My sister sent me this link to an investigative series by the Hartford Courant dealing with soldiers who are still serving despite mental illnesses that should have kept them out of duty. In some cases, this has resulted in suicide.
The writers of the series, Lisa Chedekel and Matthew Kauffman, explain their methods here; among other things, they obtained, through Freedom of Information Act requests, pre-deployment screening forms for nearly a million troops as well as investigative reports for deaths. They also spoke to nearly 100 mental-health providers, service members, friends, family and experts.
The first article, from Sunday, follows the case of Spec. Jeffrey Henthorn, who was shipped back for a second tour in Iraq despite showing severe signs of mental illness such as depression and suicidal threats (which took the form of crashing his car and slashing himself with a knife while on leave and locking himself in a latrine with his rifle in Kuwait after being re-deployed) — which his superiors were fully aware of:
But no one wears the guilt like Henthorn’s mother, Kay, a speck of a woman who has literally seemed to shrink under the burden, her family says. More than a year after his death, she still winces as she replays the last time she saw him – Christmas 2004, at Fort Riley in Kansas the day before he shipped out for his second Iraq tour.
When she hugged him goodbye, her brave soldier son – the boy who had grown up respecting the uniform, in the sprawling shadow of Tinker Air Force Base – had crumpled in her arms.
“I don’t want to go back,” he sobbed. “I don’t want to go.”
She told him she loved him and that everything would be OK.
And then she did what she was supposed to do:
She left him there.
“I will never forget the look on his face when he looked at me. It eats all over me,” says Kay, 57, who works at the deli counter of the local Wal-Mart. “Why didn’t I turn the car around, bring him home, and say the hell with them, the hell with the Army?” Her breath catches in her throat. “I didn’t know.”
No one knew that Jeffrey, 25, would be flown back to Tinker [Oklahoma] less than two months into his second deployment – in a box. Shortly after noon on Feb. 8, 2005, he shot himself through the mouth with an M-16 rifle at an Army camp in Balad, Iraq, according to the military.
Jeffrey’s father, Warren, places the blame squarely on a military that put its need for bodies in combat over the need for those bodies to have healthy minds:
Henthorn’s case is perhaps the most egregious example of a military mental health system that is focused on retaining troops in combat, even when they exhibit clear signs of psychological distress. Since the war in Iraq began, the military has stressed the importance of treating troubled soldiers on the front lines and improving “return-to-duty” rates – principles that some believe are being taken too far, putting troops’ safety at risk.
Henthorn is one of 11 service members identified by The Courant who killed themselves in 2004 and 2005 after being kept in Iraq despite obvious mental problems. His family agreed to speak out in the hope that “we can maybe save a couple of families from what’s happened to us,” in Warren Henthorn’s words.
The military considers servicemembers to be property, and what’s best for the servicemember often bows to what’s best for the military, as in this peacetime example from Kat shows:
When you are active duty, you cannot call in “sick”. You muster for sick call to your command. Your command medical person, usually a corpsman (sort of equivelent to a PA), decides whether or not you need further medical care. But this is the thing–the Corpsman’s boss is also your boss. And commands are eager to nip any “malingering” in the butt. The command also has an eye on manpower issues when deciding who gets further medical treatment/light duty chits/SIQ (sick in quarters) chits. So the Corpsman may be under indirect or direct pressure to keep you on duty despite your need for rest or care.
My ex-husband had ankle surgery in ‘92. He needed to go back for for a second surgery a few months later to have screws removed. But his command didn’t have anyone to cover for him, so they told him to get the surgery when he reported for duty at his next command. In ‘94, he reported and that command didn’t have a Chief in his division which made him the senior enlisted person in the division, so they “couldn’t afford to lose him”. By then he was back on sea duty, and surgery would mean a cast which would mean he couldn’t get on or off the submarine for 6 weeks. So no surgery. By the time he reported back to shore duty in ‘97, the doctors told him the bone had grown over and he could not have the surgery without haveing to break the bone and risk complications. The lawyer (civilian) I worked for at the time told me if he was a civilian, we would have had a fabulous case for malpractice. But there was no one he could sue.
And that’s with a clear physical injury. Mental illness is much easier to file under “malingering” than is physical injury. The military has never been very good at dealing with the psychological issues. There was an article in the New Yorker a couple of years ago (unfortunately, beyond the reach of the website) about the stress that soldiers felt. Once studies during World War II determined that soldiers felt much greater stress about killing than about being in danger, the Army stopped looking into it. They couldn’t afford that kind of introspection, seeing as how they had to train people to kill.
