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Tuesday, January 8, 2008

A shocking story about the Armed Forces and Mental Illness

I found this article while I was looking for something else, and I thought some of you might be interested in it. It made me very angry.

http://www.washingtonpost.com/wp-dyn/content/article/2007/12/01/AR2007120101782.html

'A Soldier's Officer'
by Dana Priest and Anne Hull
Washington Post Staff Writers
Sunday, December 2, 2007; A01

In a nondescript conference room at Walter Reed Army Medical Center, 1st Lt. Elizabeth Whiteside listened last week as an Army prosecutor outlined the criminal case against her in a preliminary hearing. The charges: attempting suicide and endangering the life of another soldier while serving in Iraq.
Her hands trembled as Maj. Stefan Wolfe, the prosecutor, argued that Whiteside, now a psychiatric outpatient at Walter Reed, should be court-martialed. After seven years of exemplary service, the 25-year-old Army reservist faces the possibility of life in prison if she is tried and convicted.
Military psychiatrists at Walter Reed who examined Whiteside after she recovered from her self-inflicted gunshot wound diagnosed her with a severe mental disorder, possibly triggered by the stresses of a war zone. But Whiteside's superiors considered her mental illness "an excuse" for criminal conduct, according to documents obtained by The Washington Post.
At the hearing, Wolfe, who had already warned Whiteside's lawyer of the risk of using a "psychobabble" defense, pressed a senior psychiatrist at Walter Reed to justify his diagnosis.
"I'm not here to play legal games," Col. George Brandt responded angrily, according to a recording of the hearing. "I am here out of the genuine concern for a human being that's breaking and that is broken. She has a severe and significant illness. Let's treat her as a human being, for Christ's sake!"
In recent months, prodded by outrage over poor conditions at Walter Reed, the Army has made a highly publicized effort to improve treatment of Iraq veterans and change a culture that stigmatizes mental illness. The Pentagon has allocated hundreds of millions of dollars to new research and to care for soldiers with post-traumatic stress disorder, and on Friday it announced that it had opened a new center for psychological health in Rosslyn.
But outside the Pentagon, the military still largely deals with mental health issues in an ad hoc way, often relying on the judgment of combat-hardened commanders whose understanding of mental illness is vague or misinformed. The stigma around psychological wounds can still be seen in the smallest of Army policies. While family members of soldiers recovering at Walter Reed from physical injuries are provided free lodging and a per diem to care for their loved ones, families of psychiatric outpatients usually have to pay their own way.
"It's a disgrace," said Tom Whiteside, a former Marine and retired federal law enforcement officer who lost his free housing after his daughter's physical wounds had healed enough that she could be moved to the psychiatric ward. A charity organization, the Yellow Ribbon Fund, provides him with an apartment near Walter Reed so he can be near his daughter.
Under military law, soldiers who attempt suicide can be prosecuted under the theory that it affects the order and discipline of a unit and brings discredit to the armed forces. In reality, criminal charges are extremely rare unless there is evidence that the attempt was an effort to avoid service or that it endangered others.
At one point, Elizabeth Whiteside almost accepted the Army's offer to resign in lieu of court-martial. But it meant she would have to explain for the rest of her life why she was not given an honorable discharge. Her attorney also believed that she would have been left without the medical care and benefits she needed.
No decision has yet been made on whether Whiteside's case will proceed to court-martial. The commander of the U.S. Army Military District of Washington, Maj. Gen. Richard J. Rowe Jr., who has jurisdiction over the case, "must determine whether there is sufficient evidence to support the charges against Lieutenant Whiteside and recommend how to dispose of the charges," said his spokesman.'A Soldier's Officer'
A valedictorian at James Madison High School in Vienna, a wrestler and varsity soccer player, Whiteside followed in her father's footsteps by joining the military. She enlisted in the Army Reserve in 2001 and later joined ROTC while studying economics at the University of Virginia. During her time in college, Whiteside said, she experienced periods of depression, but she graduated and was commissioned an officer in the Army Reserve.
In 2005, she received her first assignment as an officer -- at Walter Reed. As an executive officer of a support company, she supervised 150 soldiers and officers, and her evaluations from that time presaged the high marks she would receive most of her career.
"This superior officer is in the top 10 percent of Officers I have worked with in my 16 years of military service," wrote her rater, Capt. Joel Grant. She "must be promoted immediately, ahead of all peers."
Maj. Sandra Hersh, her senior rater, added: "She's a Soldier's Officer. . . . She is able to get the best from Soldiers and make it look easy."
Seeing so many casualties at Walter Reed made Whiteside feel she was not bearing her full responsibility, she said, so she volunteered for Iraq. When she left in the fall of 2006, she carried with her a gift from her father -- the double-bladed buck knife he had used in Vietnam.
Whiteside was assigned as a platoon leader in the 329th Medical Company (Ground Ambulance) at the Camp Cropper detainee prison near Baghdad International Airport. The hot light from the Abu Ghraib abuse scandal still charged the atmosphere at Cropper, which housed 4,000 detainees and included high-security prisoners such as Saddam Hussein and Ali Hassan Majeed, known as "Chemical Ali," as well as suspected terrorists and insurgents.
