When it comes to obtaining post-combat mental health services, the infamous "fog of war" appears to be following veterans of the 116th Idaho Army National Guard Combat Brigade Team back home to Idaho. With some experts estimating that up to one out of 10 soldiers returning from Iraq and Afghanistan suffers from Post Traumatic Stress Disorder (PTSD) and other emotional disorders, military officers are emphasizing increasing access to resources for those who need them. But other senior staff, spouses and state officials quietly complain that a key component of that system has been dismantled.
At issue is the procedure whereby returning vets are screened and informed of the services available to them. The first set of troops returning through Fort Lewis, Washington, were all given up to one hour of mandatory mental health assessments, performed by a team of Veterans Center counselors. Then, according to a confidential e-mail sent to Boise Weekly by a concerned public health official, "One person of influence made the in-processing screenings (along with many other important 'stations' to tell folks about their vet benefits) optional instead of mandatory."
These claims were partly backed up by Guard Lt. Col. Heather Taylor, a master's level mental health professional, who said that "approximately 3,000 of our 116th soldiers went through all ... 'Phase III' stations which included an additional Vet Center Brief, a Veteran's Benefits Brief, a Tricare Health Insurance Brief, and a Chaplain's Brief that focused on reunion with family and stress management," but acknowledged that "the only station that was made optional was the 'One-on-One Vet Center sessions' during Phase III. When it was made optional, attendance for that one station dropped off significantly."
The need for these services was elucidated in the confidential e-mail, which noted, "It has been the six month 'honeymoon' period for the National Guard in our area and we have major concerns," referring to the time it often takes before symptoms of PTSD and other mental disorders to surface after demobilization.
The licensed professional also passed on a letter from a northern Idaho clinician who treats returning vets, observing that "The soldiers are experiencing 'post-traumatic stress' due to combat fears, morbidity, near death experiences and adjusting to a completely foreign culture," yet "the soldiers do not want to 'complain' or appear 'weak' about their deployment experience, and it is manifesting itself with anger management problems."
But the concern isn't just outside the Guard. An officer within the 116th told BW that the returning soldiers he had spoken with were "pretty pissed themselves, let alone the people in leadership who thought it was an insane order" to make screening optional.
Another guard member insisted that "there would not be any written documentation about the order given to make the information and screening optional." The member added, "Lots of people out at the Guard are pissed about this too, but can't say anything."
One National Guard officer, reluctant to give his name, explained that "there's peer pressure and leadership pressure. The leadership's position is that 'We will have no problems.' There's even no tracking of the divorce rate, because they're afraid to." Soldiers deployed in Iraq "couldn't talk to those of us back home" about any emotional difficulties, the officer said, "even though some of us have been friends for decades."
Asked why so many were reluctant to make their concerns public, the officer stated, "It's hard to explain a whole culture in one paragraph. Basically, you don't talk to anyone outside the unit. You're not a team player if you do." And in the highest echelons of the unit, "their attitude is that they can do no wrong" in the area of policy-making.
In an interview with BW, Lt. Col. Taylor again confirmed the markedly lower participation levels following the change in policy. She pointed out that the idea of having Vet Center counselors available at Fort Lewis for one-on-one counseling was "the first time it was ever done at this early stage."
But Public Affairs Officer Lt. Col. Stephanie Dowling added that, in her understanding, the counselors were simply there "to make contact and not to do any assessment. It was just basically to say 'Hi, let's shake hands, here's my card, when you get back home we're available,'" she said. "They did give a public presentation to the whole group and after that people were given the option" for individual sessions.
Taylor pointed out that 116th vets have benefited from a three-tiered system of care, beginning with debriefings in Kuwait, followed by processing in Fort Lewis. Finally, the Guard and Reserve benefit from VA programs as well as a new Community Based Health Care program, designed to provide care for injured service members in their local areas while awaiting evaluation for return to duty or medical release. Additionally, guard couples may take advantage of marriage enrichment seminars. And many soldiers choose to talk with chaplains instead, partly for reasons of confidentiality.
Brigadier General Alan Gayhart commanded the 116th during its operations in northern Iraq, and has since been promoted to second in command of the Idaho Army National Guard. An affable man, Gayhart first came to national press attention for the call-in television shows he hosted in Kirkuk, broadcast on the Iraqi Media Network (IMN), a state-run station. Moreover, Gayhart also received coverage after issuing a public denial that his troops were involved with illegal abductions of minority Turmens and Arabs by Kurdish police and security forces.
Seated in his office at Gowen Field, Gayhart told BW that, in his view, the military is doing a far better job with Iraq vets than during Korea and Vietnam. "The country's got a conscience now" in terms of programs for PTSD and related conditions, he said, and even provides vets with TurboTax and other services through the VA and Military One Source Web sites. Gayhart agreed that PTSD cannot be identified upon demobilization, adding.
"We could be at the tip of the spear right now," he said. "You see the signs later on, relationship problems later on, and stress in readjustment." Acknowledging his own experience with sleep disturbance, Gayhart said that returning soldiers have been given positive welcomes. "Life is good until you have to readjust to civilian life," starting about 90 days after discharge, he said.
When asked about the decision to make mental health screening optional, Gayhart stated that "I'm not aware of any mandatory screening policy. We follow the established Army model for deprocessing soldiers through the various stages" of demobilization. "If there was a change in rules it happened at Fort Lewis." Gayhart said that he had no idea if the non-mandatory procedures apply nationwide, and BW has not been able to confirm this as of press time. As to stigma against soldiers seeking help, Gaylard acknowledges that "there's definitely the John Wayne type, who thinks they can muscle through" their problems.
"I tell my soldiers to reach out," he insisted.