Missed Treatment: Soldiers With Mental Health Issues Dismissed For 'Misconduct'

Oct 28, 2015
Originally published on June 20, 2016 9:32 pm

Staff Sgt. Eric James, an Army sniper who served two tours in Iraq, paused before he walked into a psychiatrist's office at Fort Carson, Colo. It was April 3, 2014. James clicked record on his smartphone, and then tucked the phone and his car keys inside his cap as he walked through the door to the chair by the therapist's desk.

As he sat there sharing his fears and telling the therapist he'd been thinking about suicide — all while secretly recording the entire session — James was inadvertently helping to bring a problem within the Army to light: As it tries to deal with thousands of soldiers who misbehave after returning from Iraq and Afghanistan and then being diagnosed with mental health disorders and traumatic brain injuries, the military sometimes moves to kick them out of the service rather than provide the treatment they need.

The Army tried to dismiss James in 2013, because he had been stopped for drunken driving two years earlier. This despite pledges by Army commanders and a 2009 congressional edict to make sure such misconduct is not the result of mental issues brought home from the wars.

Saying he wanted evidence to protect himself, James made secret recordings of more than 20 hours of sessions with therapists and officers at Fort Carson. In the recordings, counselors can be heard berating him for suggesting he has serious mental health problems. They try to convince him his experiences in Iraq were not too traumatic — and even seem to ignore him when he talks about wanting to commit suicide.

When Army leaders heard about the recordings, they ordered an investigation. It concluded that James had been mistreated, and two of his therapists were subsequently reprimanded.

But the general who runs the Army's medical system said the investigation also reached another conclusion: The mistreatment of soldiers at Fort Carson was "not systemic."

NPR and Colorado Public Radio also conducted an investigation, based on hours of secret recordings from James, hundreds of pages of confidential documents from Fort Carson, and interviews with dozens of sources both inside and outside the base. And that evidence suggests the Army failed to pursue key evidence in its investigation, ruling out claims of mistreatment from nine other war veterans without ever interviewing or even contacting the men.

And according to figures acquired by NPR and CPR under the Freedom of Information Act, the Army has been pushing out soldiers diagnosed with mental health problems not just at Fort Carson but at bases across the country.

The figures show that since January 2009, the Army has "separated" 22,000 soldiers for "misconduct" after they came back from Iraq and Afghanistan and were diagnosed with mental health problems or TBI. As a result, many of the dismissed soldiers have not received crucial retirement and health care benefits that soldiers receive with an honorable discharge.

The cases of the 10 soldiers we investigated raise a question: Why would commanders kick out soldiers for misconduct, instead of giving them more intensive treatment or a medical retirement on the grounds that they have persistent mental health problems? Sources both inside and outside Fort Carson suggested one possible answer: It takes less time and money to get rid of problem soldiers on the grounds of misconduct.

One of the Army's top officials who oversees mental health, Lt. Col. Chris Ivany, tells NPR and CPR that the Army is not violating the spirit of the 2009 law by dismissing tens of thousands of soldiers for misconduct after they came back from the wars, even though they were diagnosed with TBI or mental health disorders.

For instance, he says the soldiers' "functional impairment was not severe" enough in some cases to affect their judgment. In other cases, the soldiers' disorders might have been serious when they were diagnosed, but their "condition subsequently improved" before they committed misconduct — so they can't blame the war for causing them to misbehave.

And in other cases, Ivany says, soldiers' medical records show they were diagnosed with a mental health disorder — but only because a medical worker wrote it down as "a preliminary best estimate, but on further evaluation, the diagnosis was clarified" and perhaps dropped. All this "clearly shows that there is no systemic attempt" to dismiss soldiers with mental problems on the grounds of misconduct, Ivany says.

Army officials would not discuss any of the current and former soldiers' cases, on the grounds that they're protecting the men's privacy.

James says he never set out to "expose" Fort Carson or embarrass anybody. He says he started recording his meetings with officers and mental health staff to keep an accurate record of the conversations.

James' two tours in Iraq occurred during some of the bloodiest fighting. He watched through his sniper scope as his targets died and he saw his buddies die, too. He suffered a traumatic brain injury when his Humvee flipped upside down, according to Army records.

James' parents say he began to unravel after he returned to Fort Carson in 2009.

"It's pretty hard as a parent to see your kid go the way he did," says his father, Robert James. "He was happy-go-lucky. Now he's depressed, and he's always down and out."

"This isn't the boy, the young man, I raised," says his mother, Beverly Morris. "He is totally a whole different person."

James says after he came home from his last deployment, his life was in shambles.

"I was angry; I was getting in fights. I drank at least 12 beers every night, so I could pass out — that was the only way I could get any sleep. It's like my mom said, she was the person I'd always call, and I would call her, you know, after I'd been drinking so much and it's late at night and I'd tell her, 'Mom, look, I need help. Every day I wish I was dead,' " James says.

