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Fort Hood Program Seeks Better Care for Vets

September 10, 2010 at 5:38 PM EST
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A new program at Fort Hood is designed to provide better treatment for wounded soldiers who have returned home from Afghanistan and Iraq. Ray Suarez reports.
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JUDY WOODRUFF: Next: taking care of wounded soldiers from the Iraq and Afghan wars. As part of the NewsHour’s continuing coverage of military medical stories, Ray Suarez has a Health Unit report on one of the Army’s premier programs. Our Health Unit is a partnership with the Robert Wood Johnson Foundation. This story was also a collaboration with Independent Television News.

RAY SUAREZ: Soldiers at Fort Hood, Texas, are up before the sun is…

MAN: Exercise. One, two…

RAY SUAREZ: … getting their day started by working out. This is the largest Army base in the United States. Some units are just back from duty in Iraq and Afghanistan. Some are getting ready to return there. This company has a different mission: nursing bodies and minds back to health. These troops are in what’s called a wounded warrior transition brigade.

COL. PAUL HOSSENLOPP, commander, Wounded Warrior Transition Brigade, Fort Hood: Our mission is to heal the soldier to the maximum extent that healing can be done.

RAY SUAREZ: Colonel Paul Hossenlopp is the brigade’s commander.

COL. PAUL HOSSENLOPP: We do everything to get them back in the force and keep them on track with their career.

RAY SUAREZ: The Army has roughly 10,000 soldiers in 29 warrior transition units across the country, plus one in Germany. They were set up in the wake of the scandal at the Walter Reed Army Medical Center in 2007.

Patients there were found to be living in shoddy housing and receiving substandard care. Since then, the Army has done a thorough redesign of its health care system. Soldiers in the Fort Hood unit, for example, are assigned a team of nurse case managers, primary care providers, and commanding officers dedicated to providing coordinated care to those who need at least six months of medical help.

Not every soldier in this unit was wounded in battle. They all have access to specialists and occupational therapy, like this soldier wearing a helmet and heavy body armor while working out to rebuild his strength. Sergeant 1st Class Karl Pasco has two Purple Hearts, awarded for combat wounds received during two tours of duty in Iraq. He spent time recuperating at Walter Reed, and says the new transition brigades are a major improvement.

SGT. 1ST CLASS KARL PASCO, U.S. Army: The first time I was wounded, I didn’t have a nurse case manager. So, in some ways, it was stressful, because I not only had to manage my treatment, my appointments and all that.

RAY SUAREZ: And it’s better now?

SGT. 1ST CLASS KARL PASCO: Oh, it’s a lot better now.

RAY SUAREZ: Soldiers are assigned to these warrior transition units to provide a time to heal and a transition, either back to regular duties or back to civilian life. And while attention is paid to the wounds of war, the less visible wounds, the emotional healing that needs to be done, is, according to some, given less attention and less effective care.

Master Sergeant Orlando Garcia was also wounded in Iraq.

MASTER SGT. ORLANDO GARCIA, U.S. Army: All six were hit. Four of them were killed instantly.

RAY SUAREZ: The tattoo on his arm reminds him of the young men he lost in Iraq two-and-a-half years ago. The trauma of the war is still with him.

MASTER SGT. ORLANDO GARCIA: And these are the initials of the eight guys in my company.

RAY SUAREZ: He entered the warrior transition brigade two years ago after realizing that, along with his injured spine, he was having a hard time coping.

MASTER SGT. ORLANDO GARCIA: So, when we got back, and I was having a lot of these issues with the memory, especially, and just being depressed a lot, and then when I forgot my daughter, to pick her up, and I forgot I had even dropped her off, that was kind of the straw for me. You know, I said, God, I need help.

RAY SUAREZ: One-third of the soldiers in Fort Hood’s transition brigade have been diagnosed with post-traumatic stress disorder, or PTSD, or other mental health issues, like this woman having a panic attack on base. Master Sergeant Garcia says his treatment has really helped him manage his PTSD.

MASTER SGT. ORLANDO GARCIA: I took everything that they had, the different programs. I — from breathing techniques. I tried breathing techniques. I would do massage therapy, acupuncture.

RAY SUAREZ: But while high-ranking career, non-commissioned officers like Sergeants Pasco and Garcia are satisfied with their care, others told the NewsHour, they don’t get the help they need.

SOLDIER, Fort Hood Wounded Warrior Transition Brigade: And I have seen three doctors, and, as far as I know, I’m still unsure of what’s going on.

RAY SUAREZ: This soldier asked that we hide his identity, because he feared his superior officers would retaliate against him for speaking out.

SOLDIER, Fort Hood Wounded Warrior Transition Brigade: The diagnoses I have got from three different doctors are so vast, from, oh, you have got arthritis in your shoulder, you can go home, to, oh, you know, you have got a muscle that’s bad in your shoulder; we need to remove it.

RAY SUAREZ: This soldier has a physical injury, as well as post-traumatic stress disorder.

Has the treatment you have gotten for PTSD helped? I mean, are you feeling better? Are you sleeping better? Are you less reactive, less worried, any of those things?

