Trump to order mental health aid to prevent suicide among military veterans

President Donald Trump shakes hands with Secretary of Veterans Affairs David Shulkin (L) after signing the Veterans Affairs Choice and Quality Employment Act at Trump's golf estate in Bedminster, New Jersey U.S. August 12, 2017.

WASHINGTON (Reuters) – President Donald Trump on Tuesday was set to sign an executive order that will direct government departments to try to prevent suicide among military veterans by treating mental health problems before they become more serious.

Veterans Affairs Secretary David Shulkin told reporters on a conference call that Trump wants to address an alarming trend, that of 20 veterans a day taking their own life.

“That is just an unacceptable number and we are focused on doing everything we can to try to prevent these veteran suicides,” Shulkin said.

Trump’s order will direct the departments of Defense, Homeland Security and Veterans Affairs to develop a plan in 60 days to provide access to mental health treatment and suicide prevention resources for uniformed service members in the first year following military service.

The new order will cost about $200 million year to implement, money that will be diverted from the agencies’ current budget, a senior administration official said.

(Reporting By Steve Holland; Editing by David Gregorio)

Opioid abuse crisis takes heavy toll on U.S. veterans

Needles used for shooting heroin and other opioids along with other paraphernalia litter the ground in a park in the Kensington section of Philadelphia, Pennsylvania, U.S. October 26, 2017.

By Barbara Goldberg

NEW YORK (Reuters) – Opioid drug abuse has killed more Americans than the Iraq, Afghanistan and Vietnam wars combined, and U.S. veterans and advocates this Veteran’s Day are focusing on how to help victims of the crisis.

Veterans are twice as likely as non-veterans to die from accidental overdoses of the highly addictive painkillers, a rate that reflects high levels of chronic pain among vets, particularly those who served in the wars in Iraq and Afghanistan, according to federal data.

U.S. government and healthcare officials have been struggling to stem the epidemic of overdoses, which killed more than 64,000 Americans in the 12 months ending last January alone, a 21 percent increase over the previous year, according to the Centers for Disease Control. About 65,000 Americans died in Vietnam, Iraq and Afghanistan.

President Donald Trump named opioids a national public health emergency and a White House commission last week recommended establishing a nationwide system of drug courts and easier access to alternatives to opioids for people in pain.

“Our veterans deserve better than polished sound bites and empty promises,” said former Democratic Congressman Patrick Kennedy, a recovering addict and a member of the president’s opioid commission.

Kennedy said in an e-mail that more funding was needed for treatment facilities and medical professionals to help tackle the problem.

One effort to address the issue has stalled in Congress – the proposed Veterans Overmedication Prevention Act, sponsored by Senator John McCain. That measure is aimed at researching ways to help Veterans Administration doctors rely less on opioids in treating chronic pain.

“The Veterans Administration needs to understand whether overmedication of drugs, such as opioid pain-killers, is a contributing factor in suicide-related deaths,” McCain, one of the nation’s most visible veterans, said in an e-mail on Thursday. He noted that 20 veterans take their lives each day, a suicide rate 21 percent higher than for other U.S. adults.

The VA system has stepped up its efforts to address the crisis, having treated some 68,000 veterans for opioid addiction since March, said Department of Veterans Affairs spokesman Curtis Cashour.

The department’s Louis Stokes VA Center in Cleveland has also begun testing alternative treatments, including acupuncture and yoga, to reduce use of and dependency on the drugs, the VA said.

A delay in naming a Trump administration “drug czar” to head the effort, however, has fueled doubts about immediate action on the opioid crisis. Last month the White House nominee, Representative Tom Marino, withdrew from consideration following a report he spearheaded a bill that hurt the government’s ability to crack down on opioid makers.

 

(Reporting by Barbara Goldberg; Editing by Dan Grebler)

 

Trump praises veterans, hits media at Kennedy Center event

U.S. President Donald Trump waves at the Celebrate Freedom Rally in Washington, U.S. July 1, 2017. REUTERS/Yuri Gripas

By Jeff Mason

WASHINGTON (Reuters) – U.S. President Donald Trump honored military veterans in Washington on Saturday at a Kennedy Center event that resembled both a political rally and an evangelical Christian religious service ahead of the July 4 Independence Day holiday.

Using the podium again to lash out at the news media, Trump worked to energize evangelicals in his political base, noting that the U.S. currency was inscribed with the words: “In God We Trust.”

