Combat veterans of the Iraq and Afghanistan conflicts share their experiences with PTSD, and their reaction to reports that Army Staff Sgt. Robert Bales allegedly gunned down 17 Afghan civilians. Msnbc.com's Kari Huus reports.
Warning: This report contains strong language.
LOS ANGELES – The young men who answer the phones at the National Veterans Foundation's hotline for troubled veterans speak with an authority that comes from having faced down the same demons that plague their callers.
All are combat veterans, having served up to four tours of duty in Iraq and Afghanistan, and all have struggled with either PTSD or traumatic brain injury – the signature wounds of these conflicts – or both.
For them, the story of Army Staff Sgt. Robert Bales, accused of murdering 17 Afghan civilians during his fourth combat deployment, triggers mixed emotions – horror over the senseless rampage but also empathy for a soldier who, in their view, apparently was pushed beyond the breaking point. But their more immediate concern is the impact it may have on the troubled voices on the other end of the phone lines they answer each day.
"One of the biggest issues we have … is the vets don’t get the jobs," said Apolonio Munoz III, 28, an Army veteran deployed during the U.S. invasion of Iraq in 2003 who works for the hotline while pursuing a social work degree. "[Employers] think they are whack-jobs and they’re all going to be cold-blooded killers, they’re going to come in and shoot up the place, which is not the situation."
Munoz and several other former soldiers who answer the hotline agreed to share with msnbc.com their thoughts on PTSD, the stresses of war and the news that Bales – a 38-year-old soldier with a clean military record – allegedly crept into an Afghan village at night on March 11 and slaughtered Afghan civilians, including women and children.
"It’s an absolute tragedy, and it never should have happened," Cameron White, 31, who served two tours of duty in Iraq with the Marines before leaving the military and becoming a college student and anti-war activist, said of the massacre in Kandahar province. He said he believes the killing were "a byproduct of a failed policy that continues to put traumatized troops out on the battlefield when they shouldn’t be there."
Their comments will likely presage parts of Bales' trial, in which the cumulative effects of combat deployments and the degree to which PTSD and TBI (traumatic brain injury) can be linked to violence will almost certainly play a role.
Bales, who has been charged with 17 counts of premeditated murder along with other charges, suffered a brain injury in Iraq but was not diagnosed as suffering from PTSD. His defense is expected to argue, however, that he suffered "diminished capacity" as a result of the injury and possibly undiagnosed PTSD. Bales, who is being held in detention at Fort Leavenworth, Kansas, has not yet entered a plea to the charges, but his civilian defense attorney, John Henry Browne, has indicated he expects to mount a vigorous defense based in part on his client’s mental state.
How staff Sgt. Bales lawyers are fighting for his life
Many experts also expect the defense to produce expert witnesses to testify about the effects on mental health of repeat combat deployments. But just as with PTSD and TBI, the record is incomplete, as the Iraq and Afghan conflicts mark the first time the U.S. has cycled soldiers in and out of combat so many times.
The latter issue resonates loudly with the former soldiers who answer the hot line.
'Yes, I killed Iraqis'
White said that his experiences in Iraq led him to believe that not even the most hardened soldier is immune to meltdown amid the repeated stresses of combat.
James Cheng / msnbc.com
Left to right, Rich Rudnick, Wendell Guillermo and Apolonio E. Muñoz III work at the National Veterans Foundation in Los Angeles.
"I think when you say … 'that’s not me' or ‘that would never happen to me,' I think anybody that says that is just lying to themselves," he said. "… Something like that could happen to any one of us."
Another hot line operator, Freddy Cordova, 29, who served four tours in Iraq from 2003 to 2008, said the mental health evaluations he received between deployments were cursory at best.
In an evaluation after his first deployment, Cordova said he answered 'yes' to most of the combat-related questions: "Yes, I saw dead people. Yes, I saw dead Americans. Yes, I fired my weapon. Yes, I killed Iraqis. Yes, I killed the enemy."
"I didn’t report that I was a threat to others, but I put that I would like to speak to somebody," he said. "What did the Army turn around to do? They just overlook it. Four months later, I’m in Iraq again."
