Leonard Neff, 80; Doctor Diagnosed Vets’ Stress

On a summer day in 1974, a Vietnam veteran wearing combat gear took a rifle and climbed a hill in Griffith Park. There he took three men hostage, then requested to speak with his psychiatrist, Dr. Leonard Neff.

Police shut down the park, and nearby freeways were jammed, so Neff arrived by helicopter. For the next three hours Neff talked to the veteran, finally persuading him to release the hostages and surrender.

The incident ended peacefully but became part of an emerging discussion on the needs of Vietnam veterans, many of whom returned home with mental health problems.

Neff joined a nationwide push to add an accurate definition of the disorder afflicting veterans to the Diagnostic and Statistical Manual of Mental Disorders used by healthcare professionals. The effort added a new dimension to the debate on Vietnam -- and the wars that would follow.

“It will give people some idea how much it costs to pick up the pieces after a war, economically and psychologically,” Neff told the Los Angeles Times in 1976.

Neff, a noted psychiatrist whose early work helped define what became known as post-traumatic stress disorder, died March 26 at his home in Sherman Oaks. He was 80.

In recent years Neff had been diagnosed with lung and prostate cancer. In mid-March he learned that he had pancreatic cancer, which was thought to be the cause of death, said his daughter Jane Neff Rollins.

What seems commonplace now -- the idea that a traumatic experience can cause stress that surfaces later -- was not as widely understood or clearly defined more than 30 years ago when Neff began his work with veterans. In previous wars, veterans were described as “shell-shocked” or suffering from “combat fatigue,” but these descriptions were not true diagnoses, and they seldom carried the moral issue of blame.

Vietnam veterans -- many of whom were young and poor -- were often seen as the source of their own postwar problems. Some observers argued that the war itself had little to do with the veterans’ mental health issues, said Charles R. Figley, a noted psychologist, author and expert in psychological trauma. But Neff, a veteran of World War II, did not share that view.

“Neff wanted to shift the paradigm,” said Figley, who heads the Traumatology Institute at Florida State University. “He said no matter who you are under this kind of circumstance -- that being war -- it will leave a mark, and that mark is predictable and understandable, and we need to do something about it.”

Neff was working at what is now the Veterans Affairs psychiatric hospital in Westwood when a then 22-year-old Johnny Gabron took hostages at Griffith Park, recalled Floyd “Shad” Meshad, a Vietnam veteran who was a psychiatric social worker and with Neff when he negotiated the release of the hostages.

“At the time we didn’t have a diagnosis for Johnny,” Meshad said. “We didn’t have the term post-traumatic stress disorder.”

Advocates also did not have sufficient resources to help veterans such as Johnny. Of the 2.5 million men and women who served in Vietnam, 54,972 received compensation for psychiatric disorders, according to a 1974 Times article. Neff questioned the figure, believing a higher number had psychiatric disorders.

This was a time when many veterans seeking mental healthcare “were misdiagnosed and given the wrong treatment, especially the wrong drugs, some of which exacerbated the problems” and caused mistrust of the VA, Figley said.

But Meshad, who now heads the National Veterans Foundation, said Neff talked about the need to provide adequate services for veterans and society’s failure to do so.

For a time, Gabron was the face of the Vietnam veteran whose war experience left him in need of mental health care. But if he was an example, he was a problematic one. Gabron said he was a sniper who had killed 324 people. The army said he was a clerk. Gabron said he was injured by shrapnel. The army said he was injured when someone threw hot coffee on him.

To Neff, Gabron’s version of his past was “an Everyman’s story,” and whether he was lying or not did not matter to his present or future: “It’s still a story of what a lot of people went through and are carrying around with them and of their continually lethal potential,” Neff said.

When Neff spoke on behalf of veterans, he did so carrying the weight of his credentials and an international reputation, Figley said. In those contentious years when veterans returned to a sometimes hostile, sometimes ambivalent public, Neff was a bridge. He had the respect of academics, and because of his work with Meshad, a well-known street counselor, he also had the trust of veterans and their advocates who saw him as an ally.

Neff was an innovator who saw the need not only for better treatment but also for appropriate diagnoses. Clearly defining and acknowledging the disorder in the standard reference guide of mental health conditions would mean better treatment and more benefits for veterans.

In 1976 Neff and other professionals presented a working definition of the phenomenon at the annual meeting of the American Orthopsychiatric Assn. But Neff soon left the VA, Meshad said. Behind the scenes, he continued to support the efforts of Meshad, Figley and many others.

“His influence and his work and his testimonial about the real world, especially war veterans, was instrumental in making sure [post-traumatic stress disorder] became an actual diagnosis in 1980,” said Figley, who was part of a subcommittee of the American Psychiatric Assn. that examined the issue.

After leaving the VA, Neff worked in private practice but did not specialize in the problems of veterans. He also was an adjunct assistant professor at the UCLA Neuropsychiatric Institute.

Neff was born July 8, 1925, in Peoria, Ill., and was a student at the University of Illinois during World War II, when he was drafted into the Army. He served in the Pacific but did not see combat, his daughter said. Neff and his wife, Essie, a psychotherapist specializing in the treatment of children with developmental delays, had three children besides Rollins: Laurie Schlichter, Rachel E. Schooler and Jack Neff. Neff is survived by his wife, his children and four grandchildren: Monica, Jacquelyn, Robert and Amanda.

In 1995 Neff and his wife helped found the Child Development Institute in Woodland Hills, where Neff was an instructor and an early proponent of the idea that “the quality of the infant-parent relationship has a dramatic impact on the baby’s brain development and capacity for learning for the rest of their lives,” said Joan Maltese, the executive director of the institute.

Neff was active in professional organizations in child and adolescent psychiatry. The people he worked with, veterans and adolescents, had much in common. Before the war the veterans had been “ordinary teenagers who were taken off the streets to be sent to Vietnam.” They had to suspend adolescence in order to do their jobs as soldiers, he once said. In therapy sessions, they told him something changed after they killed their first three people.

“And I have often wondered what would it take to get them back” to the time before the first killing, Neff said.