Reports of disrespectful and abusive care at Warrior Transition Units have emerged, but the Army's surgeon general said Friday that the Army has gotten out in front of the media reports, and that investigations show the problem is not systemic.
News outlets in Dallas reported in November that hundreds of soldiers had suffered a pattern of "disrespect, harassment and belittlement of soldiers" at WTUs at Fort Bliss, Fort Hood, and Fort Sam Houston in Texas.This comes on the heels of another incident at a medical facility (not a WTU) at Fort Carson, Colorado, that had led to discipline against a physician and a social worker for actions dating to early 2014.
Lt. Gen. Patricia Horoho, the Army surgeon general, affirmed that while even one case of abuse isn't tolerable, most of the complaints turned out not to be medical care-related and about 24 cases of harassment have been dealt with. And she said the reports documented issues that the Army already uncovered itself.
"They weren't concerns that an outside source came to us and said do you realize you have these problems," Horoho said at a round-table update on her command for members of the media at the Pentagon on Friday. "We have eight different avenues (for) our warriors and their family members to have their voices heard. When those concerns come up, each of them is looked at and then we take appropriate action."
She cited high patient satisfaction rates with both WTUs and behavioral health in general, and the reports themselves noted that many soldiers expressed such sentiments.
The Army now has 24 WTUs in the U.S. and one in Germany, facilities designed for wounded or ill soldiers who need complex care and at least six months of rehabilitation. That number has been decreasing and will decline further, Horoho said. The WTUs now house about 4,000 soldiers, down from a peak of 11,000 at the height of wars in Afghanistan and Iraq.
"I think you will probably see a decrease in the number of Warrior Transition Units, with always having the caveat of needing expandability," Horoho said. "Because it's a concept we are going to keep, so should we find ourselves in another conflict, we're going to need to be able to expand."
She talked about the overall benefit of the WTUs, which she said have cared for 66,000 soldiers since 2007 and managed to put 45 percent back on active duty, which she said represents huge retention of knowledge and talent.
While there will be further downsizing, she said the population in WTUs would probably level off around 3,800. Although 75-80 percent of soldiers in WTUs have deployed, the injuries and illnesses don't always come from battle, she said.
WTUs represent a major learning experience from recent wars, and that includes care in the realm of behavioral health and mental health issues such as post traumatic stress. Horoho said a combination of increased awareness and availability combined with decreased stigma had increased outpatient behavioral health visits from one million in 2007 to two million visits last year, while decreasing costlier inpatient behavioral health admissions.
She also emphasized the Performance Triad initiative, which stresses good diet, exercise and sleep to improve overall health.
Sleep in particular has been a focus; she says reversing the decline in sleep hours, both for soldiers and civilians, the most important thing the nation can do from a health perspective. The steady decline in average sleep time over the last two decades has been linked by research, she said, to everything from cognitive impairment (and therefore, combat readiness) to increased obesity rates.
She admits that soldiers at first expressed skepticism about the emphasis on sleep, but that has waned.
"Now we've got leaders, one of the generals told his soldiers, sleep is like bullets for your brain. You never go to battle with an empty magazine," she said. "If you get six hours of sleep or less six days in a row, or go 24 hours without sleep, you have 20 percent cognitive impairment, and you are operating as if you had a .08 BAC [blood alcohol content]. We would never let a soldier in our formation intoxicated."
The Army said in a press release that in a six-month pilot program of the Performance Triad, 64 percent of soldiers already met activity goals before starting the Triad program. Only five percent met sleep and nutrition standards.
Army improvements include the healthfulness of food offered to soldiers, and embedding trainers in units, reducing orthopedic injury rates.