John Staresinich is a Purple Heart veteran who has slept in cracks in highway overpasses and abandoned cars, camped out in thin tents next to railroad tracks and fought off rats and bugs in Chinatown flophouses.
In December, he was diagnosed with severe combat-related post-traumatic stress disorder -- 32 years after returning from Vietnam -- and is now getting help from the federal Veterans Affairs in Chicago. He says it took more than a year of begging that agency.
"Soldiers from Iraq are going to come back with PTSD," said Staresinich, 54. "I hope they treat them sooner than they did me."
Mental health experts are predicting that as many as one-third of all Iraqi veterans will suffer from PTSD, a disabling disorder characterized by flashbacks and war nightmares. A similar percentage of Vietnam veterans have been diagnosed with the disorder -- although it took decades for the government to recognize, treat and compensate those veterans.
Still, the VA officially maintains there's no connection between military combat and homelessness. But people who work with veterans believe otherwise.
"Many people will tell you that military service is not a significant contributing factor to homelessness. But it clearly is a factor," said Pete Dougherty, national director of the VA's homeless veterans programs. "There are more veterans who have shown up in the ranks of the homeless than their average age cohort."
There are 93,000 homeless Vietnam veterans, VA officials say. Illinois has the nation's third-largest population of homeless vets -- about 20,000.
Already about 100 soldiers from Iraq have turned up at homeless shelters around the country. And a study released last summer found that 17 percent of early returning Iraqi soldiers suffered from PTSD. Less than half of them had sought mental health care.
"I think PTSD is probably higher than it was in Vietnam because of the intensity of this conflict and the fact that we're calling up a whole different demographic category of people for this conflict than we did in Vietnam," said Dr. Ron Davidson, director of the mental health policy program at the University of Illinois at Chicago's psychiatry department. Davidson directs counseling services for the Illinois Family Resource Network, the state's outreach program for National Guard and Reserve family members.
Most soldiers in Vietnam were under 25, unmarried and had no children, Davidson said. In this war, most soldiers -- especially those from the National Guard and Reserve units -- are older, married and have children.
The Defense Department says it is evaluating soldiers before deployment, after they return home and three to six months later to determine whether they are at risk for the disorder.
That was certainly not the case when veterans returned from Vietnam in the 1960s and 1970s reporting constant fear, sleeplessness, anxiety and violent dreams. The military did not acknowledge their symptoms as a mental disability until 1980. By then, some veterans had been home for 15 years.
"The VA has to get out of the mentality of sitting and waiting for the patient to come to them," Davidson said. "This is definitely a perverse part of the system."
Homeless veterans are a difficult segment of society to serve. They are transient and, according to VA studies, about 45 percent are mentally ill and 70 percent have substance addictions.
The Chicago VA's Homeless Coordinator refused an interview but her office released a list of programs that target homeless veterans, including an outreach effort that tries to get housing for those who are mentally ill.
But mentally disabled veterans, like Staresinich, say the VA's bureaucracy -- which demands reams of paperwork and months of haggling -- leaves them waiting for disability decisions and appointments with doctors.
"The VA is oriented with procedure," said John Rodriguez, a veterans representative with the Disabled American Veterans in Chicago who files disability claims for homeless veterans.
On Thursday, a Chicago Police officer and a social worker brought a homeless Vietnam veteran, a Purple Heart recipient, to Rodriguez. But when Rodriguez tried to get the VA to review the man's case, he was told he couldn't prove the veteran was homeless. Rodriguez had to get affidavits from the cop and the social worker before the VA would take the case. Staresinich says he also ran into obstacles when he went to Hines VA hospital in December 2003, asking to "be committed."
"I said I was suicidal. I begged them to help me. I wanted to see a doctor, a psychiatrist. I told them there's something really wrong with my head," said Staresinich, looking gaunt, his steel-blue eyes sunken like a skeleton. "They told me there was a wait for rehab."
...On Sept. 3, 2004, Rodriguez filed Staresinich's disability claim for PTSD, unemployability and hearing loss. His file was marked with a dark pink tag to signify that the case involved a homeless veteran and needed to be expedited.
It took five months for a decision. On Jan. 7, the VA ruled that Staresinich is 100 percent disabled. Three weeks later, he received a $6,777 check retroactive to September when his claim was filed. He will receive $2,299 a month and plans to get his own apartment so his 18-year-old daughter can live with him.
But his veteran friends worry that it may be too late for Staresinich, who, flush with cash, now spends much of his time in neighborhood bars.
Read the full story of several vets.