By Monday, Oct. 13, on Marko’s 21st birthday, he finally led deputies to a wooded area. There, investigators searched for and found Lawrence’s body, her throat slashed. She had also been raped, investigators say.

Marko, of Decatur, Mich., a man with no prior criminal history, now sits in El Paso County jail in Colorado without bail, awaiting trial for murder. He also faces separate charges for allegedly sexually assaulting a 14-year-old runaway from a psychiatric facility, and for possessing child porn.

A Fort Carson-based Army corporal, Marko served a tour of duty in Iraq from January 2007 to February 2008. According to medical records obtained by Salon through a military official, Marko was deployed to Iraq even after he was found to be suffering from a psychological disturbance.

On Nov. 2, 2006, a military doctor named Susanne Franz prepared the document that appears on the next two pages. Questioned during his “predeployment assessment,” Marko said he had problems sleeping, and recurrent nightmares. “Nightmares nightly since reading a disturbing book in 6th grade.” Franz referred him for further psychological evaluation.

Four days later, Dr. Harry B. Rauch, a psychiatrist at Evans U.S. Army Community Hospital at Fort Carson, interviewed Marko. Dr. Rauch believed that his evaluation showed that Marko, who reported “hearing sounds which seem to be voices,” had “schizotypal personality disorder.” (See that document on Pages 4 and 5.)

The disorder is a socially isolating condition that experts say is characterized by peculiar beliefs and paranoid ideas. “Nightmares generally about fantasy worlds and wars” disturbed Marko, Rauch wrote. And though Rauch also identified Marko’s history of “self-damaging behavior, generally accidental due to poor judgment and fascination with fire and exploding devices,” Marko was found fit to fight in the war.

Rauch said that Marko’s problems “may or may not result in some ultimate functional incapacity in the military.” He released him “[without] limitations.” The Army then seemed to leave it to Marko to determine whether he would seek to do anything about his personality disorder. Rauch wrote that Marko “declines follow up at present” but that Marko agreed to return to clinic if he suffered “any changes or deteriorations in thought or behavior patterns.”

Through his attorney, Marko declined an interview for this story. His attorney, Sheilagh McAteer, also declined comment on the case.

Judilianna Lawrence

Robert Hull Marko

Now Needham is gone too. He died on Feb. 19, about 10 days after back surgery at a Veteran’s Affairs hospital in Tucson, Ariz. The circumstances surrounding Needham’s death are unclear. According to his father, Mike Needham, an older brother discovered John Needham slumped over his bed at his mother’s house in Arizona, his face blue. Efforts by his brother, and then rescuers, to revive him were unsuccessful.

Needham, a tall, blond, sturdy California surfer and house painter, was deployed to Iraq in 2006. Not long after arriving, his life turned into a blur of roadside bombs, bloodshed and confusion. He was knocked unconscious by a grenade, suffering a brain injury. Shrapnel ripped into his legs. His back eventually gave him problems. He got a Purple Heart.

The damage to Needham wasn’t just physical. He also suffered from mental wounds. In Iraq in September 2007, when the carnage he had witnessed and participated in became too much, Needham pointed a pistol at his head and pulled the trigger. It would have ended there if a friend had not leaped forward to push the gun aside. The bullet hit a wall. Needham, who had a clean bill of health when he entered the Army, was shipped home.

When de Yoanna met him briefly in the airport in Colorado, Needham seemed nervous. He’d spent several weeks receiving care at Walter Reed Army Medical Center. Back at Fort Carson in Colorado Springs, Needham complained about punishment instead of treatment for his mental issues. His commanders threatened him with charges for discharging his weapon in his suicide attempt. Superiors also harassed him for falling asleep while heavily medicated. He was called a pussy. Though he had been diagnosed with post-traumatic stress disorder, Needham was punished for showing symptoms: failing to appear in formation, insubordination to superiors, and other problems.

