After Wallace Clayton served in the Army Special Forces in the mid-1970s, he says, he bounced from job to job for more than a decade. He worked in electronics assembly and repair, landscaping and home renovation — and never understood why he was having so much difficulty getting his life together.
"It was hard to hold a job," Clayton said. "It was kind of rough going. … My mind was somewhere else."
He didn't know it at the time, he says, but he was struggling with more than the switch from military to civilian life that challenges many veterans. Only after moving to Maryland nearly two years ago and getting help that led to a diagnosis of post traumatic stress disorder and depression, then to treatment and a job, did the years after he left the Army in 1983 begin to make sense to him.
"It's like night and day," said Clayton, 58, a technician at a Jiffy Lube in Pikesville.
Clayton was one of 675 military veterans referred last year to a Veterans Affairs program in Maryland with a dual focus: helping veterans diagnosed with mental health disorders continue treatment while getting them trained for and placed in jobs.
The Compensated Work Therapy program, run by the VA Maryland Health Care System, identifies veterans who have trouble getting and keeping jobs due in part to mental health disorders and illnesses such as depression, anxiety disorders and PTSD.
The staff works with veterans and the companies that hire them, offering training for specific jobs and certifications, job matching, case management and consultations. They offer the program at the Baltimore and Perry Point VA medical centers and take referrals from VA rehab centers and outpatient clinics.
"Veterans are really just looking for an opportunity to use transferable skills and to support their families as they supported their country," said LaVerne Harmon, who manages vocational rehabilitation services for the program. "What they need is an opportunity. Once they get in there they can sell themselves."
It's one of a number of efforts that links veterans with jobs or provides mental health services. But pairing mental health treatment with job services makes it unique, according to its directors and others who work with veterans.
The pairing makes sense, they say. The RAND Corp. reported in 2008 that nearly 300,000 troops who served in Iraq and Afghanistan, or more than 18 percent, had symptoms of post-traumatic stress or major depression. Nearly one in five reported experiencing a possible traumatic brain injury.
"It can affect their ability to find employment, not because they are not qualified," said Ingrid S. Herrera-Yee, manager for military and veterans policy and support at the National Alliance on Mental Illness in Washington. "In most cases, they are overqualified from their experience working as a military service person and getting exposure to so many different types of jobs. But ... many come back and can't find employment, and that starts a vicious cycle. If they can't find a job, they feel depressed and anxious."
The work and stress associated with the military, even outside of combat, can put veterans at higher risk for mental health conditions, said Barbara Van Dahlen, a clinical psychologist and founder of Give an Hour, which offers free mental health care to post-9/11 veterans. Complicating things, vets often leave the familiar jobs in the military to return to communities where they have few connections and can't find jobs, bringing additional stress, she said.
Veterans referred to the Compensated Work Therapy program often have trouble transferring military skills to the civilian work world, Harmon said. They might also have other challenges, such as lack of transportation or housing, she said. The program tries to bridge those gaps with bus vouchers, help finding jobs near public transportation and assistance with housing.
But overcoming the stigma of mental illness when trying to recruit employers, Harmon said, can be the greatest challenge.
Employers "may have employees working for them right now who have mental illness and [they] don't know it," she said. The veterans referred through the program "have a counselor working with them and a treatment team to help them stay stabilized so they can be successful."
Army veteran Gary Canteen says some employers might not have appreciated his leadership background in the military. But a counselor at the work therapy program recognized his skills and thought Canteen would be a perfect fit for one of the employers' hard-to-fill jobs. Canteen was referred to a Jiffy Lube franchise in Pikesville owned by John Way, a veteran himself who was committed to hiring fellow former service members.
Canteen, 46, served 24 years and three combat tours before his discharge in December 2013. He said the challenges he faced in transitioning out of the Army, where he had overseen logistics of a brigade and studied business management, led him to seek help from the VA.
"Once you leave [active duty], you don't have the same camaraderie and the same connections you had," Canteen said. "You go from one world to another world. …
"When you train with the military … there is structure everywhere. In the civilian world, the structure is not there. You become discombobulated a little bit."
Canteen has been general manager of Way's two Jiffy Lube locations for more than a year. In that position, he has been able to hire other veterans through the work therapy program.
"It does provide an opportunity to our veterans to achieve that stability, financial, family stability, things that mean something to a person," he said.
Three-quarters of the employees at Way's Jiffy Lube franchises are veterans. Six of his workers had previously been homeless.
"A smart reason to hire vets is they come with their own support network," Way said.
Clayton said the VA program helped him with applying for jobs and preparing for interviews while he was getting treatment.
"They were able to sit down and take the time and dig deep into the history I didn't know I had," Wallace said. "I feel more secure. I'm able to support myself. I'm happier and I'm not looking back at the bad."