Mistreating the Troops

While the U.S. military has grown increasingly more aware of the psychological ravages of war and the need to better support the psychologically wounded, their approach to the problem still leaves a lot to be desired, as the following two news stories illustrate. First, from ABC News:

Military Overmedicating Troops, Counselors Charge

Instead of providing proper counseling and care for Iraq war veterans suffering from physical and psychological pain, too often the U.S. military is trying to medicate the problem away, according to drug counselors and therapists.

Andrew Pogany, who works with service members nationwide as an investigator with the veterans advocacy group Veterans for America, said overmedicating veterans is a common problem.

“Pretty much every person in my caseload is medicated, heavily medicated,” said Pogany. “There’s potential for them to become addicted.”

According to Pogany, a reliance on prescription drugs often leads veterans to reach for other coping mechanisms — illegal drugs such as marijuana, cocaine and crystal meth.

Road to Addiction Can Start in Iraq

Army Spc. Adam Reuter joined the military in October 2001, shortly after 9/11. After Reuter was injured in a Humvee accident in Iraq, he said an Army doctor literally gave him a grab bag of painkillers and muscle relaxers.

“They gave them to me in a Ziploc bag with no instructions,” said Reuter. Reuter said he became addicted to the medication and was able to quit his habit simply because of lack of access now that he’s out of the Army.

Gamal Awad, a former major in the Marine Corps, says Marine doctors in Iraq gave him an array of antidepressants and sleep medication so he could continue to function in the field.

Awad was diagnosed with severe post-traumatic stress disorder (PTSD) after his heroic response efforts at the Pentagon on 9/11. Despite his diagnosis, he was deployed to Iraq where he said he was haunted by depression, nightmares and thoughts of suicide.

“I would go out on convoys with the purpose to die,” said Awad. “I just wanted to be hit by an IED or get shot. When we’d get hit with mortar rounds or rockets, I wouldn’t take cover.”

Awad said he was given more than a dozen prescription drugs, including Xanax, Ambien, Prasozin, Zoloft and Paxil to treat his PTSD. Awad complained that for him these drugs are highly addictive, and he is frustrated by his reliance. [full text]

And then there’s this disheartening piece from the Washington Post:

‘A Soldier’s Officer’

In a nondescript conference room at Walter Reed Army Medical Center, 1st Lt. Elizabeth Whiteside listened last week as an Army prosecutor outlined the criminal case against her in a preliminary hearing. The charges: attempting suicide and endangering the life of another soldier while serving in Iraq.

Her hands trembled as Maj. Stefan Wolfe, the prosecutor, argued that Whiteside, now a psychiatric outpatient at Walter Reed, should be court-martialed. After seven years of exemplary service, the 25-year-old Army reservist faces the possibility of life in prison if she is tried and convicted.

Military psychiatrists at Walter Reed who examined Whiteside after she recovered from her self-inflicted gunshot wound diagnosed her with a severe mental disorder, possibly triggered by the stresses of a war zone. But Whiteside’s superiors considered her mental illness “an excuse” for criminal conduct, according to documents obtained by The Washington Post.

At the hearing, Wolfe, who had already warned Whiteside’s lawyer of the risk of using a “psychobabble” defense, pressed a senior psychiatrist at Walter Reed to justify his diagnosis.

“I’m not here to play legal games,” Col. George Brandt responded angrily, according to a recording of the hearing. “I am here out of the genuine concern for a human being that’s breaking and that is broken. She has a severe and significant illness. Let’s treat her as a human being, for Christ’s sake!”

In recent months, prodded by outrage over poor conditions at Walter Reed, the Army has made a highly publicized effort to improve treatment of Iraq veterans and change a culture that stigmatizes mental illness. The Pentagon has allocated hundreds of millions of dollars to new research and to care for soldiers with post-traumatic stress disorder, and on Friday it announced that it had opened a new center for psychological health in Rosslyn.

But outside the Pentagon, the military still largely deals with mental health issues in an ad hoc way, often relying on the judgment of combat-hardened commanders whose understanding of mental illness is vague or misinformed. The stigma around psychological wounds can still be seen in the smallest of Army policies. While family members of soldiers recovering at Walter Reed from physical injuries are provided free lodging and a per diem to care for their loved ones, families of psychiatric outpatients usually have to pay their own way.

“It’s a disgrace,” said Tom Whiteside, a former Marine and retired federal law enforcement officer who lost his free housing after his daughter’s physical wounds had healed enough that she could be moved to the psychiatric ward. A charity organization, the Yellow Ribbon Fund, provides him with an apartment near Walter Reed so he can be near his daughter.

Under military law, soldiers who attempt suicide can be prosecuted under the theory that it affects the order and discipline of a unit and brings discredit to the armed forces. In reality, criminal charges are extremely rare unless there is evidence that the attempt was an effort to avoid service or that it endangered others.

At one point, Elizabeth Whiteside almost accepted the Army’s offer to resign in lieu of court-martial. But it meant she would have to explain for the rest of her life why she was not given an honorable discharge. Her attorney also believed that she would have been left without the medical care and benefits she needed. [full text]