“Since the signing of the Declaration of Independence 241 years ago, America always affirmed that liberty comes from our creator. Our rights are given to us by God, and no earthly force can ever take those rights away,” he said.

Attendees at the event for veterans waved miniature American flags from their seats in the theater and raised their hands as a sign of praise while a large choir sang ahead of Trump’s remarks.

The president praised veterans from each of the U.S. military branches and highlighted his administration’s work to reform veterans’ services.

Trump, who is spending a long weekend at his property in Bedminster, New Jersey, flew back to Washington for the rally but did not spend the night at the White House, preferring to return to Bedminster.

Later, in a rare late-night post on Twitter, which he uses prolifically and sometimes controversially, Trump wrote:

“We will always take care of our GREAT VETERANS. You have shed your blood, poured your love, and bared your soul, in defense of our country.”

Trump has held campaign-like rallies regularly during his first few months in the White House and kicked off his own re-election campaign far earlier than other incumbents in recent history.

Part of his strategy to connect with his supporters has included criticizing the media, and he included harsh words for the press again in his remarks.

“The fake media is trying to silence us, but we will not let them,” he said. “The fake media tried to stop us from going to the White House. But I’m president, and they’re not.”

(Reporting by Jeff Mason; Editing by Jonathan Oatis)

U.S. college teaches veterans to heal each others’ mental wounds

Dr. Bob Dingman, Director of the Military and Veterans Psychology Concentration, speaks to Reuters at William James College of Psychology, the first in the nation to run a program focusing specifically on training military veterans to treat the mental health problems of their fellow soldiers and veterans, in Newton, Massachusetts, U.S., May 16, 2017. REUTERS/Brian Snyder

By Scott Malone

NEWTON, Mass. (Reuters) – Former U.S. Army Specialist Tara Barney will never forget the 2013 night when a fellow soldier cried as he described holding a dying friend in his arms, a wartime memory he had not shared with anyone.

“I can’t even talk to my wife like this,” she recalled her friend saying. “Nobody would understand.”

Barney, now 34, says that moment defined her future.

She finished her four-year enlistment and enrolled in William James College, which says it is the only U.S. psychology graduate school focused on training veterans as counselors.

Founded in 2011, the school’s programs aim to address the high rates of post-traumatic stress disorder, depression and other mental health conditions experienced by veterans of the wars in Iraq and Afghanistan, and other conflicts.

“If you talk to most vets, they want to talk to people who have had the same sets of experiences,” said Robert Dingman, the director of military and veterans psychology at the school, located west of Boston. “We don’t believe by any means that only vets can help vets, but we think it’s a good career pathway.”

Estimates of how many of the country’s 19 million veterans experience mental health problems vary widely. A federal government report released last year found that about 40 percent of veterans who received care through the Veterans Health Administration were diagnosed with a mental health or substance abuse condition, most commonly depression, followed by post-traumatic stress disorder.

Other data suggest that figure may represent a higher rate of mental health and substance abuse than is seen among the overall population of veterans. An analysis of medical research by the RAND Corp think tank found that rates of PTSD likely range from 5 percent to 20 percent of veterans.

CULTURES COLLIDE

William James College wants to bridge the cultural divide between veterans, some of whom view seeking mental health care as akin to admitting weakness, and psychologists and counselors, many of whom know little about military culture.

The gap is wide enough that Barney’s fellow student, Adam Freed, left a graduate psychology program at Yale University when he realized he was failing to connect with patients’ issues related to their or their loved ones’ military service.

“It was just something that was completely alien to me,” said Freed, 31. “I became increasingly interested in why didn’t I get it?”

Freed decided the best way to understand was to enlist. He signed up for the New York Army National Guard and went on to serve a tour in Afghanistan before enrolling at William James. This month he returned to active duty as an Army captain and military psychologist.

The college, previously known as the Massachusetts School of Professional Psychology before renaming itself after the 19th-century philosopher, regarded as one of the founding thinkers of American psychology and brother to novelist Henry James, boasts a growing population of veterans, who this year represented about 50 of its 750 students.

Barney said her friends and even her wife were skeptical when she told them she was planning a career in psychology after stints as a prison guard and working on Army missile systems.

But the experience with her fellow soldier friend had convinced her that her military service would be invaluable as a counselor, she said, adding, “Some people just don’t want to know the veteran’s experience.”

