TIME Military

The PTSD Epidemic: Many Suffering, Few Solutions

Soldiers with the U.S. Army's  Bravo Company, 1st Battalion, 36th Infantry Regiment rest in an Afgan National Police compound before going on patrol near Command Outpost AJK (short for Azim-Jan-Kariz - a near-by village) in Maiwand District
Andrew Burton—Reuters Soldiers with the U.S. Army's Bravo Company, 1st Battalion, 36th Infantry Regiment rest in an Afghan National Police compound before going on patrol near Command Outpost AJK in Maiwand District, Kandahar Province, Afghanistan on Jan. 24, 2013.

The scourge of wars in Afghanistan and Iraq is worse than we thought

Now that Iraq is falling apart, it seems only fitting that the U.S. government issues a fresh accounting revealing that neither the Pentagon nor the Department of Veterans Affairs has any idea if the billions they’re spending on PTSD treatments are doing any good.

A congressionally mandated Institute of Medicine panel reported Friday that neither agency assesses the success of their PTSD care. “Without tracking outcomes, neither DOD nor VA knows whether it is providing effective or adequate PTSD care, for which they spent $294 million and more than $3 billion, respectively, in 2012,” the 300-page study concludes.

Roughly 5% of all troops have been diagnosed with PTSD, the report says, but it’s nearly double—8%—for the 2.5 million who served in Afghanistan and Iraq. Post traumatic stress disorder is also increasing among older veterans. In 2013, the VA diagnosed 62,536 new cases in veterans who did not serve in the Iraq and Afghanistan wars. One out of every three new patients in 2012 in the VA’s specialized PTSD programs was a Vietnam-era veteran. All told, the number of veterans seeking PTSD care jumped from 190,000 in 2003 to more than 500,000 in 2012.

“Although these numbers are likely to underestimate the incidence and prevalence of PTSD, they demonstrate that action is needed to respond to this growing problem,” the study says. “Demands for post traumatic stress disorder services among service members and veterans are at unprecedented levels and are climbing.”

The IOM report is crammed with data about the extent of the problem, and figures to back them up (you can see more of them here):

  • Total Pentagon spending on PTSD treatment jumped from $29.6 million in 2004 to $294.1 million in 2012.
  • Outside PTSD care funded under the Pentagon’s TRICARE program climbed from $22.4 million in 2007 to $131 million in 2012.
  • Between 2006 and 2012, the number of hospitalizations of service members for PTSD increased by 192%.
  • The total annual cost for health care for a veteran who had PTSD was estimated to be $11,342, which was more than double the annual VA health care cost of a veteran without PTSD.

Even those who have dealt with the issue for years are surprised. “The acceleration of PTSD among service members and veterans is staggering,” says Elspeth Ritchie, a retired Army colonel and the service’s one-time top psychiatrist.

The Pentagon’s PTSD treatments “appear to be local, ad hoc, incremental, and crisis-driven, with little planning devoted to the development of a long-range approach to obtaining desired outcomes,” the IOM report says. While the VA’s programs are “more unified,” they both lack records of what treatments work, meaning they “have no way of knowing whether the care they are providing is effective.”

IOMThe Pentagon PTSD bill grew 10-fold between 2004 and 2012.

“Given that the DOD and VA are responsible for serving millions of service members, families, and veterans, we found it surprising that no PTSD outcome measures are used consistently to know if these treatments are working or not,” says committee chair Sandro Galea of Columbia University’s Mailman School of Public Health. The report is a follow-up to an initial IOM assessment of PTSD treatment released in 2012 that only surveyed what was available; Friday’s study was to find out if they work.

The number of veterans of all eras who sought care for PTSD from the VA more than doubled from 2003 to 2012—from approximately 190,000 veterans (4.3% of all VA users) in 2003 to more than a half million veterans (9.2% of all VA users) in 2012. For those treated for PTSD in the VA system in 2012, 23.6 percent (119,500) were veterans of the Iraq and Afghanistan wars.

PTSD can happen when someone experiences a traumatic event, on the battlefield or elsewhere. It can lead to anxiety, depression, sleeplessness and other symptoms that can interfere with life, sometimes contributing to domestic violence, divorce and suicide. The multiple deployments required by a force too small to support the wars fought has played a major role in the PTSD increase among recent vets.

