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Wednesday, September 05, 2007

Combat Veterans, PTSD and Prison

Editor's note: The verdict has been delivered on the Binkley case. Please read California's Landmark Combat PTSD Case: Former Army Ranger Sargent Binkley Receives Treatment, Not Jail Sentence for the latest. -- Ilona Meagher, 1/14/09.

A twin spirit of mine, recently introduced via email and blogging at Healing Combat Trauma, posted yesterday on NPR's look at a new study appearing in the Lancet on worldwide mental health care. It's not pretty. Lily writes, "[N]obody does a good enough job at it, or frankly, enough of it. ...It's perfectly possible that in a three-way contest, we just prefer prisons, or outright neglect."

A story in Monday's San Francisco Chronicle is a timely example.

The article introduces us to a former West Point graduate who served in Bosnia and Honduras now coping with PTSD. He faces a possible 12-year stint in jail for holding up two pharmacies to feed his painkiller addiction, the same medication the VA prescribed -- over 15 times -- for injuries suffered while the former Army Ranger was based in Honduras. The question we might ask ourselves: Did he let us down, or did the system let him down?

The UK is grappling with this, too. From the Daily Mail:

Concern over the nation's duty of care to its soldiers has been [rising] again after it emerged that one prisoner in ten is an ex-serviceman. Ministers came under fire for 'failing' veterans who had risked their lives for the country. MPs, campaign groups and charities said the Government was not doing enough to deal with mental health problems suffered by those who had fought in war zones.

Additional US stats as well as more on the above stories in this look at veterans, PTSD and prison.

Click on 'Article Link' below tags for more...

In the interest of education, articles quoted from extensively.

From the San Francisco Chronicle:

Sargent Binkley says trying to escape the nightmares that haunted him from his military service ultimately led him to a San Mateo County jail cell.

The former Army Ranger captain from Los Altos said he was tormented by the smell of decomposing bodies in a mass grave in Bosnia, and the face of a teenage boy he gunned down during a raid on a marijuana plantation in Honduras. ... Now, the Eagle Scout and West Point graduate, who had no previous criminal record, is looking at a possible minimum sentence of 12 years under a 1997 state gun-crime law. ...

Binkley's defenders say his case raises questions about the quality of military medical care, the flexibility of California sentencing laws and the variability of prosecutorial attitudes from one county to the next.

In 2006, Binkley held up two Walgreen's pharmacies in Mountain View and San Carlos, California. One county is willing to take his previously unblemished police and service record into account for a reduced sentence; the other is not.

Some background:

Binkley grew up in a prosperous Los Altos family and was 18 when he enrolled at West Point after high school. "This is going to sound almost a little canned, but it's actually the truth," Binkley said as he sat in an orange jail uniform. "We come from a nice family. I had a great background. But growing up, I was very patriotic. I wanted to join the United States Army to make a difference for this country."

He was sent to Bosnia in 1999, where his unit guarded the unearthed mass graves of more than 7,000 Muslim men and boys who had been massacred four years earlier by ethnic Serb forces at Srebrenica. U.S. soldiers helped exhume the bodies and guarded the site from stick-wielding Serbs who hurled bottles and bricks at the soldiers, Binkley said. ...

Binkley was reassigned in 2001 to the Soto Cano Air Base in Honduras, a hub for U.S. humanitarian and anti-drug efforts in the region that is staffed by both American and Honduran forces. After one mission against a marijuana plantation, Binkley said, he watched as a Honduran officer executed three of his own men, according to his psychiatric evaluation. Binkley believes the men were suspected of helping the drug runners, but he was told by a civilian U.S. official not to ask questions, his father said.

On another mission, Binkley said, he opened fire on two armed security guards for drug traffickers as they drove toward him in a Jeep. Both were killed; one of them turned out to be a young teenage boy. "I can't get that out of my mind at all," Binkley said. "It was flat-out too hard for me to justify. I can't imagine I'm an airborne Ranger and I'm doing this."

Not surprisingly, he has been diagnosed with PTSD.

In 2001, he fractured his pelvis and dislocated his hip while on base in Honduras. He was given Percocet for pain, Binkley saying military doctors did not warn him that it was highly addictive. The following year he received an honorable discharge.

He got a job in Los Angeles as a junior executive for Neutrogena and took painkillers nightly. Ultimately, his drug use increased, and he lost the job and moved in with his parents. Throughout, military and Department of Veterans Affairs doctors could find nothing wrong with his hip, Binkley's father said.

