TACOMA, Wash. — Army leaders insist they have fixed flaws in Madigan Army Medical Center’s behavioral health department that resulted in the misdiagnoses of hundreds of patients. But they have refused to release reports that could substantiate their findings and shed light on what happened at the Army hospital last year.
The latest in a long string of denials and non-disclosures happened last week when Secretary of the Army John McHugh visited Joint Base Lewis-McChord. He called a press conference Monday to announce the completion of an Army-wide behavioral health investigation that stemmed from the Madigan reports, but he declined to share it.
McHugh said a task force review had generated 24 findings and 47 recommendations, but he would not release them and described only one. He signed a memo intended to bolster Army wellness programs and left open the door to release more information later.
“It is my intent to make major portions of that document available,” he told reporters. “I’m not here to design any kind of cover up or not put out those data points, and I’ll make those available to you.”
Later in the week, the Army rejected a Freedom of Information Act request filed by The News Tribune and The Seattle Times seeking the Madigan investigations – a request that the newspapers made in September.
Sen. Patty Murray, D-Wash., called the slow release of information “frustrating.”
“We still don’t have all the information we need,” she said Friday. “We are going to have to keep pressing the military to get it.”
The newspapers requested Army investigations that centered specifically on Madigan. The Army in November issued a “partial denial” of the requests, contending the reports were “pre-decisional” and would be used in a broader review of Army programs.
The newspapers appealed the denial in January, pointing to multiple corrective actions the Army had already announced in August, including the reinstatement of Madigan commander Col. Dallas Homas.
In its rejection of the newspapers’ appeal issued last week, the Army found that the Madigan reports should remain exempt from public disclosure requirements in the Freedom of Information Act because they contain confidential material that shaped Army decisions.
It again called the Madigan reports “pre-decisional” because they include findings that were intended to nurture “frank and open” internal discussions. Releasing the information also could inhibit candor in future investigations, or confuse the public, an Army attorney wrote in the FOIA denial.
McHugh summarized the behavioral health findings in a telephone call to Murray, a member and former chairwoman of the Senate Veterans Affairs Committee. She expects to receive a briefing on the report, and hopes to persuade the Army at least to release more information about its behavioral health findings and recommendations.
Michelle Earl-Hubbard, a Seattle attorney for the Allied Law Group who specializes in open government, said the military “is not known for openness and accountability.”
The Army’s denial of the newspapers’ FOIA requests fits that tendency, she said.
“It is unfortunate in this latest matter, so important to the public and members of our military, the Army is continuing this practice of secrecy and denial. Its citation of the FOIA exemptions at issue appears to be a violation of the law in both spirit as well as letter, particularly at this stage of the investigation,” she said.
The most recent FOIA denial came from the Army’s Office of General Counsel, which reports to the Army secretary, undersecretary and assistant secretaries in the Pentagon.
Officers at Lewis-McChord last week said they were working to release more information that could resolve local questions about the behavioral health investigations.
“We take all FOIA requests seriously,” said Col. Dave Johnson of Lewis-McChord’s I Corps. “We do our due diligence to try to run them down.”
McHugh’s public information officer, Maj. Chris Kasker, said on Friday that the Army secretary intends to release the Army-wide report.
“The Secretary of the Army not only plans to release the Army Task Force on Behavior Health Report once it’s finalized, but to share with soldiers and their families issues the Army has identified and the ways we intend to fix them. But at this point, it’s a working document, and many of details are still being reviewed and validated. This is too important an issue not to take the time to get right.”
The Army’s refusal so far to release more detailed information about its findings at the hospital south of Tacoma has similarities with an incident from 2½ years ago. Complaints at Madigan surfaced in May 2010 from Oregon National Guard members who felt they were mistreated after returning from a deployment to Iraq.
Sen. Ron Wyden, D-Ore., demanded answers, and five Army generals promised a thorough report.
The News Tribune filed a FOIA request for the reports that fall and received documents that were almost entirely blacked out. The Army refused to describe what was wrong at the hospital, citing a “quality assurance” exemption in the Freedom of Information Act that it said was applicable to medical investigations.
The Army Medical Command also wouldn’t allow Col. Jerome Penner, Madigan’s commander at the time, to discuss how the hospital changed its practices as a result of the inquiry.
The denials contrast with reports the Army issued in 2007 describing its investigation into complaints of mistreatment of wounded service members at Walter Reed Army Medical Center near Washington, D.C. That investigation resulted in testimony before Congress and the publication of reports calling for changes at military hospitals.
This time, the Army said the problems were isolated to a forensic psychiatry team that operated only at Madigan.
That team consisted of psychologists who had the final say on diagnoses during medical disability reviews. Sometimes, they changed diagnoses in such a way that patients lost benefits for combat-related ailments such as post-traumatic stress disorder. An Army inspector general obtained a report that showed a Madigan doctor encouraging his colleagues to consider the long-term costs to taxpayers of a PTSD diagnosis.
The forensic psychiatry program was once cited as an example of “best practices” in Army medicine. In November, the Army announced it gave new diagnoses to 267 patients who passed through the program; 150 of them learned they had PTSD.
In August, Army Vice Chief of Staff Gen. Lloyd Austin sought to settle the controversy by announcing that the forensic psychologists didn’t do anything wrong, but that the Army would nonetheless terminate the widespread application of their services.
“What we found is that the forensic methods are not the right ones for the United States Army disability evaluation system,” he said at the time. “We learned (Madigan) officials acted in accordance with the standard of practice for civilian disability evaluations. But we also learned that while the evaluation may be fair and appropriate, it’s simply not optimal for the unique cases that the Army diagnoses and reviews. We’ve fixed that.”
His remarks signaled the end of the Army’s investigation, and the beginning of the newspapers’ requests for a more detailed account.