Unfortunately, even if the government begins tracking outcomes, the results may be what the IOM calls “modest,” at best. The only program that routinely conducts such assessments is the VA’s small specialized intensive PTSD program (SIPP). “In 2012, the 39 SIPPs had 3,792 entrants for a total cost of $88,572,953, or $23,578 per patient,” the study found. “The average PTSD Checklist (PCL) scores for veterans at admission to the programs and 4 months after discharge were 65.9 and 60.2, respectively. That indicates that most program graduates met the criteria for clinically significant PTSD after discharge on the basis of a PCL cutoff score of 50.”

TIME Veterans

Veterans Offer Each Other Help as Iraq Falls Apart

A US marine from the 3/5 Lima company po
PATRICK BAZ / AFP / Getty Images A U.S. Marine in Fallujah in November 2004.

One group warns of “frustration” that could lead to suicide

More than 1.5 million Americans served in Iraq between 2003 and 2011. More than a few of them are upset with what’s happened to that country, where they fought and their friends died, over the past week.

That’s why the Wounded Warrior Project sent an email Tuesday to its 50,000 members acknowledging their sacrifices and offering mental-health services if they find the latest happenings from Iraq depressing.

“Your feelings are justified,” Ryan Kules, 
the project’s national alumni director and a double amputee, said. “If you feel frustration watching the news, remember that we did our duty and served admirably, coming home with the visible and invisible scars of that service.”

The reaction of those who fought, and whose friends died, in Iraq has been somber. There wasn’t so much bitter anger as a palpable sadness. Those who thought the invasion was a mistake consoled themselves by blaming President George W. Bush; others blamed President Obama for not fighting harder to keep some U.S. forces in the country after 2011 to try to ensure the lives of the 4,486 Americans who died there didn’t end in vain.

“So many of my friends died in a war that didn’t need to be fought, but that did ultimately provide a reasonable chance for a democratic Iraq in the center of the Middle East,” retired Army officer John Nagl says. “It now appears that all those lives have been squandered because of an unwillingness to pay an insurance premium of a few thousand advisers and some airpower.”

Such grim tidings can lead to despair, which is why Kules of the Wounded Warrior Project reached out. He urged troubled vets to seek help “if you are dealing with PTSD triggers because of current media coverage,” and gave a phone number—1-800-273-8255—for any veterans “struggling with thoughts of suicide.”

Michelle Roberts, the communications chief at the project, says the group reaches out when an event—like last year’s Boston Marathon bombing—might trigger adverse reactions among those who served. “We’re very aware of the conversations our alumni are having with each other, and our staff, about the recent developments and how they affect them,” she says. “We just felt it was a really appropriate time to communicate with them.”

Interviews with veterans echo that view. “I’m just heartbroken, tired and nearing mute,” says Alex Lemons, an Iraq vet and former Marine sergeant. “I never saw a concrete objective and, in consequence, a willingness to win on our part.”

Lemons pulled three tours in Iraq, and says the goal shifted with each:

I was told this at the beginning: `And our mission is to clear, to disarm Iraq of weapons of mass destruction, to end Saddam Hussein’s support for terrorism, and to free the Iraqi people.’ WMD? Nothing. Fiction. Al Qaeda and indigenous terrorism? Terrorists entered the country after we invaded and then recruited heavily amongst those Iraqis we alienated with de-Baathification and firings throughout the army. Even during the surge, we could not crush every insurgent group. Regime change? We mishandled the trial and subsequent execution of President Hussein. In some ways, the Maliki government is another Baath party in Shiite garb.

“All Americans who fought there want Iraq to succeed so that we can have personal closure and know our sacrifices were worth it even as the rest of America, like the Vietnam experience, wants to forget,” Lemons says. “But Iraq will never give us that.”

Even Army Gen. Martin Dempsey, chairman of the Joint Chiefs of Staff, feels the sting. “Many of you have served in Iraq or know friends and family who made great sacrifices there,” he said in a message sent to troops Thursday. “Like many of you, I was disappointed at how quickly the situation in Iraq deteriorated as well as the rapid collapse of many Iraqi units.”

“It was somewhat expected, yet still disappointing, says Rob Kumpf, who served in Iraq as an Army non-commissioned officer. “Fighting an asymmetric war with one hand tied behind your back, with poor planning and unengaged leadership, led to the current situation Iraq’s security forces face. We screwed up the end game when we withdrew, and will soon do the same in Afghanistan.”

