First it was the horrors of Iraq. Now, Rob Withrow is locked in a fight with his own Army superiors. He wants mental health treatment -- they want him to face a court-martial
Broken Warrior, One Soldier's Strugglearticle in Seattle PI
Broken Warrior: One soldier's struggle Saturday, April 14, 2007
By CAROL SMITH
P-I REPORTER
Rob Withrow was a good soldier until he got back from combat duty in Iraq.
Now by his own admission, he is no longer anyone's idea of a model fighting man. He screwed up, and he's screwed up -- an assessment the Army would agree with.
But that's where their agreement ends.
Withrow wants mental health treatment. He has tried to commit suicide four times since returning from Iraq. He has been hospitalized in Madigan Army Medical Center's inpatient psychiatric unit on multiple occasions and is currently on a cocktail of antidepressants and psychoactive drugs. He is a month out of treatment for an addiction to narcotic pain pills that he began taking to "numb out" the month he returned from Iraq and he does not fit the Army's new criteria for deployment.
But now the Army wants to redeploy him to Iraq, and court- martial him over there. The charges stem from his pattern of not showing up on time, or sometimes at all.
Withrow's case raises questions about how the Army handles soldiers with psychiatric illnesses, particularly PTSD and depression and whether discipline, or the threat of it, interferes with treatment.
Since his return from Iraq in November 2004, Withrow has received multiple Article 15s -- the Army's form of non-judicial punishment -- for disciplinary issues related to "patterns of minor misconduct." He's been reduced in rank from sergeant to private.
If he is discharged for misconduct, he will lose benefits for his family, which is already facing a financial crisis related to his demotions.
"I'm not going to candy coat it," Withrow said. "I'll take responsibility for my part. I have purposefully not gone to work."
At the time, medical records show he was struggling with depression, anxiety and post-traumatic stress disorder. He repeatedly informed doctors that he was late or absent to work because he was having difficulty waking up, in part because of powerful sedatives prescribed for sleep disturbances.
Still, prosecutors have indicated their intent to court-martial him in Iraq, said Capt. Geoff Deweese, Withrow's defense attorney.
"I think it would be absurd for them to do that," Deweese said. "You don't bring someone with this kind of instability to a combat zone and risk harm to himself or others."
Culture clash?
The military's handling of mental health problems has come under intense scrutiny after an increase in the number of soldier suicides in Iraq in 2005. According to the Army's most recent Mental Health Advisory Team Findings, the suicide rate was 19.9 per 100,000 soldiers in 2005, up from the year before. That review led to new mental health screening policies and more stringent criteria for sending soldiers to war with pre-existing mental health diagnoses.
"Severe mental disorders, such as schizophrenia, bipolar disorder and severe depression, preclude deployment," Col. Elspeth Ritchie, the Army Surgeon General's Consultant on Psychiatry, said in an e-mail. "Soldiers may not deploy on a variety of types of medication, to include lithium, antipsychotic agents, and anticonvulsant agents."
But for soldiers such as Withrow, the reality after they return from deployment is that behavior stemming from mental health problems can result in disciplinary action rather than treatment.
The Army does offer several ways to provide psychological help for soldiers and is in the midst of testing a number of new programs to improve resiliency. Soldiers go through an extensive evaluation two to three months after their return to gauge adjustment back to life on the base and to spot any emerging health issues -- physical or mental -- said Fort Lewis spokesman Joe Piek. The Army also offers confidential help lines and other mental health counseling.
But the military culture, and sometimes the symptoms of depression itself -- fatigue and despair -- can still make it difficult for soldiers to find and benefit from treatment, said Dr. Jonathan Shay, Boston-based author and psychiatrist who specializes in combat stress injuries.
"What you have is a military that's not set up to care for these soldiers," said Tod Ensign, attorney and director of Citizen Soldier, a non-profit veterans advocacy group that has represented a number of soldiers with mental health histories who are being charged with misconduct. The Army, under pressure to keep its troops eligible for re-enlistment, discourages treatment that would deem them undeployable, he said.
If a soldier does seek treatment, often in tandem with discipline issues that stem from PTSD or other disorders, the Army's preference is to discharge them for misconduct or for having pre-existing mental conditions, either of which would reduce the burden on the Veterans Affairs medical care system, Ensign said.
Withrow said when he first tried to get help, he felt like he was getting the runaround. So he gave up.
When his symptoms were bad enough for him to go to the emergency room, he did receive help. But his symptoms persisted, despite treatment. At the same time, he began having trouble in his unit with a commander he perceived as unsympathetic.
Withrow and his lawyer contend that if he had gotten the right help at the appropriate time, his situation never would have escalated.