Whiteside, given the radio handle "Trauma Mama," supervised nine medics who worked the night shift at the prison. She was in charge of dispatching drivers, medics and support staff to transport sick and wounded Iraqis and U.S. troops around the prison and to a small hospital inside.
"I loved our mission," Whiteside said, "because it represented the best of America: taking care of the enemy, regardless of what they are doing to us."
The hours were brutal. Whiteside ate one meal a day, slept in two four-hour shifts and worked seven days a week. Her superiors credited her with her unit's success. "She has produced outstanding results in one of the most demanding and challenging Combat Zones," her commander, Lt. Col. Darlene McCurdy, wrote in her evaluation.
But the dynamics outside her unit were rockier. From the beginning, Whiteside and some of her female soldiers had conflicts with one of the company's male officers. They believed he hindered female promotions and undercut Whiteside's authority with her soldiers, according to Army investigative documents.
As the tensions with the officer increased, Whiteside said, she began suffering panic attacks. She stopped sleeping, she said, and started self-medicating with NyQuil and Benadryl, but decided against seeking help from the mental health clinic because she feared that the Army would send her home, as it had recently done with a colonel.
On Dec. 30, U.S. military officials took Hussein from his cell at Camp Cropper for execution. The next day, the prison erupted. Thousands of inmates rioted, and military police used rubber bullets, flash-bang grenades and tear gas to restore order.
Whiteside took charge in the chaos, according to written statements by troops in her unit. She dispatched a pair of medics to each compound to begin triage, handed out gas masks and organized her unit to smuggle the prison's doctors out in an ambulance.
The next day, weary from the riots, Whiteside ran into the problem officer. They had another argument.
Army investigative documents describe what happened next.
At 6:20 p.m. a soldier frantically approached Maj. Ana Luisa Ramirez, a mental health nurse at the prison, and said Whiteside was "freaking out" and wanted to see Ramirez. The nurse found Whiteside sitting on her bed, mumbling and visibly upset. Ramirez left to get some medication.
Later, she spotted Whiteside in the darkened hallway with her sweatshirt hood pulled over her head and her hands in her pockets. Ramirez asked Whiteside to come into her room and noticed what appeared to be dried blood on her neck and hands. When she tried to take a closer look, Ramirez said, Whiteside pointed her sidearm, an M9 pistol, at her and "told me to move away and she locked the door," according to a statement Ramirez gave to the Army.
Ramirez tried to take Whiteside's gun, but Whiteside pushed her away and expressed her hatred of the officer she thought was sabotaging her. She grew more agitated and twice fired into the ceiling.
Nurses in the hallway began yelling, and Whiteside shouted that she wanted to kill them, the report said. She opened the door and saw armed soldiers in battle gear coming her way. Slamming the door, she discharged the weapon once into her stomach.
Whiteside says she has little recollection of the events of that night. "I remember bits and pieces," she said. She declined to comment on whether she was trying to kill herself.
The medics who responded to the shooting scene were Whiteside's own crew.Recovering at Walter Reed
Whiteside was still unconscious when she arrived at Walter Reed a few days later. The bullet had ripped through one of her lungs, her liver, her spleen and several other organs. Her parents and siblings kept a round-the-clock bedside vigil, and her condition gradually improved. Within two weeks an Army criminal investigator showed up in her hospital room, but a doctor shooed him away.
After a month, Whiteside was moved to Ward 54, the hospital's lockdown psychiatric unit, where she was diagnosed with a severe major depressive disorder and a personality disorder. According to a statement by an Army psychiatrist, she was suffering from a disassociation with reality.
Tom Whiteside visited his daughter every afternoon, bringing pizza or Chinese takeout. He often noticed from the sign-in sheet that he was the only visitor on the ward. The psych patients formed a close bond and shared an overriding fear: that the Army would drum them out with no benefits.
One soldier Whiteside befriended was a 20-year-old private named Sammantha Owen-Ewing. Intelligent and funny, Owen-Ewing was training to be a nurse when she suffered mental problems and was admitted to Ward 54. She was still receiving psychiatric care at Walter Reed when the Army abruptly discharged her. According to her husband, she was dropped off at a nearby hotel with a plane ticket.
While on Ward 54, Whiteside received a package from her crew in Iraq. Inside was a silver charm, inscribed with the crew members' names and the message: "Know that you are always loved by us. Never be forgotten and dearly missed. Your Trauma Team." The crew also wore "Trauma Mama" bracelets in solidarity.
After being released from Ward 54, Whiteside joined the outpatient ranks just as the Army was scrambling to overhaul its system for treating wounded soldiers and President Bush ordered a commission to study military care for Iraq veterans.
At Walter Reed, the Army brought in combat-experienced officers to replace the recovering patients whom it had asked to manage the lives of the 700 outpatients on post. The new Warrior Transition Brigade and its more experienced leaders were supposed to manage more adeptly the tension between soldiering and patient recovery.
