Military Doctors Withholding Treatment from Soldiers with Mental Health Problems

By Maggie Mahar, Health Beat. Posted February 27, 2008.

Since 9/11, one Army division has spent more time in Iraq than any other group of soldiers: the 10th Mountain Division, based at Fort Drum, New York.

Over the past 6 years and and six months, their 2nd Brigade Combat Team (BCT) has been the most deployed brigade in the army. As of this month, the brigade had completed its fourth tour of Iraq. All in all, the soldiers of BCT have spent 40 months in Iraq.

At what cost? According to a February 13 report issued by the Veterans for America's (VFA) Wounded Warrior Outreach Program, which is dedicated to strengthening the military mental health system, it is not just their bodies that have been maimed and, in some cases, destroyed. Many of these soldiers are suffering from severe mental health problems that have led to suicide attempts as well as spousal abuse and alcoholism.

Meanwhile, the soldiers of the 2nd BCT have been given too little time off in between deployments: In one case they had only six months to mentally "re-set"; following an eight-month tour in Afghanistan -- before beginning a 12-month tour in Iraq.

Then, in April 2007, Secretary of Defense Robert Gates decided to extend Army tours in Iraq from 12 to 15 months -- shortly after the BCT had passed what it assumed was its halfway mark in Iraq.

As the VFA report points out, "Mental health experts have explained that 'shifting the goalposts' on a soldier's deployment period greatly contributes to an increase in mental health problems."

Perhaps it should not come as a surprise that, during its most recent deployment, the 2nd BCT suffered heavy casualties. "Fifty-two members of the 2nd BCT were killed in action (KIA)," the VFA reports and "270 others were listed as non-fatality casualties, while two members of the unit remain missing in action (MIA)."

This level of losses is unusual. "On their most recent deployment," the VFA report notes, "members of the 2nd BCT were more than five times as likely to be killed as others who have been deployed to OEF and OIF and more than four times likely to be wounded." One can only wonder to what degree depression and other mental health problems made them more vulnerable to attack.

When they finally returned to Fort Drum, these soldiers faced winter conditions that the report describes as "dreary, with snow piled high and spring still months away. More than a dozen soldiers reported low morale, frequent DUI arrests, and rising AWOL, spousal abuse, and rates of attempted suicide. Soldiers also reported that given the financial realities of the Army, some of their fellow soldiers had to resort to taking second jobs such as delivering pizzas to supplement their family income."

What has the army done to help the soldiers at Fort Drum? Too little.

In recent months, VFA reports, it has been contacted by a number of soldiers based at Fort Drum who are concerned about their own mental health and the health of other members of their units. In response, VFA launched an investigation of conditions at Fort Drum, and what it found was shocking.

Soldiers told the VFA that "the leader of the mental health treatment clinic at Fort Drum asked soldiers not to discuss their mental health problems with people outside the base. Attempts to keep matters 'in house' foster an atmosphere of secrecy and shame," the report observed "that is not conducive to proper treatment for combat-related mental health injuries."

The investigators also discovered that "some military mental health providers have argued that a number of soldiers fake mental health injuries to increase the likelihood that they will be deemed unfit for combat and/or for further military service."

The report notes that a "conversation with a leading expert in treating combat psychological wounds" confirmed "that some military commanders at Fort Drum doubt the validity of mental health wounds in some soldiers, thereby undermining treatment prescribed by civilian psychiatrists" at the nearby Samaritan Medical Center in Watertown, NY.

"In the estimation of this expert, military commanders have undue influence in the treatment of soldiers with psychological wounds," the report noted. "Another point of general concern for VFA is that Samaritan also has a strong financial incentive to maintain business ties with Fort Drum -- a dynamic [that] deserves greater scrutiny."

Because some soldiers do not trust Samaritan, the report reveals that a number of "soldiers have sought treatment after normal base business hours at a hospital in Syracuse, more than an hour's drive from Watertown ... because they feared that Samaritan would side with base leadership, which had, in some cases, cast doubt on the legitimacy of combat-related mental health wounds.

"In one case," the report continued, "after a suicidal soldier was taken to a Syracuse hospital, he was treated there for a week, indicating that his mental health concerns were legitimate. Unfortunately, mental health officials at Fort Drum had stated that they did not believe this soldier's problems were bona fide."

See more stories tagged with: soldiers, military, ptsd, alcoholism, depression, iraq, mental health

Maggie Mahar is a fellow at The Century Foundation and the author of Money-Driven Medicine: The Real Reason Health Care Costs So Much (Harper/Collins 2006).

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