More than two years after he left the Army, Binkley's parents took him to a sports medicine specialist who used a high-resolution MRI scan to detect small tears in the cartilage surrounding his hip. Outpatient surgery fixed the problem, his father said.

After that, the pain faded away and the VA prescriptions stopped, but Binkley said he was hooked on the painkillers. His attempts to get treatment for post-traumatic stress disorder were stymied by two years' worth of paperwork problems between the VA and the Army, his father said.

"He's having unbelievable nightmares at home, and the only way he can knock himself out is 30 or 40 Percocets," Ed Binkley said. "By the time we can get his papers to the Veterans Administration, he's been in jail for a year. It reminds me so much of the novel 'Catch-22.' I really am waiting to turn the corner in a hallway someplace and run into Major Major Major." ...

Binkley, who sits in jail on $100,000 bail, concedes that he deserves some penalty. "I do need to be punished on some level," Binkley said. But he added, "This wasn't to make money or better myself in any other way. This was to feed an addiction."

In a May 2007 report covering data through 2004, the DOJ's Bureau of Justice Statistics revealed the following:

In 2004,10% of State prisoners reported prior service in the U.S. Armed Forces, down from 12% in 1997 and 20% in 1986. Since BJS began surveying Federal prisoners in 1991, they have shown the same decline over a shorter period. Overall, an estimated 140,000 veterans were held in the Nation's prisons in 2004, down from 153,100 in 2000.

The majority of veterans in State (54%) and Federal(64%)prison served during a wartime period, but a much lower percentage reported seeing combat duty(20% of State prisoners, 26% of Federal). Vietnam War-era veterans were the most common wartime veterans in both State(36%) and Federal(39%)prison. Veterans of the Iraq-Afghanistan eras comprised 4% of veterans in both State and Federal prison. The average length of military service of veterans in prison was about 4 years. An estimated 62% of veterans received an honorable discharge and 38% received various types of other discharges.

Veterans in State and Federal prison in 2004 were almost exclusively male (99%). When compared to other men in the U.S. resident population, male veterans have had lower incarceration rates. Among adult males, the incarceration rate of veterans (630 prisoners per 100,000)was less than half that of nonveterans (1,390 prisoners per 100,000). This lower rate is due in part to age differences since older men typically have lower incarceration rates. Most male veterans(65%)were at least 55 years old in 2004, compared to 17% of nonveteran men.

More than half (57%) of veterans in State prison were serving time for a violent offense, including 15% for homicide and 23% for sexual assault which included rape. Among nonveterans, less than half (47%) were in State prison for a violent offense; 1 in 5 were held for homicide (12%) or sexual assault (9%).

Veterans had shorter criminal records than nonveterans in State prison, but reported longer prison sentences and expected to serve more time in prison than nonveterans. Nearly a third of veterans and a quarter of nonveterans were first-time offenders. The average maximum sentence reported by veterans in State prison(147 months)was 2 years longer than that of nonveterans (119 months). On average veterans expected to serve 22 months longer than nonveterans (112 months compared to 90 months).

Less than half of veterans in State prison (43%) reported recent drug use, compared to 58% of nonveterans. At the time of the offense, a quarter of veterans and a third of nonveterans reported being under the influence of drugs.

Half of State prisoners reported ever having a mental health problem, regardless of veteran status. However, veterans(30%)were more likely than nonveterans (24%) to report a recent history of mental health services, including an overnight stay in a hospital, use of a prescribed medication, or treatment by a mental health professional.

Detailed information on the characteristics of veterans and nonveterans in State and Federal prison is provided in appendix tables available on the BJS website at

The full report is available in a number of formats. For comparison purposes, you may also wish to review the 2000 DOJ Bureau of Justice Statistics report, Veterans in Prison or Jail.

Americans are far from the only ones who the issue of veteran incarceration is an issue. From last month's Daily Mail:

Figures obtained by the charity Veterans In Prison revealed that 7,999 of the [United Kingdom's] 80,000 prisoners had served in the forces. Of these, 7,353 were in the Army, 404 in the RAF and 242 in the Navy. Charity chiefs came up with the figures - which are not collated by the Government - after surveying inmates in British jails.

Vince Cable, deputy leader of the Liberal Democrats, said: "These figures represent the appalling neglect of ex-servicemen, many of whom have served their country with distinction. Stress-related conditions are not being picked up because they are not being properly screened."

Sounds familiar, doesn't it?

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