A mental health patient's audiotaped encounters with Fort Carson doctors led to a sweeping investigation of Evans Army Community Hospital and a series of reforms in patient care, documents obtained by The Gazette show.
The Army found that some workers in the hospital's behavioral health department were demeaning, patronizing, foul-mouthed and told the soldier that a mass shooting at Fort Hood, Texas, would make commanders pay attention to his claims of mental illness because they would see him as likely to snap.
The 775-page report cleared the hospital of allegations that psychiatrists and therapists worked to push mentally ill soldiers out of the Army on conduct-related discharges but found they did feel pressure from commanders to clear the way for discharges.
A social worker and a major working as a physician were disciplined after the report. Fort Carson said the major "was removed from his leadership position."
"This incident does not speak to the core values or the common practices of the Fort Carson behavioral health staff," said Col. Dennis LeMaster, the hospital's commander.
The investigation began in May when a staff sergeant presented commanders with recordings made during mental health visits. It concluded in August when Army Surgeon General Lt. Gen. Patricia Horoho ordered the hospital to retrain its behavioral health staff.
"The Evans Army Community Hospital commander will conduct a phased behavioral health stand-down to address issues of professionalism in the workplace; dignity and respect during patient encounters; the use of profanity during patient encounters; how to balance demands from the chain of command with providing objective, patient-centered care and proper boundaries when discussing benefits with patients," Horoho ordered.
Horoho discussed some of the problems at Fort Carson during a Pentagon roundtable with reporters this month - the first time the Army had revealed the issue.
The staff sergeant, a sniper and Bradley Fighting Vehicle gunner from the post's 3rd Brigade Combat Team, told investigators that the Army began threatening to kick him out in 2014 after he reported suffering from war-caused mental illness.
In May, when his symptoms became worse, he was reportedly told by workers at Evans that his pending discharge would go forward.
The sergeant recorded a visit with an Army psychiatrist that included the doctor accusing him of lying about his condition, the report found.
Like the names of those involved, the content of the recordings was not released in Army documents.
Reaction to the recordings was clear, though.
"If the recordings I heard are any indication of the care this soldier has received then this soldier urgently needs competent and compassionate care," one Army Medical Command civilian wrote in an email to superiors.
The sergeant said his medical care was influenced by the Army's desire for a discharge, including records that described him as a "31-year-old patient pending chapter (discharge) for misconduct."
The Army has come under fire for giving disciplinary discharges for minor misconduct to soldiers suffering from war-caused mental illness. Those other than honorable discharges, which can leave soldiers without their VA medical benefits, were documented in a 2013 Gazette investigation that earned a 2014 Pulitzer Prize. One story from that investigation was included in the Army report.
The Army's investigation found that health care providers at Fort Carson still feel pressure to sign off on discharges for soldiers with war-caused mental wounds.
LeMaster said the investigation found no sign that the hospital was colluding with leaders of combat units to speed discharges for soldiers. Still, hospital workers were instructed after the report's release to not let outside influences guide their mental health care decisions.
"They are encouraged to make a clinical diagnosis based on the facts that come to them," LeMaster said.
The hospital also was ordered to clean up its ombudsman process after the surgeon general found that the advocates for patients were "disenfranchised."
The ombudsman, in a statement to investigators, said patient complaints about behavioral health were common and described pressure from commanders and military lawyers to discharge mentally ill troops rather than put them through a process that can lead to medical retirement.
Other leaders at the hospital denied that the pressure existed or said it didn't affect medically evaluating troops.
The report showed that stigma remains in the ranks when it comes to mental health. One sergeant in the 3rd Brigade told investigators that combat leaders are suspicious of their comrades in psychiatry and psychology.
"Some soldiers use them to their advantage to get out of work or get benefits," he said.
LeMaster said there will always be a degree of conflict when it comes to behavioral health, including how to handle patients.
"There is going to be spirited disagreement," he said. "The providers need to stick to the clinical facts and then make an opinion based on those facts."
Mental illness in the ranks skyrocketed during the wars in Iraq in Afghanistan, with some estimates saying one soldier in five will come home with war-caused mental trauma.
At Fort Carson, the hospital has increased its mental health staff from 40 to 150 since 2008. Those 150 mental health workers handle an estimated 375 patient visits per day.
LeMaster said that in patient surveys 83 percent of those getting help for mental illness at Fort Carson report they're satisfied with care, and 6 percent reported they were unhappy.
The colonel said his staff works to treat every patient with dignity and respect. Plans are in place to reinforce training on how to deal with patients and the ethics of the job.
The staff sergeant at the center of the inquiry avoided a conduct discharge and is now in a unit for wounded and ill troops on the path to a medical retirement, LeMaster said.
He said the system to treat soldiers like the staff sergeant is fair, professional and compassionate.
"What we have here, based off the report, appears to be an isolated incident," LeMaster said. "A very disturbing isolated incident that we responded to forcefully."
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Contact Tom Roeder: 636-0240
Twitter: @xroederx
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