Hearts back home, minds still in war zone

Bleary-eyed Stryker soldiers file into a Joint Base Lewis-McChord gym, standing straight despite their exhaustion from a flight taking them to the South Sound from the other side of the planet.

“It’s been a long year,” their brigade executive officer, Lt. Col. Robert Halvorson, tells them, building anticipation for family members who wait nearby.

“But in about five seconds, it’ll all be over. You are released.”

Parents, spouses and children rush the gym floor to embrace their soldiers, relieved to have them out of harm’s way.

Celebrations like this are playing out almost every day this winter at the base south of Tacoma. Lewis-McChord is welcoming home one of its largest waves of soldiers from the past 11 years of war. It does not expect to hold a homecoming season of this magnitude again.

Some 8,000 soldiers in two of the base’s three Stryker brigades are due home this winter, ending a tough year in southern Afghanistan that cost 25 lives and sent home many more with wounds and injuries.

But after the parties, the soldiers will face a new challenge: How to tone down the urgency of combat to the everyday pace of life in the states.

In a sense, these men and women are still in Afghanistan even though their feet are in the South Sound and their arms are around their loved ones.

“You’re not the same after you go to war, and that’s fine,” said Halvorson, who helped lead the 3rd Brigade, 2nd Infantry Division in Afghanistan this year. He returned ahead of the main body and is overseeing homecoming preparations for the 3,500 Stryker soldiers in his brigade.

Lewis-McChord is aiming to prevent vulnerable soldiers from falling through post-deployment cracks by building on two changes to its support system since the last major wave of troops returned in the spring and summer of 2010.

 • The base is placing teams of behavioral health specialists inside Army units as they come home, integrating psychologists with infantry commanders for the first time. This takes the doctors out of Madigan Army Medical Center and places them inside a headquarters where they can get a better understanding of what their patients are dealing with.

 • The base has a new division headquarters overseeing the health and training of its largest combat brigades. The 7th Infantry Division’s management role is markedly different from the 2010 homecomings when the base’s highest-ranking I Corps officers were at war themselves or just coming home from combat tours.

The changes reflect 11 years of hard-earned experience preparing soldiers for repeated deployments and guiding them back to civilian lives. It’s a sensitive time, as demonstrated by homecoming challenges throughout the Army.

Late last year, the XVIII Airborne Corps at Fort Bragg, N.C., brought home thousands of troops from Iraq. Within weeks, commanders noticed a spike in risky behavior capped by a surge in suicides and two apparent homicides.

“We have got to stop the violence,” then-Lt. Gen. Frank Helmick told his airborne troops in February, according to reports in the Fayetteville Observer.

When Lewis-McChord brought back some 18,000 soldiers from Iraq and Afghanistan in 2010, the base got ready by staffing up its behavioral health teams. It also developed a system of checkups designed to connect soldiers with therapists multiple times regardless of whether they asked for help.

Still, the base went through a difficult transition. It saw its highest number of suicides in a single year in 2011, when 13 soldiers took their own lives. It also saw climbing numbers of misdemeanors and arrests for driving under the influence of alcohol or drugs, according to records The News Tribune obtained through the Freedom of Information Act.

In August 2010, Lewis-McChord Spc. Brandon Barrett went AWOL after being arrested for driving under the influence of alcohol. His command punished him by denying him a promised leave, and Barrett vanished from the base until he died in a shootout with Salt Lake City police.

An Army investigation showed he had a trying tour in Afghanistan, losing two soldiers in his Stryker brigade and seeing others wounded.

The circumstances of Barrett’s death were exceptional, but the stress he exhibited is prevalent throughout the Army. About 1 in 5 combat veterans tend to show signs of depression or post-traumatic stress, according to a 2008 Rand Corp. study.

Challenging times have also accompanied other homecoming periods. Since 2006, Lewis-McChord’s worst year for felony arrests and reports of domestic violence was 2008 — the year thousands of Stryker soldiers came home from hard fighting during the Iraq “surge.”

RUSHING TO NORMALCY

In September, senior noncommissioned officers at a Lewis-McChord retreat shared a frank discussion about coming home from war.

They talked about feeling uneasy while shopping in stores, or wanting to shout at civilians who took everyday conveniences for granted.

“You have the feeling you don’t belong here,” one soldier said.

In some cases, their routines in Afghanistan made more sense to them than the scenes they observed waiting in line to buy groceries.

“Even though you’re in chaos over there, it’s a controlled chaos,” another senior noncommissioned officer said. “All sorts of things can go on, but it’s what you want. When you’re out of it, in a store, you can’t control any of it.”

Glen Wurglitz, the Army psychologist who led the Soldier 360 exercise, encouraged the noncommissioned officers to be patient with themselves and the troops they lead.

“You can’t just dial off these processes that make you you,” he said, hitting his body to demonstrate that the feelings they expressed are akin to physical reactions to extraordinary experiences.

