Michael de Yoanna

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.”

View a slide show

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.

Last month, Salon published a surreptitious tape recording of a psychologist at the Army’s Fort Carson in Colorado admitting privately to a wounded soldier that he and “all clinicians up here are being pressured not to diagnose PTSD.” Instead, psychologist Douglas McNinch says on the tape, the soldier would receive another diagnosis likely to result in lower disability payments.

In a follow-up piece, Salon showed how the tape made its way to the upper reaches of the Pentagon and staff on the Senate Armed Services Committee not long after it was recorded in mid-2008. The Army Medical Command then investigated itself — failing to contact the soldier involved — and found that nobody did anything wrong.

Through a Freedom of Information Act request, Salon obtained the Army’s investigation exonerating itself, but redactions make it difficult to glean any insight into the Army’s reasoning. Try to make your way through the two blacked-out pages of “conclusions” reproduced here on Pages 3 and 4.

In two stories published this week, Salon has described how a soldier secretly taped an Army psychologist named Douglas McNinch saying that the Army was exerting pressure on him not to diagnose soldiers with post-traumatic stress disorder. According to McNinch, the Army preferred that he diagnose soldiers with anxiety disorder instead — the same diagnosis Marino received. Marino’s experience is a case study in what happens when Army medical care is influenced by the need to keep soldiers on the battlefield and the need to hold down the cost of long-term disability payments.

Marino returned to the States from his second tour in Afghanistan at the beginning of 2007 with symptoms nearly identical to those he’d experienced after his first tour. But the Army processed him out by Feb. 10, 2007 without a real medical examination. Marino recalls filling out a written questionnaire and then being discharged. “They didn’t spend any time checking me when I went out the door.”

When Marino left the Army, all he had were his anti-depression pills and a vague diagnosis from the Army. The diagnosis said, essentially, that Marino was anxious and depressed, but that neither his anxiety nor his depression were necessarily caused by the war. His condition worsened. “My wife was pushing me to go to therapy over and over again,” he said.

And he did. This time, however, Marino went to a facility in Boston run by the Department of Veterans Affairs, the government agency responsible for pay and benefits for service members after they leave the military. There, doctors diagnosed him with PTSD from the war. This means he can receive therapy tailored to help ameliorate the symptoms of combat stress. He also now receives financial benefits from the VA for his mental wounds.

There is no way of knowing for certain whether the Army misdiagnosed Marino with anxiety disorder instead of PTSD after his initial deployment in Afghanistan. His symptoms, however, suggest that that’s exactly what happened. “If you want my opinion,” says Marino, “I believe that I did have PTSD after the first tour.” Marino thinks the Army misdiagnosed him with anxiety disorder, but “I can’t say whether it was by intent or negligence that it was misdiagnosed.”

If Marino had not gone to the VA clinic in Boston and asked for help, who knows how long he would have gone on with the wrong diagnosis and without proper benefits. “There are probably plenty of people walking around with the same thing,” he said. “PTSD has caused me a lot of hardship. If I can help anyone else with my story I’m happy to do it.”