Continuing: More Love For Our Troops From Our Leaders Who Sent Them To Patently Unnecessary Wars

The four tours in Iraq served by the Second Brigade at Fort Drum here have created an unusual level of stress, especially after the standard Iraq tour was increased to 15 months from 12. Yet according to a new report on the shortcomings of mental health care at the base, a soldier’s wait to be seen for psychological help can take more than a month.

The draft report, “Fort Drum: A Great Burden, Inadequate Assistance,” which was given to The New York Times last week, was done by Veterans for America, a nonprofit advocacy organization for wounded members of the armed forces. It also uncovered several other problems with the mental health services on the post, which is north of Syracuse.

Based on interviews with a dozen soldiers and the mental health providers on the base, the report describes problems with understaffing, a reliance on questionnaires to identify soldiers in need of treatment and a sometimes dismissive view at the company level of post-traumatic stress disorder.

“The system is very much overburdened,” said Jason W. Forrester, director of policy for Veterans for America, in a telephone interview last week. “These problems are going to continue as long as we have units, such as the Second Brigade Combat Team, that have seen high-intensity combat, extended deployments and inadequate time between deployments.”

Maj. Gen. Michael Oates, the commander of the 10th Mountain Division, which includes the Second Brigade, acknowledged the shortcomings of the mental health care on the base, and said the problems were being addressed. “We recognize that there is stress on the force and our families from this conflict,” General Oates said. “But until recently we have not fully appreciated the extent of some of the mental stresses and injuries or how best to identify them”

In particular, he said, the providers of psychological services on the base have been expanding their effort to interview “those who are most at risk,” though “the screening process is not where we want it to be.”

Indeed, the report said that the wait for an appointment has eased since three Army psychiatrists were reassigned last month from Walter Reed Army Medical Center, joining three psychiatrists already on the base, to address the needs of 3,500 Second Brigade soldiers recently back from Iraq. But, the report noted, the reassignment was “only a temporary fix” since the psychiatrists from Walter Reed would probably return to Washington in a few weeks.

Fort Drum lacks its own hospital, so any soldier needing inpatient treatment has to be sent to Samaritan Medical Center in Watertown, which recently increased the number of beds in its psychiatric unit to 32 from 24.

But the report said that when the psychological facilities at the base have closed for the day, some soldiers have bypassed Samaritan and driven more than an hour to Syracuse for treatment. The Veterans for America report said the soldiers fear that doctors at Samaritan will side with some base leaders, who had, “in some cases, cast doubt on the legitimacy of combat-related mental health wounds.”

“The Department of Defense itself has recognized that with every tour you increase the likelihood of post-traumatic stress disorder,” said Adrienne Willis, spokeswoman for Veterans for America. “Here we have a brigade that has served four tours.”

Nor is the heavy service the only problem at Fort Drum. In the last two weeks, it has been at the center of a controversy over whether the Army instructed the Department of Veterans Affairs last March to stop helping soldiers there with their disability claims. At first, the Army surgeon general, Eric B. Schoomaker, denied that the Army had told Veterans Affairs to do so.

But after National Public Radio reported on a memorandum from the March meeting in Buffalo in which a colonel was quoted as directing Veterans Affairs to discontinue counseling, the surgeon general apologized for his denial and said it was based on a “miscommunication.”

In the report issued by Veterans for America, one soldier, Eli Wright, 26, who was a medic in Iraq in 2003 and 2004 and remains on active duty while awaiting a medical discharge, said his symptoms of post-traumatic stress disorder began after his tour ended and have worsened since then.

“My nerves are basically shot,” Mr. Wright said in a recent interview at the Different Drummer Cafe downtown. “I have flashbacks if I hear loud noises, especially if weapons are being fired. Sometimes just putting on my uniform can bring me right back to my experience in Iraq.”

He said that when he was in Iraq, he treated more civilians than American soldiers, and that two in particular stood out in his mind: an old woman and a child who were shot through a door as soldiers were “going door to door, tearing apart entire neighborhoods” searching for insurgents.

Mr. Wright said he waited weeks at Fort Drum to see a mental health professional, who diagnosed post-traumatic stress disorder. He was prescribed medication and pointed toward group therapy, where, he said, “half the time the group is staring at the floor.” At times, he was taking two pills at once. “I couldn’t stay awake,” he said.

But his chief complaint with the Army is the long wait for treatment. “The average wait time is five to six weeks,” he said. “When a soldier is having a mental breakdown, he has to wait over a month to see a counselor about his problems.”

Mr. Forrester of Veterans for America said that while the top brass at Fort Drum, especially General Oates, have spoken passionately about the need for soldiers to seek psychological treatment, others have not.

“There’s a trickle-down problem with the message, and that is that there’s still a pervasive stigma around mental health treatment in the military, along with a lack of confidentiality,” he said. “For those who still doubt the legitimacy of these wounds, they often are quite abusive of fellow soldiers or people in their units.”

While Fort Drum has two dozen psychologists, social workers and substance-abuse counselors, the low number of psychiatrists is worrisome because psychiatric medication is common, Ms. Willis said. “They’re heavily medicated, and it’s not something a social worker can deal with,” she said. “You really need a psychiatrist to manage that.”

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