He joked that civilians can make soldiers feel displaced by rushing a return to normalcy: “What’s the problem, you’ve been home a week?”

GETTING HELP IS KEY

This winter at Lewis-McChord, the Army expects soldiers themselves to be on the front lines taking care of one another. They can do that by checking on each other, or by being open about seeking services such as therapy or marriage counseling.

Maj. Elvis Coronado sees an Army more willing to talk about behavioral health issues today than he saw three years ago.

Coronado commands the rear detachment of the 2nd Brigade, 2nd Infantry Division, which has a few months to go in southern Afghanistan. He had the same assignment three years ago for the same brigade on its initial tour of Afghanistan.

The job requires him to look out for hundreds of soldiers who did not deploy, or who came home early because of injuries.

“You can see the cultural changes,” Coronado said. “I had a sergeant first class (a traditionally hard-nosed rank) who told me he saw a behavioral health specialist, and I thought that was great.”

Halvorson in the 3rd Brigade has gone to marital counseling in the past, and encourages it for his soldiers.

“Everybody needs help,” he said. “We have sergeants major who have been fighting these last 10 years. They have PTSD. It’s just a constant thing in these guys’ lives.”

He plans to pay extra attention to soldiers who were splintered off from their normal chains of command. They include support units that travel throughout the battlefield, possibly not seeing the most intense combat but feeling isolated.

One notable example of a splintered unit resides within Lewis-McChord’s battle-hardened 3rd Brigade.

The 2nd Battalion, 3rd Infantry Regiment has had an unusual command structure over the past year with its 40-man platoons breaking up and joining different Special Forces teams in southern Afghanistan.

One of the battalion’s soldiers was Staff Sgt. Robert Bales, who’s awaiting a court-martial at Lewis-McChord on charges that he left his Special Forces outpost on March 10 and murdered 16 Afghan civilians. Bales’ defense attorneys have suggested he lacked oversight from those who might have caught on to signs of his distress.

EMBEDDING TREATMENT

The 2nd and 3rd brigades are the first at Lewis-McChord to benefit from so-called embedded behavioral health teams as they return from war. Each brigade has a 13-person behavioral health unit that contains psychologists, social workers, prescribers and a nurse case manager.

Previously, those resources were available only at Madigan. Now, Madigan commander Col. Dallas Homas said, doctors are able to break down the stigma of seeking behavioral health resources by showing they’re part of the team and endorsed by senior officers.

“It’s all about pushing higher and higher levels of expertise down to where soldiers feel comfortable using it, and pushing it away from the ivory tower of Madigan,” Homas said.

The Army developed the embedded behavioral health model at Fort Carson, Colo. It found placing the teams inside units kept soldiers healthier and reduced certain stress-related incidents, such as acute psychiatric admissions, suicide attempts and domestic violence.

It also can generate more accurate diagnoses because providers can collect better information.

“What’s most important is the (units) know their behavioral health person by name,” said Simon Pincus, Madigan’s chief behavioral health officer. “That one-on-one relationship is developed.”

Psychologist Keri Clark was among the first Madigan doctors to “embed” in the 2nd Brigade. He said he’s energized by being so close to the infantry.

“This is what I thought I’d be doing when I came to work for the Army,” said Clark, a civilian with no previous military experience.

At Madigan, Clark said the only thing he knew about a patient’s job was what the soldier told him. Clark also had trouble tracking down commanders and peers to learn more about his patients.

Now, Clark has regular meetings with a battalion commander and is in the thick of planning for the 2nd Brigade’s return in January and February.

“We already know soldiers. We’re already tracking them,” he said.

A NEW APPROACH

Lewis-McChord’s new division headquarters also gives senior leaders more opportunities to pay closer attention to signs of stress in the ranks compared to past homecoming waves.

In 2010, for instance, Lewis-McChord’s senior officers in the I Corps started making reintegration plans for their Stryker soldiers at the tail end of their own deployment managing daily operations for the Iraq War.

This time, Maj. Gen. Stephen Lanza, commander of the 7th Infantry Division, has been calling on deployed brigade commanders for updates on the health of their soldiers for the past two months. They hold telephone conferences in which they discuss individual soldiers who might need extra attention.

Brigade commanders also provided spread sheets tracking the frequency of behavioral health visits in Afghanistan. They showed a rush of soldiers seeking help when they first saw heavy fighting in May — a month when six local soldiers were killed in combat — and again this fall as the deployments were winding down. (Lanza showed the charts to The News Tribune, but did not let a reporter a keep a copy.)

The information he gained from brigade commanders can help officers and doctors pinpoint soldiers who need help right away, or develop reintegration plans for the months ahead.

For example, behavioral health teams are meeting troubled soldiers as soon as they land at Lewis-McChord if they’ve been identified as needing help by commanders in Afghanistan. A health care provider will stick with the soldier until the soldier makes a plan for follow-up visits.

“We didn’t know what we had coming back” in the past, Lanza said. “The intent is to give us more situational awareness so we know who’s coming back.”