Then one night in 2011, local police pulled James over for drunken driving in Colorado Springs. Two years later, officers at Fort Carson told him they were going to "chapter" him out of the Army for misconduct, as a result of that DUI. James says he knew that meant he might never get the retirement pay or health insurance that the Army promised when he enlisted. Getting forced to leave without an honorable discharge could also mean that he could have trouble finding a decent job.

We first reported in 2006 that Fort Carson was kicking out some soldiers who had mental health problems and committed "misconduct," instead of helping them. Less than three years later, Congress passed the law to help stop the practice.

The law does not forbid the Army to dismiss troops with mental disorders who commit misconduct, but a spokesman for one of the key congressional committees that drafted the language says members of Congress "wanted to make sure the military was not putting people out that have service-related medical issues because the services have a responsibility to get them the care they need."

Secret Recordings Lead To Investigation

James' recordings veer from mundane conversations about scheduling appointments to sessions in which James despairs about his life.

In one, James tells a therapist that he feels angry and miserable most of the time. He doesn't trust anybody, and he isolates himself.

"Like, remember I told you I'm like, I feel like I'm coming into a combat zone when I drive on the base," he asks the counselor. And then he starts trying to talk about some of his scariest experiences in Iraq. "In, like, one month, there was over 1,000 IEDs and multiple ambushes."

Standard therapy textbooks say that counselors can help patients best when they are supportive, build trust and are empathetic. When patients feel safe enough to share their deepest fears, a therapist can then help them understand their problems and start to get better.

The therapist responds, interrupting him: "Yeah, it was a suck fest ... big time. ... But it was not an emotionally crippling experience," she declares. "Because for the last six years, you've been able to get up and come to work. Have you had things that lingered and it affected you? Yes. But you're not emotionally crippled. You're not a in a corner rocking back and forth and drooling."

In another session, James meets with one of the Army's chief psychiatrists at Fort Carson. A few weeks before, James had filled out a survey used to help diagnose PTSD. James ranked many of his symptoms as "5s," the most extreme symptoms, which potentially signals that the person is in crisis. But the Army psychiatrist doesn't try to get James to open up and explain his answers. Instead, the psychiatrist challenges him.

"When I see 'extreme,' you should be in a hospital," the psychiatrist says in a confrontational tone. "People that put that down, all those 5s, most of those people need to be in a hospital to be stabilized."

The psychiatrist suggests that since James is able to report for duty at Fort Carson, he must be exaggerating his symptoms.

"Because right now, you shouldn't be walking around, if that's how bad you're doing," the psychiatrist says gruffly, after scolding James and repeatedly interrupting him.

In yet another session, with another Army psychiatrist at Fort Carson, James sounds like he's close to the breaking point. He cries audibly as he tells the psychiatrist that he wanted to kill himself hours before.

"I can't do it, Sir, I'm ... losing my mind," James says. "Like, last night I just wanted to ... take all my pills and," James pauses, his voice shaking, "couldn't do it sir. This is killing me, physically and mentally."

As James continues sniffling, the psychiatrist changes the topic. He speaks in a soothing voice, but he never asks James what he is feeling about committing suicide.

"I spent almost a week listening to all of Eric James' recordings," says Andrew Pogany, CEO of Uniformed Services Justice and Advocacy Group, a legal services nonprofit that Pogany and a colleague created to help soldiers in trouble. "It painted a picture that was mortifying. And horrifying."

Pogany used to be a soldier himself at Fort Carson. He fought back against the Army for mistreating him, and won. Pogany and his co-director, Robert Alvarez, sent some of James' recordings to Charles Hoge, a psychiatrist and retired colonel who advises Lt. Gen. Patricia Horoho, the Army's surgeon general.

"What no one fully appreciates is the serious nature of what transpired during clinical encounters with at least two mental health providers at Fort Carson," Hoge warned one of the general's top aides in an internal email. He wrote that some of what he heard "demonstrates unprofessionalism, hostility, and lack of empathy" and "potential for negligence leading to significant potential harm."

Less than one month later, Horoho ordered an investigation of Fort Carson. She announced the results at a press conference in February.

"The investigation concluded that we had two providers that actually showed a lack of dignity and respect to one soldier," Horoho told reporters. In other words, the investigation found that James was the only soldier at Fort Carson who had been mistreated.

"I thought the investigation was a very thorough investigation. I believed it gave the facts and certified that there wasn't a systemic problem," she said.

Also, according to Horoho, two of the therapists who worked with James had been reprimanded.

Meanwhile, commanders at Fort Carson did a dramatic about-face: Instead of dismissing James from the Army, they sent him for treatment at the National Intrepid Center of Excellence in Bethesda, Md., the nation's top military center for TBI and PTSD. The Army also gave James a medical retirement, with honor and full benefits.

Horoho also ordered staff at Fort Carson to get special training. According to an Army document, mental health employees took a few hours off work to discuss issues such as "dignity and respect during patient encounters." The Army also made it easier for soldiers to appeal if they feel they have been mistreated.