But other veterans have shrugged off what is happening. “Iraq’s political situation is not the concern of individual veterans of the war,” says William Treseder, who deployed to Iraq and Afghanistan as a Marine sergeant. “Combat veterans should value their service based on what they did, not on what happened after the fact or in some larger international context.”

Those who haven’t fought don’t know how combat can change one’s perspective. “Love, loyalty, sweat, and blood are the currency of service—its beating heart. Politics is a dry husk that tries to cover and limit that vitality,” Treseder says. “I wish Iraq and Afghanistan the best as countries, but I do not give them the power to determine how I feel about my service to the United States of America. Nor do I think it’s wise for any other combat veteran to do so.”

But some plainly do. “Your examples of valor and strength educate and inspire those around us,” Kules of the Wounded Warrior Project told them in his email. “Remember, you are not alone. Many of your fellow warriors make themselves available to help others…and WWP remains by your side to provide whatever support and assistance you need.
”

TIME Veterans

WATCH: George H.W. Bush Went Skydiving to Celebrate His 90th Birthday

The World War II vet turns 90 on Thursday.

President George H.W. Bush celebrated his 90th birthday Thursday by jumping from 10,000 feet. The 43rd president, who also jumped on his 80th and 85th birthdays, followed up on a pledge two years ago that that he had “one more left in me,” TODAY reports. It marked his eighth parachute jump. Bush Sr. made the jump with retired members of the U.S. Army’s Golden Knights near his family’s home in Kennebunkport, Maine, according to a statement. https://twitter.com/GeorgeHWBush/statuses/477061870478581760 Bush was a fighter pilot in the Pacific during World War II, and was shot down in 1944. He parachuted into the water and was rescued by an American submarine, and he says that experience sparked his interest in skydiving. “I did it wrong,” he said in an interview with granddaughter Jenna Bush Hager, a contributor to TODAY. “I pulled the ripcord too early and hit the tail of the plane with my head, just [a] glancing blow. I’ve decided that later on, well, I want to do it right.” Bush has mostly been bound to a wheelchair this year as a result of a form of Parkinson’s disease.

TIME Military

FBI Launches Criminal Probe Into Veterans Affairs Scandal

The agency director James B. Comey said agents in Phoenix are heading up the investigation

The Federal Bureau of Investigation is launching an inquiry into possible criminal wrongdoing stemming from mismanagement at Veterans Affairs clinics, FBI Director James B. Comey said in congressional testimony Wednesday.

“We will follow wherever the facts take us,” Comey said, in response to a question from Rep. Suzan DelBene (D—WA) in a hearing of before the House Judiciary Committee.

Stories of falsified records and serious misconduct have continued to surface after it was revealed earlier this year that more than a dozen veterans may have died while awaiting care at a Phoenix VA clinic. An inspector general’s report released Monday found that more than 100,000 veterans have waited longer than 90 days to see a doctor, including 64,000 over the last decade who simply fell through the cracks, never seeing a VA doctor after seeking an appointment.

The unfolding scandal brought down former VA Secretary Eric Shinseki, who resigned under pressure from critics on May 30.

TIME Veterans

VA Appointment Delays Keep Getting Worse

From left: Philip Matkovsky, assistant deputy under secretary for health for administrative operations at the Department of Veterans Affairs, and Richard J. Griffin, acting inspector general for the Department of Veterans Affairs, testify as the House Committee on Veterans' Affairs holds a hearing to examine why thousands of military veterans have been waiting for up to three months for medical appointments, on Capitol Hill in Washington, D.C., on June 9, 2014.
J. Scott Applewhite—AP From left: Philip Matkovsky, assistant deputy under secretary for health for administrative operations at the Department of Veterans Affairs, and Richard J. Griffin, acting inspector general for the Department of Veterans Affairs, testify as the House Committee on Veterans' Affairs holds a hearing to examine why thousands of military veterans have been waiting for up to three months for medical appointments, on Capitol Hill in Washington, D.C., on June 9, 2014.

Latest report shows that book-cooking happened at 76% of VA sites surveyed

Things are an even bigger mess at the Department of Veterans Affairs than we thought.