With the advocacy of his father and others fighting behind the scenes, the charges against Needham disappeared and in July of 2008, the Army had washed its hands of him. He received an honorable discharge and a partial disability — but his benefits didn’t provide full access to mental health treatment, a critical gap in his care.

Had he received such care, things might have been different just weeks later. In September 2008, Needham made headlines across the country after allegedly beating his girlfriend, 19-year-old aspiring model Jacqwelyn Villagomez, to death in his San Clemente, Calif., condo.

After 10 months in a maximum-security jail cell awaiting trial, Mike Needham raised the $1 million needed to bail his son out to prepare for the murder trial.

Based in Colorado, de Yoanna traveled to California last summer and spent several days with Needham — part of Salon’s ongoing effort to understand veterans struggling with the hidden wounds of war.

Needham told de Yoanna during that visit that he couldn’t provide specifics about his case, fearing any statements he made to the press might become ammunition for prosecutors. He emphasized, however, that he was “not the murderer” authorities and the press had made him out to be. Looking over the crashing waves he loved to surf, the war veteran also said he had become an outcast and wanted to leave his home and live somewhere on the California coast where nobody would know him.

So he lived in the present, often on the beach. He surfed some, hoping the ocean would restore his body, but the pain in his lower back persisted.

After a first V.A. surgery on his back in Los Angeles that did not go as planned in late November, Needham struggled with severe pain. He developed an addiction to painkillers and was hospitalized in Long Beach in the following weeks to deal with it. Then his family brought him to Tucson, hoping the V.A. hospital near his mother’s home would do better. There was another surgery a few weeks later and one more — Needham’s third – earlier this month. Each was an effort to repair Needham’s deteriorating lower back.

Though Needham had a serious infection after his last surgery and a “tumor the size of a grapefruit” on his back, according to his father, he was only cared for by a visiting nurse while staying at his mother’s home at the time he died.

Autopsy and toxicology reports are being completed; medical investigators did not return a call to Salon by deadline.

Needham’s father feels the Army and perhaps the V.A. let his son down. “He never got correct care in the Army and, in my opinion, never got correct care from the V.A. either,” Mike Needham said. “What if they helped him when he first struggled after the explosions in Iraq? Instead, they sent him into battle day after day and harassed him when he struggled. As for the V.A., I think they’re the medical authority and responsible. I question why he was on outpatient status with a tumor the size of a grapefruit on his back.”

Mike Needham plans to join with family and friends in a small private ceremony to scatter the ashes of his son at the beach where he loved to surf. “That’s our spiritual altar — the ocean.”

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As Dr. Kernan Manion investigated the two Marines’ claims about conditions at the North Carolina military base, the largest Marine base on the East Coast, he found they were true. Manion, a psychiatrist hired last January to treat Marines coming home from war with acute mental problems, warned his superiors of looming trouble at Camp Lejeune in a series of increasingly urgent memos.

But instead of being praised for preventing what might have been another Fort Hood massacre, Manion was fired by the contractor that hired him, NiteLines Kuhana LLC. A spokeswoman for the firm says it let Manion go at the Navy’s behest. The Navy declined to comment on this story.

While military officials and the media examine whether the Army missed warning signs that might have indicated an unhinged Nidal Hasan was capable of killing 13 people at Fort Hood, Manion’s Camp Lejeune story is a cautionary tale of what happens to those who blow the whistle on conditions for military personnel with mental problems.

Manion says the April incident with the two Marines was just one of a series of disturbing events and serious problems with mental healthcare he saw at Camp Lejeune, a base that may be best known for a water contamination scandal that led to high rates of cancer and birth defects among Marines and their families who lived there. He was particularly concerned to see that troubled Marines were stricken with the overwhelming impulse to commit suicide or murder, telltale signs of severe combat stress.

