A key House leader is proposing to establish a "de-boot camp," where returning service members would undergo mandatory diagnosis for brain injuries and post-traumatic stress disorder (PTSD) in order to reduce instances of domestic violence and suicide.
Rep. Bob Filner, chairman of the House Veterans' Affairs Committee, said Wednesday he will lobby the Obama administration for the de-boot camp and other new initiatives for service members returning from Iraq and Afghanistan, as well as veterans from the Vietnam era.
"There were more suicides [postwar] by Vietnam veterans than those who died in the war. We cannot make the same mistakes again. Mental illness is an injury that has to be dealt with," Mr. Filner said during an editorial board at The Washington Times. "We all have to understand what they are facing. We all have to understand PTSD."
The California Democrat said he wants the Department of Veterans Affairs (VA) to reduce a backlog of claims by granting all claims made by Vietnam veterans who say they suffer illnesses from exposure to the defoliant Agent Orange.
He said he also advocates a "radical" new approach to veterans health care that would allow veterans living in rural areas to have more choices to access health care, even private alternatives, rather than travel hundreds of miles to veterans hospitals.
Mr. Filner, who is not a veteran himself but represents a large veterans constituency in the San Diego area, said he would even support privatizing psychological care for veterans suffering from PTSD.
Many active-duty personnel are returning home as veterans who are "wounded psychologically," he said during an hourlong meeting with editors and reporters. "If they don't kill their wives or themselves, they end up homeless."
"Something is going on that we are not dealing with," said Mr. Filner, 66.
With a survival rate at 95 percent, nearly 1 million new veterans will emerge from the wars in Iraq and Afghanistan.
"The psychological wounds are going to last a very long time," Mr. Filner said. "The public has to support the new veterans."
After the Vietnam War, there was a failure to distinguish between the war and the warrior that lead to social displacement, mental disorders, homelessness and even suicide, Mr. Filner said.
News reports suggest that as many as 1,000 veterans a month attempt suicide. A third of those diagnosed with PTSD have committed felonies, Mr. Filner said.
"This is a moral issue, and I think [President-elect Barack] Obama will agree with that," he said.
The "de-boot camp" Mr. Filner envisions could last weeks, even a month, to prepare the military and National Guardsmen to re-enter society. It would include mandatory evaluations by medical professionals to diagnose brain injuries and PTSD.
Currently, the military only offers a two-hour lecture in which "kids are falling asleep," Mr. Filner said. "It's so boring."
While diagnosis would be mandatory, seeking psychological help would be voluntary. Such help would include educational and vocational counseling and would involve spouses and family.
Mr. Filner said he would like to see more access to necessary private hospital care for seriously wounded veterans in rural areas where they may not have the major medical facilities that are available in urban centers.
"In terms of access to that care for rural veterans, who may be away from main centers where their community may have good care, they ought to be far more open to specialties that may not be available within their locale, then we ought to get them into the private system as quick as we can," he said.
Unfortunately, VA hospital officials all too often are "very hesitant about doing it" because of cost considerations, he said. "They don't want" care delivered outside the VA hospital system "because if everyone is going to the Mayo Clinic, it's going to cost a lot."
But Mr. Filner said he favors expanding access to private care "in certain situations for rural veterans in some specialty areas," adding that "they've got to be far more open and quick about allowing that to happen."
Mr. Filner also addressed The Washington Times/ABC News investigation into ethical questions about experiments that involve human subjects - specifically, the smoking-cessation drug Chantix that has been linked to dozens of suicides and suicidal behavior.
A study that specifically targeted veterans suffering from PTSD included more than 100 who were taking the drug, but the VA failed to notify the participants of the new Food and Drug Administration warnings until nearly three months later.
"There has got to be really tight kinds of controls on this kind of research," said Mr. Filner, who expressed disappointment that the VA did not pull the program, which he said was "problematic" for "fragile" veterans.
The entire culture at the VA must be overhauled, Mr. Filner said.
"For a lot of veterans, VA means advisory instead of advocate," he said. "People in there are really good people, they just need to be inspired."
• Donald Lambro contributed to this report.