Senator Daniel Akaka / As U.S. Senator Daniel Akaka approaches the 20-year milestone of his time in the Senate–some of those years highly productive, others less so–the 85-year-old chairman of the Senate Committee on Veterans Affairs says he’s still looking forward. In honor of this week’s holiday, the Weekly talked with Sen. Akaka about some of his initiatives to help America’s veteran population, and the biggest challenges he faces in enacting them.

When we talk about veterans, we’re talking about people who range in age from 18 years old to 100-some years old. What are some of the defining challenges of serving these different groups?

When we quickly compare Iraq and Afghanistan to World War II or Vietnam, you immediately see difference in the needs. In this day and age, we have been keeping more military personnel alive and some of them are badly hurt but they’re still alive. We get them back here and we take care of them for the rest of their lives… Recently we had a mental health summit that was headed by [U.S. Department of Veterans Affairs] secretary [Eric] Shinseki and [U.S. Department of Defense] secretary [Robert] Gates and also by a Senior Oversight Committee that has been around just a few years. I mention that in particular because when I took over the [U.S. Senate Committee on Veterans Affairs], I wanted to increase transparency, and bring about collaboration and cooperation, and the way I did it was to urge DoD and the VA to speak to each other.

I’m glad you brought up transparency–it’s not something that appears to come about naturally to military leaders. How does that aspect of military culture impede attempts to best help veterans?

Yes, that’s true. It’s why the important thing was to get the leaders together and to have them deal with transparency issues. What I’m particularly happy about is that they are focusing on being transparent about a newer area of concern for veterans. What they call it is “mental health” but what I’m calling it is a focus on relationships. This deals in areas I like to call “invisible wounds,” where you cannot see it, you cannot test it, and it comes out in ways that affect relationships. So to stay away from the words “mental health” because of stigma, I prefer to say we’re dealing with relationships issues in that these are problems that affect relationships.

One of the stories the Weekly recently reported is the growing suicide rates across military branches.

We’re really concerned about suicides. Without question, it’s a serious problem. More veterans have committed suicide since 2001 than the number of service members killed in Iraq and Afghanistan in that same time… What we find is that stigma is causing many of our early veterans not to pursue any help because they don’t want to be recorded as having mental problems. As a result they say, “Hey, I’m fine, I’m OK,” and later suffer for it. We need to find a way to get around that.

Another ongoing problem you’ve addressed is homelessness. The VA estimates one-third of the men who are homeless are veterans, and half of them served in Vietnam.

I’m especially pleased with President Obama’s and Secretary Shinseki’s commitment to ending homelessness. But it is important to address the underlying contributors to homelessness such as healthcare and maintaining employment. The point I want to make here is that homelessness is a symptom. All these other things bring about homelessness. We now have some bills that would hopefully help with homelessness.

I understand you’re also working on passing legislation that entails measures to improve access to services.

Hawaii’s unique geography of course presents challenges. Some veterans from neighbor islands and other states have no options except air travel to get the care they need. I’m working to pass legislation that would authorize VA to reimburse air travel from veterans if they need it. This will be a huge step in providing access to veterans, many of them in Hawaii, where flying is the best or sometimes only way to get from one island to another.

How infuriating is it to have a single senator thwart this kind of legislation in the name of being “fiscally conservative”?

I’ve been trying to move some bills and of course my problem is U.S. Senator [Tom] Coburn (R-Oklahoma), who has been holding it up.

It’s frustrating. If we send troops to war, we must provide the care and services they need and earn.

In this bill, I am trying to structure a new area instead of only designating “urban” and “rural,” I want to structure a “remote area.” I’m also focusing on caregivers, the use of families to help the veterans. These families, by my bill, would be trained to treat whatever the case of disability and even pay them a stipend to help the family… We must also remember the important role that families play as caregivers, families caring for veterans with PTSD and other invisible wounds.

Aside from actually getting legislation passed, what’s the greatest challenge you face?

Well one of the huge challenges has been resources, meaning money… I’ve also pushed to maintain the Senior Oversight Committee to make sure they’re working on issues like suicide.

There was a moment there when it looked like that committee would be disbanded.

I guess I can say that I was the one that argued against disbanding it. This Senior Oversight Committee is the key organization in achieving collaboration and seamless transition. With this kind of cooperation we’re able to move things faster… just so that they can talk about it and agree on it and do it instead of us trying to write laws for it or to micromanage.

We also need to work with personnel while they’re active in service and discover their problems before they leave rather than after they leave.

So, remembering that active duty people will eventually join the veteran population.

That’s right. Seamless transition from active duty to VA will be the sharing of records and information to coordinate this information on their disabilities, their ratings, whatever the concerns may be.