In a telephone interview from his Surf City, N.C., home, Manion talked of overburdened staff and inadequate resources at the Naval hospital at Camp Lejeune. The psychiatrist charged that medical officials failed to study and discuss violent events among returning Marines in an effort to prevent further, similar events, and did little planning to improve handling distraught Marines who were killing themselves and others in shocking numbers. In 2008, for example, 42 Marines committed suicide and 146 attempted to do so, according to the Marine Corps.

Coincidentally or not, within 12 hours of Hasan’s shooting spree, Camp Lejeune officials discovered the body of one Marine and took into custody another Marine, Pvt. Jonathan Law, who is accused of killing his colleague. Law, who had served a seven-month tour in Iraq, was suffering from self-inflicted wounds when arrested.

Mirroring reports from military installations across the country, Manion also reported harassment of Marines seeking mental help. The psychiatrist began to worry about the possibility of a major outburst of violence on the base.

“A significant number of Navy medical officials and Marine commanders do not get it,” a frustrated Manion said about the situation at Camp Lejeune. “They do not understand the implications of what happens if somebody loses it,” explained Manion, who has 25 years of experience as a psychiatrist and who also specializes in traumatic brain injury — exactly the kinds of skills needed so desperately at military hospitals, because mental problems and brain injuries are the signature wounds of the ongoing wars. “People either commit suicide, commit homicide, get drunk, beat up the wife, all these things. I’ve seen it,” he added. “That is how serious this is and they just don’t get it.”

Manion believes he likely prevented a “Columbine-style attack” late last April after the two Marines who warned that someone might “lose it” directed him to a third Marine who seemed on the verge of violence. Manion also provided his superiors with documentation showing troubling incidents and neglect for the needs of returning Marines that could easily precipitate violence. Maybe not on the scale of the massacre at Fort Hood, but more like the rampage by a frustrated Sgt. John Russell, who gunned down five fellow soldiers at a military mental health facility in Baghdad last May.

Manion provided to Salon a stack of correspondence with superiors, a virtual crystal ball predicting dire consequences if mental healthcare at Camp Lejeune isn’t immediately improved.

In an April 24 memo to his superiors, including Cmdr. Robert O’Byrne, head of mental health for the Camp Lejeune Naval Hospital, Manion describes a frustrated Marine punching a telephone pole with his bare fists outside a treatment clinic, then storming around, cursing, with a piece of lumber with a nail in it, though nothing was done to ensure he didn’t hurt himself, again, or others. In another case, a severely homicidal and suicidal Marine pounded his fists into a table and stormed out of treatment. Yet the hospital, Manion complained to his superiors, made no efforts to discuss these cases or how to better handle similar events in the future.

“There was — and continues to be — no means of discussion of high-intensity/dangerous cases such as this,” a desperate Manion wrote on April 24. He warned of “immediate concerns of physical safety” at the base’s mental health facilities. Manion wanted to set up special protocols for handling intense situations, such as having specially trained MPs ready to intercede if things got bad, and a plan to hospitalize potentially violent patients quickly. “They dragged their feet on that,” he told me.

Within days that April, Manion intervened with the two Marines who’d warned of colleagues potentially losing it. They directed him to a third Marine who they believed was going to go on a shooting rampage. Manion worked hard to get that Marine into treatment, possibly averting bloodshed. The two Marines involved also reported harassment for working limited duty while seeking mental healthcare for themselves. They heatedly claimed that two noncommissioned officers had recently told them, “I don’t care why you are on [limited duty]. You are nothing but worthless pieces of shit,” according to an April 29 e-mail Manion sent to O’Byrne and others, complaining about such attitudes.

Like many healthcare providers at military bases across the country, Manion technically worked for a military contractor, Spectrum Healthcare Resources, a subcontractor for  NiteLines Kuhana LLC.

On June 24, a supervisor for the contractor warned Manion to stop making trouble. “Kernan Manion, it is requested that you cease and desist all further correspondence with the government,” the supervisor with NiteLines, Pamela Friend, wrote to Manion.

