After investigating, Wyden and a state lawmaker demanded that the secretary of the Army review what they described as second-class medical treatment.
“If you’re serving in the same foxhole, you ought to be able to come back to the same sort of benefits,” Wyden said.
Identifying red flags
At demobilization centers, reservists are inundated with forms, health assessments and presentations before going home, including a checklist to self-report potential mental health issues.
Andres Alvarez was pushed through that system several times while serving three tours in Iraq; one with the Kentucky National Guard and two with Tennessee.
On Aug. 25, 2005, during his second deployment, Alvarez’s vehicle struck an improvised explosive device, injuring him and resulting in PTSD and traumatic brain injury, he said. He went on to serve another tour, after the post-deployment screening process did not identify problems.
“There was stuff that should have raised flags,” he said.
Several years into the wars in Afghanistan and Iraq, the Defense Department realized that troops required follow-up checks months later, when combat trauma typically reveals itself. In 2005, the military added a subsequent checkup during the three- to six-month period following deployment.
When Alvarez returned from his third Iraq tour in late 2006, a medical review officer identified symptoms of PTSD and traumatic brain injury and refused to let him go home, instead sending him to an extended-care treatment facility. “He probably saved my life,” Alvarez said.
In 2008, the screening process was digitized and more questions were added to help identify PTSD and brain injury. The next year, spurred by the suicide of a young Montana guardsman, Congress mandated confidential one-on-one screenings with behavioral health professionals before deployment and in post-deployment reassessments.
At a November reintegration event in Bozeman, Mont., Capt. Russ Cunningham said the post-deployment process for all troops has improved greatly since his first tour, in 2003. “You almost feel like they’re trying to wrap you in bubble wrap. They want to do everything they can possibly think of to make sure that you get the physical, psychological, family help that you need.”
But the system still relies on self-reporting, even though studies have shown that troops often don’t know they have problems, or are reluctant to report them because they want to return home to their families and their jobs.