Sunday, January 2, 2011

Rhode Island treatment program gives veterans with PTSD alternative to prison

The intro to the story in The Providence Journal in R.I.:

Joseph Domenic Sportelli (pictured) pushes his photo ID forward. “Look at me,” he says. “I look like an alien.”

The image shows 27-year-old Sportelli’s face battered and purple, his left eye swollen to a slit. The swelling has eased in the 11 days since the shot was taken as Sportelli registered as an inmate at the Adult Correctional Institutions, but his mind is tangled as he contemplates his life, sober for more than a day or two for the first time in three years.

“I just think I’m nuts,” says Sportelli, who stands 5 feet, 4 inches with a wrestler’s wiry, muscular frame. “I’m a changed person. I do things I shouldn’t be doing.”

Sportelli is perplexed by his latest arrest by Coventry police for stealing sunglasses and an iPod from a car in the early morning hours. He punched the owner when he tried to call the police; the owner punched him back. The incident, he says, came just days after he received a $16,000 disability payment from the military for the posttraumatic-stress disorder he experienced upon his return from a tour in Iraq as a convoy truck driver.

He’s disgusted he didn’t seize the opportunity to set himself up with a car and apartment. His crimes, he says, don’t make sense. He had drugs in his pocket that day; he didn’t need money, he says.

“I know I’m capable of things better than this,” he says. He shakes his head as he sits at the edge of a chair in a stark conference room at the ACI, his left eye still scarlet from the scuffle.

A prisoner sweeping the floor at the ACI brought Sportelli to the attention of Scott Tirocchi, a mental-health clinician at the Department of Corrections. Tirocchi, a National Guardsman himself, has been trying to identify veterans entering prison who might be eligible for a new jail diversion program. The floor sweeper told him he wasn’t a veteran, but he knew someone who was: Sportelli.

And with that Sportelli became one of the first veterans to participate in the state’s pilot program for people experiencing the after-effects of trauma. The pilot program is geared toward people suffering from posttraumatic-stress disorder, veterans and active military personnel in particular. It is kicking off in Kent County court, funded by a $1.9-million federal grant.

The idea is to catch potential candidates, including those impacted by the trauma of rape or abuse, before they land in jail. A clinician assesses whether the individual suffers from PTSD. If so, the clinician puts him or her in touch with resources and arranges mental health and substance abuse treatment as an alternative to prison, with the prosecutor’s and a judge’s consent. The goal is get people who have suffered trauma the mental-health care they need to achieve recovery. The hope for veterans is to demystify PTSD.

“It might be a longer sentence than a criminal sentence,” said Corrina Roy, a behavioral-health planner with the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals.

About 80,000 veterans live in Rhode Island, with about 26,127 who served in Vietnam and 12,618 in Iraq and Afghanistan. National statistics show that about 25 percent to 40 percent of service members deployed to Iraq and Afghanistan return with psychological and neurological injuries associated with PTSD. That would mean more than 2,000 Gulf War veterans could be experiencing mental-health problems in Rhode Island based on 2008 figures.

It can be difficult to identify veterans in the judicial system, court officials say. Sometimes they are reluctant to reveal their military status, preferring to settle matters privately. Others don’t want to admit they are having trouble readjusting, fearing they will be stigmatized, or worse suffer consequences in their career, they say.

“A great number of them have issues we can hardly imagine going on in their heads,” District Court Chief Judge Jeanne E. LaFazia said. “They need our help and attention.”

Just a decade ago, Sportelli competed in the state wrestling championships for Cranston West. He had moved to Rhode Island from New Jersey as a sophomore after his parents’ divorce.

By 2003, he was 20 and back in New Jersey, pouring concrete. His girlfriend was attending college. Sportelli decided to join the U.S. Marines out of patriotism and to “step it up a notch.”

He liked the Marines’ credo of being bigger, faster, louder than the rest. “I felt like a leader. I found things in myself that I didn’t know I had.”

His commanders recognized his strengths too, promoting him to sergeant in just under three years. He was, he says, a picture-perfect Marine.

He drove trucks in Okinawa for two years and was scheduled to head to Indonesia to clean up after the tsunami. Instead, he was sent to southern Fallujah. There, troops encountered torture chambers, improvised explosive devices and spider holes where enemy fighters concealed themselves. They uncovered a massive cache of weapons when a colonel tripped over a lock on the ground.

