They're Throwing Them Away
Sunday, October 21, 2007
POST-DISPATCH WASHINGTON BUREAU by Philip Dine
WASHINGTON — After two combat tours in Iraq on a "quick reaction team" that picked up body parts after suicide bombings, Donald Schmidt began suffering from nightmares and paranoia. Then he had a nervous breakdown.
The military discharged Schmidt last Oct. 31 for problems they said resulted not from post-traumatic stress disorder but rather from a personality disorder that pre-dated his military service.
Schmidt's mother, Patrice Semtner-Myers, says her son was told that if he agreed to leave the Army he'd get full benefits. Earlier this month, however, they got a bill in the mail from a collection agency working for the government, demanding that he repay his re-enlistment bonus, plus interest — $14,597.72.
Schmidt, 23, who lives near Peoria, Ill., is one of more than 22,000 service members the military has discharged in recent years for "pre-existing personality disorders" it says were missed when they signed up.
"They used these guys up, and now they're done with them and they're throwing them away," Semtner-Myers said.
Her frustration extends to Capitol Hill, where the stage is being set for a confrontation between Congress and the Pentagon.
Rep. Bob Filner, D-Calif., chairman of the House Veterans Affairs Committee, calls the treatment of these troops "disgraceful."
"If they have personality disorders, how did they get in the military in the first place?" Filner asks. "You either have taken a kid below the standards, in which case you've got obligations after you send him to war, or you're putting these kids' futures in danger with false diagnoses. Either way it's criminal."
The Pentagon defends its policy.
"No military in the history of the world has done more to identify, evaluate, prevent and treat the mental health needs and concerns of its personnel,"
Defense Department spokeswoman Cynthia O. Smith said. All cases of personality disorder discharges are diagnosed by a psychiatrist or clinical psychologist, and troops receive some benefits including health care, life insurance and education, she said.
Filner isn't buying it.
"These young people are being lied to and manipulated," he said. "We deny them proper classification so they can't get benefits, then they get this bill for a prorated signing bonus."
In the Senate, Missouri Republican Christopher "Kit" Bond, along with Sen.
Barack Obama, D-Ill., is leading an effort to force the Pentagon to change its practice. Bond says it appears worse than the scandal earlier this year over poor conditions at Walter Reed hospital.
"This is a very sad story," Bond says. "We are fortunate enough to bring many severely wounded soldiers and Marines home, but we're not dealing with their mental health problems. They need help, not a discharge because some phony pre-existing condition is brought up."
'I JUST CRACKED'
William Wooldridge, 37, of Blytheville, Ark., re-enlisted shortly after the Sept. 11 terrorist attacks. He says he made the grade by losing 44 pounds in eight weeks by a combination of running and dieting.
But intense fighting combined with family problems — his wife left him while he was in Iraq — sent him into a mental tailspin.
"We're doing 20-24 hour days, sleeping underneath our trucks, people trying to kill us and blow us up," Wooldridge said. "Then I got a letter saying I didn't have a reason to come home — and I just cracked."
Back in the United States, he continued to have blackouts, hear voices and have nighttime hallucinations of terrorism and children dying. The Army discharged him, citing a pre-existing personality disorder, even though several doctors diagnosed him as having post-traumatic stress.
"They told me the best way to handle it was to go along with a personality disorder discharge, that the (Veterans Administration) would take care of me.
So I signed it and went to the VA, and the VA said, 'You were discharged with a personality disorder; you don't get any benefits.'
"I was no longer of any use to them."
Wooldridge says the military recently decided it had overpaid him for a period of time and is deducting $137.85 a month from his Social Security payments. He says he's unable mentally to hold a job.
"This is not the way I want to be," he says, "but it's the way I am."
Wooldridge appealed to the discharge review board in St. Louis, arguing that soldiers with conditions brought on or aggravated by service are supposed to be eligible for service-related assistance. He eventually got $2,635 in monthly benefits restored — but not his self-pride.
"If there's really that many people who were dysfunctional going into the military, this country is one dysfunctional mess," he said.
CLINICALLY VALID?
Col. Bob Ireland, an Air Force psychiatrist and flight surgeon, is the Pentagon's program director for mental health policy.
He says as many as 100,000 service members have been diagnosed with personality disorders in the past six years. Discharges take place only where the disorders "are genuinely interfering with the ability of the unit to function," he said.
Troops suffering from post-traumatic stress disorder get the same extensive coverage as retired military personnel who spent their career in uniform, Ireland said, including lifetime benefits and VA treatment in a military hospital if needed. Along with that come various privileges, such as use of military recreational facilities.
Those discharged with pre-existing disorders get a reduced set of benefits equivalent to those provided to uninjured troops who did their tour and got an honorable discharge, including six months of treatment for some ailments, then two years of priority VA benefits; and GI education loans.
Soldiers who think they were misdiagnosed can appeal to a review board, he says.
"We track their deployment experience, including exposure to trauma. We track, 'Did you see dead bodies? Was it so horrible you couldn't shake it?'"
Asked whether the softening of basic training in recent years might be failing to weed out some troops while not preparing others for combat conditions, Ireland says that's possible — and that the matter is being studied.
Although the Pentagon's policies are sound, he said, they may not always be carried out perfectly. "You need to make sure people have time to do an assessment, to do an adequate mental status exam. We have to make sure this process is clinically valid."
Dr. Karen Pentella, assistant clinical professor of neurology at Washington University's medical school, doubts that thousands of young men and women entered the military with personality disorders and now have problems unrelated to their military experiences.
"At this point it's not possible for us to know whether these people really have these disorders, because having been in combat, a lot of these people suffer from PTSD and many from TBI (traumatic brain injury). From explosions, their brains literally have been shaken up ... which helps explain why their personalities may be changing.
"It's too late when they get back from Iraq to say, 'Whoops, we missed it.
Thanks for fighting, but you have a pre-existing condition.'"
'HEARING BOMBS'
Patty Harvey's son, Nick Harvey, 26, of Costa Mesa, Calif., was discharged from the Army after fighting in Iraq and has spent time in a variety of hospitals and now at home, often in what his mother describes as "almost a catatonic state."
Military doctors said he had a pre-existing personality disorder, meaning reduced benefits, but his mother disagrees.
"It's obvious what happened — he gets into a war zone, the bombs are flipping him out, and all of a sudden he's an entirely different person. Before, he partied with his friends, was a surfer, played guitar like you couldn't believe. Now he has fears about everything, he has fears about the food he eats, he has fears about people poisoning him.
"He stays home every day. ... If this kid doesn't have PTSD, I don't know who does. But they won't give him the diagnosis unless I continue to fight, and I'm running out of fight."
Rep. Phil Hare, D-Ill., of the veterans panel, says the Pentagon has yet to come to grips with the problem.
"They're in denial," Hare says. "There was a huge mistake here. We need to stop it, and then see how it happened, ... I can't think of a crueler thing to do to people who defend the nation."
Hare says by his calculations, the Pentagon stood to "save $12.5 billion by doing what they're doing."
Bond and Obama secured an amendment to the Senate defense bill that restricts use of personality-disorder discharges. The House bill lacks that provision, and the Senate-House conference committee will soon try to reconcile the two bills.
Rep. Todd Akin, R-Mo., of the House Armed Services Committee, is on the conference panel. "My sense is if there's going to be any errors, it's on the side of making sure we're taking care of our troops properly," he says.