But Manion was still frustrated that Camp Lejeune did not seem to be taking these risks seriously. On Aug. 30, he appealed to a series of military inspectors general in a written complaint. He warned of an “immediate threat of loss of life and/or harm to service members’ selves or others” if conditions did not improve. He complained of a “complete disregard for … implications for patient safety and well-being.” He decried that officials at Lejeune had ignored “repeated overt and emphatically stated concerns about the very safety and overall welfare of the affected patients.” And he warned that “many patients’ lives are imminently at risk.”

Four days later, the contractor fired Manion “effective immediately,” according to his termination e-mail. The note provides no reason for the firing. Manion was directed to clean out his office the next day, under the watchful eye of a chief petty officer, and have no further contact with his patients.

In a statement to Salon, NiteLines said the Navy wanted Manion fired, but did not explain why. “The treatment facility at Camp Lejeune notified (Nitelines) that Dr. Manion did not meet the Government’s requirements in accordance with the contract, and they directed he be removed from the schedule,” it reads.

Salon e-mailed the spokesman for the Naval Hospital Camp Lejeune, Raymond Applewhite, with details of this story and then described some of these facts with him in a follow-up telephone call, requesting an interview with O’Byrne. The Navy did not respond further.

Manion left Camp Lejeune after he got fired, but he did not stop worrying about the potential for violence there. In mid-September, Manion filed a 14-page complaint with the Department of Defense inspector general. On Sept. 29, he warned the Navy’s Bureau of Medicine and Surgery inspector general in writing of “serious mismanagement of post-deployment mental health services that was both endangering patient, staff and community safety as well as severely compromising the quality of care” for returning Marines. Manion noted that the poor care at Camp Lejeune continued despite “the ever present threat of life-threatening violence by distraught service members towards themselves or others.”

Finally, Manion wrote President Obama that same day. “Frankly, in my more than 25 years of clinical practice, I’ve never seen such immense emotional suffering and psychological brokenness — literally a relentless stream of courageous, well-trained and formerly strong Marines deeply wounded psychologically by the immensity of their combat experience,” he wrote to the president. Manion added, however, that at Camp Lejeune, that immense problem was being met with “inadequate treatment” and “callous indifference.”

He still worries. “I don’t like seeing these guys mistreated,” Manion said. “This is akin to somebody dying on the battlefield and not being attended to,” he added. “These guys are saying they are broken and need help, and the system is saying, ‘next, next, next.’” 

Harrelson, on the other hand, seems like a guy totally determined not to let the artificiality of these interactions impinge on his sense of who he is. Perversely, the fact that he is frank and thoughtful, and known to hold unorthodox political opinions he doesn’t keep to himself, has only augmented his fame. You can’t throw an empty Chardonnay bottle out your car window in west L.A. without hitting a Hollywood liberal, but Harrelson is something much rarer: a vegan, raw-foodist, antiwar, anti-capitalist, pro-marijuana, eco-funky, genuine radical who happens to be a beloved character actor with a good-ol’-boy demeanor.

Like the other journalists who showed up to talk to him about his role in “The Messenger,” writer-director Oren Moverman’s film about the United States Army’s Combat Notification Unit (i.e., the dreaded door-knockers who show up with really bad news), I was asked by the publicists to restrict my questions to the film and Harrelson’s acting career. It’s a laughable request anyway, but in fact I would have needed to tie Harrelson up and gag him if I didn’t want to hear his opinions about the wars in Iraq and Afghanistan, the dangers of capitalism and the looming possibility that Barack Obama could become a second LBJ.

For the first half of this decade, Harrelson was mostly absent from the movie screen; he did some theater and TV, a fair amount of environmental and pro-cannabis activism — his illegal banner-drop from the Golden Gate Bridge goes back to 1996 — and a lot of time with his family. (He lives most of the year on Maui with his wife and three daughters.) It seemed entirely plausible that the one-time “Cheers” star and Oscar nominee (for “The People vs. Larry Flynt”) had burned up his 15 minutes, and then some.

