Thursday, January 15, 2009

Suicide Spotlights Troops' Mental Care

Suicide Spotlights Troops' Mental Care

January 15, 2009
Associated Press

WASHINGTON - In 2005, an Army captain in Iraq asked for a mental health evaluation for one of his Soldiers, a private first class from North Carolina who was known to put the muzzle of his weapon in his mouth.

The case was assigned to a psychologist who was unlicensed - a common practice in the early years of the war, when the Army rushed mental health counselors to the combat zone even if some weren't certified or fully qualified.

The psychologist reported that a screening indicated the 20-year-old private, Jason Scheuerman, was "capable of claiming mental illness" to manipulate his superiors and did not have a mental disorder. Three weeks later, Scheuerman stepped into a barracks closet and shot himself to death. He had nailed a note to the closet that said, "Maybe finaly I can get some peace."

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His death, the subject of an internal Army investigation exposed to The Associated Press by his family, casts light on the armed forces' reliance on unlicensed counselors before the Army policy was changed to exclude them in 2006.

At the time of Scheuerman's suicide, unlicensed psychologists and other counselors were allowed to examine Soldiers provided they were supervised by licensed professionals. The same rules are common in civilian evaluations.

It is not clear whether the psychologist in Scheuerman's case, Army Capt. Chris Hansen, was supervised according to those rules before he sent the Soldier back to duty.

Hansen, whose report also said Scheuerman should be taken seriously if he acted depressed again, received his doctoral degree in 2007 and his license in 2008, in Alabama. He is currently stationed at Fort Benning, Ga.

Defense Department rules require a "doctoral level" health care provider to evaluate a Soldier who is believed to be at risk for suicide.

At least 200 Soldiers have taken their lives while serving in the wars in Iraq and Afghanistan. In 2007 alone, the Army reported 115 suicides everywhere in the service, the highest yearly figure since it started keeping track in 1980.

Scheuerman's suicide note was among hundreds of pages of documents his family shared with the AP after wrangling with a military bureaucracy that family members say did not want to get to the bottom of the death.

A complaint in August to the U.S. Army Medical Department by Scheuerman's father, Chris, a former Army master sergeant, triggered an internal investigation into whether a senior medical officer was aware of the unlicensed psychologist's certifications and failed to take corrective action.

"There is a direct correlation between his actions and the events that led up to my son's death," Chris Scheuerman said, speaking of the unlicensed psychologist.

Historically, the Army deployed unlicensed psychologists under supervision until they were licensed, Col. Bruce E. Crow, the psychology consultant to the Army surgeon general, said in a statement to the AP. But by early 2005, "potential problems obtaining supervision in a combat zone" were identified, Crow said.

An Army spokesman, Lt. Col. George Wright, said 10 to 12 unlicensed psychologists were deployed to Iraq between March 2003 and May 2006, when the practice was stopped. Prior to May 2006, Wright said, unlicensed psychologists could be assigned to their first duty stations while they were completing the requirements for either their doctoral dissertations or their licenses. He did not say what mechanisms were in place to ensure the unlicensed psychologists were supervised.

Chris Scheuerman said he had been told by Col. Elspeth Ritchie, who served as the psychiatry consultant to the Army surgeon general, that more than 100 unlicensed mental health professionals had been deployed to Iraq.

Scheuerman also contends Ritchie told him Hansen was not qualified at the time to evaluate the young Soldier. Ritchie was the target of Scheuerman's complaint to the Army. The spokesman said Ritchie was not available for an interview.

The American Psychological Association reported in 2007 that there was a 40 percent vacancy rate in active duty psychologists in the Army.

Patrick Campbell, an Iraq veteran and chief legislative counsel for Iraq and Afghanistan Veterans for America, said unlicensed professionals are not the answer to the shortage.

"To send people who are half-trained into the field is dangerous not only for the service member, but for those professionals as well," Campbell said.

Barbara Romberg, a clinical psychologist in Washington, D.C., who donates mental health sessions to recent veterans, commended the military's efforts to improve mental health care but said combat is far from an ideal environment for a psychologist in training.

"We certainly would hope that all the mental health professionals deployed are licensed, seasoned mental health professionals, and in this situation it sounds like the folks who weren't certainly would've needed a whole lot of supervision, more than the average mental health professional," she said.

Scheuerman's behavior raised enough alarms that, according to one Soldier who spoke to investigators, when a call came over the unit's radios that there had been a death, he immediately suspected it was Scheuerman.

A separate investigation into Scheuerman's death last year by the Army inspector general determined the Soldier's leaders relied too much on physical training as punishment. It said "military-related issues" played a role in Scheuerman's suicide.

It also said personal issues, such as a recent breakup with a girlfriend, may have contributed as well. Much of the report is blacked out.

Scheuerman's family says Hansen's license should be revoked and there should be discipline for others who they feel either mistreated their son or didn't take actions that would have prevented his death. Wright, the Army spokesman, said no decision has been made on disciplinary action related to the young man's death.

Chris Scheuerman and his wife, Anne, were in San Antonio this week for a suicide prevention conference sponsored by the Defense Department and the Department of Veterans Affairs.

Anne Scheuerman said the military has brushed the case under the rug and avoided "just coming straightforward and admitting what's going on so it could be fixed."

This case kind of reminds me of the grandmother who kept telling everyone she was sick, she had these words put on her tombstone "Do you believe me now?" Of course people are capapble of "conning superiors into thinking they have mental issues" but the fact the young man was putting the muzzle of his weapon in his mouth, showed deep rooted problems.

But given the fact that the military is sending mentally troubled troops back to Iraq with back packs full of meds from Valium to Buspar and Aripipazole and other meds for mental health issues, then there will continue to be problems in war zones.

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