By Howard Wilkinson
The Cincinnati Enquirer
The next time you walk the streets of downtown Cincinnati, make note of the first three homeless men you see. Statistics say that one of those three is a military veteran - a soldier, sailor, airman or marine who once wore the uniform proudly and served his country in war or peace.
"They are too often the forgotten veterans," said Iola Green, a longtime social worker who heads the Cincinnati VA Medical Center's health care for the homeless outreach program. "Not just forgotten. Invisible, almost."
Iola Green talks with Navy vet Leroy Woodward at Prospect House in Price Hill.
(Glenn Hartong photo)
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The U.S. Department of Veterans Affairs estimates that there are as many as 250,000 homeless veterans on the streets and in shelters on any given day.
Nearly half, the statistics show, suffer from mental illness.
Nearly 70 percent suffer from alcohol or drug abuse problems.
The lives they lead on the streets lead to a host of other health problems, making them among the most vulnerable of veterans and most in need of VA health care.
"I've often said we ought to issue military uniforms to every homeless veteran in America," said U.S. Rep. Ted Strickland, D-Lucasville, a member of the House Veterans Affairs Committee. "That way, when people saw them on the street, they wouldn't just see a homeless guy. They'd see a man who served his country."
The VA operates a massive health-care system - 163 hospitals and 850 outpatient clinics. More than 4.5 million people used VA health care facilities last year.
With increasing pressure on the VA system, the Bush administration is trying to focus services toward those who need it most - those with the most severe service-related disabilities and those low-income veterans who have no other options, including the homeless.
That is why Green spends her days driving her government car from one homeless shelter to another, talking to administrators and meeting one on one with homeless veterans to evaluate their needs and hook them up with services.
In the process, she said, she tries to inspire the men - only about 3 percent of homeless veterans are women - to confront what has left them without homes and, often, without hope.
"I try to make them understand that you were once a man and fighting for our country. Let's get your manhood back," said Green, sitting in the office of the mess hall at the Mount Airy Shelter for the Homeless, which sits high atop a tree-covered hill seven miles from downtown.
The vast majority of the homeless veterans Green and her staff meet are from the Vietnam era. Now in their early 50s, these men suffer from a variety of mental disorders - most commonly post-traumatic stress syndrome (PTSD) - and have had substance-abuse problems for decades. They also suffer the various illnesses of middle age.
VA statistics show that 57 percent of the nation's homeless veterans have used VA medical care services, but many thousands are not aware of what is available.
Green's job is to find them.
One day last week, Green started her day at the Mount Airy shelter, then drove to the Drop-Inn Center Shelter House in Over-the-Rhine, the city's largest. Outside the Elm Street front door stood a cluster of men smoking cigarettes - smoking isn't allowed inside. One of them recognized Green and ran up and gave her a hug.
"Still clean and sober," Gregg Gibert said, draping his arm around Green's shoulder. "Thanks to you."
Gibert, 50, said he was a Vietnam-era veteran who suffered decades of drug and alcohol abuse until a few years ago when he met Green at Mount Airy Shelter. She got him into a substance abuse program and "pointed me in the right direction."
Now, he says, he is about to complete an associate degree at Cincinnati State.
"I really did not know what was out there for veterans until Iola came along," Gibert said. "I just wandered around in the dark."
Inside the Drop-Inn shelter, Green stopped in on a meeting that VA nurse practitioner Susan Ball was having with a homeless veteran in his 60s who was applying for VA health-care benefits for the first time. Although he left the service 38 years ago, he had lost his honorable discharge papers and had never had contact with the VA, despite decades of living mostly on the streets.
One of Green's other regular stops is at the Joseph House on Vine Street in Over-the-Rhine, which offers transitional housing for homeless veterans who are trying to kick substance abuse.
About 29 percent of the Joseph House's income comes from the VA, in per diem payments to house veterans who have substance abuse problems.
Director Bill Malone said that if a veteran who comes to Joseph House stays "clean and sober," he can stay for another seven to eight months while he finds work and a place of his own.
"This is a tough place for guys with a monkey on their backs," said Malone. "That monkey hates this place."
At Joseph House, a veteran's day is full of chores, group therapy sessions, education classes, AA meetings, from morning until night.
Darryl Bowman has lived that life for more than four months now. He is a recovering alcoholic who served in Vietnam as a combat medic - a time of his life he does not like to recall.
Bowman said that after the war he returned to his native Indiana and found that he "just didn't fit in any place. I was screwed up. I had all kinds of problems, and I didn't understand what was causing it."
He couldn't keep a job, or a home, for very long.
But it was not until the early 1980s that he became aware of VA health care services. He was diagnosed as having bipolar disorder and PTSD. In another recent visit, he was diagnosed with hepatitis as well.
"If it wasn't for the VA, I wouldn't know what was wrong with me," Bowman said. "And knowing what is wrong is the only way I can get better."
It is not a perfect system, Bowman said. The clinic is crowded and there are often long waits to see doctors.
"If you've got an appointment up there at 9 o'clock in the morning, you'd better take a lunch with you," Bowman said.
But, as a homeless man with severe physical and mental disorders, Bowman said he knows that without VA health care, "I'd have nothing at all."
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