But Horoho stressed the takeaway conclusion two more times at the press conference: "I have not seen anything that's systemic in the way that our behavior health providers treat our patients," she added.

Here's what's curious about Horoho's declarations: Documents show that the Uniformed Services Justice and Advocacy Group told investigators under oath that commanders and mental health staff at Fort Carson have mistreated many soldiers — and thrown many out of the Army for misconduct after they came home from the wars with mental health problems. The advocates told investigators about nine current and former soldiers, in addition to James, who they said were typical cases.

NPR and CPR contacted all of those soldiers. They told us that Horoho's investigators never contacted them.

"Every case has a slightly different flavor, there's slightly different facts to it," says Pogany. "But when you take a step back, it is all the same stuff. If [Army officials] honestly want to fix this problem, they need to understand what's going on here and they need to admit that this is going on across the board."

The Case Of Jason Holmer

Consider the case of Jason Holmer — one of the names on the list that investigators never called. Holmer deployed three times to Afghanistan and Iraq. The Army awarded him the Bronze Star, one of the service's most prestigious medals.

One night, Holmer and his unit were ambushed. A mortar round landed about 10 meters from him "and it lifted us up off the ground," Holmer says.

That was the first possible TBI documented in Holmer's medical records.

The story of what happened after he came home echoes James' transformation. Holmer says his wife told him he was a different person — and they divorced. His medical records show he suffered "major depression" and "feelings of hopelessness" and "high irritability." He had trouble remembering things — a common TBI symptom — and he couldn't sleep.

"I had one doctor saying, 'Oh, you just got some anxiety, here's some sleeping medication and antidepressants. You'll be fine,' " Holmer says.

Instead, Holmer started drinking a lot. Then one night in 2012, police found him sleeping in his blue Dodge Ram pickup truck, parked along the side of the road. They charged him with driving under the influence. And three days later, the Army started the process of dismissing him for misconduct.

Commanders sent Holmer to a therapist at Fort Carson, in line with the 2009 law, to evaluate whether PTSD or TBI might have played a role in causing his behavior. His medical records show he had some classic symptoms.

But soon, Holmer received a curious email written by the therapist. The therapist had not intended Holmer to see it, but she sent her email to an officer who accidentally forwarded it to Holmer.

"At this time, while [Holmer] may have a significant [behavioral health] condition, I'll be able to clear him," the therapist wrote. "I believe it would be in our best interest to assist in expediting the process." In military language, that means it would be in their best interest to kick Holmer out for misconduct.

The therapist signed her email with a smiley face.

The Case Of James Vanni

And consider the case of Sgt. James Vanni. He deployed to Iraq in 2004, and then was assigned to a base near Sadr City.

"Our Day 1, we got ambushed," he says. "Day 1. We lost eight guys dead that day, and 60 more wounded."

Vanni and his wife say he still wakes up screaming from a recurring nightmare about the first victim he watched die that day.

After he returned home, he started unraveling — much like the other eight soldiers whom the Army's investigators did not interview. His Army records list at least one TBI, and possibly more, and show that he reported getting frequent headaches and was forgetting things. An ambulance took him to the emergency room one morning because it looked like he was having a heart attack. It turned out to be a panic attack.

Vanni's wife, Michelle, says he would also fly into rages, "screaming and yelling and throwing stuff" at her and their two children. "It's like he hated to be around us," she says.

He also kept threatening to kill himself.

At 1 a.m. the day before Christmas, Vanni freaked out after he and Michelle had an argument. Vanni says he can't remember much about what happened. "The whole incident is really blurry to me," he says.

"He came in the house screaming and yelling, and he made absolutely no sense," Michelle says. "I mean, he even turned and he was just talking to the wall, like he was talking to somebody. He was pointing the gun, but there was no magazine in it, you know I didn't know that, so I tried to call 911, because he was scaring me. "

Michelle says when the police arrived she told them he was depressed, suicidal and needed help.

"They told me they were taking him to a hospital," she says.

Instead, the police took Vanni to jail.

Officers at Fort Carson then started the process of dismissing Vanni from the Army without benefits, on the grounds that he committed domestic violence. An Army psychiatrist evaluated Vanni, as the law requires.

His conclusion: "This service member does not suffer from any deployment related mental health issues," the psychiatrist wrote. It was the same psychiatrist who was later reprimanded for mistreating James.

Independent Adviser: Soldiers Deserve 'Benefit Of The Doubt'

Horoho's spokeswoman, Maria Tolleson, acknowledged that investigators did not get in touch with the nine soldiers whom soldiers' rights advocates named as examples of how some troops at Fort Carson have been mistreated. She wrote in an email that Army staff reviewed soldiers' files "for quality and standard of care in accordance with [the Army's] regulatory guidance," and the "review of these files did not reveal any provider misconduct."

