Jeff Elizalde's patriotism is as plain as the U.S. flags in his Salem condo, rescued after parades or blown from car lots. Elizalde has cleaned, pressed and hung them across his windows and walls, next to framed tributes to a World War II radioman -- his dad.

But beyond the stacks of Marine Corps Times and the "USMC" tattoos on each biceps, Elizalde's own military career is nothing to celebrate. He was discharged under conditions "other than honorable" after an incident he says "set me into a pattern of drinking and ruined my life." Elizalde says he was an 18-year-old Marine playing spades on an Okinawa, Japan, base in November 1977 when he followed a staff sergeant to look for another party. As they walked through an empty Quonset hut, he says, the sergeant overpowered and raped him.

"I didn't tell anybody," Elizalde, 49, said. "I didn't know how. How do you tell someone in the Marine Corps you've been raped?"

As the nation grapples with the aftershocks of two long wars, the Department of Veterans Affairs is confronting a quiet wave of veterans with mental health problems linked to sexual misconduct. New research has uncovered hundreds of cases among those serving in Afghanistan and Iraq, and found that those combat vets are two to three times likelier to suffer depression, post-traumatic stress syndrome, and alcohol and drug abuse.

Help for military sexual trauma

Portland VA's Mental Health Access Clinic at 503-273-5058 or outside Portland at 800-949-1004 ext. 56409

Earlier this year, Sen. Patty Murray, D-Wash., introduced legislation to provide more money to the VA to treat such cases and strengthen protection for women who seek help. Congress will not consider the matter this year. But Murray said Thursday that she'll relaunch the initiative in January. She said she acted after "women would pull me aside and whisper in my ear" about being harassed and even raped while serving in Iraq and Afghanistan.

The VA reports that between 2002 and 2007, 59,345 male veterans and 57,637 female veterans screened positive for some sexual trauma during military service.

In April, clinical psychologist and retired Navy Reserve Capt. Connie Lee Best warned U.S. senators that sexually traumatized veterans will further swell the wave of mental health needs that will hit in years to come.

"To quote a line ... from 'Jaws' when one of the characters saw the shark for the first time," Best said, "We're going to need a bigger boat."

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In April 2008, nearly 400 women veterans from Oregon, Washington and Idaho gathered in Pendleton to celebrate their military service, dating to World War II. They packed one workshop to trade war stories -- of sexual harassment and rape.

"I have that topic at every conference because it's a huge issue with women in the military, and it's something they don't talk about if they don't feel free or safe," says Valerie Conley, women veterans coordinator for the Oregon Department of Veterans' Affairs.

Conley was never assaulted. But after joining the Army in 1982, the 27-year-old mother and two other women in their transportation company "took a lot of harassment."

"It was not teasing," Conley said. "It was more vile than teasing. You didn't walk anywhere alone. I got to the point where I wouldn't even walk to the mess hall by myself."

Most Americans didn't link sexual misconduct to the U.S. military until Tailhook, the raunchy three-day reunion of Navy and Marine aviators in 1991 at which 83 women and seven men were assaulted. But the scandal shone light on what turned out to be a wider problem.

Until recently, however, the Pentagon's male-dominated leadership, its allies in Congress and interest groups have largely dismissed allegations as unfounded or exaggerated. Military officials and independent analysts say punishment varies widely, as does how aggressively some accused are prosecuted.

In 2004, the Department of Defense established a Sexual Assault Prevention Response program; all soldiers receive training.

But in September, Brenda S. Farrell, a senior investigator for the nonpartisan Government Accountability Office, told lawmakers that although progress has been made, it's impossible to know how much because the right questions aren't being asked, and important data are not being collected. That's led analysts to conclude that the size of the problem is larger than the Pentagon documents.

"At the 14 installations where we administered our survey, 103 service members indicated that they had been sexually assaulted within the preceding 12 months," Farrell told a House Oversight and Governmental Affairs subcommittee Sept. 10. "Of these, 52 service members indicated that they did not report the sexual assault."

GAO investigators said that victims cited "the belief that nothing would be done; fear of ostracism, harassment, or ridicule by peers; and the belief that their peers would gossip about the incident." They also feared hurting their careers or unit morale and that a report using the restricted reporting option would not stay confidential.

Portland lawyer Kelly Clark, who has represented victims involving the Catholic Church and Boy Scouts of America, says people underestimate how difficult it is for individuals to challenge a powerful institution to which they've sworn their loyalty and life.

"That's a huge context that cannot be overstated," Clark said. "People don't have a hard time saying to me, 'I was sexually violated by a stranger.' But they have a terrible time saying, 'I was violated by Uncle Don, the family hero, or by my commanding officer or my priest.'"

Psychiatrists say sexual trauma in the military may be so damaging because the victims often continue to live and work alongside the perpetrators and rely on them for safety, basic needs or advancement. Accusing a colleague also betrays the most sacred tenant of the military: the team.

