The first call came 10 years ago, just as veterans from the wars in Iraq and Afghanistan were starting to rotate back to the States in large numbers.
The wife of a Marine sniper called Jill Boultinghouse, a licensed marriage and family therapist in Laguna Hills, asking if she could do something to help her husband. He was suffering from depression, drinking too much, was terrorized by nightmares.
Boultinghouse, 42, explained that she didn’t have any specific expertise in how to treat posttraumatic stress disorder, or PTSD, among vets.
That’s not all she didn’t know. “There’s a whole military language that I was not familiar with at all,” Boultinghouse says. “I didn’t know the difference between a platoon and a battalion. … I said, ‘Can’t you just call the right person? Why are you calling me? I’m in private practice. I don’t know.’ I really honestly was like, ‘I have no military background. I’d be a terrible fit.’ ”
The wife didn’t care. She needed to see someone quickly, and confidentially. Boultinghouse agreed to see them both for counseling.
Word of mouth spread, and gradually other veterans found her number and her website. The calls kept coming and haven’t stopped.
Now the trickle of post-9/11 veterans returning to civilian life has become a torrent, and many are dealing with severe mentalhealth issues. This year, a report by the U.S. Department of Veterans Affairs estimated that between 1999 and 2010, an average of 22 veterans a day committed suicide. Thirty-one percent of the victims were 49 or younger.
Boultinghouse and her best friend, Evan Fewsmith, a clinical psychologist and family therapist who practices in Mission Viejo, have received so many requests for help that they’ve started a nonprofit organization, Strength in Support, that seeks to provide mentalhealth services for as many veterans and their families as possible. There’s no cost to the client if he or she can’t pay.
Fewsmith, 51, says it’s fallen to private practices to help the overwhelmed VA deal with a growing problem.
“In a perfect world, I guess, the government would fix what the government broke, but that ain’t happening,” he said.
Dr. Lawrence Albers, chief of the mental-health group in the Long Beach VA Healthcare System, noted that nationally the VA had begun to make progress on the notorious backlog of disability claims that had brought outrage from veterans groups, politicians and the media.
At the Long Beach hospital, all new patients requesting, or referred for, mentalhealth services must receive an initial evaluation within 24 hours, and a more comprehensive diagnostic and treatment planning evaluation within 14 days.
Also, since May 2012, the hospital has hired about 40 mental-health professionals.
Boultinghouse says in addition to paying nothing, veterans who come to Strength in Support are completely anonymous; there’s no record of their treatment and there’s no paperwork to fill out. Often a vet wants nothing to do with anything military-related, even if it’s seeing a counselor in a VA hospital or clinic.
“Just being part of that system is so brutalizing and dehumanizing that they really are traumatized by anything having to do with anything government, anything military, anything bureaucratic,” Fewsmith said.
Albers, and the two O.C. therapists, acknowledge that it’s exceedingly difficult to get vets to reach out to someone for help.
“That’s the biggest issue, is the average returning combat veteran comes home from their tour of duty, which has often not been their first or second or third, and nobody really wants to go see a doctor,” Albers said.
OUT OF ISOLATION
Fewsmith, who is executive director of Strength in Support, and Boultinghouse, who is vice president of the board, knew early on that they had to reach out to other veterans groups to spread the word about their services.
One way is through golf. Every Thursday, a volunteer and golf pro from Coto de Caza named Tony Guilder works with a handful of vets at the Mission Viejo Country Club. Most of them have swings that make you want to avert your eyes. But it’s a great way for them to relax, to bond with other vets, and to take their mind off their other problems.
“It’s the pipeline that gets some of these guys to show up for counseling,” Fewsmith said. “These guys will not show up for a mentalhealth professional, but they might play golf.”
Chris Kupitz, 32, wore a white cap and shirt for a recent session with Guilder. He resembled a golfer, but his tee shots at the driving range just dribbled out of the box or sliced off at an angle. He didn’t get frustrated. He was at a country club on a perfect Southern California morning, a lifetime away from where he once was.
Kupitz served two tours of duty in Iraq. During his first one, in 2005 and 2006, he was with the Army’s 445th Civil Affairs Battalion, based out of Mountain View. He helped coordinate reconstruction projects in the ravaged city of Samarra, but he also carried an M4 assault rifle as his unit provided perimeter security for infantry units that searched for key insurgents. His unit was attacked multiple times over the course of Kupitz’s tour.