And now you have a situation where there are no real front lines or rear areas, where soldiers are being asked to do tour after tour, where National Guardsmen who thought they were signing up for stateside duty on the weekends and for short periods have also done tour after tour, and the military is stretched almost to breaking. Add in the fact that the war is terribly, deeply unpopular, that recruiters are having mental breakdowns from the pressure to sign people up (so much so that they’re signing up autistic kids to fill quotas as well as resorting to other not-so-kosher tactics), that those who were due to get out of the military have been kept in against their wills, that they’re reactivating people who haven’t been in uniform for 20 years, that there’s no end in sight, and you have a situation where it’s very easy to look the other way when soldiers show signs of mental illness. And in some cases, they’re just not looking for those signs:
Despite a congressional order that the military assess the mental health of all deploying troops, fewer than 1 in 300 service members see a mental health professional before shipping out.
Once at war, some unstable troops are kept on the front lines while on potent antidepressants and anti-anxiety drugs, with little or no counseling or medical monitoring.
And some troops who developed post-traumatic stress disorder after serving in Iraq are being sent back to the war zone, increasing the risk to their mental health.
These practices, which have received little public scrutiny and in some cases violate the military’s own policies, have helped to fuel an increase in the suicide rate among troops serving in Iraq, which reached an all-time high in 2005 when 22 soldiers killed themselves – accounting for nearly one in five of all Army non-combat deaths.
The Courant’s investigation found that at least 11 service members who committed suicide in Iraq in 2004 and 2005 were kept on duty despite exhibiting signs of significant psychological distress. In at least seven of the cases, superiors were aware of the problems, military investigative records and interviews with families indicate.
Here are two examples of soldiers showing clear signs of psychological distress but not being given the care they need:
In a case last July, a 20-year-old soldier who had written a suicide note to his mother was relieved of his gun and referred for a psychological evaluation, but then was accused of faking his mental problems and warned he could be disciplined, according to what he told his family. Three weeks later, after his gun had been handed back, Pfc. Jason Scheuerman, of Lynchburg, Va., used it to end his life.
Also kept in the war zone was Army Pfc. David L. Potter, 22, of Johnson City, Tenn., who was diagnosed with anxiety and depression while serving in Iraq in 2004. Potter remained with his unit in Baghdad despite a suicide attempt and a psychiatrist’s recommendation that he be separated from the Army, records show. Ten days after the recommendation was signed, he slid a gun out from under another soldier’s bed, climbed to the second floor of an abandoned building and shot himself through the mouth, the Army has concluded.
And another case, a soldier with a history of mental illness that should have kept him out of the military in the first place:
On March 9, 2004, less than three months into his second deployment to the Middle East, Spec. Edward W. Brabazon shot himself in the head with his rifle at a palace compound in Baghdad, the Army has concluded. He was 20.
The Brabazons say they have trouble making sense of the Army’s investigation into his death, which notes his psychiatric past.
“They talked about how he had a history of mental problems,” Margaret said. “I said, `No kidding. If you knew he had mental problems, then why was he there?'”
The military — as well as the administration — has an interest in keeping this kind of thing quiet. After all, the current military is a volunteer force. There is no political support for a draft, so that the military still needs to keep a volunteer force going. It’s already showing terrible signs of strain, and that’s without anyone being able to photgraph bodies arriving at Dover AFB or the wounded arriving. Yet it’s the very voluntariness of service that’s increasing the pressure on those already in the service:
Military experts and advocates point to recruiting shortfalls and intense wartime pressure to maintain troop levels as reasons more service members with psychiatric problems are being deployed to the war zone and kept there.
“What you have is a military stretched so thin, they’ve resorted to keeping psychologically unfit soldiers at the front,” said Stephen Robinson, the former longtime director of the National Gulf War Resource Center. “It’s a policy that can do an awful lot of damage over time.”
And despite that damage, the military has no plans to change they way they handle soldiers with PTSD:
While the 2005 jump in self-inflicted deaths was as pronounced as the 2003 spike that had stirred action, Army officials said last week that there were no immediate plans to change the approach or resources targeted to mental health. They said they had confidence in the initiatives put in place two years ago – additional combat stress teams to treat deployed troops and increased suicide prevention programs.
Col. Elspeth Ritchie, the top psychiatry expert for the Army surgeon general, said that while the Army is reviewing the 2005 suicides as a way to gauge its mental health efforts, “suicide rates go up and down, and we expect some variation.”
Ritchie said the mental health of troops remains a priority as the war enters its fourth year. But she also acknowledged that some practices, such as sending service members diagnosed with PTSD back into combat, have been driven in part by a troop shortage.
“The challenge for us … is that the Army has a mission to fight. And as you know, recruiting has been a challenge,” she said. “And so we have to weigh the needs of the Army, the needs of the mission, with the soldiers’ personal needs.”
At some point, those soldiers struggling with mental illness such as PTSD who do not kill themselves or get killed will return to civilian life. They will no longer have the military’s health care system to rely on, and if they are unable to work, or to get a job that carries health insurance, they will have to rely on the Veteran’s Administration. Which is being gutted, during wartime, by our War President.