But NPR and CPR also obtained the soldiers' records, with their permission, and we asked three independent psychiatrists to review them. Two of those psychiatrists served as top medical officers in the military. And all three say that based on the records they have seen, they would have advised the Army not to dismiss these soldiers for misconduct.

"Especially for our soldiers who are coming back not just with post-traumatic stress disorder, but with traumatic brain injury and other wounds, I really think that we as a society need to take that into account," says Col. Elspeth Ritchie, who served as the Army's top adviser on mental health during some of the worst fighting in Iraq and Afghanistan. "I think as a society, they deserve to have us do everything we can to support them. I absolutely would want them to get the benefit of the doubt."

Some sources who work with Fort Carson say perhaps commanders used to dismiss soldiers unfairly, but things have changed.

"I'm encouraged by this. I think there's been a shift," says Miriam Blum, an independent psychologist in Colorado Springs. She estimates that she has treated hundreds of soldiers based at Fort Carson. "What I experience, what I hear from soldiers and what I see with soldiers, is that Fort Carson is doing many things to address the mental health issues of the soldiers before any kind of disciplinary procedure is even remotely considered. I see [that] soldiers who are seeking help are getting help."

Peter Chiarelli, the Army's vice chief of staff from 2008 to 2012, agrees that commanders at Fort Carson, and other bases across the country, are doing a far better job of identifying and helping soldiers in trouble. But he says NPR and CPR are making the issue of mental health and misconduct sound simpler than it really is.

"It would be wonderful if we could tell 100 percent of the time whether or not that misconduct is because an individual is, in fact, acting bad or it's because they have some kind of a mental issue," Chiarelli says. "But the fact of the matter is — and this is the important point for you to understand — is our diagnostics are so horrible we cannot always make that determination."

Chiarelli says that given the uncertainties and the enormous pressures on the Army, it makes sense for commanders to push out soldiers who have mental health problems and commit misconduct.

"Does it make sense if they're going to be nondeployable for a long period of time, and if we don't have good diagnostics and good treatments, yes it does make sense. Because I need deployable soldiers inside my ranks," he says. "The Army has a mission and that's to fight and win our nation's wars. When people have any kind of an illness and are not deployable, they're not going to be available to do that."

Actually, it turns out that some of the soldiers NPR and CPR followed did not get kicked out after all. That includes Vanni and Holmer. An Army official, speaking on background, says that demonstrates that commanders are willing to take a second look and reverse course and treat soldiers fairly.

The soldiers we interviewed say that commanders took that second look only after the soldiers' rights advocates intervened and threatened to take their stories to Congress and the media.

The Case Of Larry Morrison

Meanwhile, our investigation found that Fort Carson has decided to dismiss yet another soldier to whom the Army awarded the Bronze Star — suggesting that Horoho's actions have not fixed the problems.

Sgt. Larry Morrison, 42, has served 20 years in the Army. He led soldiers on three deployments in Afghanistan and Iraq. Army records show Morrison was scheduled for a medical retirement due to chronic PTSD, with honor and full benefits, on March 17 of this year. But at roughly 3 p.m. that day, Morrison's commander handed him a document announcing that the Army was going to dismiss him for misconduct instead.

Officers who have served with Morrison told us he is one of the best leaders they have ever known. Capt.Tyson Walsh, who commanded Morrison in Afghanistan in 2010 and 2011, says Morrison was "phenomenal" and served as one of his platoon sergeants during a "brutal deployment."

Walsh says Morrison was the mentor who held the unit together.

"The Sgt. Morrison I know stands for honesty and integrity," he says. "I've had to put my life in his hands more than once. And every single time I did, it was the right answer."

But Army documents list three justifications for kicking him out: Morrison pleaded guilty two years earlier to drunken and reckless driving, and, according to the Army, he belongs to a "criminal" motorcycle gang that a federal report links to shootings and drugs.

Morrison and other soldiers told us it's not a gang but one of the most popular bike clubs for African-American troops.

Fort Carson's decision to dismiss Morrison is not yet final. Because he has served so many years, the Department of the Army has to sign off, and he's still waiting to hear the final decision. Meanwhile, he's working part time as a security guard at a chain clothing store.

"I've given [the Army] all of my youthful years. I'm 42 years old now," Morrison says, in a defeated-sounding monotone. "And now they want to put me out with no benefits, they want to give me an other-than-honorable discharge — so I can't get a job, I can't go to school — and take my retirement away. So they want to put me on the streets with nothing."

Morrison says he struggles to get just a few hours of sleep each night before he wakes up from recurring nightmares about a buddy who was killed in Afghanistan. A doctor prescribed medication to help him sleep, but Morrison says he doesn't always take it.

"Nightmares are bad but at the same time, they're good, actually, because the nightmares help you remember the guys that are gone," Morrison says. "And you know you can't go see them, you can't call them and you can't go talk to them. So sometimes you want the nightmares — to help you to spend time with the guys that are actually gone."

