Innocent Casualties of the Iraq War - Intervention is Inadequate

The following articles illustrate the woefully inadequate treatment of returning veterans. With all the money being spent on the war, surely the government has the funds to hire more than one psychologist trained in treating post-traumatic stress disorder for all returning veterans who live between Los Angeles and San Francisco, including Jeffrey Lehner, a 40-year-old Marine sergeant who recently shot himself and his father:

He had joined the Marines enthusiastically, he told me, and served as a flight mechanic for eight years. Not long after 9/11, he began helping to fly materials into Afghanistan with the first wave of U.S. troops.

In the beginning, Jeff supported the administration's policies in the region. But over time, that began to change. As we talked, Jeff brought out an album of photos from Afghanistan. He pointed to a series of photographs of a trailer and several huts behind a barbed-wire fence; these were taken, he said, outside a U.S. military camp not far from the Kandahar airport. He told me that young Afghans -- some visible in blue jumpsuits in his photos -- had been rounded up and brought to the site by a CIA special operations team. The CIA officers made no great secret of what they were doing, he said, but were dismissive of the Marines and pulled rank when challenged.

Jeff said he had been told by soldiers who had been present that the detainees were being interrogated and tortured, and that they were sometimes given psychotropic drugs. Some, he believed, had died in custody. What disturbed him most, he said, was that the detainees were not Taliban fighters or associates of Osama bin Laden. "By the time we got there," Jeff said, "the serious fighters were long gone."

Jeff had other stories to tell as well. He said the CIA team had put detainees in cargo containers aboard planes and interrogated them while circling in the air. He'd been on board some of these flights, he said, and was deeply disturbed by what he'd seen.

His case was compounded, his friends said, by strong feelings of "survivor's guilt" involving the crash of a KC-130 transport plane into a mountain in January 2002 — killing eight men in his unit. He'd been scheduled to be on the flight and had been reassigned at the last minute. As part of the ground crew that attended to the plane's maintenance, he blamed himself. Afterward, he went to the debris site to recover remains. He found his fellow soldiers' bodies unrecognizable. He also told me he was deeply shaken by the collateral damage he saw to civilians from U.S. air attacks — especially the shrapnel wounding of so many Afghan children.

Jeff told me that he often couldn't sleep at night, thinking about what he had seen and heard. He had gone to Afghanistan a social drinker but came home, like so many veterans, a problem drinker. And he admitted self-medicating with drugs. He was seeking help — and just days after we met, he drove 100 miles to enter a treatment program in Los Angeles. But the Veterans Affairs hospital's PTSD ward was full, he told me, so he was placed in a lockdown ward for schizophrenics, which only aggravated his isolation and despair.

In another tragic killing that possibly could have been prevented if appropriate intervention measures were in place, a 19-year-old vet has been accused of stabbing his 18-year-old wife 71 times with knives and a meat cleaver:

Spc. Brandon Bare, 19, of Wilkesboro, N.C., was charged with premeditated murder and indecent acts related to the mutilation of his wife's remains.

Bare had returned to Fort Lewis from Iraq in April to recuperate from cuts and internal ear injuries in a grenade attack on his Stryker brigade unit in Mosul. He was there as a machine-gunner with the 1st Brigade, 25th Infantry Division.

His wife, Nabila Bare, 18, was killed July 12.

"The murder was premeditated, deliberate and savage," prosecutor Capt. Scott DiRocco said in January during Bare's Article 32 hearing, similar to a preliminary hearing in civilian court. "He did not stop after he killed her."

Bare's lawyer said there was nothing to show the killing was planned.

"What this looks like ... is an act of rage, or some sort of other unexplainable act," defense attorney Capt. Patrick O'Brien said.

Witnesses testified that Bare had enrolled in treatment programs for anger management and combat stress after his return from Iraq. He had said he was having trouble controlling his anger and didn't like his wife going out and partying, said Michael Collins, a nurse and case manager at Madigan Army Medical Center.

A day before his wife was found dead in the couple's kitchen, Bare told his rear detachment commander Capt. Mickey Traugutt that he was taking a new prescription that made it hard to get up and that he had missed a treatment.

A 2005 study by the Department of Veterans Affairs found that out of nearly 170,000 Iraq veterans about 34,000 were diagnosed with psychological disorders. You would think the current 'support our troops' president would spend some of his precious time publicizing this issue and ensuring resources are in place to deal with these escalating problems. Instead, he's attending a $500-per-plate luncheon for Indiana Rep. Chris Chocola today. He'll be posing for photos with those who pay $4,000 per person or $6,000 per couple. Thanks again for the tax cut, Mr. Bush. Don't forget to pretend to 'support the troops' once in a while.

Update: The American Psychiatric Association says Bush's proposed budget fails to meet the needs of veterans with mental illnesses:

While the Administration’s budget does allow for increases in spending over FY06, the APA is concerned that the budget assumptions, such as the reliance of legislative proposals to collect user fees and copays from priority level 7 and 8 veterans, might be overly ambitious. The Friends of the VA advocacy group estimates that up 200,000 vets will drop out of the VA system with the proposed copays. While level 7 and 8 veterans are not service-connected for disability, we are concerned that the VA has not considered the impact on those 200,000 who rely on the VA to pay for psychiatric medications such as anti-depressants that keep them well and employable.

Veterans with substance use disorders are drastically underserved. The dramatic decline in VA substance use treatment beds has reduced physicians’ ability to provide veterans a full continuum of care, often needed for those with chronic, severe problems. Funding for programs targeted to homeless veterans who have mental illnesses or co-occurring substance use problems does not now meet of the demand for care in that population. Additionally, despite the needs of an aging veteran population, relatively few VA facilities have specialized geropsychiatric programs.

The APA is concerned that VA mental health service delivery has not kept pace with advances in the field. State-of-the-art care requires an array of services that include intensive case management, access to substance abuse treatment, peer support and psychosocial rehabilitation, pharmacologic treatment, housing, employment services, independent living and social skills training, and psychological support to help veterans recover from a mental illness. The VA’s Committee on Care of Veterans with Serious Mental Illness has recognized that this continuum should be available throughout the VA. However, at most, it can be said that some VA facilities have the capability to provide some limited number of these services to a fraction of those who need them.