Could Timely PTSD Treatment Have Prevented a Tragedy?

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A little over a week ago, we brought you the story of Iraq war vet Joshua Stepp, whose lawyers tried to use a post-traumatic stress disorder [PTSD] defense to explain why he killed his 10-month-old stepdaughter. In the end, a jury deadlocked, and the judge sentenced him to life without the possibility of parole.

A number of questions hovered over the case: Are the “invisible wounds of war” (PTSD and traumatic brain injury, or TBI) legitimate legal defenses? And how should judges and juries take these injuries into consideration?

In cases like Stepp’s where the death penalty is a possible punishment, judges are required to take into consideration a landmark 2009 U.S. Supreme Court decision that threw out the death penalty for a Korean War vet. Justices argued that “combat stress must be considered by a jury before it hands down the harshest punishment.”

But what about non-death penalty trials?

This case caught our attention this weekend: the DUI manslaughter trial of Marine Capt. Scott Sciple, pictured in the above mug shot. Sciple served in both Afghanistan and Iraq, earning three Purple Hearts and a Bronze Star, and was cleared for an eventual fifth tour of duty by the Marines. But in April 2010, after having been deployed to Central Command in Tampa, Fla. — and with a blood alcohol level three times the legal limit — he crashed into Pedro Rivera’s car, killing Rivera.

Sciple suffered so many physical wounds in combat that he was nicknamed “the shrapnel magnet.” But according to his lawyer, he also suffers symptoms of PTSD and TBI, including dissociative episodes, dizzy spells, flashbacks, and headaches.

What’s particularly startling about the case is that both the Marines and Rivera’s widow in part blame the military for not diagnosing and treating Sciple. Marine Corps investigators wrote an 860-page report stemming from the incident, recommending the corps “be more thorough in evaluating and treating post-traumatic stress disorder, especially in Marines with brain injuries.”

“They should have helped him before. Why did they wait until my husband died?” asked Carmen Rodriguez, Rivera’s widow, who was injured in the crash.

Sciple has pleaded not guilty, and his lawyers say they will present an insanity defense at his trial.

The Marine Corps report is an acknowledgment that PTSD and TBI need to be better addressed by the military. According to Sharon Weinberger, who has a fascinating piece in Nature this month on the increased risk of dementia faced by TBI sufferers, the top brass face a new challenge. Now that they recognize TBI’s legitimacy, they must keep pounding the pavement to innovate its diagnosis and treatment. And in the short term, they’re succeeding:

The Pentagon has come a long way from just three years ago, when TBI was mostly ignored. In January, it became mandatory for the military to track all concussive injuries, and troops now receive pre-deployment cognitive testing that can be used as a baseline in case they are later affected by concussion. Experiments with brain-wave measurements are also under way. And with the new reporting requirements, the military is creating what is likely to be the single largest repository of data on TBI.

But will efforts stop there?

The question is how to keep the momentum going. That may prove difficult, given the United States’ mounting budget woes. After the initial boost in 2007, funding levels for TBI research dropped dramatically. In fiscal year 2011, the congressional appropriation specifically for the Pentagon’s brain-injury research is expected to be just $45 million [down from $150 million].

For some background on how PTSD and TBI affected the trials of several soldiers in Fort Carson, Colo., watch our 2010 film The Wounded Platoon.

Bonus: Read my Q&A with Stars and Stripes reporter Megan McCloskey on whether web therapy is working for soldiers suffering from PTSD.

Photo: An undated Hillsborough County jail booking photo of Scott Sciple. (AP/Hillsborough County Jail)

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