An internal investigation released Monday into the secret waiting lists and other chicanery that kept veterans from receiving timely care is like a Chinese firecracker that keeps exploding with every turn of its 54 pages:

— More than 100,000 vets have experienced waits longer than 90 days for medical care. That includes 57,000 who are waiting 90 days or more for their initial appointment, and 64,000 who requested appointments over the past decade and never got them.

— More than three of every four VA health-care sites—76%— entered different appointment dates than those sought by veterans, usually under orders from a superior.

—13% of VA personnel scheduling appointments had been instructed to log appointment dates that differed (i.e., were later) from the one sought by the vet. That made wait times appear shorter.

— 8% of schedulers created off-the-books wait lists that some VA officials have described as secret. They were spread across 70% of the facilities surveyed, which included all of the VA’s major hospitals.

— Efforts to make the system work “led to an overly complicated scheduling process” that made fudging easy.

— The 14-day goal of an initial appointment for a vet seeking care “was simply not attainable,” the report said. “Imposing this expectation on the field before ascertaining the resources required and its ensuing broad promulgation represent an organizational leadership failure.” The 14-day target, which played a role in job evaluations and resulting bonuses, has been scrapped.

“Organizational leadership failure” is investigator-talk for Secretary Eric Shinseki, who resigned May 30 after the VA inspector general found, in a May 28 report, that such problems more widespread than Shinseki thought—but not as widespread as the latest report makes clear. Shinseki blamed a “totally unacceptable lack of integrity” for the rampant cheating on his watch.

“Individual questions were not worded to ascertain the reason that policy may have been violated,” the report noted. “Therefore, findings from this audit cannot be extended to identify deliberate deception, fraud, or malfeasance.”

The report set off another round of criticism from lawmakers and veterans’ groups. “The fact that more than 57,000 veterans are still waiting for their first doctor appointment from the VA is a national disgrace,” House Speaker John Boehner said.

“We must work together to fix the unacceptable, systemic problems in accessing VA healthcare,” Sloan Gibson, the acting VA secretary, said following the report’s release. “This data shows the extent of the systemic problems we face, problems that demand immediate actions.” The late appointments and resulting delayed care have been linked to as many as 40 veteran deaths in the Phoenix VA facility alone.

“This is not just ‘gaming the system,'” said Daniel Dellinger, national commander of the American Legion. “It’s Russian Roulette and veterans are dying because of the bureaucracy.”

Roughly 400 senior employees from the Veterans Health Administration, which runs health-care facilities for the VA, interviewed, between May 12 and June 3, nearly 4,000 of the VA’s 30,000 junior workers involved in scheduling appointments. “Site survey teams were not able to interview all employees, and time did not allow assessment of intent or potential culpability,” the report noted. “All of the information collected from audit site visits has been shared with VA’s Office of Inspector General,” which is conducting a parallel probe that could lead to criminal charges.

The three reasons VA employees gave for the lengthy waits were lack of doctors, the 14-day goal, and inadequate clerical help.

On May 15, the VA had more than 6 million scheduled appointments, with 5.8 million of them—96%—slated to take place within 30 days. It also had 63,869 veterans who requested an appointment to enroll in the VA system over the past 10 years “for whom an appointment has not yet been scheduled.” There are an additional 57,436 vets slated to wait 90 days or more for their initial appointment.

The VA plans to extend clinic hours, pay overtime to its staff, take steps to improve productivity and get additional help from outside the VA to tackle the backlog. “As of today,” acting VA chief Gibson said Monday, “VA has contacted 50,000 veterans across the country to get them off of wait lists and into clinics.”

TIME Veterans

Demand for Health Care Spikes as Veterans’ Ranks Fall

Veteran Affairs Clinics To Be Audited After Patient Deaths At Phoenix Hospital
Christian Petersen—Getty Images The Veterans Affairs Medical Center on May 8, 2014 in Phoenix, Arizona.

Aging, poor economy and better outreach cited in paradox

Despite all the recent complaints about difficulty in getting medical appointments at the Department of Veterans Affairs, the facts show a soaring number of vets are taking advantage of its health care: While the total number of U.S. veterans has shrunk by 17% between 2001 and 2014, the number of vets enrolled in the VA health care system has jumped an amazing 78% over the same period.

The percentage of veterans enrolled in the system has more than doubled, from 20% to 42%, over the 13-year span. That plays a major part in the tripling of the VA’s annual budget, to $150 billion, since 2001.

