3 Apr 2014

Is the US military failing its soldiers?

The latest shooting incident at Fort Hood in Texas mirrors an attack in 2009 which was the deadliest inside a US military base in history. So are returning soldiers being given effective treatment?

For those sent to fight in foreign lands, home should be a peaceful haven. Not so in Fort Hood.

America’s largest army base suffered another tragedy on Wednesday when Ivan Lopez, a 34-year-old veteran who had served in Iraq, opened fire on fellow soldiers, killing three before shooting himself.

Fort Hood was the scene of similar carnage less than five years ago – when army psychiatrist Nidal Hasan shot dead 13 soldiers and civilians, and wounded 30 others, before he was captured after being shot.

Hasan’s rampage was the worst instance of soldier-on-soldier violence in modern US history. He was sentenced to death last year.

Once again, just like in 2009, President Obama has called for patience, saying there are questions still to be answered. Yet, assuming the prospect of gun reform is now beyond Obama’s control, attention will shift on the care offered for soldiers returning from conflict.

As of yet we know little about Lopez, other than that he spent four months in Iraq and was suffering from depression and anxiety for which he had just started receiving treatment.

He joins America’s growing roll-call of returning soldiers with mental health problems involved in fatal shootings.

The threat at home

More than a thousand US soldiers have taken their own lives since 2003. And more than one in ten of all these suicides have been by soldiers based at Fort Hood.

Major General William Grimsley, the base’s senior commander, warned back in 2011 that officials were “deeply concerned about this trend” and looking for “innovative ways” to support soldiers and their families.

As well as restrictions on personal weapons, the base now offers “suicide awareness training” for soldiers, so that “warning signs” can be spotted both in themselves and others.

More widely, as the Iraq and Afghanistan missions wind down, there is greater awareness and acceptability of the lingering effects of combat, helped in part by TV dramas such as Homeland, and a growing number of organisations helping the mentally wounded veterans of war.

A ticking time bomb?

But is it enough? Dr Deidre MacManus from Kings College London said the US has historically had greater awareness of Post Traumatic Stress Disorder (PTSD), with its own designated department for veteran health formed in the aftermath of the Vietnam War.

“There is widespread awareness of the psychological risk in trauma-exposed individuals. Often detection of their situation is far easier than getting treatment,” she told Channel 4 News.

“Young servicemen exposed to trauma are particularly prone to difficulties but these are also those newly trained to operate in a tough environment where the idea of mental health does not sit comfortably.”

But there are fears that the worse is still to come.

Soldiers diagnosed with PTSD face “unconscionable” waits for treatment, according to testimony given to the US Senate and reports published by the Department of Veterans Affairs (VA) in recent years.

The VA reports that between 11 and 20 per cent of veterans of the Iraq and Afghanistan wars have PTSD, which considering more than two million have been deployed to serve in both conflicts, poses concerns for the future. Some say the illness takes on average 11 years to manifest itself.

After more than a decade fighting wars in Afghanistan and Iraq, America appears to have lost its appetite for foreign intervention. But it could soon find its most serious soldier-related crisis not on battlefields abroad, but directly on its doorstep.