It doesn’t look that way now. Harrelson has appeared in more than two dozen films over the past three years, with more in the pipeline, and three of them are piling up on top of each other this fall. He co-stars in the action-comedy “Zombieland” and the apocalypse-thriller “2012,” both of them likely to gross more in a single weekend than “The Messenger” will in its entire history. But Moverman’s low-budget, high-intensity drama about the social and psychological costs of war is clearly “a labor of love” for all concerned, as Harrelson puts it.

In “The Messenger,” Harrelson plays Capt. Tony Stone, a damaged, middle-aged hardass assigned to mentor the younger Sgt. Will Montgomery (Ben Foster), a decorated and wounded Iraq vet, as they take on the uniquely difficult task of informing civilians that their loved ones serving overseas won’t be coming home. If that sounds wrenching, well, it is. But the acting is superlative — Harrelson’s right when he says that Foster’s starring role has echoes of James Dean or the young De Niro — and the half-improvised quality of the filmmaking feels dangerous and intimate but never showoffy.

When Stone and Montgomery are assigned to notify an NOK — that’s “next of kin,” in Army parlance — Foster and Harrelson literally went into the scene not knowing what would happen. They hadn’t even met the actors playing the bereaved-civilian roles, and weren’t sure whether they would break down in tears or respond with physical violence. (Moverman and co-writer Alessandro Camon partly based his screenplay on stories they heard from casualty-notification soldiers.) The story of what Stone and Montgomery have to do, and how it affects them, offers an intimate, human-scale portrait of the real costs of warfare.

Once Harrelson was safely tucked under the covers, wearing an Army T-shirt and a pair of blue jeans, I put my tape recorder on top of the duvet and we got talking. It was a nice big bed, and looked extra-comfy. Woody probably wouldn’t have taken it the wrong way. I can’t say I wasn’t tempted.

This movie isn’t connected to the Fort Hood shooting in any way, but still. It’s kind of intense to be talking about this subject, about death and the military, right after that.

It’s related in the sense that it’s another sad story connected to this war. There’s a lot of those, and that one’s pretty devastating. I feel really terrible for those families.

And then I just happened to notice, on the same page of today’s New York Times as that story, two more of those names in bold-face type. Two more soldiers whose families are going to be getting visits from guys like the one you play in the movie. [Just to put names to them, they were Spc. Tony Carrasco Jr., of Berino, N.M., and Staff Sgt. Amy C. Tirador of Albany, N.Y.]

It really is a devastating thing. I’ve had an evolution of sorts in terms of my attitude toward the war. Not in the sense of the war itself, which I do continue to think is wrong — and I think it’s pretty obvious what the war is about, both of them. During the course of making this, I had the opportunity to spend time with a bunch of soldiers and hear a bunch of stories, and you know, just start to feel a great deal of empathy and compassion toward the men and women who are over there working their asses off every day, not getting paid much and just putting their lives on the line for love of country. I do think that a big part of supporting the troops would be the concept of not sending them into battle in a war for resources.

So you think both Iraq and Afghanistan are wars over resources?

Iraq’s about the oil and Afghanistan’s about a pipeline. It always has been. They started building a pipeline as soon as there was a moment to do so. They started building a pipeline to the Caspian Sea, that’s always been their directive. The guys from Chevron went in and met with the Taliban and realized those guys just weren’t in control enough. That’s why they wanted to oust them. Otherwise it’s an absurd concept: You’re going to war because a guy from some other country, a Saudi, is living somewhere in the mountains? So we’re going to bomb Kabul, bomb the cities? That’s absurd. It’s a foreign policy gone way wrong. But that’s how it always is. American foreign policy has always been, not about spreading democracy, but about spreading capitalism.

It does feel sometimes like our government suffers from some kind of amnesia or OCD. It’s like they keep making the same foreign policy mistakes and just hoping it won’t turn out quite as badly the next time.

