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Latest Fort Hood Shooting Raises Questions About Military Mental Care

Fort Hood Shooting Puts Focus Again on Mental Illnessi
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Greg Flakus
April 04, 2014 9:14 PM
The tragedy at Fort Hood, Texas, this week has drawn attention to the challenge of treating mental illness in the military and the misconceptions about mental afflictions in society as a whole. VOA's Greg Flakus spoke to one of the top U.S. experts on mental illness and filed this report from Houston.
Greg Flakus
— Military investigators are looking closely at the medical record of Ivan Lopez, the gunman who killed three people and wounded 16 others before taking his life at Fort Hood, Texas Wednesday. Indications that Lopez had mental problems have raised questions about how much mental health help the U.S. military is providing for service members who need it.

As the investigation into this week's shooting at Fort Hood continues, officials are saying little about the shooter, Army Specialist Ivan Lopez, and have provided little information about what may have been his motive. Other soldiers and family members on the sprawling Army base in central Texas who were acquainted with Lopez described him as friendly and normal in appearance.

Lt. General Mark Milley told reporters Thursday that there is evidence of a history of mental problems that may have contributed to his sudden rampage.

"We have very strong evidence that he had a medical history that indicates an unstable psychiatric or psychological condition," said Milley.

Milley said there is evidence that the shooting spree may have been triggered by an argument he had with someone on the base earlier that day. Critics of the U.S. military's mental health programs say this may have been a case of a patient who was not given all the help he needed.

Authorities say Lopez had been treated for mental problems, but had not been diagnosed with post-traumatic stress disorder, a condition sometimes suffered by soldiers who have been in combat. Lopez served in Iraq for four months, but was not in combat. He had been taking a number of prescribed medications, including Ambien, a drug used to induce sleep. It has been associated with numerous side effects, including aggressive behavior.

Mental health experts say such reactions are rare and that assessing risk of violence is a tricky task. John Oldham, chief of staff at the Menninger Clinic in Houston and former president of the American Psychiatric Association, said very few mental patients turn violent.

"It is a very small minority of people with psychiatric or brain disorders where there is this risk of violence," said Oldham.

Oldham said psychiatrists look for a number of risk factors when evaluating patients, but absent some very clear signs, they cannot always determine who might turn violent.

"We know things that are risk factors: when it runs in the family, when there has been in fact a severe depression, when there has been a previous suicide attempt; there are lots of things on that list, but it does not mean that it is easy to tell if the person you are individually talking to is going to be at risk for either violence or self-harm," said Oldham.

Oldham said the bigger problem for the military is that half of the soldiers who need help for conditions like depression, anxiety or mood shifts do not seek help.  Many soldiers say they believe having any kind of mental treatment could hurt their careers.

Oldham said both in the military and in civilian life, people with such problems are stigmatized and that each time there is a violent incident like the Fort Hood shooting, it becomes worse.

"What does not get noticed is the thousands and thousands and many more of people who are perfectly safe and benefiting from treatment.  We need people with problems to walk through the door and get help.  We do not need them to be afraid to," he said.

As the investigation at Fort Hood proceeds and more information comes out concerning Ivan Lopez and his mental problems, there is bound to be more debate over what military officials should be doing to make sure that those in their ranks who need help will have it available and not be afraid to take it.

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