories of veterans suffering and the absence of appropriate, compassionate care afterwards are troubling. She agreed the issues “absolutely need to be addressed,” including by the Department of Defense in cases of retaliation.

Several services are in place at VA facilities, she said, citing universal screening to identify patients who have suffered military sexual trauma (which relies on self-reporting) and free care that does not require disability claims for sexual assault victims. “MST coordinators” are present at VA sites and community-based Vet Centers, and national MST consultation services exist so an “expert” can be contacted by frontline staff.

“The VA uses a recovery model that focuses on a patient’s strengths,” Bell says. “We want to meet a veteran where she is [in terms of needs] and based on what her goals are.” But, says psychologist and veterans’ advocate Paula J. Caplan, Ph.D., “Vast numbers of women veterans who were sexually assaulted are not given supportive care. They are put on drugs, told they are sick, and their stories are often disbelieved when they tell the truth. Some therapists in the VA system are good that way, but others are not.”

In its fact sheet on military sexual trauma, the VA states that it is “strongly committed to ensuring that Veterans have access to the help they need in order to recover from MST.” But personal testimonials and accounts by family members, whistleblowers, journalists, and others stand in stark contrast to the rhetoric of most VA voices and documents.

In a commentary posted to the health policy blog Disruptive Women in Health Care earlier this year, Diana Danis, senior advisor to the Atlanta-based Women Veteran Social Justice, a support organization for women veterans, quoted Secretary of Veterans Affairs Robert McDonald: “The day every single veteran gets the care they deserve and they have earned, then we can relax a little bit.”

Given the apparent state of care in the VA system and the military response to sexual trauma, the Secretary’s vision of accessible quality care being available any time soon seems facile. In the meantime, women in service and veterans who continue to need appropriate, compassionate care struggle mightily in its absence.

The author wishes to acknowledge Paula J. Caplan’s valuable insights on this topic.



More articles by Category: Disability, Violence against women, WMC Loreen Arbus Journalism Program
More articles by Tag: Military, Sexualized violence
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