Nidal Malik Hasan case: Are Army psychiatrists overwhelmed?

The case of Nidal Malik Hasan, the Army psychiatrist who is the primary suspect in the Fort Hood shooting spree Thursday that killed 13 people, is pointing up the enormous need to help soldiers overwhelmed by the stress – or even the prospect – of serving in wartime.

As the military begins its eighth year of the war on terror, much of the focus has been on the inability to fully support the growing number of troops diagnosed with post-traumatic stress disorder or traumatic brain injury. But the events at Fort Hood cast the issue even wider.

According to reports, Mr. Hasan desperately wanted to avoid being deployed to a war zone. While there appeared to be several reasons for this, including a conviction that he was a victim of harassment, he was also troubled by the stories he heard from overseas.

The lack of mental-health counselors has been an ongoing problem that both the military and the Veterans Affairs have been working to resolve in recent years.

"The system is largely playing catch-up to the explosion in demand for mental-health care," says Meredith Munger Leyva, the spouse of a naval officer and editor of CinCHouse.com, a website serving the military-spouse community.

To keep up with the demand, the military has turned to private contractors who do not know the rigors of combat or some of the other stresses military personnel endure, Ms. Leyva says.

The shootings at Fort Hood, Texas, hark back to a similar violent outburst in Baghdad in May, in which five soldiers were killed when a fellow soldier struggling with depression opened fire at a stress clinic.

The Pentagon has pushed to increase the amount of time between deployments – known as "dwell time" – to allow troops time to reengage with their families and seek the help they need.

The Army, for example, is at a rate of about one year of dwell time to one year of deployment. The Marine Corps, which deploys for different periods of time, is on average giving Marines about 12 months at home between seven-month deployments.

The "strain on the force" was an issue at the White House as recently as last Friday, when Defense Secretary Robert Gates, Chairman of the Joint Chiefs of Staff Adm. Mike Mullen, and the chiefs of each of the services met to discuss the strategy for Afghanistan. The group reportedly discussed how deploying new troops to Afghanistan would impact the overall health of the force.

The Obama administration has pushed to remedy what it saw as many wrongs – improving military and veterans care and spending billions of dollars more to do it. But some believe that the depth of the problem has just begun to emerge and will confront the administration for the rest of its term.

President Obama has suggested he is prepared for such an undertaking: "As commander in chief, there is no greater honor, but also no greater responsibility for me than to make sure the extraordinary men and women in uniform are properly cared for and that their safety and security when they are at home is provided for."

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