Several students in the program said they also hope to overcome the cultural gaps that can make it harder for therapists to connect with veterans.

Fewer than one in 12 adult Americans have served in the armed forces, and the students said many veterans are wary of discussing their wartime experiences with people who do not share a military background.

Freed recalled a psychologist asking him during a job interview what it felt like to be “blown up.” Freed had avoided such an incident in combat but said he did not consider the topic as appropriate for casual conversation.

“I don’t think people ask about other forms of trauma with the same laissez-faire attitude,” Freed said. “I would confidently say that they would not ask, ‘What was it like to be raped?’ These are both things that are extremely, extremely traumatic and yet they are treated in a very different way.”

(Reporting by Scott Malone; Editing by Colleen Jenkins and Jonathan Oatis)

Military veterans suffering PTSD get back on course with golf

FILE PHOTO - The pin on the 6th hole casts a shadow across the green in Augusta, Georgia, U.S. April 4, 2017. REUTERS/Jonathan Ernst

(Reuters) – Sylvan Olivieri, who suffers from post traumatic stress disorder (PTSD) after serving in the Vietnam War as a U.S. Marine, is among dozens of veterans who have sought therapy on the golf course.

Olivieri, who is completely new to the game, told Reuters he learned of the Professional Golfers’ Association’s (PGA) Helping Our Patriots Everywhere (HOPE) program through his PTSD group.

“The first time was rough because I was making some minor mistakes but the instructors got me straight,” Olivieri said at the West Point Golf Course, just steps from New York’s prestigious U.S. Military Academy.

“I’m motivated. It’s all for fun, relaxation,” he said.

The U.S. Department of Veterans Affairs, which is a partner in the program with the PGA, said its goal is to help veterans assimilate back into their communities through the social interaction, mental stimulation and physical exercise that golf provides.

PTSD is caused by an overactive fear memory and includes a broad range of psychological symptoms that can develop after someone goes through a traumatic event.

A study published in JAMA Psychiatry, decades after the end of the U.S. war in Vietnam, said more than one in 10 of all American veterans continues to experience at least some symptoms of post traumatic stress disorder.

“PGA HOPE is an opportunity to bring veterans out onto the golf course and give them something to look forward to,” said Andy Crane, the head PGA professional at West Point Golf Course.

The program started in 2014 and the six-week course is now offered at more than 80 locations across the country. It is free to military veterans and fully funded by the PGA’s charitable foundation.

Bobby Colletti also turned to golf in hopes of happiness. He served in the U.S. Army in Iraq and as a contractor in Afghanistan and started abusing drugs after returning home.

“I thought at first (drugs) helped,” he said. “But then it turned into a problem and kind of just made everything worse to the point where you almost want to commit suicide because of it.”

Colletti heard about PGA HOPE while in treatment for addiction and said it “has definitely helped me along the way in my process of recovery.”

Colletti encouraged his stepfather John Edd, a Vietnam War veteran, to try golf. Edd completed the program two years ago and the two have since become regulars on the golf course.

Like Colletti, Olivieri said the course helped him heal and he now describes himself as “a pretty happy guy.”

“It puts you in a different place,” he said of golf. It makes you concentrate. You are not thinking about anything else but that ball. That period of time is PTSD-free.”

(Editing by Melissa Fares and Bill Trott)

Most U.S. troops kicked out for misconduct had mental illness: study

FILE PHOTO - U.S. army soldiers are seen marching in the St. Patrick's Day Parade in New York, March 16, 2013. REUTERS/Carlo Allegri

WASHINGTON (Reuters) – A majority of U.S. troops discharged from the military for misconduct during a four-year period ending in 2015 had been diagnosed with mental health conditions like post-traumatic stress disorder or traumatic brain injury, a new study found.

The report by the U.S. Government Accountability Office will likely add to scrutiny over whether the U.S. military is doing enough to care for troops identified with mental health issues during their service, instead of simply casting them out.

The GAO analysis showed that 62 percent of the 91,764 servicemembers discharged for misconduct during the fiscal years 2011 through 2015 had been diagnosed within the previous two years with conditions including PTSD, TBI “or certain other conditions that could be associated with misconduct.”

Twenty-three percent of the servicemembers received an “other than honorable” discharge, which made them potentially ineligible for health benefits from the Department of Veterans Affairs.

