Edgardo Padin began working with the Department of Veterans Affairs 25 years ago. And despite the deluge of bad press about the VA in recent months, he says things have improved a lot over the last two decades. That’s largely because the general public has learned, as he puts it, “to separate the war from the warrior.”

The certainty of ambiguity
But Padin acknowledges the transition to civilian life remains a tough one for young men and women – many of whom came to maturity in a military hierarchy “where everybody does their job; they’re all mission-oriented.

“Then they come into a civilian system that is very ambiguous, where they don’t know who to trust and who not to trust. And so their first inclination is not to trust someone until they give them a reason.”

Padin says surmounting that requires those working in agencies “to be able to listen, to be able to empathize without necessarily coming across as someone who knows what the veteran needs to do in order to engage back into the civilian world.

Acknowledging what you don't know
“Nobody really knows fully what each individual veteran needs. But what we do know is that we can provide them with the support according to the needs that they have and according to where they are at this particular phase of their lives.”

“Providing the support to the veterans as they transition is important, but even more important than that is if the veteran feels like the support is being provided. … So even if all you say is, ‘I really appreciate your service, thank you very much, if I can ever do anything for you, let me know.’ Even if they never ask you, they feel like the support is there.”

So for those working with vets, “it’s acknowledging your own kind of lack of knowledge and your own helplessness and helping him recognize that you’re willing to start a dialogue  -- or her.”

Sexual assault and matters of trust
Padin says special issues are emerging as the number of women vets grows. That includes the military sexual trauma. He notes that 2-3 percent of the victims of military sexual assault reports are men and says the percentage is likely higher because men tend not to file reports.

As for the female victims, most of the assaults are by comrades, and usually by someone of higher rank. And though he says the military is getting better, it’s history has been to ignore such reports.

So the women feel betrayed “by an institution that … they felt they belonged to equally with everybody else.”

"So one of the things that happens to women as a result of that is a fear and distrust of people in authority. And that sometimes translates into a fear and a distrust of institutions” including the VA.

Padin, says another issue that’s growing for the VA is the number of homeless women with children, which traditional veterans shelters are not equipped to handle. He says that’s where community agencies have become absolutely crucial.

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Another aspect of the Cleveland VA outreach are Community Resource and Referral Service centers.

LISTEN: Barbara Karam on drop-in centers and flexibility

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The mental health summit in suburban Cleveland was set up to do two things:  To strengthen ties between the Lou Stokes Cleveland VA and the community agencies that are its partners, and to train those agencies to work with veterans who may come to them on their own.

Barbara Karam oversees the VA’s two Community Resource and Referral Centers, drop in centers in Cleveland and Akron. She says working with vets requires flexibility.

“Maybe you just want a shower. We have a shower, we have laundry facilities.  Some veterans aren’t quite ready work on all of their issues that are causing their homelessness or impacting their homelessness. So it’s a matter of starting where they’re at. We do have a full array of social work services to connect them with mental health services, talk about  their substance abuse. And we also have vocational counselors, individuals who can look at, ‘What services did you do in the military, what types of jobs and how does that translate into civilian life?”

The centers see about 20 vets a day, and Cleveland is the only regional VA in the country that got funding for two such centers.