NPR and CPR sent more than half a dozen emails to Horoho, telling her that soldiers like Morrison are still getting kicked out of Fort Carson and asking to talk with her about the issues. We also asked to interview the top two generals in the Army, to find out what they make of the fact that the Army has pushed out tens of thousands of troops in recent years who came back from the wars with mental health disorders.

None of the generals would meet with us.

NPR's Courtney Mabeus and Barbara Van Woerkom contributed to this report.

Copyright 2017 NPR. To see more, visit http://www.npr.org/.

ARI SHAPIRO, HOST:

NPR has learned that the Army has kicked out tens of thousands of soldiers who have been diagnosed with brain injuries and mental health problems. Our investigations unit found that this has happened since 2009 as these soldiers have returned from war. We've obtained information from the Army which has never been released before. NPR's Daniel Zwerdling joins us now. And Danny, what are the details?

DANIEL ZWERDLING, BYLINE: All right. First, I need to give you some background. We reported many years ago that a lot of troops who came home from the wars with mental health problems and brain injuries misbehaved. They'd get drunk and drive. They'd talk back to their officers.

SHAPIRO: That's not good, but that's not surprising considering that they had brain injuries and mental health problems.

ZWERDLING: Exactly. But we found that instead of giving them enough help, a lot of commanders were kicking those soldiers out of the Army and taking away their benefits because they committed misconduct. So Congress passed a law to try to stop that, and this was back in 2009. Congress basically told the military, look; if troops come back from the wars and get in trouble, you can't just kick them out like criminals. You've got to figure out if there are extenuating circumstances.

SHAPIRO: Extenuating circumstances like post traumatic stress disorder or traumatic brain injury.

ZWERDLING: Right. So I teamed up with our colleague Michael de Yoanna. He's at Colorado Public Radio. And we got the Army to give us data that they say they've never compiled before. They've kicked out more than 22,000 soldiers for misconduct since Congress passed the law even though they'd been diagnosed with brain injuries or mental health disorders.

SHAPIRO: So these are 22,000 soldiers who served in Iraq and Afghanistan with mental health problems or brain injuries, exactly the kinds of soldiers this 2009 law was designed to address, who are nonetheless kicked out.

ZWERDLING: That's right. Now, an Army official told us, look; some of those soldiers didn't have serious mental health problems when they committed misconduct, so you can't blame their behavior on the war. But he couldn't give us data to back that up. And there's more to our investigation. A top general received allegations last year that a lot of troops who had mental health problems were not getting proper treatment still at Fort Carson in Colorado. That's one of the most important bases in America.

So what'd the Army do? Our investigation found not much. So, Ari, settle back because we're going to tell you the whole troubling story now. And we can tell it only because there was a staff sergeant at Fort Carson named Eric James, and he did something kind of sneaky.

(SOUNDBITE OF MUTED RUSTLING)

ZWERDLING: He recorded his meetings last year with Army psychiatrists and officers secretly. So that rustling - that's the recorder jostling in the soldier's pocket as he walks to his next counseling session at Fort Carson.

(SOUNDBITE OF DOOR CLOSING)

ZWERDLING: And that's the door closing as he enters the psychiatrist's office. James gave us his recordings. They've never been broadcast before.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED PSYCHIATRIST #1: How are you doing today?

ERIC JAMES: Oh, I'm OK I guess.

ZWERDLING: But as you listen to James's recordings, it's clear that he is not doing OK at all. In fact, he tells the psychiatrist he's been feeling suicidal. And the Army psychiatrist responds by telling him that - well, let's hear what the psychiatrist says in the minute.

Eric James was a sniper in Iraq. He served two tours during some of the bloodiest fighting. He got a traumatic brain injury when his Humvee flipped upside down. One of his commanders in Iraq told me that James was one of the finest soldiers he's ever known. But since he came back in 2009...

ROBERT JAMES: It's pretty hard as a parent to see your kid go the way he did. He was happy-go-lucky. Now he's depressed, and he's always down and out.

ZWERDLING: Robert James is Eric's father. His mother is Beverly Morris.

BEVERLY MORRIS: I can't even find the words to - it's just - this isn't the boy - young man I'd raised. He is totally a whole different person.

E. JAMES: It's like my mom said. She was the person I'd always call.

ZWERDLING: You've heard stories about soldiers like James. He says he drank 12 beers every night so he could sleep.

E. JAMES: And I would call her, you know, after I'd drinken so much. And it's late at night, and I'd tell her, Mom, like, I need help. Every day, I wish I was dead.

ZWERDLING: Then one night in 2011, James was pulled over for drunk driving in Colorado Springs. And two years later, officers at Fort Carson suddenly told him, we're going to kick you out of the Army for misconduct because of that DUI two years ago. James knew a bad discharge could mean forget your retirement pay; forget your health insurance, and good luck finding a job. James didn't even realize at the time that Congress had passed that law to try to protect soldiers like him. But now Fort Carson was about to put him on the street.