Veterans’ advocates have long complained about a lack of support for former U.S. servicemembers who do not have honorable discharge papers, something new Veterans Affairs Secretary David Shulkin has announced plans to address.

The watchdog said the Navy does not require medical examination or screening of some sailors who are being kicked out of the service for misconduct. It said the Army and Marine Corps “may not have adhered to their own screening, training and counseling policies related to PTSD and TBI.”

(Reporting by Phil Stewart)

Trump extends program allowing some veterans to use local doctors, hospitals

U.S. President Donald Trump smiles after signing S.544, the Veterans Choice Program Extension and Improvement Act, at the White House in Washington, U.S., April 19, 2017. REUTERS/Kevin Lamarque

By Lisa Lambert

WASHINGTON (Reuters) – President Donald Trump on Wednesday moved a step closer to fulfilling his campaign promise to reform the troubled Veterans Affairs department, but some veterans groups are concerned that the administration may be working toward privatizing their healthcare.

Trump signed a law extending the pilot “Veterans Choice” program, which allows some veterans to receive healthcare from local doctors and hospitals closer to their homes than the VA’s 150 hospitals and nearly 1,000 outpatient clinics. The law eases procedures for reimbursing private providers and creates a system for sharing medical records with them.

“This new law is a good start, but there is still much work to do,” Trump said at a signing ceremony attended by VA Secretary David Shulkin and Florida Governor Rick Scott.  “We will fight each and every day to deliver the long-awaited reforms our veterans deserve.”

Trump pledged to hold a news conference next week on “all of the tremendous things that are happening at the VA and what we’ve done in terms of progress and achievement.”

Reforming the agency, rocked by a waiting-time scandal in 2014, was one of Trump’s most-repeated campaign trail promises. He has frequently suggested having the government pay outside physicians to provide veteran healthcare.

During his confirmation hearings, Shulkin said he supported overhauling the agency but did not believe in privatizing it. Still, on Tuesday the VA announced it was seeking cutting-edge treatments from the healthcare industry for brain injuries, mental health problems and chronic pain.

Extension of the “Veterans Choice” program could worry Democrats and other critics that Trump and Shulkin are inching toward sending some of the $65.6 billion the department spends annually on medical care to corporations and private businesses.

Conservatives calling for privatization say the VA provides medical services to only about 45 percent of veterans, and they point to delays and inefficiencies dogging the current system.

Some veterans groups and Democrats have warned against moving funds away from healthcare providers with expertise in injuries and illnesses unique to serving in the armed forces.

In a March report, the Government Accountability Office said veterans in the Choice program still face long wait times, mostly because cases must be referred to private contractors for scheduling.

Last year a congressionally mandated panel of experts found the Choice program was inefficient, but recommended establishing a community-based healthcare system that would include private doctors.

(Reporting by Lisa Lambert; Editing by David Gregorio)

U.S. to expand mental health care for some veterans

(Reuters) – The U.S. Department of Veterans Affairs said on Wednesday that it intends to expand mental health care to former service members with other-than-honorable (OTH) administrative discharges.

As part of the proposal, former OTH service members will be able to seek treatment at a VA emergency department, Vet Center or contact Veterans Crisis Line, the department said in a statement.

Veterans who receive do not receive an honorable discharge are not eligible for many Veterans Affairs benefits.

Secretary of Veterans Affairs David Shulkin said suicide prevention was one of the top priorities for him and U.S. President Donald Trump.

At an event with veterans last year in Virginia during the presidential campaign, Trump called for better mental health services for those returning from combat, saying that while many are “strong,” others “can’t handle” what they have seen on the battlefield.

The department said Shulkin will meet with Congress, Veterans Service Organizations and Department of Defense officials before finalizing the plan in early summer.

(Reporting by Kanishka Singh in Bengaluru; Editing by Lisa Shumaker)

On 75th anniversary, U.S. veterans recall Japanese attack on Pearl Harbor

Pearl Harbor survivors Delton Walling (C), Gilbert Meyer (R) and U.S. Navy Admiral Margaret Kibben salute during a ceremony honoring the sailors of the USS Utah at the memorial on Ford Island at Pearl Harbor in Honolulu, Hawaii

By Dana Feldman and Hugh Gentry

LOS ANGELES/HONOLULU, Dec 7 (Reuters) – It has been 75 years, but U.S. Navy veteran James Leavelle can still recall watching with horror as Japanese warplanes rained bombs down on his fellow sailors in the surprise attack at Pearl Harbor that brought the United States into World War Two.

