Showing posts with label VA. Show all posts
Showing posts with label VA. Show all posts

Friday, April 20, 2007

Soldier's Choice - Court Martial instead of Mental Health Services

First it was the horrors of Iraq. Now, Rob Withrow is locked in a fight with his own Army superiors. He wants mental health treatment -- they want him to face a court-martial

Broken Warrior, One Soldier's Struggle

article in Seattle PI
Broken Warrior: One soldier's struggle

Saturday, April 14, 2007

By CAROL SMITH
P-I REPORTER

Rob Withrow was a good soldier until he got back from combat duty in Iraq.

Now by his own admission, he is no longer anyone's idea of a model fighting man. He screwed up, and he's screwed up -- an assessment the Army would agree with.


But that's where their agreement ends.

Withrow wants mental health treatment. He has tried to commit suicide four times since returning from Iraq. He has been hospitalized in Madigan Army Medical Center's inpatient psychiatric unit on multiple occasions and is currently on a cocktail of antidepressants and psychoactive drugs. He is a month out of treatment for an addiction to narcotic pain pills that he began taking to "numb out" the month he returned from Iraq and he does not fit the Army's new criteria for deployment.

But now the Army wants to redeploy him to Iraq, and court- martial him over there. The charges stem from his pattern of not showing up on time, or sometimes at all.

Withrow's case raises questions about how the Army handles soldiers with psychiatric illnesses, particularly PTSD and depression and whether discipline, or the threat of it, interferes with treatment.

Since his return from Iraq in November 2004, Withrow has received multiple Article 15s -- the Army's form of non-judicial punishment -- for disciplinary issues related to "patterns of minor misconduct." He's been reduced in rank from sergeant to private.

If he is discharged for misconduct, he will lose benefits for his family, which is already facing a financial crisis related to his demotions.

"I'm not going to candy coat it," Withrow said. "I'll take responsibility for my part. I have purposefully not gone to work."

At the time, medical records show he was struggling with depression, anxiety and post-traumatic stress disorder. He repeatedly informed doctors that he was late or absent to work because he was having difficulty waking up, in part because of powerful sedatives prescribed for sleep disturbances.

Still, prosecutors have indicated their intent to court-martial him in Iraq, said Capt. Geoff Deweese, Withrow's defense attorney.

"I think it would be absurd for them to do that," Deweese said. "You don't bring someone with this kind of instability to a combat zone and risk harm to himself or others."

Culture clash?

The military's handling of mental health problems has come under intense scrutiny after an increase in the number of soldier suicides in Iraq in 2005. According to the Army's most recent Mental Health Advisory Team Findings, the suicide rate was 19.9 per 100,000 soldiers in 2005, up from the year before. That review led to new mental health screening policies and more stringent criteria for sending soldiers to war with pre-existing mental health diagnoses.

"Severe mental disorders, such as schizophrenia, bipolar disorder and severe depression, preclude deployment," Col. Elspeth Ritchie, the Army Surgeon General's Consultant on Psychiatry, said in an e-mail. "Soldiers may not deploy on a variety of types of medication, to include lithium, antipsychotic agents, and anticonvulsant agents."

But for soldiers such as Withrow, the reality after they return from deployment is that behavior stemming from mental health problems can result in disciplinary action rather than treatment.

The Army does offer several ways to provide psychological help for soldiers and is in the midst of testing a number of new programs to improve resiliency. Soldiers go through an extensive evaluation two to three months after their return to gauge adjustment back to life on the base and to spot any emerging health issues -- physical or mental -- said Fort Lewis spokesman Joe Piek. The Army also offers confidential help lines and other mental health counseling.

But the military culture, and sometimes the symptoms of depression itself -- fatigue and despair -- can still make it difficult for soldiers to find and benefit from treatment, said Dr. Jonathan Shay, Boston-based author and psychiatrist who specializes in combat stress injuries.

"What you have is a military that's not set up to care for these soldiers," said Tod Ensign, attorney and director of Citizen Soldier, a non-profit veterans advocacy group that has represented a number of soldiers with mental health histories who are being charged with misconduct. The Army, under pressure to keep its troops eligible for re-enlistment, discourages treatment that would deem them undeployable, he said.

If a soldier does seek treatment, often in tandem with discipline issues that stem from PTSD or other disorders, the Army's preference is to discharge them for misconduct or for having pre-existing mental conditions, either of which would reduce the burden on the Veterans Affairs medical care system, Ensign said.

Withrow said when he first tried to get help, he felt like he was getting the runaround. So he gave up.

When his symptoms were bad enough for him to go to the emergency room, he did receive help. But his symptoms persisted, despite treatment. At the same time, he began having trouble in his unit with a commander he perceived as unsympathetic.