"In combat, buddies become your brother or sister with whom you live, sleep, shower and share secrets. They become family," says Mandy Martin, an Iraq war veteran and outreach worker with the Portland Vet Center. "So when you tell the secret of a family member, that family now is angry."

Few understand that better than the people around Suzanne Swift. The 21-year-old Army specialist was arrested at her mother's Eugene home in June 2006 after failing to report for her second deployment to Iraq. In a case that shot onto the international stage, Swift claimed she could not face returning to duty because she had been harassed or abused by two colleagues in Iraq and one at Fort Lewis. Swift said she'd been coerced into a sexual relationship, subjected to humiliating punishments for rebuffing advances and ordered to report for duty to a superior's bed -- naked.

On the eve of a court-martial that would have ended her career, she pleaded guilty to going AWOL. She was busted to the rank of private, sent to jail for 30 days and reassigned to a base in California.

One man she named received a written reprimand and was reassigned. He later left the Army. The Army did not substantiate claims against the others.

Swift has declined to speak further. But her mother, Sara Rich, said the experience was more disheartening than she'd ever imagined.

"You can't go up against the military," said Rich, a family therapist who was the city of Eugene's human rights commissioner for seven years. "If you speak out, you get punished. It's really hard to survive."

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Susan Avila-Smith, an Enumclaw, Wash., woman who founded one of the largest advocacy groups for women veterans, says cases surface decades later because most veterans are so busy trying to survive that they compartmentalize or suppress the experience until some event causes the floodgates to open.

Usually when post-traumatic stress disorder keeps people from sleeping and doing their job, "pretty soon, someone who was a functioning person with a high security clearance is working at a job washing dogs," she said. "I call it hitting the wall.

"Then, after you have no job, no house and nowhere to go, you finally go to the VA."

But VA experts say men often fail to disclose assaults even when they are far along into other mental health treatment. Earlier this year, a lead VA psychiatrist told the International Society for Trauma Studies that many kept their trauma secret for 30 years, even after it destroyed their military careers. She advised caregivers to ask frank questions and look for clues: substance abuse -- often severe -- and lifelong problems with intimate relationships, authority and anger.

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Photos of Jeff Elizalde show a trim 145-pound rifleman in the late 1970s, hair neatly clipped. He had no disciplinary problems in his first 14 months as a Marine. Then records show an abrupt descent into alcoholism, including drinking as much as two cases of beer a day, passing out on guard duty, disobeying orders and failing to complete treatment.

"I lost faith in my leaders," Elizalde says. "I had to drink to be in the same room with them."

Within 18 months of the alleged assault, Elizalde faced a court-martial for five drinking-related or disobedient offenses. A commanding officer recommended that Elizalde accept an other-than-honorable discharge. He agreed.

He worked in his parents' restaurant in California, where he racked up two drunken driving convictions in quick succession. He eventually went to work in construction, following the trades to Salem, where he worked as a union pipe layer. After a construction accident, he went on 100 percent Social Security disability in 1999.

He never married. "It's hard for me to even be with a gal," he says. "Believe me, I'm straight, but this has affected me so much mentally."

He was treated for severe depression, anxiety and other symptoms for years. Still, Elizalde never told anyone until he saw an item on television in 2006. It said that if you suffer from severe depression and have a sexual assault in your background, that will affect diagnosis and treatment. Documents show that on Feb. 9, 2006, he first disclosed the rape to the Kaiser Permanente mental health counselor he'd seen regularly since 2004.

The counselor and a supervising psychiatrist concluded that his alcoholism, depression, some hallucinations and fear about the security of his home could be the result of the attack. They later wrote that in treating him for five years, "It is our opinion that your PTSD is more than likely the direct result of personal trauma you experienced on active duty with the United States Marine Corps."

Shortly after disclosing the attack, Elizalde also contacted the Oregon Department of Veterans' Affairs, where a caseworker helped him file a claim to upgrade his discharge.

In April 2007, the Board for the Correction of Navy Records rejected the claim, saying that the evidence was insufficient to warrant an upgrade given his five disciplinary actions. "Further, there is no evidence in the record to show you were raped or suffered PTSD at the time of your service."

Elizalde appealed, asking that mental health experts review his records. He also called congressional offices and even candidates, and exhausted the state employees. (The department spokesman declined to discuss his case, even with his permission.) In January, Elizalde was charged with drunken driving -- for the first time since the early 1980s.

Finally, two years after he first spoke out, he tried the federal government, and the Portland VA medical center agreed to see him immediately.

Under a new federal mandate that expands services for potential victims, any veteran is eligible for care for sexual trauma in the military as long as he or she had active service, said Sue Hippe, Psych Mental Health Nurse Practitioner, PTSD Clinical team and sexual trauma coordinator. So a veteran with a discharge other than honorable is still potentially eligible, based on an evaluation by the regional office.

Elizalde says at the very least, he'd like the VA to cover some of the mental health care.

"This has been my personal battle for 30 years," he said. "I'm a veteran, even though I don't feel like one. This has affected every aspect of my life."

-- Julie Sullivan; juliesullivan@news.oregonian.com