Bullets bounced off the steel deck of his own ship, the USS Whitney, anchored just outside Honolulu harbor, but a worse fate befell those aboard the USS Arizona, USS Oklahoma, USS Utah and others that capsized in an attack that killed 2,400 people.

“The way the Japanese planes were coming in, when they dropped bombs, they’d drop them and then circle back,” said Leavelle, a 21-year-old Navy Storekeeper Second Class at the time of the attack.

Leavelle, now 96, was among 30 Pearl Harbor survivors honored at a reception in Los Angeles before heading to Honolulu to mark Wednesday’s 75th anniversary of the attack.

James Leavelle, a 96-year-old Pearl Harbor Survivor, attends an event honoring 30 surviving World War II veterans who will travel to Hawaii to attend ceremonies for the 75th anniversary of the attack on Pearl Harbor, in Beverly Hills, California, U.S., December 2, 2016. Picture taken December 2, 2016. REUTERS/Ted Soqui

James Leavelle, a 96-year-old Pearl Harbor Survivor, attends an event honoring 30 surviving World War II veterans who will travel to Hawaii to attend ceremonies for the 75th anniversary of the attack on Pearl Harbor, in Beverly Hills, California, U.S., December 2, 2016. Picture taken December 2, 2016. REUTERS/Ted Soqui

The bombing of Pearl Harbor took place at 7:55 a.m. Honolulu time on Dec. 7, 1941, famously dubbed “a date which will live in infamy” by U.S. President Franklin Roosevelt. Fewer than 200 survivors of the attacks there and on other military bases in Hawaii are still alive.

Wednesday’s commemoration at a pier overlooking the memorial to the sunken USS Arizona built in the harbor is set to begin with a moment of silence at precisely that time.

About 350 World War Two veterans and their families will be serenaded by the Navy’s Pacific Fleet Band with a musical remembrance made bittersweet by the knowledge that every member of the USS Arizona band – one of the best in the Navy – died that day.

Attendees will watch a parade, and two families will participate in a private ceremony in which the ashes of crew
members who survived the attack and later died, will be interred in a turret of the Arizona.

Across the United States on Wednesday, Americans will pause to remember those who died at Pearl Harbor, and the long and difficult war that followed.

WAR BEGINS

The shock of the Pearl Harbor attack is vividly illustrated in an exhibit at Massachusetts’ Museum of World War II, which features relics including a West Point cadet’s letter to his father – then-Brigadier General Dwight Eisenhower – on how to prepare himself for the coming war.

The United States declared war on Japan the next day. Three days after that, Germany’s Adolf Hitler declared war on the United States.

Pearl Harbor survivor Delton Walling walks with family members during a ceremony honoring the sailors of the USS Utah at the memorial on Ford Island at Pearl Harbor in Honolulu, Hawaii December 6, 2016. REUTERS/Hugh Gentry

Pearl Harbor survivor Delton Walling walks with family members during a ceremony honoring the sailors of the USS Utah at the memorial on Ford Island at Pearl Harbor in Honolulu, Hawaii December 6, 2016. REUTERS/Hugh Gentry

Will Lehner, 95, was among those who had a chance to fight back in the 1941 Pearl Harbor attack. The 2nd class naval fireman was working in the boiler room at the USS Ward, patrolling the entrance to the harbor when crew members spotted a Japanese submarine.

“That submarine was on the surface and our skipper didn’t know if it was ours or not,” Lehner, 20 at the time of the attacks, said at the Los Angeles event. “He said: ‘Load your guns.'”

“The first shot went right over the top, the next shot right after it hit that submarine and punched a hole in it.”

After the war, a historical discrepancy nagged at Lehner. The remains of the Japanese submarine had not been recovered, and many historians doubted that it existed. That changed in 2002, when the sub was found.

“For 62 years,” Lehner said, “Nobody believed us.”

For his part, Leavelle would be touched twice by the hand of history. After the war, he became a policeman in Texas. On Nov. 24, 1963, he was the Dallas officer handcuffed to Lee Harvey Oswald when the accused assassin of President John F. Kennedy was shot to death by nightclub owner Jack Ruby.

