How Vietnam veterans built the first Vet Centers

If you have ever sat in a Vet Center, you were sitting in something that exists because a previous generation of veterans refused to stop asking for it.

I did eight years in the Army with two deployments and left as a staff sergeant in 2017, and the first counselling I ever got that was any use was at a Vet Center in El Paso. It took me a while to find out where the building came from.

What the problem was

Veterans came home from Vietnam to a VA system built around the second world war and Korea.

That system was set up for physical injury and for the older veteran. What a lot of Vietnam veterans were carrying did not have a name yet. Post traumatic stress disorder did not enter the diagnostic manual until 1980, which means that for most of the 1970s the thing people were experiencing was not officially a thing.

If it is not a diagnosis, there is no treatment programme, no budget line, and no obligation.

And the relationship between those veterans and the VA was poor. Long waits, hospitals that felt institutional, staff who had not served, and a sense that the whole apparatus regarded them as a problem.

A lot of men simply stopped going.

What the veterans did

They organised.

Veterans' groups, including organisations formed by Vietnam veterans themselves rather than by the older established associations, pushed for readjustment counselling as a specific service, separate from the medical system.

The argument they made was practical. Put small offices in ordinary buildings, in the community rather than on a hospital campus. Staff them substantially with veterans. Make the intake informal. Keep the records separate from the medical record so that walking in the door does not feel like entering a system.

Congress passed the legislation in 1979 and the first Vet Centers opened in that period.

Why the design worked

Every element of it was chosen against a specific failure.

Storefront locations, because veterans were not going to hospitals. Veterans on the staff, because the first question in any veteran's head is whether the person across the desk understands what he is talking about. Informal intake, because paperwork at the door turns people away. Counselling for families as well, because the family is where the damage shows up first.

Confidentiality that is real, because the fear of a record affecting a job or a clearance kept a great many people from asking for help.

None of that was designed by an administrator. It came from men who had already tried the existing system and knew exactly where it failed.

What they cover now

Eligibility has widened a great deal since 1979. Combat veterans of any era, veterans who experienced military sexual trauma, those who provided mortuary services or drone crew support, and family members including bereaved families.

Readjustment counselling, group work, marriage and family counselling, referral into the wider system.

You do not need to be enrolled in VA health care and you do not need a service connected disability rating.

Why I write about this

Because the lesson generalises, and it is one I have watched get forgotten.

The services that work for veterans were mostly not designed for veterans by other people. They were built by veterans who had already been failed by something, worked out exactly why, and then spent years arguing for the fix.

Nobody handed the Vietnam generation the Vet Centers. They are a monument to a long and unglamorous political fight conducted by people who were, at the time, being told they were ungrateful for having it.

If you have not been in one, go. Look up the nearest location, walk in and ask. That is the whole process, and it was designed that way deliberately, by somebody who knew you would not make a phone call.