The numbers, published in a Congressional Research Service fact sheet last week, illustrate two truths: Once you get past the challenges associated with getting into the system, it’s pretty good, and the escalating demand for the VA’s health care services no doubt has played a major role in the scandal that led VA Secretary Eric Shinseki to resign May 30.

The retired four-star Army general left, after more than five years on the job, following an internal probe that revealed there was “systemic” gaming of the VA scheduling system to mask lengthy delays in getting initial appointments.

In 2001—the year of 9/11—there were about 26 million veterans, about 5.1 million of whom had enrolled in the VA health care system. But as World War II vets died far more quickly than the number of post-9/11 vets grew, the total number of veterans fell to an estimated 21.6 million today. Yet the number of veterans enrolled in VA health care has risen about to about 9.1 million. Roughly two of every three enrolled veterans receive VA health care in any given year.

The terse four-page CRS fact sheet, released by the Federation of American Scientists (CRS data isn’t generally made public), doesn’t offer any reason for the increase.

“The number of veterans is dropping because there simply aren’t as many veterans today as there were during the draft period,” says one former senior VA official who declined to be named amid the ongoing investigations into the agency’s problems. “As for more vets using VA health care, better outreach, the internet, and a bad economy have driven up enrollment numbers.”

Troops coming back from Afghanistan and Iraq are given more details about VA benefits than their fathers and grandfathers. “The Defense Department has been diligent in their educational programs for service members leaving active duty,” says Rebecca Townsend, a private mental-health counselor in Clarksville, Tenn., just outside the Army’s Fort Campbell. The city is also home to the second-biggest population of veterans in the country, trailing only Killeen, Texas, outside Fort Hood. “Every branch of service has a program for service members transitioning into civilian life, including extensive information regarding VA benefits.”

Those who served decades ago also are reaching out to the VA as they retire and face ailments common among older Americans. “We’re seeing veterans from prior wars entering the system for the first time, some because of the change in focus and interest by Americans over the last decade,” says Barbara Van Dahlen, a psychologist in Washington, D.C., and founder of the non-profit Give an Hour organization, which pairs military members needing mental health help with professionals who volunteer their time. “I’ve had Vietnam veterans tell me that they decided to get help because the country seems to be respectful toward, interested in, and concerned about those who serve.”

TIME Military

Freed American Soldier Reportedly Won’t Call Parents

Sergeant Bowe Bergdahl has reportedly declined to call his family

Sergeant Bowe Bergdahl suffered harsh treatment at the hands of his Taliban captors and is not yet emotionally ready to speak with his family more than a week after his release, according to reports Sunday.

Bergdahl, who was freed May 31 by the Taliban in a controversial exchange for five Guantánamo Bay prisoners, has not yet contacted his parents even though he is free to do so at any time, multiple news sources reported, citing anonymous U.S. officials. He has received a letter from his sister but has not yet responded, the New York Times reports. The Wall Street Journal, citing an anonymous official, reports Bergdahl has declined to speak with his family so far.

The 28-year-old is suffering from disorders affecting his gums and skin after five years in captivity, though he is otherwise in sound health and shows few signs of the malnourishment apparent in earlier videos the Taliban made of the soldier late last year. Bergdahl was held in a metal cage in the darkness for weeks after a failed escape attempt, according to reports, and is emotionally unstable. Despite that, he is physically healthy enough to travel back to the U.S. for treatment, officials said.

“The Department of Defense does not comment on discussions that Sergeant Bergdahl is having with the professionals who are providing him medical and reintegration care,” Rear Admiral John Kirby, the Pentagon press secretary, said in a statement. “We will respect that process in all regards.”

His release has ignited a political firestorm, with members of Congress clamoring that President Barack Obama broke the law by transferring detainees from Guantánamo Bay without congressional notification, and some of his fellow soldiers accusing him of desertion.

“As we have noted, the Army will conduct a comprehensive review to learn the circumstances of Sergeant Bergdahl’s disappearance and captivity,” Kirby added. “That process, too, needs to be respected. Our focus remains on providing him with the care he needs.”

Republican Representative Mike Rogers of Michigan said on Sunday he was sure that three of the five former Guantánamo prisoners exchanged for Bergdahl would return to the battlefield. “I am absolutely convinced of that,” Rogers said on ABC’s This Week.