E. JAMES: My unit, the Army, was the enemy. And you learn to gather intelligence, and you surveillance every move that the enemy make. That's what you do. And that's when I determined that I was going to record everything.

ZWERDLING: James recorded more than 20 hours of meetings with Army therapists or counselors, some people call them.

(SOUNDBITE OF ARCHIVED RECORDING)

E. JAMES: I think that I'm more mad and irritated and, like...

ZWERDLING: In this session, James is telling a therapist that he feels angry most of the time. He doesn't trust anybody. He isolates himself.

(SOUNDBITE OF ARCHIVED RECORDING)

E. JAMES: Like, remember I told you I'm - like, I feel like I'm coming into a combat zone whenever I'm on base? Well, now...

ZWERDLING: And then James tries to talk about some of his scariest experiences fighting in Iraq. The standard therapy textbooks say the counselors can help patients best when counselors are supportive and build trust, when they're empathetic because when your patients feel safe enough to share their deepest fears, you can help them understand their problems. And then you can help them start to get better. Listen now to this therapist.

(SOUNDBITE OF ARCHIVED RECORDING)

E. JAMES: And, like, one month, there was over a thousand IED strikes.

UNIDENTIFIED PSYCHIATRIST #2: You said Sadr City - yeah.

E. JAMES: IED strikes, ambushes...

UNIDENTIFIED PSYCHIATRIST #2: Yeah. It was a suck fest...

E. JAMES: Yeah. It was bad.

UNIDENTIFIED PSYCHIATRIST #2: ...Big time. That was one of the big ones. But it was not an emotionally crippling experience. You're not in a corner rocking back and forth and drooling.

ZWERDLING: And James recorded another session with one of Army's top psychiatrists at Fort Carson. A few weeks earlier, James filled out a questionnaire used to help diagnose post traumatic stress disorder. You rank your systems on a zero-to-five scale, and James put down lots of fives, which are the most extreme symptoms. But the psychiatrist doesn't try to get James to open up and explain why he ranked his symptoms extreme. Instead, the psychiatrist challenges him.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED PSYCHIATRIST #3: You know, for somebody to be, I mean, extremely - from - when I look at this, and I see disturbing memories - when I see extreme, you should be in a hospital.

E. JAMES: You didn't see my sleep study, obviously, that I did. You didn't see the fact that I don't sleep at all, the fact that they give me medicines that doesn't [expletive] work.

UNIDENTIFIED PSYCHIATRIST #3: Well, I did [expletive] see your sleep study, and there's no reason to cuss, OK?

E. JAMES: Well, Sir, I'm - I mean, that's just the way I am. If this is going to be a formal interview, then I'll stand up and be at attention. I don't want to disrespect you, but you're sitting here telling me that I'm not feeling the way that I...

UNIDENTIFIED PSYCHIATRIST #3: That's not what I'm telling you. See, you - that's what you're hearing. People who are like this - this means you cannot function.

E. JAMES: So then why is it...

UNIDENTIFIED PSYCHIATRIST #3: You're missing - you're so angry at me right now. You're missing...

E. JAMES: I'm not angry at you.

UNIDENTIFIED PSYCHIATRIST #3: You're missing the questions that I'm asking. I said, for people that put that down - all those fives - most of those people need to be in a hospital to be stabilized because right now, you shouldn't be walking around if that's how bad you're doing.

ZWERDLING: James also meets with another psychiatrist at Fort Carson. And this time, he sounds like he's close to the breaking point. As you probably know, the nation's leaders have said that preventing soldier suicides is a top priority. James tells the psychiatrist in this recording that he's thought about killing himself.

(SOUNDBITE OF ARCHIVED RECORDING)

E. JAMES: I can't do it, Sir. I'm [expletive] losing my mind. I can't even sleep last night. Like, last night, I just wanted to [expletive] take all my pills and just - couldn't do it, Sir. This is killing me, physically and mentally.

ZWERDLING: As the psychiatrist responds, he sounds sympathetic but doesn't ask James a single follow-up question to find out what he's feeling about committing suicide. After James started recording these sessions, a buddy referred him to a free legal services group that helps soldiers in trouble. It's called the Uniformed Services Justice and Advocacy Group. Andrew Pogany is the co-director. He used to be a soldier himself at Fort Carson. He fought back against the Army for mistreating him, and he won. Pogany says he listened to all 20 hours of Eric James's recordings.

ANDREW POGANY: It painted a picture that was mortifying and horrifying.

ZWERDLING: Pogany sent some of the recordings to a psychiatrist who advises the general who runs the entire Army's medical system. And that psychiatrist was horrified too. He fired off a memo warning that some of what he heard, quote, "demonstrates unprofessionalism, hostility and lack of empathy and potential for negligence leading to significant potential harm," unquote. As a result, the general ordered an investigation. She asked, have staff members at Fort Carson mistreated Eric James and other soldiers?

