Mind games, part 1: The things they carry

Nancy Goldstein
Published: Tuesday October 24, 2006

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PART I, The things they carry: Mental health disorders among returning troops

The same administration that many claim sent US troops overseas without sufficient intelligence, planning, numbers, or armor is equally unprepared to deal with the wars' psychic toll on service members, RAW STORY has learned.

A former commander-in-chief describes today's overextended, under-equipped military as nearing the "breaking point."

In Afghanistan, insurgent attacks and bombings are surging this year, as the Taliban rapidly regains power and popularity.

In Iraq, where US troops are, by the administration's own admission, struggling unsuccessfully with an increasingly bloody insurgency, US and civilian casualties are rising by the day. This past Sunday, the Associate Press reported that this month is on track to be the deadliest one of the war yet. It is already the deadliest since November 2004, when 92 American Marines were killed and another 500 wounded over the course of Operation Phantom Fury in Fallujah.

Even before this latest surge in violence, the men and women returning from Operation Iraqi Freedom (OIF) and Afghanistan's Operation Enduring Freedom (OEF) were seeking treatment in droves.

In August, the Veterans Administration (VA) released a report showing that almost one-third of the nearly half-million vets from these two conflicts are seeking treatment from VA facilities. Of these, a full 35% received a diagnosis of a possible mental disorder--a tenfold increase in 18 months. (View full VA PowerPoint presentation.)

Some of this increase in demand among returning service members can be traced to the military's demonstrable preference for keeping troops deployable rather than discovering and treating mental health issues. A must-read piece from the Hartford Courant earlier this year indicates that the military, which is now in the midst of a recruiting crisis and with no end to the war in sight, is not looking hard enough for signs of mental illness in prospective and active service members. Nor is it willing to acknowledge what it finds, especially if that means removing another warm body from an over-stretched unit, letting the public see the negative consequences of an already unpopular war, or paying for treatment or compensation.

The investigative reporters who researched "Mentally Unfit, Forced to Fight" concluded, from studying military investigative records and interviewing troops' family members, that the military was sending troops into combat, or re-deploying them, despite knowing that they were suicidal or had other signs of mental illness.

Despite a congressional mandate that all deploying troops must have a mental health assessment, the reporters found that "Fewer than 1 in 300 were seeing a mental health professional" after filling out a pre-deployment health assessment that includes one mental health question--and before going to war.

Once in the theater, and in violation of the military's stated policies, "some unstable troops are kept on the front lines while on potent antidepressants and anti-anxiety drugs, with little or no monitoring or counseling," and despite the fact that their superiors are aware of their mental condition.

In 2005, these practices contributed to the suicides of 22 soldiers in Iraq, or nearly one in five of all Army non-combat deaths--an all-time high.

In the war zone, commanders rather than medical professionals decide whether to retain troubled soldiers. Ann Scheurman's son, Pfc. Jason Scheurman, was referred for a psychological evaluation and stripped of his gun after he wrote her a suicide note. Shortly thereafter he was "accused of faking his mental problems and warned that he could be disciplined, according to what he told his family." The Army gave Jason his gun back.

Three weeks later, he killed himself with it.

Jason's mother, Ann, "said her family has had a frustrating time getting the Army to acknowledge mistakes in the way her son was treated." She wants to make sure that if "whatever protocol they have in place is used, and it doesn't work, [they] fix it," but "to date, we're just not getting anything at all."

Army Spec. Jeffrey Henthorn, a young father and third-generation soldier, "had been sent back to Iraq for a second tour even though his superiors knew he was unstable and had threatened suicide at least twice, according to Army investigative reports and interviews."

The M-16 he used to kill himself in Balad, Iraq, in February of 2005 was so powerful that "fragments of his skull pierced the barracks ceiling."

Henthorn's superiors also ignored multiple warnings that he was suicidal. In one incident at the military base, prior to his second deployment, he slashed his arm; in another, 18 days before his suicide, he took his gun into a latrine and "charged it, in what his fellow soldiers feared was a suicide gesture."

Henthorn's superiors took away the gun, but according to a sworn statement, they returned it to Henthorn later the same day after a half-hour talking-to by his platoon sergeant. Though the platoon's first lieutenant was notified, "there is no indication that Henthorn was referred for a mental health evaluation or counseling."

In speaking with reporters, Col. Elspeth Ritchie, the top psychiatry expert for the Army's surgeon general, insisted that the Department of Defense (DOD) still prioritized the mental health of service members in the war's fourth year. "But she also acknowledged that some practices, such as sending servicemembers diagnosed with post-traumatic stress disorder (PTSD) back into combat, had been driven in part by 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."

Or, as Cathleen Wiblemo, deputy director for health care for the American Legion says, "The DOD is in the business of keeping people deployable."

The other consequence for soldiers whose combat-related trauma goes undiagnosed and untreated during their term of service was first made known to me by Andrew (not his real name), a VA psychiatrist who spoke on condition of anonymity for this article. First the soldier's symptoms are ignored by military personnel; then the soldier self-medicates; then the military tests the soldier for substances. If the soldier tests positive, he or she is given a less-than-honorable discharge and stripped benefits, often winding up on the street--still addicted and traumatized.

One of the men Andrew was treating at his VA inpatient treatment center was a young soldier who had returned from Iraq, where he was engaged in active combat and had been in a number of life-threatening situations. Back on US soil, still enlisted and performing military duties, his nightmares got to be so bad that he finally went to the military medical personnel.

"They waved off his concerns and advised him to just keep doing what he was doing to get to sleep," Andrew explained. "He started drinking, and when the booze started making it difficult to wake up in the morning, he started doing cocaine--all in the name of being a good solider." Finally, when the military could no longer ignore this soldier's having become something of a mess, they subjected him to a random drug test, which he failed, and gave him a less-than-honorable discharge that stripped him of his VA benefits.

By the time the soldier got to Andrew's VA hospital, he was in such bad shape that the staff took him in despite his lack of benefits under a "compassionate care" provision. He was diagnosed with one of the worst cases of post-traumatic stress disorder that Andrew had ever seen, and "required a six week stay instead of the usual two just to get back to some kind of baseline functioning."

Andrew emphasized that this soldier's primary problem, like so many of the others I heard about while researching this piece, was PTSD caused by his experiences while serving for the US military. He had not previously had any problems with drugs: he turned to them as a sedative and a stimulant so he could continue to function when military medical personnel chose to ignore his PTSD.

Andrew is pretty sure that the military will eventually have to recognize that this young soldier's PTSD is what is known as a "service-connected disability" and give him benefits. But applying for that status, proving that the substance abuse was not a pre-existing condition, and waiting to have benefits reinstated is a long and arduous process, with no happy ending guaranteed.


Part II of Mind Games, "Coming Home: Obstacles to care," will appear Thursday, October 26, 2006 on RAW STORY.