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Secret Army tape | Salon News
After a soldier taped a psychologist saying he'd been pressured not to diagnose PTSD, the Army launched an investigation. Read the details of how the Army declared itself innocent.
Editor's note: Read about Sgt. X's tape -- and listen to a segment of it -- in the first story in this series, "I Am Under a Lot of Pressure to Not Diagnose PTSD." Read a summary of the Army's internal investigation, in which it determined that it was not exerting such pressure, here.
By Mark Benjamin and Michael de Yoanna
Stichman's NVLSP counterpart, Abrams, recalled that Cody avoided talking about the specifics of the tape or discussing how a thorough investigation of the tape might ultimately improve Army mental health care. Instead, Abrams remembered Cody describing Army initiatives to improve mental health care, including efforts to deal proactively with suicide risk through "chain teaching" -- commanders supporting commanders to get soldiers help. In other words, Abrams said, Cody seemed reluctant to explore whether the tape was a representation of specific abuse and possibly wider problems. Instead, Cody merely spoke in broad terms about how the Army's existing healthcare system operates. Cody's tone, Abrams said, was "insulting."
Cody told Stichman and his associates that an internal investigation of the tape would be conducted. To Stichman's surprise, Cody then suggested what the not-yet-completed investigation would reveal.
Cody denied that the Army was pressuring doctors not to diagnose PTSD in soldiers. "There is no one in leadership telling doctors to do this," stated Cody. "This is not Army policy." Cody called the evidence on the tape "anecdotal."
After the meeting was concluded, Stichman never heard from Cody again. None of the other officers in the room contacted Stichman, either. Just three weeks after the meeting, Cody retired from the Army. Last September, the former general joined L-3 Communications, a defense contractor, as corporate vice president. Salon described this article to an L-3 spokeswoman and requested an interview with Cody, but was told Cody was "not interested" in talking. "He has retired and moved on," the spokeswoman said.
On July 28, a week before Cody's retirement, the Army completed its internal investigation, an informal review known as an "AR 15-6."
Salon requested a copy of the investigation in November through the Freedom of Information Act. The Army finally produced a copy in March, after it became apparent that Salon had obtained the recording and planned to write about it. Large portions of the report are blacked out, including several entire pages of the "analysis of evidence" and the explanation of the conclusions. The Army even blacked out some references to "PTSD."
What is not blacked out is that the Army Medical Command, which investigated itself, determined that none of the medical workers under its watch did anything wrong. "This investigation," it states, "does not find that any level of [the Army Medical Command] staff and leadership have attempted to coerce or otherwise influence the outcome of clinical evaluations."
What also escaped the black pen was the name of the man who presided over the review: Brig. Gen. James Gilman, who commands Great Plains Regional Medical Command, which oversees several Army hospitals, including the one under scrutiny at Fort Carson. Gilman assigned Col. Bruce Crow, the clinical psychology consultant to the Army surgeon general, to supervise the actual investigation.
Almost the entire investigation consists of questionnaires handed out to a handful of healthcare providers. There is no interview of Sgt. X, the soldier who made the tape, or any review of his case.
The copy of the investigation ultimately obtained by Salon shows that the Army reached almost exactly those conclusions that Cody had predicted it would reach: "This investigation does not find that any level of [the Army Medical Command] staff and leadership have attempted to coerce or otherwise influence the outcome of clinical evaluations."
Yet the investigation found "potential systemic pressures" that could cause a misdiagnosis. Those pressures "may lead providers to avoid making a diagnosis of PTSD ... contrary to their clinical judgment." The Army says it fixed those problems last December by removing a requirement that soldiers produce "credible supporting evidence" that they faced trauma in war in order to receive benefits.
In addition to relying almost exclusively on questionnaires to a handful of Army healthcare officials and failing to interview Sgt. X or scrutinize his medical records, the Army also did not interview the NVLSP's Pogany, who has documented several cases that support what was said on Sgt. X's tape. And there is no evidence the Army went back to see how many soldiers might have been refused benefits to which they were entitled during the years since the nation began its wars in Iraq and Afghanistan.
Gilman, the general who ordered the Army's investigation, defended the Army's response to the tape. "We were very, very concerned about what we heard on the tape," he said in an interview. "We felt that an investigation was warranted and we moved out on that as expeditiously as we could." He also supported the idea of limiting the investigation mostly to questionnaires sent to healthcare providers. "The thing that concerned me was that internal to the hospital … somehow people were getting the word that people should use something other than good clinical practice and clinical judgment to assign diagnoses," Gilman said. To investigate that, he added, "you go talk to the people who are involved in those processes."
It appears, however, that investigators did not question the Army officer who Douglas McNinch said had pressured him not to diagnose PTSD. In an interview with Salon, McNinch said the pressure to misdiagnose soldiers came from the psychiatrist who used to head the Department of Behavioral Health at Fort Carson. "His name was Steve Knorr," McNinch said. When asked if he told Army investigators this information, McNinch responded, "Yes, I did." Though the extensive redaction makes it difficult to say for certain, there is no sign in the report that Knorr was contacted or interviewed by Army investigators.
McNinch also said he was afraid to talk. He himself suffers from medical issues and, as a civilian employee of the Army, is going through the process of getting government benefits. "I am going through a disability process right now," he said, "and quite frankly, I would not put it past the Army to, you know, fuck me over, to be blunt."
McNinch's naming of Knorr is particularly intriguing, given that Knorr's name has come up before in connection with internal investigations of possibly questionable Army medical care. In a 2007 article for the Nation, journalist Joshua Kors documented a shocking cover up of Army misdiagnoses. The Army was apparently diagnosing soldiers as having "personality disorders" instead of combat-related stress. Since "personality disorders" supposedly preexist military service, they cannot be attributed to combat, meaning veterans are potentially ineligible for proper benefits. Kors reported that Knorr conducted a review of cases on behalf of the Army's acting surgeon general and determined that no one in the Army had done anything wrong. Within a year, in response to the Nation article, the Government Accountability Office, the investigative arm of Congress, released a report questioning why 2,800 war veterans had been diagnosed as having "personality disorders."
Contacted by Salon, Knorr said, "I don't talk with media. Good day," and hung up.
Salon has learned that one of the officers conducting the investigation of the tape is a junior officer to Knorr at their shared Army post. Lt. Col. Kris Peterson, chief psychiatrist at Madigan Army Medical Center at Fort Lewis, Wash., assisted Col. Bruce Crow in the investigation of the tape. Knorr is now a health consultant at Madigan.
Crow, meanwhile, was also implicated in the "personality disorder" scandal. As Knorr was writing up his review back in 2007, the Army dispatched Crow to Congress to "set the record straight," as he told the House Committee on Veterans' Affairs on July 25, 2007. Crow said the Army would study soldiers dismissed with personality disorders but suggested the Army was doing nothing wrong. He said soldiers with a diagnosis of personality disorder only "feel" they have been wrongly separated from the Army. "I want to assure the Congress that the Army Medical Department's highest priority is caring for our warriors and their families," he told the panel.
In a statement to Salon, Col. Catherine Abbott, an Army spokeswoman, reiterated Gilman's defense of the Army's internal investigation of Sgt. X's tape. "They did do an investigation into it," said Abbott in a phone interview. "There was indeed no pressure and no coercion to make any diagnosis other than the correct ones,."
"This story," Abbott said, "is over and done with."
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