Withrow says he wanted to stay in the Army. In the midst of all his turmoil, he pleaded to be reassigned to his original battalion in the 3rd Brigade, 2d Infantry Division, which he knew would be going to Iraq again. (It deployed last July.)
"They said they would welcome me back, even knowing everything that was going on," said Withrow.
Now he wants a discharge on the best terms possible for himself and his family. Instead, he is facing a court-martial.
Born on the Fourth of July
Withrow, 27, was born in Gettysburg, Pa., on the Fourth of July. He enlisted in the Army and headed to boot camp 20 days after graduating high school in June 1997. A field artillery sergeant, he planned to make the military his life's work.
In November 2003, he went to Iraq with the 1st Battalion, 35th Field Artillery Regiment. When he returned a year later, he received an Army Commendation Medal for "Exceptionally meritorious service as an air guard during operation Iraqi Freedom."
Prior to returning from Iraq, he had no disciplinary record and consistently received good-conduct medals, his attorney confirmed. A memorandum from his first sergeant with his old brigade noted, "I would gladly serve with SPC Withrow in combat again because I believe him to be a true Warrior."
Tall and lean with trimmed dark hair, Withrow is personable and straightforward while relaying his story, but bluish circles under his brown eyes betray fatigue. In addition to his legal and health problems, he is facing bankruptcy and loss of his base housing. He worries frequently out loud about what will become of his wife and three children if he goes back to Iraq. "I don't want them to wind up on the street," he said.
"When he got back, I could tell he was just different," said Jenny Withrow, his wife of six years.
Like many of his comrades, he said he had images from Iraq burned into his brain -- a mass grave with still decomposing men's bodies layered over women's and children's, fresh bullet holes in his Humvee.
"I would lay in bed at night and wonder if this is the night I get blown up," he said.
Adjusting to life back home wasn't what he expected. He had left when his baby girl was 4 months old.
"When I got back, my daughter -- it's like she didn't know me," he said.
Other guys gravitated to alcohol, he said. "I gravitated to opioids. All I wanted to do is be numb."
In May 2005, short on non-commissioned officers, the Army transferred Withrow to a different unit. But he didn't click with his new command and missed the soldiers he had deployed with. "We were like family," he said. His depression worsened and he started having difficulty waking. He began showing up at the ER with problems breathing from panic attacks. In August 2005, he was diagnosed with PTSD as well as depression and anxiety.
He was also late reporting to work on a number of occasions.
Instead of recommending him for mental health treatment, however, he was threatened with an Article 15 -- a demotion. "They said fix your issues, or we'll take your stripes," Withrow said.
At his request, the Army did switch him to a different battery for a fresh start in September 2005. But the second day with that unit, he woke late again. He said that the night before, he laid in bed and contemplated killing himself.
Distraught, he first tried to cut his wrists. He then tried to drive straight into a tree at full speed with his seat belt off. He swerved at the last possible moment, he said.
"I drove myself straight to the ER instead," he said.
He was admitted to the psychiatric ward and stayed four days before being discharged to full duty, with the understanding he would go through a two-week outpatient behavioral health program.
His commander picked him up from the hospital and offered him a chapter discharge "nice and quiet," but Withrow, who had put in nearly nine years, wasn't ready to give up the Army.
The scope of the problem
Estimates of the number of soldiers who suffer from PTSD and mental problems vary, but most experts agree that the nature of the fighting in Iraq sets up soldiers for psychological trauma.
According to Ritchie of the Surgeon General's Office, an estimated 15 to 17 percent of deployed soldiers experience PTSD and 23 percent experience other behavioral health problems. Others put the numbers higher.
According to a study published last month in the Archives of Internal Medicine, nearly one-third (31 percent) of 103,788 veterans who had served in Iraq and Afghanistan were diagnosed with mental health or psychosocial problems upon their return.
The Surgeon General's Office indicated about 11 percent of soldiers who have returned receive mental health diagnoses.
For Withrow, as his mental anguish grew, his problems with his commanders intensified.
"If I were his commander, I'd be frustrated with him as well," said Deweese, who has also worked as a prosecutor.
At the end of March, Withrow was informed he would deploy this week with the 4th Brigade, 2nd Infantry Division back to Iraq.
As part of predeployment screening, an Army psychiatrist specified his "symptoms are not stable" and indicated he should have "no access to weapons or ammunition, no exposure to combat situations, no exposure to casualties, and was not recommended for deployment."
The issue of whether to send him to Iraq for a court-martial is still pending.
P-I reporter Carol Smith can be reached at 206-448-8070 or carolsmith@seattlepi.com.
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