SOLDIER, Fort Hood Wounded Warrior Transition Brigade: No, I — I worry all the time. I mean, I don’t sleep. I mean, sleep’s a luxury around here.

So, I was in a funeral procession yesterday, you know, just a harmless funeral procession. And literally driving down the road in that thing just freaked me out. I was sitting there, it was like I was back in the convoy, security. And I’m looking all over, you know, scanning my zones. I mean, I’m just freaking out. I felt trapped.

RAY SUAREZ: He’s decorated soldier has been at the Fort Hood Transition Brigade for three months, and says he’s received little counseling for his post-traumatic stress disorder. Instead, he got mostly prescription drugs.

SOLDIER, in Fort Hood Wounded Warrior Transition Brigade: The first psychiatrist I went to, I thought was there to help me. She was just there to medicate me. You know, I’m sitting there telling — trying to open up a little bit to her and trying to talk, because I thought this was going to be the doctor they sent me to, to talk to, my psychiatrist. Come find out she’s just the psychiatrist that gives me the meds.

RAY SUAREZ: We heard this complaint, about too much medication and not enough access to talk therapy, from other soldiers in the transition brigade and from a psychiatrist in private practice who visited Fort Hood last year.

DR. STEPHEN STAHL, Psychiatrist: Too many opiates, too many psychotropic drugs, and just overmedication, not enough access to skilled psychiatrists, not enough psychotherapy.

RAY SUAREZ: Dr. Stephen Stahl is an expert in the use of medications for treating mental illness.

DR. STEPHEN STAHL: I think that there is a crisis in the delivery of mental health care in the Army. I think the overall care that the soldiers were getting for psychological wounds was substandard.

RAY SUAREZ: A year-and-a-half ago, Dr. Stahl taught health care providers at Fort Hood the latest in best practices.

Just months later, Army psychiatrist Major Nidal Hasan allegedly went on a shooting rampage, killing 13 and wounding dozens more. In the aftermath of the killings, it was reported that Major Hasan was kept on staff, in spite of concerns about his abilities, because there are so few psychiatrists in the Army.

Dr. Stahl says that, while they are understaffed, they are doing heroic work. He says the 34 psychiatrists, psychologists and other counselors at the base are overwhelmed by the demand for their services.

Besides treating the soldiers in the transition brigade, they also have to provide services to 50,000 to 60,000 other soldiers and their families.

One of Fort Hood’s top psychiatric nurse practitioners, Colonel Tom Yarber, acknowledged that getting timely mental health care appointments was a problem, and that soldiers have complained about this.

COL. TOM YARBER, psychiatric nurse practitioner, Fort Hood: Our average wait to see a medication provider now is about is about — is about five to six weeks here on post. That is a common concern of soldiers, that they have to wait a long period of time.

RAY SUAREZ: Dr. Stahl thinks the shortage at Fort Hood could be alleviated if the Army trained the 59 nurses and social workers in the wounded warrior unit to prescribe medication and provide counseling, making better use of the staff already there.

In the civilian world, Stahl said, most nurses are trained to do just that.

DR. STEPHEN STAHL: And that kind of struck me as starving in the midst of plenty, when the nurse case managers that we saw didn’t have prescribing privileges, and they were not as effective as a — if you will, a medical force multiplier, as one would have expected, given the great amount of need for mental health care delivery.

RAY SUAREZ: Dr. Stahl also says that, while at Fort Hood, he polled the squad leaders, and found that, while some of them recognized the physical limits of soldiers, that’s not always the case with post-traumatic stress disorder and other mental health issues.

DR. STEPHEN STAHL: I think there’s an entirely different way of looking at physical injuries than there is at psychological injuries.

RAY SUAREZ: A study of warrior transition units asked the cadres about whether they thought PTSD was a real illness and needed psychiatric care. Nearly half of the cadres reported that they didn’t think so, that either they didn’t think so, or they thought men under them, you know, faking it or — or malingering or whatever.

COL. PAUL HOSSENLOPP: I almost don’t even believe. The cadre that I select are generally — nine times out of 10, they have combat experience themselves. And they surely understand PTSD, and they surely believe, as I, it is a real illness. So, what you just told me, I — I almost don’t even believe.

RAY SUAREZ: And Colonel Hossenlopp says the current setup of the warrior transition brigade is adequate.

COL. PAUL HOSSENLOPP: I recognize that there are some appointments that take four to five weeks to get. I recognize that. But, from my experience, it seems to be adequate to care for the psychiatric needs of our soldiers.

RAY SUAREZ: But the soldier we spoke to, who is now leaving the wounded warrior brigade, says he simply wants the Army to fix what it broke.

SOLDIER, Fort Hood Wounded Warrior Transition Brigade: I’m not asking for anything, other than to get fixed. That’s all I want. I understand I might not ever be 100 percent, but get me as close to it as you can. I feel I’m not productive. I’m not doing anything. I’m wasting away.

RAY SUAREZ: This soldier is among tens of thousands of injured in Iraq and Afghanistan who will require years of treatment, one of the legacies of the two wars which produced fewer fatalities, but far more wounded.

JUDY WOODRUFF: Ray’s next report looks at another program to help returning veterans and their families cope with the wounds of war.