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Military counselors face case overload

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The New York Times

Published: November 8, 2009

Many of the patients are bereft, angry, broken. Their stories are gruesome and the process of recovery exhausting. In time, the repeated stories of battle and loss can leave even the most professional therapist numb or angry.

And hanging over it all, for psychiatrists and psychologists in today's military, is the prospect of their own deployment - of working under fire with combat units in Iraq and Afghanistan.

That was the world that Maj. Nidal Malik Hasan, an Army psychiatrist, inhabited until Thursday, when he was accused of one of the worst mass shootings ever on a military base in the United States, an attack that killed 13.

Investigators are still trying to determine Hasan's motives, exploring everything from job pressures to harassment as a Muslim to his opposition to the wars in Iraq and Afghanistan.

But those who treat the psychological wounds of the country's warriors say Thursday's rampage has put a spotlight on the strains of their profession. Hasan was one of a thin line of military therapists trying to hold off a rising tide of need. By the latest Army count, there are only 408 psychiatrists serving about 553,050 servicemen and women.

As a result, some soldiers home from war, suffering from nightmares and panic attacks, say they have waited almost a year to see a psychiatrist. Many military professionals, meanwhile, describe crushing schedules with 10 or more patients a day.

Some of those hired to heal others end up needing help themselves. Others, like Bret A. Moore, a former Army psychologist at Fort Hood, look for other work.

The Fort Hood shootings have raised a pressing question: Who counsels the counselors? Moore and others said mental health evaluations of therapists themselves were nonexistent.

If it turns out that Hasan did, in fact, break partly under the stress of the job and impending deployment, many veterans would not be surprised.

"If this guy can go over the edge, imagine what it is like for the actual combat troops who have been through four or five deployments," said Bryan Hannah, 22, a disabled Iraq war veteran from San Marcos, Texas, who was discharged a year ago because of post-traumatic stress disorder and other injuries. "There are a lot of others who are worse off than him."

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