I’m hoping that other countries look at us and say, “OK, there’s the government and then there’s the people.” Granted, you’d like the will of the government to be conjoined with the will of the people. But it’s the same way I’ve made the evolutionary step of looking at the war as separate from the soldiers. When I look at Russia, I don’t look at Putin as representing the Russian people. I’m sure they’d love to get him out of there. Regardless, the Bushes and their various oligarchies have gotten us into a situation that’s just very unfortunate.

At least at this point, it appears that Obama is pushing onward with the war in Afghanistan. Is he just constrained by geopolitics? Is he simply not free to say, “Look, we’re not going to do this anymore”?

I think there’s a lot of persuasive and powerful people around Obama. For a president to make his own decisions, I think that’s a rarity. Even someone who we think of as our guy — this is a guy with integrity, a guy who cares, for the first time in a long time — in the Oval Office, even with him we don’t really know who’s pulling the strings. I think of every president as being a marionette. Whether he’s any different, I don’t know. Certainly his military advisors all want him to prosecute this war to the end, just as they did in Vietnam with LBJ.

It’s just too depressing, I think we’re going to have to hit the streets. Obama has the chance of becoming JFK or LBJ. I think JFK was one of our last great presidents, although I thought Carter was pretty great too. LBJ could have been a great president if he hadn’t gotten bogged down in war, but that was quite a war to get bogged down in. Notwithstanding the fact that the war was wrong and they were talking about the Red Scare and the domino effect, if you go and read the Pentagon Papers they were also talking about rubber, tin and oil. They killed 2 and a half million people. What was it all for? In Korea they killed 4 and a half million. Like, we’re liberating these people?

Well, one of the things this movie engages, in a way, is the fact that the combined U.S. fatalities in Iraq and Afghanistan are still below 4,500. Not that that’s not terrible for those families, but it’s not a number that has affected every town and every neighborhood, the way other wars did.

Yeah, but it’s got to be more than 10 times that in terms of people with injuries, people strongly affected by it. I’m not sure what’s going to make people hit the street, and, you know, I’m one of those people who’s not on the street. I recognize that I’m just a guy bitching about it, not a guy who’s doing anything.

The thing I love about this movie is that it really takes into account the consequences of going to war. It’s been gratifying to me to hear from people who say, “Before it was just a thing in the news, a statistic.” You’re not really seeing a blown-up body, or seeing the coffins at Dover. I think it’s a good thing that it puts a human face on it.

On one level I really dreaded those scenes where you and Ben went to knock on people’s doors, do the notifications. They were hard to sit through. But on the other hand, I kind of needed that emotional catharsis. And they’re very intense. In the first scene we see, the woman completely goes nuts and attacks you.

That was cool because of the way Oren shot it. We really didn’t know what was going to happen. I didn’t know she was going to hit me. You don’t know what level the people are going to, the way they’ll manage their grief. I think it made those scenes much more realistic. We never rehearsed, and never even met the people ahead of time. We shot those in one shot. All of that was really good.

They weren’t all done in one shot, were they?

No, there’s only two notification scenes that are actually one shot as you see them in the movie. One is Steve Buscemi’s and then there’s another one. But they were all shot as a one-camera, single-shot thing, with one camera following the action. Later on, if Oren did three takes or whatever, he’d join the different takes together, find whatever worked better. But they were designed to be one-shot takes, and it felt very real. It kept us right on our toes, and on edge.

That guy that you’re playing felt very real to me. He’s this hardass military lifer, an Army guy, and he’s really messed up in ways he doesn’t even recognize. I mean, this guy badly needs a hug.

[Laughter.] That’s the best description yet. He badly needs a hug. That’s true.

I thought there was terrific chemistry between you and Ben Foster, who plays your younger tag-team partner. Obviously you guys are pros so it can be hard to tell, but it felt like there was something real happening there.

