US Military Mental Health Crisis

Summary

In January 2009 more US troops committed suicide than were killed in action in Iraq & Afghanistan. In recent years suicide rates in the military have more than doubled, mental health entry standards for new recruits appear to have been lowered and the resulting problems are being medicated with a dangerous cocktail of psychotropic drugs despite manufacturers warning labels. The following story follows the tragic story of one soldier à ‚¬" just one of hundreds. When are the military authorities going to accept they have a major crisis on their hands?Â
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However, a few days later her name was removed from the casualty list altogether and no further information appeared in the local paper. In the months that followed there was desultory 'chatter' on the internet speculating that there had been some sort of army cover-up. At the time lurid rumors were widespread about unexplained deaths of female military personnel both overseas and on bases in the US. Further investigation revealed that SPC Nestling had not been killed on active service in Iraq but was supposedly found slumped dead on the floor of a barrack room (not her own) at Ft.Bragg, North Carolina.

Delay & obfuscation by military authorities

Fast forward a year and a half and the Army was still refusing to make available any information about Nestling's death following requests submitted thru the Freedom of Information Act (FOIA). The reason given was that an active investigation of the case was still in progress.

A second request for details under the FOIA submitted in January 2007 indicated that the US Army Criminal Investigation Command had finally assigned the application a case number. In June 2008, that's two years and five months after Nestling's death, a partial report was released by the army. Withheld from the report were key pieces of information:-

• The Emergency Medical Service Pre-Hospital Report made out when the paramedics responded to the 911 call after the body was discovered
• SPC Nestling's army medical/psychiatric records
• The Autopsy Examination Report determining the manner & cause of death (which was not actually completed until over four months after the autopsy itself took place)
• The Report of Toxicological Examination which was completed within a fortnight of the fatality
• Information on the contents of about a dozen prescription pill bottles found either with the body or in her room at the time of death.
• The contents of letters & journals written just prior to her death
• Evidence of completion of any Army Suicide Event Reports. These are mandatory and must be completed by a credentialed behavioral health clinician within 30 days of an evacuation/hospitalization due to suicidal behavior or within 60 days of an actual suicide
• Evidence of a completed psychological autopsy. Also mandatory when the manner of death is uncertain.
• Swab test results of red and brown stains found on the floor next to the body

The original death certificate, signed 19^thJanuary 2006 & filed five days later, listed the cause of death as 'pending'. It claimed that an autopsy had already been performed & its findings were available prior to completion of the document. This is totally untrue; the autopsy report was not actually completed until the 15^th May 2006 which happened to be the same date as the Supplemental Report of Cause of Death Certificate was completed. This now listed the cause of death as 'undetermined'. So how did an active 24 year-old female soldier die alone in a total stranger's barrack room on a US Army base? How come three years after the event the manner and cause of death are still undetermined? Why have the authorities failed to come to a satisfactory conclusion concerning her demise? Why are they still withholding vital information?

Prescription drug cocktail - an accident waiting to happen?

From the scant and heavily censored details in the partial report released by the army it is still possible to piece together some of the history leading up to the death of SPC Nestling. What it reveals is the tragic story of a young woman with chronic psychological problems including severe depression and anger management issues, a track record of heavy drinking, abusing prescription drugs, bulimia, self-harm including cutting, overdosing, and failed suicide attempts, relationship problems, and questions about sexual orientation.

It begs the question, how did such a person with so many psychological problems come to be accepted into the military in the first place? A military life exposes soldiers to high stress situations which would be traumatic enough in the ordinary civilian world but in combat can result in deadly serious consequences for both individuals & their colleagues. It could be argued that such personnel need to be very carefully selected, well-balanced, and best able to cope with difficult circumstances.

Was her psychological entry-screening really so inadequate or has the desperate need to put boots on the ground meant that psychological standards had been lowered to such an extent that severe depression and bazaar self-destructive behavior are no longer seen as being a disqualification for entry? Once in the service was this same behavior condoned or just overlooked as long as it didn't interfere too much with prosecuting the war in Iraq? How was Nestling treated once in the army, what counseling did she receive, what drugs was she prescribed, and where was the duty of care to look after this young woman? All questions the military authorities have so far failed to answer.

You don't have to dig far into the army documents to find that Nestling had been diagnosed and medicated as a manic depressive with bi-polar disorder from the age of 13. Her brother and mother both had similar problems. Prior to joining the military she had been institutionalized for six months due to depression. Evidence also suggests a chaotic childhood, broken home, family drinking problems, and even the possibility of sexual abuse.

The released army documents are surprisingly light on information as to Nestling's subsequent performance & experience in the army. She appeared to do well, liked service life and working with helicopters but continued to have chronic mental & relationship problems. She was described as being a 'good soldier, she only had problems in her time off'. It was noted she unusually didn't have a cell phone of her own and often borrowed others. She was seen as a à ‚¬Ëœloner with no close friends'. Even prior to being sent overseas she was mixing prescription anti-depressants with alcohol and was once rushed to the ER to have her stomach pumped in what may have been a failed suicide attempt.

It's not clear if Nestling was actually posted to the war zone in Iraq but we do know while stationed in Egypt she was cutting herself, drinking and abusing prescription drugs, before again attempting suicide. She was evacuated to a medical center in Israel for evaluation and put on a 24 hour watch for about 2 weeks, before being sent to the LandstuhlMedicalCenter in Germany where she was diagnosed with a borderline personality disorder and medicated for depression.

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