Coast Guard veteran Ryan Niemiec, right, is joined by volunteer Pat Witt of the Blue Star Mothers of America during a canteen hosted for veterans. “They make it feel like grandma’s house or your mother’s house,” he says.

Serving those who served the nation

Willie Breedlove said he lost it one day in 2000 while walking down Clinton Avenue with a friend.
The weather was hot and humid, and Spanish music blared from a stereo somewhere in the neighborhood.
It took him back to his Army days in Panama where he was stationed before and during the military action to capture Gen. Manuel Noriega in 1989 and 1990.
“You meet people. You become friends with people. And later you’re tearing up their country,” said Breedlove, who felt the number of civilian casualties and destruction of buildings was an excessive show of force.

Willie Breedlove, an Army veteran who served in Panama, relied on drugs and alcohol to cope. He turned his life around and now works at the Veterans Outreach Center.

“When you’re part of a war machine, it’s not so much you pulling the trigger, but you’re just watching the destruction and knowing that thing you’re a part of did this much damage,” he recalled.
That day was the beginning of his downward spiral.

Breedlove, 47, stopped going to work and started drinking heavily and using drugs. He spent three years living on the streets before he sought help at the nonprofit Veterans Outreach Center on South Avenue.
“I just came in because I was hurting. I just wanted the pain to go away. I wanted the pain to stop,” said Breedlove, who is now working for the center on the front lines of an effort to assist a growing number of veterans seeking help.
New York has the fifth-highest population of veterans nationwide, and western New York has a large concentration of them, second only in the state to New York City, according to U.S. Census Bureau estimates.
Government statistics show that the number of veterans in Monroe and the five surrounding counties has dropped from about 99,000 in 2000 to about 80,000 today. While those who served in the post-9/11-era wars add to the population, about 2,000 veterans of earlier conflicts die each year in Monroe County, and many have retired and moved away from the area.
Yet, the region’s Veterans Affairs medical centers have seen more patients over the last decade and their budgets have grown significantly at a time when federal spending is under the microscope. The number of vets served by V.A. medical centers in Canandaigua, Batavia and Bath is up 16 percent since 2003. The centers’ budgets have risen between 32 percent and 41 percent since 2005 when adjusted for inflation.
The growth in demand — due in part to the recession, the aging of veterans and the changing profile of those who have returned from more recent conflicts — is forcing the expansion and restructuring of government and community programs that help veterans facing homelessness, addiction, mental health problems, unemployment and medical needs.

Growing demand

Like Breedlove, veterans often struggle for years with the scars of war before seeking help. “The peak demand for services for veterans doesn’t materialize until 30 to 40 years after they separate from service,” said James D. McDonough, president and CEO of the Veterans Outreach Center, 459 South Ave., which helps about 3,500 veterans each year with employment, wellness, educational and other services.
Dell Young, 69, of Henrietta suffered a brain injury while in the Navy during the Vietnam War, but he didn’t get treatment until 28 years later. In 1970, when he was a flight officer, Young was one of eight men who survived a plane crash. Twenty-two others died.
“I probably suffered a traumatic brain injury at that time,” Young said.

He spent three months in an Army hospital and then went back to his squadron and continued to fly more missions.
“I had a lot of anger, a lot of depression. I drank too much. I lost one wife,” said Young, who now participates in weekly group sessions to deal with post-traumatic stress disorder.
But he didn’t get help for PTSD until 1998, when he went to a V.A. doctor for separate health issues, and he was referred to a readjustment counselor.
“If it wasn’t for the medical practitioner, I wouldn’t be here now,” Young said. “I was already contemplating running my car into a bridge abutment.”
Mental health services have seen the most growth in demand at V.A. medical centers, based on spending, in the upstate New York region, which covers the V.A. medical centers in Albany, Syracuse, Bath, Buffalo, Batavia and Canandaigua.
The aging of veterans is also putting pressure on the system. Almost 41 percent of veterans are now 65 or older. The number of veterans 85 and older, the largest users of long-term care services, who are enrolled for benefits, is expected to increase about 20 percent to almost 710,000 by 2019.
The recession also has brought more veterans to the V.A. system as they, like many others, lose their employer-provided health insurance when jobs are eliminated or when retiree benefits are cut.
For more recent veterans, improvements in battlefield medicine are another factor increasing their need for services, said Robert L. Morrill, a past state commander for the American Legion Department of New York who lived in Rochester for about 50 years.
“In the past, they would die from these injuries, but now they come back in some cases,” he said. And those wounded soldiers require extensive follow-up.
These more complex cases and an increasing recognition of conditions like PTSD are making claims for care more complex. Claims with eight or more issues went from about 21,000 in 2000 to more than 67,000 in 2009. And the trend is expected to continue.
Changing needs