Floyd "Shad" Meshad, founder and president of the National Veterans Foundation and a psychiatric social worker with 40 years' experience working with combat veterans, said he has repeatedly seen the effects to overexposure to the horrors of war.
"We know that soldiers, when they have seen too much combat, they will either implode – in suicide – or explode," he said. "The military just continues to send people back into combat like they were rifles, just kind of cleans them up and sends them back in. … I don’t want to say that everybody flips out like this, but a significant number do."
James Cheng / msnbc.com
Floyd 'Shad' Meshad, founder and president of the nonprofit National Veterans Foundation.
Meshad started his career as an Army mental health officer in Vietnam and was instrumental in developing a national network of community-based Veteran Centers, offering counseling, referrals and readjustment assistance, beginning in the 1970s. He has served as an expert witness in about a dozen trials for veterans facing the death penalty, he said, and appeared in court for hundreds of others facing lesser charges.
When Bales was identified as the suspect in the Afghan killings, Meshad rushed the soldier's defense team an advance copy of a new book published by NVF, "Attorney's Guide to Defending Veterans in Criminal Court."
But he said he fears that politics -- including the need to appease the Afghan government -- may outweigh the role of mental health factors in the court's ruling on the Afghanistan slayings.
"They are going to cook Bales," he predicted.
But even the mention of PTSD and Bales in the same sentence worries Matthew Friedman, executive director of the National Center for PTSD under the U.S. Department of Veterans Affairs.
"It will be a terrible thing if people with PTSD were painted with a Sgt. Bales paintbrush. It’s just not appropriate," said Friedman, who has been involved in research and treatment of PTSD for 35 years and is also a professor of psychiatry, toxicology and pharmacology at Dartmouth Medical School. "There is evidence that some people with PTSD may exhibit irritable or aggressive behavior at times. There’s no evidence that this kind of indiscriminate violence is a symptom of PTSD."
And he said that Bales’ history before joining the military – which included financial fraud and an assault case in Washington state – signaled that he was a troubled individual.
Referrals and suicide intervention
The veterans working the NVF hot line have what most experts consider textbook cases of PTSD. They have struggled with anxiety, anger and hyper-vigilance brought home from the combat zone. For some, visiting a shopping mall is a daunting experience, as they find themselves constantly scanning for potential threats. Even as these men recover and pursue civilian jobs and studies, some yell in their sleep, dream about explosions or are startled by loud noises or a glimpse of trash along the road that looks like an IED.
Most of the time, experts say, the damage from repeated exposure to combat plays out in insidious ways. It contributes to divorce and substance abuse, and takes a toll on the mental health of children. According to the Center for New American Security, 18 vets commit suicide every day.
The NVF hotline has been fielding between 11,000 and 12,000 calls a year over the last several years. Four or five a month come from veterans, or even soldiers still in service, who are dangerously depressed and threatening suicide, Meshad said.
Most others are from frustrated veterans and family members who need help navigating the complex VA benefits process, in need of legal assistance, substance abuse treatment or job training. NVF employees pride themselves in walking them through every step, and then following through if they encounter problems.
Each week, NVF staff does rounds in a van to check in on homeless veterans – mostly older Vietnam era veterans who tend to cluster together in encampments after losing jobs and families to mental illness and addiction.
To these young veterans serving at NVF, the weekly workload highlights the need for more attention to the mental health of soldiers. In the case of the massacre in Afghanistan, they suggest, responsibility for that mental health lies with more than one individual.
"My reaction to Sergeant Bales … was shock," said Jose Castro, an Army veteran of both Iraq and Afghanistan. "But, you know, when certain things are ignored about an individual soldier… and people are … forced into situations that that aren’t healthy … (that) ultimately can lead to something like this. It’s bound to happen."
"What do you expect for a guy who’s been deployed four times? Losing buddies, getting hurt, being in firefights and so forth," agreed Army veteran Wendell Guillermo, 26. "And whether or not the military wants to acknowledge it … there is a breaking point."
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