(Reporting by Dana Feldman in Los Angeles and Hugh Gentry in Honolulu; Writing and additional reporting by Sharon Bernstein; Editing by Peter Cooney)

U.S. veterans to meet with tribe elders in pipeline protest

Trek Kelly of Venice Beach, California, stands with veterans who oppose the Dakota Access oil pipeline on Backwater Bridge near Cannon Ball, North Dakota,

By Ernest Scheyder and Terray Sylvester

CANNON BALL, N.D. (Reuters) – U.S. military veterans will meet with tribal leaders on Saturday as they continue to entrench themselves in a North Dakota camp where thousands of activists are protesting a multibillion-dollar pipeline project near a Native American reservation.

Veterans Stand for Standing Rock members will meet with Standing Rock Sioux elders to determine how the potentially  3,500 veterans arriving over the weekend can aide protesters who have spent months demonstrating against plans to route the Dakota Access Pipeline beneath a lake near the tribe’s reservation.

Phyllis Young (C) of the Standing Rock Sioux Tribe talks with veterans who oppose the Dakota Access oil pipeline and local law enforcement on Backwater Bridge near Cannon Ball, North Dakota,

Phyllis Young (C) of the Standing Rock Sioux Tribe talks with veterans who oppose the Dakota Access oil pipeline and local law enforcement on Backwater Bridge near Cannon Ball, North Dakota, U.S., December 2, 2016. REUTERS/Terray Sylvester

The group of veterans are also expected over the weekend to complete building a barracks and mess hall near where they constructed a headquarters at the Oceti Sakowin camp about 5 miles (8 km) north of the small town of Cannon Ball.

The Native Americans and protesters say the $3.8 billion pipeline threatens water resources and sacred sites.

Wesley Clark Jr, a writer whose father is retired U.S. Army General Wesley Clark, met with law enforcement on Friday to tell them that 3,500 veterans may join the protest and the demonstrations would be carried out peacefully, protest leaders said.

Tribal leaders asked the veterans, who aim to form a wall in front of police to protect the protesters, to avoid confrontation with authorities and not get arrested.

There have been violent confrontations near the route of the pipeline with state and local law enforcement, who used tear gas, rubber bullets and water hoses on the protesters, even in freezing weather.

“I felt it was our duty and very personally more of a call of duty than I ever felt in the service to come and stand in front of the guns and the mace and the water and the threat that they pose to these people,” said Anthony Murtha, 29, a Navy veteran from Detroit, at the Oceti Sakowin camp.

Some 564 people have been arrested, the Morton County Sheriff’s Department said.

The number of protesters in recent weeks has topped 1,000. State officials on Monday ordered them to leave the snowy camp, which is on U.S. Army Corps of Engineers land, citing harsh weather, but on Wednesday they said they would not enforce the order.

A man rests on top of a hill inside of the Oceti Sakowin camp as "water protectors" continue to demonstrate against plans to pass the Dakota Access pipeline near the Standing Rock Indian Reservation, near Cannon Ball, North Dakota

A man rests on top of a hill inside of the Oceti Sakowin camp as “water protectors” continue to demonstrate against plans to pass the Dakota Access pipeline near the Standing Rock Indian Reservation, near Cannon Ball, North Dakota, U.S., December 2, 2016. REUTERS/Lucas Jackson

Morton County Sheriff Kyle Kirchmeier spoke by phone on Friday with U.S. Attorney General Loretta Lynch, but assistance for law enforcement and a timeline for a resolution to the situation were not offered, the sheriff’s office said.

Lynch said in a statement that the U.S. Department of Justice has been in communication with all sides in an effort to reduce tensions and foster dialogue.

State officials never contemplated forcibly removing protesters, and Dalrymple said his evacuation order stemmed mainly from concerns about dangerously cold conditions as the temperature in Cannon Ball is expected to fall to 4 degrees Fahrenheit (-16 Celsius) next week.

The 1,172-mile (1,885-km) pipeline project, owned by Texas-based Energy Transfer Partners LP, is mostly complete, except for a segment planned to run under Lake Oahe, a reservoir formed by a dam on the Missouri River.

Protesters, who refer to themselves as “water protectors”, have been gearing up for the winter while they await the Army Corps decision on whether to allow Energy Transfer to tunnel under the river. The Army Corps has twice delayed that decision.

(Additional reporting by Timothy Mclaughlin in Chicago, Brendan O’Brien in Milwaukee and David Gaffen in New York; editing by Susan Thomas)