It was Whiteside's commanders in this unit, a captain and a colonel, who drew up criminal charges against her in April. The accusations included assault on a superior commissioned officer, aggravated assault, kidnapping, reckless endangerment, wrongful discharge of a firearm, communication of a threat and two attempts of intentional self-injury without intent to avoid service.
The Army ordered Whiteside to undergo a sanity board evaluation to determine her state of mind at the time of the shooting.
Tom Whiteside said the criminal charges threatened to unglue his daughter's already tenuous grip on recovery. "If they are doing this to her, what are they doing to those young PFCs without parents by their side?" he asked.
By early August, Elizabeth Whiteside sought an alternative to court-martial. She requested permission to resign, a measure the military often accepts.
Rowe, commander of the U.S. Army Military District of Washington, which has jurisdiction over her case, would decide whether to grant her request.
He reviewed recommendations from Whiteside's two commanders at Walter Reed and the facility's commander, Maj. Gen. Eric B. Schoomaker, a physician. Whiteside's immediate commander at the hospital, a captain, recommended that she be given an "other than honorable" discharge, according to a document obtained by The Post. The captain wrote that her "defense that she suffers from a mental disease excusing her actions is just that . . . an excuse; an excuse to distract from choices and decisions made by 1LT Whiteside."
Col. Terrence J. McKenrick, commander of the Warrior Transition Brigade, agreed: "Although the sanity board determined that at the time of the misconduct she had a severe mental disease or defect, she knowingly assaulted and threatened others and injured herself."
Schoomaker, now the Army's surgeon general, dissented. "This officer has a demonstrably severe depression which manifested itself . . . as a psychotic, self-destructive episode. . . . Resignation in lieu of court-martial eliminates all of the benefits of medical support this officer deserves after 7 years of credible and honorable service."
Rowe overruled Schoomaker. He agreed to accept Whiteside's resignation with a "general under honorable conditions" discharge that would still deprive her of most benefits, according to her pro bono civilian attorney, Matthew J. MacLean.
But then, from her battalion commander in Iraq, Whiteside learned that an investigation there had concluded that there was "insufficient evidence for any criminal action to be taken against" her. Furthermore, it had found a hostile command climate and recommended that the officer who had been her nemesis be removed from his position and "given a letter of reprimand for gender bias in assignments and use of intimidation, manipulation and hostility towards soldiers."
With this news, Whiteside asked that her letter of resignation be withdrawn. She would fight the charges.
In an e-mail exchange, the prosecutor, Wolfe, told MacLean that even if Whiteside won in court she would probably end up stigmatized and in a mental institution, just like John Hinckley, the man who shot President Ronald Reagan.
Wolfe suggested that the military court might not buy the mental illness defense. "Who doesn't find psycho-babble unclear . . . how many people out there believe that insanity should never be a defense, that it is just, as he said, an 'excuse.' "Awaiting a Decision
Whiteside lived with other outpatient soldiers in a building on the grounds of Walter Reed. She kept her quarters neat and orderly. As her preliminary hearing approached, she often went to bed at 8 p.m. to sleep away her impending reality. She attended morning formation and medical appointments. On weekends she hung out with her clique from Ward 54, "my little posse of crazy soldiers," as Whiteside called them.
She still had the innate ability to motivate soldiers. To pass time one recent Sunday, Whiteside drove a small group of outpatients to go bowling at the National Naval Medical Center in Bethesda. "You can do better," she told a young private who was a terrible bowler. "We'll pool our energy together and get a strike."
Whiteside also offered encouragement over the phone to her friend Sammantha Owen-Ewing, the soldier she befriended on Ward 54 who had been abruptly dismissed from the Army. Sammantha was waiting to see if she could receive her care from the Department of Veterans Affairs.
Whiteside feared the same fate.
At the hearing, the testimony focused on Whiteside's state of mind at the time of her shooting. The hearing officer would have seven days to make a recommendation on whether to dismiss the charges, offer a lesser punishment or go to court-martial. The final decision will be Rowe's.
A psychiatrist who performed Whiteside's sanity board evaluation testified that he found the lieutenant insane at the time of the shooting. One of the doctors said that Whiteside had a "severe mental disease or affect" and that she "did not appreciate the nature and quality of her actions." Brandt, chief of Behavioral Health Services in Walter Reed's Department of Psychiatry, testified that Whiteside was "grappling with holding on to her sanity," adding: "She was right on the edge, and she fell off."
Wolfe made his argument for a court-martial. "These are very serious charges," he said. "The more serious the crime, the higher level it must be disposed of. . . . The government's position is it should be a court-martial."
When the hearing ended, Whiteside walked outside into the cold. Her phone buzzed with a text message from the husband of her friend Sammantha, asking Whiteside to call right away.
Sammantha had hung herself the night before.
On Friday, Whiteside and her father flew to Utah for the funeral. Yesterday, after a service at a small Mormon church, Sammantha Owen-Ewing was buried.
Grief-stricken by the death of her friend and bitter at the Army, Whiteside awaits the Army's decision this week.
"I can fight them," she said, "because I'm alive."

Staff researcher Julie Tate and photographer Michel du Cille contributed to this report.