Oh, it was incredible. I feel like he’s my brother, I really love him. And as an actor, he’s one of the best I’ve ever worked with, if not the best. Total immersion in the mind-set of the character, and constantly reminding himself of the significance of what we’re doing. Just before a scene, maybe I’m not completely grounded, and he hands me these pictures of soldiers smiling or hanging with their kids, and they’re marked with the dates they died, 2003, 2004, whatever. You can’t help but be full of the emotion, with what this movie’s connected to. It’s one of the few times that I’ve felt emotional pretense really skirting on emotional reality. I don’t think I said that right. It’s just, you know, we’re pretending, but the reality of it is big.

I’ve seen him in other movies, but people are really going to notice him this time, if they haven’t already.

I think he’s one of the most amazing actors. It’s like I’m working with James Dean before people know that he’s James Dean. I feel like I just did “East of Eden” with James Dean. His talent is so expansive, he’s got a huge career ahead of him.

You took several years off, and for a while there it didn’t seem clear whether you wanted to make Hollywood movies anymore. I guess you’re at peace with them now! I’m not ranking on you for making movies. You’re an actor. But does it help you somehow to do a smaller project like this one alongside a big movie like “2012,” which can pay a lot of bills?

You know, I don’t feel like a movie has to have a message, necessarily. If a movie’s fun and funny and just great entertainment, that’s enough. But it’s nice to do a movie like “The Messenger” where you feel like people watch it and it’s initiating conversations that are important. What more could you hope for?

I did take a long time off. I wasn’t planning on taking that long, it just kind of happened. Five years. I did keep my hand in, in terms of doing some plays. I wasn’t entirely out of the loop. But it was a good thing. I needed to spend some time with my kids. I needed to get away from it. I wasn’t liking the whole, I guess you would say, business-y side of it. I came into acting initially because I loved theater, I wanted to be on Broadway. You know, I would have been on Broadway, but I ended up doing this show.

I’ve heard about that! Apparently you were on TV for a few years.

Yeah. Otherwise I just would have been here in New York. I love theater, that is where my passion is. There was a lot about “The Messenger” that felt very theatrical. Just really being in a scene with a fucking serious actor, like a young De Niro type of actor. It was just a great experience all the way around. I feel super lucky to be a part of this movie.

“The Messenger” opens Nov. 13 at the Angelika Film Center and Lincoln Plaza Cinemas in New York, with wider release to follow.

According to the report, “Survey data from this investigation suggest a possible association between increasing levels of combat exposure and risk for negative behavioral outcomes.” The study also says that “combat intensity/exposure . . . may have increased the risk for violent behaviors” and that its “findings are consistent with recent research on combat exposure and subsequent behavior outcomes among Soldiers.”

Salon’s Coming Home series showed that soldiers who returned from combat duty with symptoms of stress were often ridiculed or otherwise discouraged from seeking help, were overmedicated or misdiagnosed, or chose to self-medicate with drugs and alcohol. Many had been deployed even though they were already displaying signs of combat stress. Additionally, some of the soldiers involved in violence against themselves or others had preexisting conditions that should have disqualified them from service, but were allowed into a military hard-pressed for new recruits via waivers.

The 126-page report issued by the Army Wednesday — an epidemiological study, or EPICON in military lingo — focused largely on 14 of the Army post’s soldiers allegedly involved in murders since 2005. Ordered by Fort Carson commander Maj. Gen. Mark Graham in the wake of the slayings, it is studded with statistical evidence that buttresses Salon’s investigation. The numbers point to a link between violent behavior and substance abuse, repeated deployments, exposure to combat and enlistment waivers. In addition, many of the 14 soldiers allegedly involved in murders witnessed incidents described in the report as War Crimes. Five either heard of or witnessed the “murdering/killing” of non-combatants; three, “detainee abuse;” and, two, “fabricating evidence to justify attacks or criminal acts.”