Withrow and his lawyer contend that if he had gotten the right help at the appropriate time, his situation never would have escalated.

Withrow says he wanted to stay in the Army. In the midst of all his turmoil, he pleaded to be reassigned to his original battalion in the 3rd Brigade, 2d Infantry Division, which he knew would be going to Iraq again. (It deployed last July.)

"They said they would welcome me back, even knowing everything that was going on," said Withrow.

Now he wants a discharge on the best terms possible for himself and his family. Instead, he is facing a court-martial.

Born on the Fourth of July

Withrow, 27, was born in Gettysburg, Pa., on the Fourth of July. He enlisted in the Army and headed to boot camp 20 days after graduating high school in June 1997. A field artillery sergeant, he planned to make the military his life's work.

In November 2003, he went to Iraq with the 1st Battalion, 35th Field Artillery Regiment. When he returned a year later, he received an Army Commendation Medal for "Exceptionally meritorious service as an air guard during operation Iraqi Freedom."

Prior to returning from Iraq, he had no disciplinary record and consistently received good-conduct medals, his attorney confirmed. A memorandum from his first sergeant with his old brigade noted, "I would gladly serve with SPC Withrow in combat again because I believe him to be a true Warrior."

Tall and lean with trimmed dark hair, Withrow is personable and straightforward while relaying his story, but bluish circles under his brown eyes betray fatigue. In addition to his legal and health problems, he is facing bankruptcy and loss of his base housing. He worries frequently out loud about what will become of his wife and three children if he goes back to Iraq. "I don't want them to wind up on the street," he said.

"When he got back, I could tell he was just different," said Jenny Withrow, his wife of six years.

Like many of his comrades, he said he had images from Iraq burned into his brain -- a mass grave with still decomposing men's bodies layered over women's and children's, fresh bullet holes in his Humvee.

"I would lay in bed at night and wonder if this is the night I get blown up," he said.

Adjusting to life back home wasn't what he expected. He had left when his baby girl was 4 months old.

"When I got back, my daughter -- it's like she didn't know me," he said.

Other guys gravitated to alcohol, he said. "I gravitated to opioids. All I wanted to do is be numb."

In May 2005, short on non-commissioned officers, the Army transferred Withrow to a different unit. But he didn't click with his new command and missed the soldiers he had deployed with. "We were like family," he said. His depression worsened and he started having difficulty waking. He began showing up at the ER with problems breathing from panic attacks. In August 2005, he was diagnosed with PTSD as well as depression and anxiety.

He was also late reporting to work on a number of occasions.

Instead of recommending him for mental health treatment, however, he was threatened with an Article 15 -- a demotion. "They said fix your issues, or we'll take your stripes," Withrow said.

At his request, the Army did switch him to a different battery for a fresh start in September 2005. But the second day with that unit, he woke late again. He said that the night before, he laid in bed and contemplated killing himself.

Distraught, he first tried to cut his wrists. He then tried to drive straight into a tree at full speed with his seat belt off. He swerved at the last possible moment, he said.

"I drove myself straight to the ER instead," he said.

He was admitted to the psychiatric ward and stayed four days before being discharged to full duty, with the understanding he would go through a two-week outpatient behavioral health program.

His commander picked him up from the hospital and offered him a chapter discharge "nice and quiet," but Withrow, who had put in nearly nine years, wasn't ready to give up the Army.

The scope of the problem

Estimates of the number of soldiers who suffer from PTSD and mental problems vary, but most experts agree that the nature of the fighting in Iraq sets up soldiers for psychological trauma.

According to Ritchie of the Surgeon General's Office, an estimated 15 to 17 percent of deployed soldiers experience PTSD and 23 percent experience other behavioral health problems. Others put the numbers higher.

According to a study published last month in the Archives of Internal Medicine, nearly one-third (31 percent) of 103,788 veterans who had served in Iraq and Afghanistan were diagnosed with mental health or psychosocial problems upon their return.

The Surgeon General's Office indicated about 11 percent of soldiers who have returned receive mental health diagnoses.

For Withrow, as his mental anguish grew, his problems with his commanders intensified.

"If I were his commander, I'd be frustrated with him as well," said Deweese, who has also worked as a prosecutor.

At the end of March, Withrow was informed he would deploy this week with the 4th Brigade, 2nd Infantry Division back to Iraq.

As part of predeployment screening, an Army psychiatrist specified his "symptoms are not stable" and indicated he should have "no access to weapons or ammunition, no exposure to combat situations, no exposure to casualties, and was not recommended for deployment."

The issue of whether to send him to Iraq for a court-martial is still pending.


P-I reporter Carol Smith can be reached at 206-448-8070 or carolsmith@seattlepi.com.

