Fratricide at Fort Hood brings veteran mental health back to forefront

We’ve known soldiers can have difficulty mentally readjusting to civilian life for almost as long as we’ve been fighting wars. But help often lags behind the need. (Photo by Sgt. Michael J. MacLeod, U.S. Army, for the Department of Defense; used under Creative Commons license)

On the plane ride back to the states the Marine next to me started slamming his head against his seat and half-crying in his sleep.

Teenage and clean-cut, he was clenching his fists and sweating enough to smell like a high school locker room.

We had all come off the various Iraqi deserts, hopping a CH-47 Chinook helicopter across the border to Kuwait and then onto a commercial airplane bound for Germany. From Germany it was off to Shannon, Ireland, where the Marine had boarded next to me with only a small rucksack and a jar of peanut butter he apparently brought for a snack, which he occasionally opened to eat with a plastic spoon.

It had been three days in transit for everyone headed home on leave. Just a few more hours over the Atlantic.

When he woke, we talked some. He had been in Ramadi several months, what in the American media during the pre-Surge era occasionally lumped into an area called the Sunni Death Triangle.

I had convoyed there twice with my Army unit. It was a dust bowl base about two hours west of Baghdad. The day before we arrived, insurgents had improvised a dump truck into a bomb and blown up a side gate, killing two troops.

Even back then, I remember looking at the 19-year-old guy next to me having nightmares wondering if someone that young could ever get over those kind of experiences.

Sometimes I think I see the answer, like this week when, clicking through the news, I see an Iraqi veteran at Fort Hood has killed three soldiers and wounded 16 others, before turning the gun on himself when military police confronted him.

The alleged shooter, 34-year-old U.S. Army Spec. Ivan Lopez, apparently sought mental health treatment for depression and anxiety, according to Lt. Gen. Mark Milley, Ft. Hood commanding general.

While it is far too soon to know whether the soldier's four-month-long deployment to Iraq in 2011 (which did not include any combat) played a role in his decision to kill fellow soldiers, the warning signs that he had a self-described traumatic brain injury and other mental issues highlight how veterans continue to need avenues to get help – even for noncombat related stress like separation from his family, which can trigger mental illness.

The incident joins a growing number of tragedies stemming from veterans, including an Army sergeant who killed his squad leader and another soldier in 2008 at an Iraqi patrol base, as well as the 2009 killing of five service members at Camp Liberty in Iraq by an Army sergeant.

The single worst soldier-on-soldier attack was also at Ft. Hood, where Army Maj. Nidal Malik Hasan killed 13 people and injured 32 others in 2009, which he was found guilty and sentenced to the death penalty in August 2013. The motive in the latter case has been deemed terrorism.

Both the White House and Capitol Hill claim help is on the way to address the mental health component of the post-war military, who are expected to withdraw from Afghanistan before the end of the year.

On paper, supporting veterans is one of the few nonpartisan spending agreements in Washington, D.C.

President Barack Obama's 2015 budget proposal allocates $7 billion for expanded mental health services for veterans. House Republicans' own budget version left the additional spending for the Veterans Affairs Administration intact.

“Veterans are, and will remain, the highest priority within this budget,” the Republican-led House budget plan states.

And the costs will likely continue to grow as veterans return, so there is no question the increases will be needed.

About one in five returning veterans are diagnosed with PTSD, according to the Veterans Administration. Each veteran with post traumatic stress disorder costs the Department of Defense an average of $8,300 more per year, the Congressional Budget Office estimated in 2012, and has meant more than $2 billion in spending already.

Meanwhile, the added funding will require Congress to pass a budget that could require difficult wrangling about spending cuts elsewhere, such as the Affordable Care Act and Social Security reform.

As it has throughout two shifting wars, the military has tried to make its own adjustments internally with formal training for its officers and noncommissioned officers about PTSD and brain injuries. Squad leaders are now expected to maintain regular contact with soldiers — even in National Guard and Reserve units.

But, dealing with mentally injured veterans requires more than professionalism. It is going to take a cultural overhaul in how the nation sees service members returning from war and provides real, timely solutions for those who need help, especially those career soldiers who should be able to address their injury with medical professionals when needed without a stigma.

What happens going forward seems to depend on an old equation about how fast some wars fade from statesmen's minds, while other people will mercilessly never forget.