Yet the Army officials presenting the report denied that it established any cause-and-effect relationships. Eric Schoomaker, the Army’s surgeon general, waved his hands across his chest under clear blue skies during the outdoor press conference, dismissing the notion that the report proved a tie between soldier-involved killings and the horrors those soldiers experienced in the war.

“While this is probably the most intensive and in-depth investigation on the clustering of violent-on-violent crimes in the Army that we’ve ever seen or are aware of,” said Schoomaker, “it is still in many respects preliminary.”

Without causation, there is no way to establish how the murders could’ve been prevented. “We would all like to look back at the cluster of misconduct and criminal activities,” said Schoomaker, “that resulted in devastating human tragedies here in Colorado and be able to say, ‘This is the reason they happened and we know exactly what could have been done to prevent them,’ but that’s rarely the way things work when dealing with human behavior.”

Without causation, there is also limited accountability. While commanders were blamed for standing in the way of soldiers receiving mental health and substance-abuse care, Lt. Gen. Michael Rochelle, the Army’s director of personnel, said the report “was not a tool that was intended to be used to either fix accountability or to be used for any sort of disciplinary action that may follow.”

Schoomaker, Rochelle and Maj. Gen. Graham, who was also on the podium Wednesday, were able to deny cause-and-effect because of caveats in the study. The authors of the report, a 24-member team assembled the Army’s Center for Health Promotion and Preventive Medicine, issued recommendations to stop the belittling of soldiers who seek mental health care and to identify units with high exposure to combat. They stopped short, however, of positing causation, saying that “”the cross-sectional nature of the study does not allow for making causal inferences.”

Thus Schoomaker could say, truthfully, “It’s pointing the finger to levels of causation, but we don’t know direct causation yet. … I’m very reluctant to put cause and effect there. In fact, the authors [of the report] are very careful to say these are correlations … not necessarily one causing the other.”

Yet Schoomaker also seemed to place some blame on the soldiers themselves for failing to seek help. He suggested that units where the soldiers were more willing to get help were less likely to be plagued with violence. The study, he noted, analyzed two brigades at Fort Carson, the 4th and the 3rd. “What did seem to differ between the two was the willingness and ability of those soldiers within the unit where crimes were committed to seek and get effective care for emerging behavioral health problems — alcohol and drug problems — and prompt attention to misconduct.”

But Schoomaker also claimed that the experiences of the 4th and 3rd Brigades in combat were “similar.” That’s not what’s indicated in the report — the 4th Brigade, where the murder suspects were clustered, had eight times more combat deaths than the 3rd. Moreover, the report indicated that the Army itself played a role in denying care to the soldiers — half, some with suicide issues, were sent back to Iraq “early,” according to the report.

U.S. Senator Mark Udall, a Colorado Democrat, who met on Tuesday with Schoomaker, issued a statement following the release of the report, noting it raises “serious questions about whether the military is doing enough to help service members transition from battle back into civilian life.”

“This is a matter of life and death, for our service members – and civilians,” Udall stated. “We must do everything in our power to ensure that the military is providing all necessary treatment and support to protect our service members, their families, and our communities.”

That could be a long road. The report indicated that “overall staffing” for behavioral health at Fort Carson’s Evans Army Community Hospital between 2006 and 2008 was just 65 percent of authorized positions.

A new Army investigation of homicides at Fort Carson, released at a press conference at the Colorado Army post today, confirms these findings. According to the 126-page report, researchers found “higher levels of combat intensity” among soldiers who later ended up in trouble (p. 8). They also found “a strong theme of soldiers using alcohol or drugs to self medicate” after returning from war (p. 13). The troops reported problems getting proper healthcare, ridicule for trying, and complained about “an over-reliance on pharmacotherapy” when they did access healthcare (p. 16). A significant number of the soldiers being studied also witnessed incidents described by the report as “War Crimes.”

Excerpts from the report follow, beginning with the introduction to the executive summary, which describes how the study was commissioned after “8 [alleged] homicides in the previous 12 months.”