They faced constant sniper fire and mortar attacks. A bomb hit the chow hall. An IED left a female soldier, his close friend, with third–degree burns, her legs torn by shrapnel.

“You don’t get your guard down, even at night,” he says. “You can tell by the whistle whether you are going to get hit or not.”

An IED hit his convoy, rattling his unit and knocking him out.

“I thought I was in hell and somewhere along I died,” Sportelli says.

After a seven-month tour, he returned home to New Jersey in 2007, following a 45-minute military briefing about readjustment, he says.

He found it hard to relate to people he once considered his friends. “You’re with your drinking buddies and they’re not the people you trust anymore,” he says. He began isolating himself.

It’s around this time, he says, he began taking “Oxycodone, painkillers, any drug” and embarked on what he calls a warpath against himself. He couldn’t sleep at night and still can’t, he says.

He hid his habit from the Marines, which have a zero-tolerance policy for drugs. “I was always on the run.”

He didn’t want to return to Iraq. “I wanted to get out,” he says. “I didn’t want to hurt people. You do that once. You don’t do that two or three times.” The blood, bullets and death were too much to take.

He left the service, just before the Marine Corps station in Cherry Point, N.C., received the results of urine tests that would have shown he was using drugs, he says.

His track record since is one of addiction and petty crime. Although he was convicted of driving under the influence of alcohol before he enlisted, his crimes in New Jersey since his return center on narcotics possession and resisting arrest. He was charged with drug possession in 2007, 2008 and 2009. In the most recent case there, a waitress chased him after he was found shooting up heroin in a diner bathroom. Sportelli ended up pleading guilty to a misdemeanor drug charge and was placed on probation, according to the Point Pleasant Borough Municipal Court.

He moved to Rhode Island, where his mother, Terry, lives. Since March, he has pleaded no contest to shoplifting and to punching a friend during a drunken night in West Warwick. Cranston police arrested him in April in connection with a break into the home of an 80-year-old man who pointed a .25-caliber pistol at the intruder and chased him out the door. Officers found Sportelli hiding in a pile of leaves. He struggled when they tried to cuff him and refused to walk, forcing the police to carry him up an embankment, reports show. Officers reported that his eyes were wide open and watery, as if he was on drugs.

The arrest that landed him at the ACI in November took place Oct. 29 in Coventry.

Asked to explain, Sportelli gives a textbook answer for a soldier said to be suffering from PTSD: “Life just didn’t seem interesting to me enough anymore. I don’t know what the hell I’m doing.”

Symptoms of PTSD, which experts say can be the result of spending months on end on constant alert, include hyper-vigilance, increased consumption of alcohol or drugs, feelings of numbness, agitation, anxiety, denial and survivor’s guilt.

Rhode Island’s jail diversion program came into play for Sportelli during a tense day in court three weeks after his Coventry arrest. The plan was to have a judge sign off on a plea agreement in which Sportelli would admit to the crime and be sent to a residential drug-treatment program in western Massachusetts. Sportelli’s mother had packed a bag for him. Sean Lonergan, justice outreach coordinator for the Providence VA Medical Center, was ready to drive him. Carolyn DiDonato, the program’s clinician, was prepared to plead his case. Tirocchi, who did a tour in Afghanistan, stood by.

Sportelli’s lawyer hadn’t shown up; public defenders stepped in. Then, a shortage of deputy sheriffs caused District Court Judge Frank J. Cenerini to delay proceedings for a half hour.

Finally, Sportelli appeared in a black-and-white-checked sweatshirt, black jeans, and high-tops — almost a month sober.

DiDonato told the judge Sportelli has an opiate dependency and suffers from combat-related PTSD. They had found an inpatient substance-abuse program for veterans to enroll him in for six months to two years.

Sportelli pleaded no contest to assaulting the Coventry man, with another charge dismissed under an agreement reached with Special Assistant Attorney General Michael White. Cenerini sentenced him to a one-year suspended sentence to be followed by a year of probation.

Cenerini asked Sportelli if he realized he faced two years in jail if he didn’t complete the drug-treatment regimen. “I do understand that, your honor.”

Did he have anything to add? “I’m ashamed of what I did,” Sportelli says.