(SOUNDBITE OF ARCHIVED RECORDING)

PATTI HOROHO: Lieutenant General Patti Horoho, the 43rd surgeon general and the commander of Army Medicine.

ZWERDLING: General Patricia Horoho called a press conference at the Pentagon earlier this year, and she announced the results.

(SOUNDBITE OF ARCHIVED RECORDING)

HOROHO: The investigation found that we had two providers - one, a social worker and one, a physician - that actually showed a lack of dignity and respect to one soldier.

ZWERDLING: In other words, the investigation found that one soldier at Fort Carson - one soldier - had been mistreated. Horoho also told reporters that two of the therapists were reprimanded. But then Horoho gave good news.

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HOROHO: We did not find that this was a systemic issue.

ZWERDLING: Horoho repeated that conclusion.

HOROHO: I thought the investigation was a very thorough investigation. I believed it gave the facts and verified that there wasn't a systemic problem.

ZWERDLING: And she stressed it again.

HOROHO: I have not seen anything that systemic.

ZWERDLING: Problem solved, except not really. The soldiers advocates had met for hours with Army investigators, and they told them the commanders at Fort Carson mistreated lots of soldiers after they came home from the wars with mental health problems. In fact, Pogany and his colleague gave investigators details about nine current and former soldiers who they said were typical cases. But General Horoho's investigators did not interview a single man on that list. Ask a former soldier named Robert Kinnon. We tracked him down and all the others too.

Has anybody from the Army contacted you to investigate your case?

ROBERT KINNON: (Laughter). No.

ZWERDLING: Or ask a former soldier named Frank Costabile.

So nobody has said, we're doing an investigation; we need you to help us?

FRANK COSTABILE: No, no.

ZWERDLING: And Dennis Tackett, did the surgeon general's investigators interview you?

DENNIS TACKETT: No, no. I never got an email. I never got a phone call, a text message - nothing.

ZWERDLING: Yet, General Horoho declared there were no systemic problems at Fort Carson.

SHAPIRO: That's NPR's Daniel Zwerdling, who is in the study with us. And Danny, before we take a brief break, let me just quickly ask you, why would commanders kick out soldiers when those soldiers have mental health problems?

ZWERDLING: Those sources at Fort Carson told us there's a few possible reasons. For one thing, a lot of commanders still have an unforgiving attitude, and even some therapists do too. You know, if you mess up, you pay the consequences. Also, if you're a commander and you have problem soldiers, just about the easiest and fastest way to get rid of them is to kick them out for misconduct.

SHAPIRO: Thanks, Danny. So to repeat, the Army has kicked out more than 22,000 soldiers since 2009 after they came back from wars with mental health issues or traumatic brain injuries.

ROBERT SIEGEL, HOST:

More on allegations that commanders at Fort Carson in Colorado have mistreated soldiers who returned from war with mental health problems. NPR's Daniel Zwerdling picks up our story.

ZWERDLING: Fort Carson is by no means the only base where soldiers have made these kinds of allegations, but we're focusing on Fort Carson because, first of all, we got those secret recordings that a soldier named Eric James made last year of his meetings with Army therapists. Second, the Army investigated Fort Carson, and a top general concluded that there's no systemic problems there. They didn't meet James Vanni.

JAMES VANNI: Oh, hush.

ZWERDLING: We dropped by Vanni's house one evening near Fort Carson. He was standing at the stove, stirring ground meat. His kids were plopped on the couch watching TV. Bri (ph) was 12, Christian (ph), 9.

CHRISTIAN: My dad is awesome.

BRI: He's a good cook with steaks.

ZWERDLING: What about tacos? That's what you're having tonight, I think.

BRI: My mom's better, but he's OK.

CHRISTIAN: But he is better than nothing.

ZWERDLING: Vanni's name was on that list that soldiers' rights advocates gave to Army investigators as examples of troops with mental health problems whom the Army tried to kick out. Those investigators never called him. Vanni deployed to Iraq in 2004. His unit got assigned near Sadr city.

J. VANNI: Our day one, we got ambushed - day one. We lost eight guys dead that day and 60 more wounded.

ZWERDLING: Vanni came home the next year and started unraveling. He kept getting headaches and forgetting things. Medics rushed him to the emergency room one morning. It looked like he was having a heart attack. It turns out it was a panic attack. And then at 1 a.m. the day before Christmas 2013, Michelle Vanni says he freaked out.

MICHELLE VANNI: He came in the house screaming and yelling, and he made absolutely no sense. I mean, he even turned, and he was just talking to the wall.

J. VANNI: I - the whole incident is really blurry to me because I was kind of there, but I wasn't.

M. VANNI: And he was pointing to the gun, but there was no magazine in it. And you know, I didn't know that, so I tried to call 911 'cause he was scaring me.

ZWERDLING: Michelle says when the police showed up, she told them.