Another factor in the rising demand for veterans’ services is what McDonough, a retired Army colonel, calls the “new dynamic of the family.” In the past, veterans were often single men, but today a growing number are married men and women with children. About 75 percent of veterans are married with spouses who also will need benefits and services.
“In this country, the Department of Veterans Affairs has not been given the mandate to deal with veteran families,” McDonough said, and many support services are geared toward individuals, not families.
While that is slowly changing, non-governmental organizations, such as the Outreach Center and Vietnam Veterans of America, are offering help to families of veterans.
The Ontario County Chapter of the Blue Star Mothers of America, for example, not only provides a meeting place for veterans in a home on the Canandaigua V.A. campus, but the group also offers support when there is an illness or a death in a veteran’s family and during times of financial hardship. The group routinely holds special family-oriented events on holidays.
“They make it feel like grandma’s house or your mother’s house,” said Ryan Niemiec, a 24-year-old Coast Guard veteran who lives in a dormitory at the Canandaigua V.A.
“It’s just a place you can be yourself and not be judged,” said Niemiec, who got all of his clothes from the Blue Star Mothers.

The V.A. also must adjust to the increasing number of female veterans. Women account for 7.5 percent of the total veteran population and about 5.5 percent of all veterans who use V.A. health care services. By 2020, female veterans are expected to account for 10 percent of the veteran population and 9.5 percent of V.A. patients.
Female veterans are more likely to enroll in V.A. health care and are often sole providers in a family. They also have much higher exposure to traumatic experiences, such as rape and assault, before joining the military, in addition to sexual trauma while in the service, which increases the likelihood of PTSD.
The V.A. has begun offering services just for women and has instituted training to make women more comfortable seeking help from the V.A.

Homelessness among veterans also continues to be a challenge. About 20 percent of homeless adults are veterans, and one in three homeless men has served in the military, according to the Department of Veterans Affairs 2011-15 strategic plan.
The Veterans Outreach Center’s homeless shelter, Richards House, has room for 20 vets overcoming substance abuse problems, but has a waiting list with 78 names. About 30 of the vets who used the shelter last year had served in Iraq, Afghanistan or both wars.
“We see a growing number of homeless veterans in this community, and we see, within this data, this generation of veterans is finding itself homeless faster than previous generations have,” said McDonough.
A successful transition from military to civilian life is key to preventing homelessness among veterans.

Soldiers are so accustomed to following the orders of officers and maintaining a strict routine that it becomes difficult to make decisions on your own, Niemiec said.
Breedlove, a graduate of Monroe High School who joined the Army in 1986, had so much trouble adjusting to civilian life that he unsuccessfully tried to re-enlist. He bounced among jobs and his marriage fell apart before he became homeless.
“If you don’t transition well, recovery becomes the next transition you go through,” he said.

Finding solutions

In good times, veterans and their families may not think much about what services are available. When the need arises, they often may not know what is available. They may also not feel they can seek help.
“In basic training, it was always, ‘Suck it up and drive on. This is not a place where we whine and snivel,'” Breedlove said.

When he finally sought help in 2003, Breedlove spent six months at the Bath V.A. Medical Center for drug and alcohol rehabilitation and then went to Richards House.
Since then he’s earned a degree from Nazareth College and for five months has been a clinician intern at the Veterans Outreach Center. He’s on schedule to earn his master’s degree in social work in May.
Outreach has been an important factor in drawing veterans in for services.

“We are outreaching to vets that might be uninsured due to unemployment and early retirement. We’re outreaching to veterans that might be attending school using the GI benefits and letting them know, if they don’t currently have health insurance, to enroll them,” said Kathleen E. Hider, spokesperson for the U.S. Department of Veterans Affairs.
The efforts have led to about 30 percent of veterans in the Rochester area enrolling in V.A. health care, up from about 20 percent in 2003.

“I think we’ve improved in getting the message out in the past decade,” said James Carra, director of the Monroe County Veterans Service Agency, which helps veterans and their families. The agency handles an ongoing caseload of about 9,000.
“More people are aware, through churches, through aging associations, and through the various towns.”

The need for new approaches to help veterans is also gaining attention from federal officials, and more community groups are stepping in to assist.
“I’m pleased that the government is realizing for the first time that there is a role to play for communities in supportive services,” McDonough said.
The V.A. has announced the availability of grants for agencies that provide services to veterans. Applications from community-based organizations are due March 11.

KEY FINDINGS:
* The six-county Rochester region has an estimated 80,000veterans, a decline of about 19 percent since 2000.
* The number of patients treated at the area’s V.A. medical centers has risen 16 percent since 2003.
* About 20 percent of homeless people are veterans.
* The number of veterans 85 and older, the largest users of long-term care services, who are enrolled for benifits, is expected to increase about 20 percent to almost 710,000 by 2019.

RESOURCES:
* Veterans Outreach Center: www.veteransoutreachcenter.org (585) 546-1081
* Blue Star Mothers: www.bluestarmothersny1.org (585) 301-2662
* Monroe County Veterans Service Agency www.monroecounty.gov/vet-index.php (585) 753-6040
* U.S. Department of Veterans Affairs www.visn2.va.gov