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Sunday, April 15, 2007

Returning troops face obstacles to care.

Article below published in its entirety accoding to Fair Use law.

Huffington
Post Wires





Tammy Edwards, the wife of Army Staff Sgt. Christopher Edwards who was
severely burned when a 500-pound bomb exploded under his vehicle while
serving in Iraq, speaks during a commission hearing on the treatment of
wounded veterans, Saturday, April 14, 2007, in Washington. Spouses often
most drop everything to provide care, and parents and grandparents
frequently change their way of life because of the burdens, Edwards
said. (AP Photo/Haraz N. Ghanbari)





Returning
Troops Face Obstacles to Care

HOPE YEN | AP | April

14, 2007 08:43 PM EST

WASHINGTON — Injured soldiers returning home for medical treatment face anunacceptable maze of paperwork and bureaucracy, leaders of a presidential

commission on veterans' health care said Saturday.

At its first public meeting, the nine-member panel heard from veterans,spouses and advocacy groups who decried what they said was a failedsystem. The commission pledged to work quickly to find solutions ratherthan assign blame.

"This is not going to be a witch hunt," said former GOP Sen. Bob Dole of
Kansas, one of the heads of the Commission on Care for America's Returning
Wounded Warriors.

Dole said the commission planned to build upon the work of at least nine
congressional committees and other government panels that are
investigating veterans' health care problems. Those inquiries followed
disclosures in February of squalid conditions and poor outpatient
treatment at Walter Reed Army Medical Center in Washington.

Their reviews in recent weeks have pointed to inadequacies with the
treatment of brain injury and post-traumatic stress disorder, as well as
outpatient care.

Donna Shalala, health and human services secretary under President
Clinton, said the commission planned a report by late July that would be
pragmatic and "solution-driven."

Among the areas the report will address: fostering cooperation between the

Pentagon and the Department of Veterans Affairs, which do not have systems
in place to share inpatient records electronically; providing
institutional support to families who bear burdens of caregiving; and
reforming a disability benefits system that critics say shortchanges
injured soldiers.

"Our timeline for action is very short," Shalala said. As a result, she

said commissioners may not be able to visit every military hospital and VA
clinic to examine conditions.

Shalala encouraged injured troops and veterans to express their concernsto the commission through their Web site http://www.pccww.gov

During the hearing, the commission heard stories of confusion and
frustration as veterans navigated the Pentagon and VA's vast health care
network. Veterans complained of bureaucratic doublespeak when they sought
help and said the problems extended beyond Walter Reed.

Veterans must take on "mammoth bureaucracies," said Bobby Muller,president of Veterans for America. He said the government has been slow torespond to brain injuries and other medical problems from the Iraq war.

Three commissioners who experienced problems after they or their spouses
were injured in Iraq said their final report would address the maddening
red tape.

Tammy Edwards spoke of recommending ways to alleviate burdens on families.

In 2005, her husband, an Army staff sergeant, was burned severely in Iraq
when a 500-pound bomb exploded under his vehicle.

Spouses often must drop everything to provide care, and parents and
grandparents frequently change their way of life to because of the burdens
of providing for injured service members from Iraq who are much younger
compared to past wars, Edwards said.

"I have watched several marriages fall apart because the spouses did not
receive the emotional support necessary to help them through such a
challenging time," Edwards said.

When President Bush named Dole and Shalala to head the panel, he said the
nation has "a moral obligation to provide the best possible care and
treatment to the men and women who served our country."

The commission also heard from two former Army secretaries, John O. "Jack"
Marsh and Togo D. West, who headed an independent review ordered by
Defense Secretary Robert Gates. Its report last week found money problems
and Pentagon neglect were to blame.

A different panel also has raised questions about whether injured soldiersmight be shortchanged by the system used for rating their disabilities.

Critics say the Pentagon has a strong incentive to assign ratings so the
military will not have to pay disability benefits.

West faulted a system that ignored problems for so long. He noted that
many of his group's recommendations _ which include a quick infusion of
funds, an overhaul of the disability evaluation system and creation of a
national "center of excellence" for brain injury cases _ had been offered
by other commissions and congressional panels in the past 10 years.

"We know what to do as a society, as two cabinet departments, to fix that

system," he said. "We must summon the will and persistence to see that
through. We can do better."

West and Marsh suggested that responsibility may lie with Bush andCongress. Dole did not seem to disagree, suggesting the commission mayincorporate many of the previous recommendations.

"Maybe if we put a different set of names in front of it, things will
happen," Dole said.

In the coming weeks, the commission plans more than a dozen hearings andsite visits to military and VA facilities around the country, includingLos Angeles and San Antonio. The commission's next hearing will be April23 in Washington, with a visit to Walter Reed the following day.


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