Army Reports Still Having Problems in Trauma Unit

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Problems in Army’s Trauma Units
By JAMES DAO
The New York Times


The Army units created to provide special care for wounded soldiers after the Walter Reed Army Medical Center scandal continue to struggle with short staffing, inadequate training and an overabundance of prescription medications, a report by the Army inspector general’s office.


Army Inspection of the Warrior Care and Transition Program
The easy access to medications in the so-called Warrior Transition Units has meant that about a quarter to a third of all the soldiers in the units are “over-medicated, abuse prescriptions and have access to illegal drugs,” the report said, based on estimates provided by staff at the units.

The report, which was released this week, said that over all, the program was working. But it suggested that too many soldiers were staying longer in the units than was necessary, either because they were trying to “game” the system to improve their disability benefits or because a slow and understaffed medical bureaucracy had delayed treatment.

As a result of those delays, deserving soldiers are being prevented from rejoining their regular units or from getting out of the military altogether, while less deserving soldiers may be taking resources away from troops who need care more.

“The inspection team noted a ‘sense of entitlement’ among some warriors in transition,” the report said.

The report was the result of growing complaints from the soldiers in those units about the quality of care they were receiving as well as from their commanders about the discipline problems posed by some soldiers.

The New York Times described complaints from soldiers about overmedication, a lack of therapists and long waits for medical discharges in an article last year about the Warrior Transition Unit at Fort Carson, Colo.

The units were created in 2007 after articles in The Washington Post exposed serious shortcomings in care for wounded soldiers at Walter Reed, the Army’s flagship hospital. Soldiers assigned to the units are expected to get healthy and return to regular duty, or transition out of the Army. Specialized health care services are provided to them during their recovery periods and they are given more limited duties.

More than 26,000 soldiers have passed through the units. There are about 9,500 soldiers in several dozen transition units across the Army, including at all major Army posts and in community-based programs for reservists.

In a statement, the Army said it had accepted the findings of the inspector general and already tried to fix some of the problems, including by improving training for overseeing soldiers with mental health problems. The Army is also trying to expand therapies that do not require medications and tighten monitoring of pain prescriptions, the statement said.

The transition units have long been criticized by some commanders as dumping grounds for soldiers not fit to deploy. That concern is raised in the report, which notes that just 10 percent of the transition unit soldiers had been physically wounded in combat, while the rest had mental health problems or noncombat related injuries or illnesses.

The report said the soldiers with physical combat wounds tended to move out of the units faster and more frequently returned to full duty, while the noncombat wounded tended to be the greater discipline problems.

It also noted that the units too often seemed to push soldiers toward seeking disability compensation over getting healthy, noting the influence of “barracks lawyers” — older soldiers who counseled younger ones in how to get benefits.

Some advocates for wounded soldiers say such concerns are overblown. Many soldiers in the units are taking medications for post-traumatic stress disorder that make them forgetful, irritable or disoriented — thereby causing tensions with their platoon sergeants.

The report said that many of the platoon sergeants and leaders themselves felt they were not qualified to handle soldiers on medications or with mental health problems, and they wanted better training.

It also recommended that the Army make serving in the units a more attractive career option. Some platoon sergeants told the investigators that overseeing the wounded soldiers was equivalent to “taking a knee” and not as prestigious as being a drill sergeant or in a combat unit.

“On several occasions, we were informed that ‘the best qualified person is often the first/most available,’ ” the report said.

The volatility of some wounded soldiers, particularly those waiting for medical discharges, made certain staff members nervous, the report said. Some reported having tires slashed or receiving threats from soldiers, and several suggested installing “panic buttons” in their offices for protection.