Case of Afghan shooter puts military mental health care under microscope

The recent killing of 17 Afghan civilians at the hands of a U.S. soldier has reignited concerns on whether the Pentagon is doing enough to care for its newest generation of combat veterans.

On Friday, the Army officially charged Staff. Sgt. Robert Bales with multiple counts of murder, attempted murder and aggravated assault.

The 38-year old veteran of three combat tours in Iraq is accused of shooting Afghan civilians in a nearby village were his unit was stationed.

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He is currently awaiting court martial at the military's maximum-security facility at Fort Leavenworth, Kansas.

Bales' attorney, John Henry Brown, claims the soldier, who was on his first tour in Afghanistan during the time of the incident, suffered from post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI).

However, a pair of Army behavioral health and rehabilitation specialists told reporters Thursday that "the science has not been able to identify" any clear links between PTSD, TBI and violent incidents like the shootings Bales is accused of.

The March 11 incident sent shockwaves across the country and Capitol Hill, prompting many lawmakers to question whether U.S. forces had started to reach the breaking point after a decade of war in Southwest Asia.

At a Wednesday Senate hearing on the Army budget, Sen. Patty Murray (D-Wash.) pressed Army officials on how pervasive the cases of PTSD were among U.S. troops returning home from war.

“In light of all the tragedy we’ve seen stemming from untreated invisible wounds of war today, I’m sure you’d agree this is very concerning,” Murray said. “I want to know if it’s system-wide.”

Bales was posted at Joint Base Lewis-McChord in Murray's home state of Washington before his deployment to Afghanistan.

The base has become notorious as the site of a number of violent, high-profile incidents involving soldiers returning home from Iraq and Afghanistan.

During the hearing, Army Secretary John McHugh assured Murray and other panel members the Army was not suffering from a "systemic" problem of PTSD within its war-weary ranks.

“We don't see any evidence of this being systemic,” McHugh said. “We want to make sure that . . . it was an isolated case, and if it were not, to make sure we address it . . .  holistically." 

Panel member Sen. Lindsey Graham (R-S.C.) went the other way during the hearing, looking to paint Bales' case as the actions of a rogue solider who had snapped under the pressures of combat.

"This is a severe aberration and does not reflect who our men and women are in terms of their behavior under stress, do you agree with that?” Graham asked McHugh and Army Chief of Staff Gen. Ray Odierno, who also testified at the hearing.

While both men agreed with Graham's assessment, McHugh did acknowledge the Army is planning a comprehensive review of its mental health services, specifically focusing on PTSD.

However, the Pentagon does not plan to conduct a similar, department-wide study, but is "fully aware" of McHugh's planned review, DoD spokesman George Little told reporters on Wednesday.

Addressing issues concerning PTSD and other mental afflictions caused by combat "is a priority for us to look at" inside DoD, Little said, adding the department fully supports the Army's effort.


Rep. Randy Forbes (R-Va.) agreed with the department's decision, saying military officials must avoid any "knee-jerk reactions" concerning military mental health despite recent events.

If the Army study does show a wider review is warranted then that is when action should be taken, he told The Hill on Thursday. Short of that, Congress and the American public should give the service time to do a thorough review, according to Forbes.

The service is already taking steps to improve mental health care on the battlefield, the Army behavioral health specialist told reporters at the Pentagon on Thursday.

Army leaders are beginning to attach "embedded behavioral health" teams alongside Army brigade combat teams when they deploy. The healthcare teams are on the front lines with U.S. soldiers and maintain close ties to the ground commanders, the specialist said.

By being embedded, mental health professionals can develop a "habitual relationship" with unit members, in the hopes they will be more willing to seek help from the teams, the specialist said.

In addition, soldiers are screened for possible cases of PTSD five times during any given combat rotation, according to the Army specialist.

Soldiers get three screenings before, during and after a deployment. They are screened again between 90 to 100 days after they return home. A final screening is conducted a year after a soldier’s combat rotation.

American troops are also regularly screened for cases of TBI, an Army rehabilitation specialist said during the same Pentagon briefing.

To date, the Army has screened over 12,000 service personnel for TBI in Iraq and Afghanistan, with "a small percentage" of the troops being actually diagnosed with brain injury. The Army has also built 11 TBI care centers in various parts of Afghanistan, with plans to build another center in the near future.

The specialists refused to comment on the Bales case specifically, but noted he had likely undergone that series of mental health reviews as part of his multiple trips to the war zone.

That said, questions still remain on how Bales could have passed through that intensive screening process without Army officials picking up any signs of trouble.

Critics of the screening system claim soldiers sometimes provide false answers during the screenings, to avoid being separated from their unit and pulled off the front line.

When pressed on the issue, the Army behavioral specialist noted the PTSD screening sessions were "closer to five minutes than half-an-hour."

However, the face-to-face interviews included in the screenings gives health professionals a good read on a soldier's mental state, regardless of how long the interviews last.