The closest he came to dying, he says, came one day when his unit was ambushed by insurgents with small arms and rocket-propelled grenades. One RPG sailed over Kupitz’s head; he felt the shock wave from its propulsion. Another clanged off a truck about 20 feet from him; it hadn’t traveled far enough for the explosive to be armed. He wasn’t wounded, but some among the unit were killed.
After the deployment ended, his Army roommate did die, but by his own hand. Paul Clevenger, who had served with Kupitz in Samarra and had played hours and hours of PlayStation video games with him, attempted suicide once in early 2008; in September of that year, he succeeded by jumping off the Golden Gate Bridge.
Kupitz already was in Iraq, on his second tour of duty, when he learned of Clevenger’s death. By now Kupitz was a staff sergeant, doing more bureaucratic work at Camp Victory in Baghdad. He had met briefly with an Army counselor, “but wasn’t ready to deal with any of it.” After that 13-month deployment, he returned to the Bay Area and started drinking heavily. One night he drank a whole bottle of Jack Daniel’s.
“I became an alcoholic like so many other soldiers,” he said. “I always knew if I had Paul in my life, I had someone who could relate to everything I went through. When he took his own life, that’s what really set me on my downward spiral.”
On top of that, he couldn’t get a job. He applied online for a position at McDonald’s not far from his San Jose apartment, but didn’t hear back. A guy who had once helped coordinate public reconstruction projects in Iraq, with a budget of $750 million at his disposal, couldn’t get hired.
After leaving the Army Reserve in July 2011, he enrolled at Vanguard University in Costa Mesa, which has a growing veterans-affairs student program. Kupitz is pursuing a degree in psychology and hopes to help other soldiers. Last year, he saw a therapist for his own problems, for about three months, until he felt like he was in a better place.
“There is life beyond the PTSD,” he said. “It’s just hard to see sometimes.”
Strength in Support also offers counseling at the Veterans First shelter for homeless vets in Anaheim. Some don’t think they need therapy, but others want desperately to talk to someone.
Fewsmith and Boultinghouse have worked hard to build a level of trust among vets, to learn their language. But sometimes the vet still wants to talk to someone who’s been there. So they send them to Paul Shumate, an Army helicopter pilot who flew more than 1,400 hours of combat missions in Vietnam. He ferried wounded soldiers to safety, took enemy fire and practically lived in his Huey from April 1971 until April 1972. He was 24 years old.
Shumate says he didn’t discuss his experiences for many years, but now he’s reaching out to younger vets to help them with what he calls re-entry.
He says when he returned from the war, wearing his dress uniform, he was spit on at the San Francisco airport.
“I thought at first, ‘Oh, Vietnam veterans have it a lot worse than current guys do.’ But I don’t think that anymore, because they’re doing so many deployments back to back,” said Shumate, who is 65 and works in health care technology from his home in Laguna Niguel.
“I’ve talked to so many of them, and even though they’re welcomed home, and people aren’t spitting on them – they’re being polite – most people simply don’t understand. So they feel lonely and isolated. Who are you going to talk to? If you seek help on the base, you feel branded. It’s hard to talk to your friends about it, so you bottle it up. Having a group like Strength in Support, where somebody can go into a nonthreatening environment, they can talk to me, they can talk to a mental-health professional like Jill or Evan, it’s amazingly effective.”
Fewsmith and Boultinghouse are very different: His family is New York all the way, and he still has the accent. But he’s the softie, a necessary empathy for working with some clients who are adult victims of abuse. She was born in Arizona but lived in Laguna Hills since she was 9. She’s more straightforward; people sometimes think she’s from the Midwest.
They could be concentrating on building up their own practices, and collecting the customary $150 fee per session. But they saw a need and are working to fill it – even if veterans are sometimes reluctant and even take offense at the notion that they might be “crazy.”
“So that’s one of the things we’ve decided, that we have to go out there first, press the flesh, mingle with them, destigmatize, and say, ‘You don’t have to do therapy because you’re sick. You deserve to get assistance and counseling and be heard because you served,’ ” Fewsmith said.
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