By John T. Kuehn,
Best Defense guest columnist
In a 2005 meeting with the faculty at the Command and General Staff College (CSGC), a senior Army mental health professional acknowledged how woefully unprepared the Army mental health personnel and facilities were for the drastic increase in the numbers of people needing help for combat related stress ailments, including Post Traumatic Stress Disorder (PTSD). At Fort Leavenworth, for example, there were about three to four counselors and therapists for an army community of several thousands, including nearly 1,400 field grade officers at CGSC -- most of whom had at least one combat deployment in either Iraq or Afghanistan, many more than one. The crisis was clear, the Army was unprepared, DOD was unprepared, but the first step to recovery is acknowledging that one has a problem.
Fast-forward to 2007. Same meeting, same location, and now the Army had maybe five or six mental health professionals on the post with the training and education to handle combat stress problems -- still the same problem, only the population was even more at risk, more likely than not suffering from combat stress, PTSD in some cases. The programs were inadequate, although attempts would soon be made to help build up something the Army called "resilience." The Army had also finally decided to let its personnel exclude mental health counseling for combat stress from its security questionnaire as "Having ever been treated for a mental disorder," but most of the students had not seen this announcement and did not trust the institution to NOT count mental health counseling against them even when they learned of it. Problem still there, getting bigger, and still nothing "heroic" -- as they say in the medical community -- going on to solve it.
Then came November 2009. Nidal Hasan murdered and wounded dozens of fellow soldiers at Fort Hood, Texas. More evidence that the measures taken to solve the mental health catastrophe in the armed forces were at best inadequate and, in Hasan's case, ruinously counterproductive. The goal to hire more mental health professionals had run into the problem of what is called quality control for these same professionals. The system in place to monitor, accredit, and hold them accountable, as well as their raters accountable, had been exposed as inadequate, to say the least. As an aside, a family member discharged honorably from the Army (in 2011), but with alcohol problems and problems with depression (not related to combat, he served in Korea), was being managed not with counseling and therapy, but with drugs. Another family member, a veteran social worker with over 30 years of experience, could not get hired by the Veterans Administration due to bureaucratic red tape and the lack of a sense of urgency about this problem (in the last five years), despite public pronouncements that the military medical branches were trying to hire more talent to help with the problem. The military claims a shortage of health care workers? It hired people like Hasan to alleviate a growing mental health epidemic related to combat stress?
Okay, so the military and DOD got its act together after the first Fort Hood shooting, right? It would seem not. April 2, 2014 -- still not enough workers, still managing people with drugs rather than one-on-one therapy and aggressive command support for professionally-led support groups, still underfunding the effort, still not properly monitoring the personnel in the system providing the care, still with hands over its eyes about a problem that certainly is not going to go away. Now, again at Fort Hood, where the warning klaxons went off about as loudly as they could over four years ago, a mentally disturbed soldier kills three of his comrades and wounds another 16, and then turns the gun on himself.
No matter what the investigations and finger pointing will reveal, this is also a crime by a macho, tough-it-out culture and the larger society that created it -- a society that routinely abandons its mentally ill citizens to homelessness on the streets and to "management" with drugs. Problem solved. No, problem not solved. To know there is a problem and not solve it is a crime of omission AND commission. This second Fort Hood shooting reveals a national crime against our own -- by us, by the bureaucrats, by the leadership of DOD that should be resourcing its mental health community -- embattled, understaffed and overworked -- and by the larger medical community itself for not standing up and speaking truth to power about its inadequate resources and internal policing.
For shame -- on all of us. We should all refuse to remain silent any longer.
John T. Kuehn teaches military history and is a retired naval aviator. Prior to joining the Navy in 1981 he worked for over seven years in hospitals, mental hospitals, alcohol and drug detoxification centers, and with the developmentally challenged. The views are those of the author and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government.
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