May 9, 2010
Most Fort Carson soldiers are greeted with fanfare as they return from war: cheering throngs of friends and relatives, children they haven’t seen in months, comrades who whisk them away for a night on the town.
But what happens when the homecoming euphoria fades?
As the 4th Brigade Combat Team trickles home from Afghanistan, Fort Carson says it is poised to treat the effects of the unit’s difficult year at war, from the depression, anxiety and nightmares that gradually afflict some returning soldiers to brain injuries that might have gone unrecognized.
Nearly 200 of the brigade’s 3,800 soldiers have arrived at Carson since late April. They will continue to return through June.
“I’m expecting to see a unit that’s been worked hard and put up wet,” said Col. John Powell, an Army physician who oversees the post’s Soldier Readiness Center, which provides mandatory medical screenings for soldiers about to deploy or just getting home.
Getting the soldiers the care they need is job No. 1 for the center’s health care providers, and signs from the war zone suggest they will be tested.
Forty-six of the brigade’s soldiers have died in the past year — the latest death was announced Friday — and health experts at the Soldier Readiness Center say those losses will reverberate long after the homecoming parties.
During preliminary assessments conducted in Afghanistan, approximately one-quarter of the brigade — about 920 soldiers — was flagged by unit health care providers to receive a closer-than-normal look after returning to post, Powell said.
These at-risk soldiers were listed as “amber” under Fort Carson’s triage system, either because of concerns voiced by their commanders or because unit doctors identified risk factors that could be aggravated by sustained combat, such as a history of depression or turmoil at home.
An additional 21 soldiers were listed as “red,” meaning the Army considers them a potential danger to themselves or others.
“As soon as they leave the airplane, somebody’s there,” Powell said. “Some of them will end up as inpatients. Not a large number, but some.”
The influx of battle-worn soldiers comes as Fort Carson grapples with fallout from an April 24 story in the New York Times that suggested serious flaws in the post’s Wounded Warrior Battalion, where injured soldiers who are unfit for duty receive long-term care before they are released from the Army or returned to service. Top Army officials pledged to look into the newspaper’s claims that fragile soldiers suffer from overmedication, neglect and harsh treatment.
As many as 100 soldiers from the 4th Brigade Combat Team are expected to join the unit upon their return, Fort Carson officials said last week, after defending the care they provide.
Administrators at the Soldier Readiness Center say they have improved their screenings based on seven years of deployments at Carson. One notable change is the introduction of a behavioral health station as a mandatory stop alongside other routine screenings such as eye exams, immunizations and hearing tests.
“If you send them away, and you don’t have everything here, there is the tendency for a soldier to fall through the cracks,” said Alden Prowell, the center’s medical director.
Every soldier must complete a daylong assessment before being cleared for a 30-day post-deployment leave.
Each soldier must return for a reassessment within 90 days, to catch problems that arise after the passing of a “honeymoon phase” when the soldiers are just glad to be home, officials say.
One top concern: Getting honest answers from soldiers who often want to go straight home to their families rather than face the prospect of further treatment.
The soldiers meet individually with physicians, clinical social workers and other health care providers who poll them about their welfare and compare their answers against medical histories and observations from commanders and unit doctors.
“It’s that provider contact that allows us to get a feel for how the soldier is really doing,” said Rick Bretthauer, the center’s chief physicians assistant. “We try to get an idea of the problems that they’ve had during their deployment, and some of the things that have affected them. We ask how they’re feeling now, and how things are going with their home and with their finances, with their job.”
If a soldier appears to be downplaying past problems, Bretthauer said, the soldier may be referred to a behavioral health provider for a more detailed examination.
Capt. Trent Elliott, a psychologist, said health information gathered during a soldier’s tour of duty had “improved dramatically,” enhancing screeners’ ability to accurately assess a soldier’s well-being.
“There’s a certain skeptical eye you have when you’re asking questions of somebody who all they want to do is leave,” said Powell, the center’s supervisor.
He said the center’s care providers tend to err on the side of caution.
“It’s a big deal to them to see these guys and make sure they’re square,” Powell said.
Soldiers flagged as “amber” or “red” during the preliminary assessments in Afghanistan are subject to greater scrutiny to ensure they receive help they may need, officials said.
Screeners make sure the Army has telephone numbers for family members or other sources of support before the soldiers are allowed on leave.