M. VANNI: He's depressed, and he's suicidal. He needs help. They told me they were taking him to a hospital. They took him to jail.

ZWERDLING: And then Fort Carson started kicking him out of the Army for domestic violence. Army officials acknowledged they did not interview Vanni or any of the other eight men whom soldiers' rights advocates said had been mistreated. The officials say they did review the soldiers' medical records, and that convinced them the men got proper treatment. But we obtained the soldiers' records too, and we asked three independent psychiatrists to review them. And each of those psychiatrists told us, based on the records I've seen, I would've said do not kick out these soldiers. One of those psychiatrists used to be the top mental health advisor in the Army, Colonel Elspeth Ritchie.

ELSPETH RITCHIE: Especially for our soldiers who are coming back not just with post-traumatic stress disorder, but with dramatic brain injury and other wounds, I really think that we, as a society, need to take that into account. I absolutely would want them to get the benefit of the doubt.

ZWERDLING: But then I talked with the former number two general in the Army, and he told us that we're making this issue of mental health and of misconduct sound simpler than it really is. Here is General Pete Chiarelli.

GENERAL PETE CHIARELLI: It would be wonderful if we could tell 100 percent of the time whether or not that misconduct is because an individual is, in fact, acting bad or it's because they have some kind of a mental issue. But the fact of the matter is - and this is the important point for you to understand - is our diagnostics are so horrible, we cannot always make that determination.

ZWERDLING: Chiarelli commanded multinational forces around Baghdad during some of the worst fighting in Iraq. He retired a few years ago.

So, Pete Chiarelli, does it make sense for the Army to push out soldiers who have mental health problems and who commit misconduct?

CHIARELLI: Does it make sense? If they're going to be non-deployable for a long period of time and if we don't have good diagnostics and good treatments, yes, it does make sense because I need deployable soldiers inside my ranks.

ZWERDLING: It turns out that some the soldiers we tracked down who were getting kicked out for misconduct did not get kicked out after all. That includes James Vanni and Eric James who made the secret recordings. Commanders at Fort Carson did an about face after James triggered the investigation, and they retired the soldiers with honor and full benefits. General Patricia Horoho announced the results of the Army's investigation at Fort Carson earlier this year. She ordered the staff at the base to take a workshop on issues like dignity and respect during patient encounters. And the Army made it easier for soldiers to appeal if they feel they've been mistreated. But our investigation found that these actions have not fixed the problem, at least not for soldiers like Sergeant Larry Morrison.

SERGEANT LARRY MORRISON: Hi. Here's all my clothing, my dressers...

ZWERDLING: Morrison's world right now is jammed in this commercial storage locker off a busy road in Colorado Springs. Morrison has served 20 years in the Army. He led soldiers on three deployments in Afghanistan and Iraq. The Army awarded him a Bronze Star. That's one of the most prestigious medals the Army can give you.

MORRISON: It says right here - Sgt. 1st Class Morrison's superb leadership and commitment to excellence contributed to great - to the overall success of the command.

ZWERDLING: But at this very moment, Fort Carson's trying to kick him out. One of his former commanders can hardly believe it. Captain Tyson Walsh fought with Morrison in Afghanistan.

Out of all the leaders you've known, where does Larry Morrison rank?

CAPTAIN TYSON WALSH: Oh, I mean, in the top 10 for sure. I've had to put my life in his hands more than once, and every single time I did, it was the right answer.

ZWERDLING: That's the Larry Morrison who was scheduled to retire with honor on March 17 of this year. The Army said he deserved to retire on medical grounds because he has chronic PTSD. But around 3 p.m. that very day, Morrison's commander gave him a document that said instead of retiring him, the Army's going to kick him out and take away his benefits. Why? Because Morrison pleaded guilty to a DUI and reckless driving two years ago and because the Army alleges that Morrison joined a criminal motorcycle gang that's been linked to shootings and drugs. Morrison and other soldiers told us, criminal gang - that's one of the most popular bike clubs for black troops. Morrison's hired a lawyer to fight for him.

Meanwhile, he gets recurring nightmares about one of his soldiers who got killed in Afghanistan. A doctor prescribed pills to suppress the dreams, but Morrison says he doesn't always take them.

MORRISON: Nightmares are bad, but at the same time, they're good, you know, actually because the nightmares help you to remember the guys that are gone. And you know you can't go see them. You can't call him, and you can't go talk to them. So sometimes you want the nightmares to help you spend time with the guys that are actually gone.

ZWERDLING: We've sent more than half a dozen emails to General Horoho asking to meet with her. We've also asked to interview the top two generals in the Army. What do they make of the fact that the Army has kicked out tens of thousands of troops in recent years who came back from the wars and were diagnosed with mental health disorders? None of the generals would meet with us. Daniel Zwerdling, NPR News.

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SIEGEL: You can see more about the soldiers getting kicked out at npr.org. Transcript provided by NPR, Copyright NPR.