Secretary of State John Kerry vigorously defended the prisoner swap on Sunday, saying it would have been “offensive and incomprehensible” to leave Sergeant Bergdahl in the hands of people who might torture him or “cut off his head.” Kerry warned that the released Taliban leaders could be killed if they return to the fight.

TIME Veterans

New York Drops 1 Million Rose Petals on Statue of Liberty For D-Day

Statue of Liberty D-Day
Richard Drew—AP One of three helicopters showered 1 million rose petals on the Statue of Liberty during a ceremony commemorating the 70th anniversary of the D-Day invasion, on Liberty Island in New York City, June 6, 2014.

The roses were a thank-you from France, like Lady Liberty herself.

TIME Veterans

Top Senators Strike Bipartisan VA Reform Deal

Less than a week after VA Secretary Eric Shinseki resigned amid reports of deadly delays for veterans waiting for health care, Sens. John McCain and Bernie Sanders strike an agreement to reform the department.

Sens. Bernie Sanders (I-Vt.) and John McCain (R-Ariz.) agreed on a framework for a bipartisan veterans’ health bill Thursday, less than a week after Veterans Affairs secretary Eric Shinseki resigned amid scandal over the mismanagement of VA facilities in Phoenix, Ariz.

The legislation would allow the construction of 26 new medical facilities, authorize funding to hire more doctors and nurses, and make it easier for veterans to seek private care. McCain said the bill would also improve the access to health care for victims of military sexual assault.

The Senate deal comes as the Obama Administration attempts to deal with accusations that officials in Veterans Affairs facilities manipulated waiting lists to hide long delays veterans were facing before they could get care.

The measure gained accolades from both sides of the aisle, including from New York Sen. Chuck Schumer, the third ranking Democrat, and Sen. Marco Rubio (R-Fla.).

“I am pleased that real accountability measures are included in the legislation,” wrote Rubio in a public statement. “Considering the deep debt of gratitude our nation owes our veterans, I’m optimistic that the Senate will soon join the U.S. House of Representatives and pass these important reforms. As we look forward to voting on this bill, I will be reviewing it closely to ensure it delivers on America’s promises to our veterans.”

The package would allow the Veterans Affairs Secretary greater authority to fire employees who do not uphold the “standards that we expect,” said McCain, but it would also provide the fired employee due process. The employee would have a week to appeal to the merit systems protection board and three weeks for the board to render a final decision.

“Reaching a compromise among people who look at the world very different is not easy,” said Sanders, the Senate Veterans Affairs Committee Chairman. “But right now we have a crisis on our hands and it is imperative that we deal with that crisis.”

TIME Military

Where Bowe Bergdahl Goes From Here

Afghanistan Bergdahl
Uncredited—AP In this image taken from video obtained from Voice Of Jihad Website, which has been authenticated based on its contents and other AP reporting, Sgt. Bowe Bergdahl sits in a vehicle guarded by the Taliban in eastern Afghanistan.

Sgt. Bowe Bergdahl is just days into what could be months or years of recovery

U.S. Army Sgt. Bowe Bergdahl arrived at a German hospital three days ago, which means he’s just finished the minimum 72-hour decompression period of his “Phase III Reintegration.”

What does this mean? It’s part of a three-step process to Bergdahl’s reintegration into American society. For someone who’s been gone for five years—one of the longest-held POWs ever treated by the U.S. Southern Command—that process is bound to be a long one.

Phase I, initial recovery, occurs “at the forward operating location within hours of recovery.” In Bergdahl’s case this was likely on a military base in Afghanistan. It involves “medical triage, psychological support and tactical debriefing for time sensitive information,” according to a fact sheet given to TIME by the U.S. Southern Command.

Phase II is called “decompression” and it happens in a regional hospital — Landstuhl Medical Center, in this case. It lasts a minimum of 72 hours, but it can last longer depending on the medical and psychological needs of the POW. There is no indication of how long Bergdahl will stay in Germany. When he’s ready, he’ll move on to Phase III, which will happen at Brooks Army Medical Center at Ft. Sam Houston in Texas.

Bergdahl’s parents had yet to even speak to him by phone as of Tuesday evening, according to Idaho National Guard Spokesman Timothy Marsano, who has acted as the family’s spokesman for years. After appearing alongside President Barack Obama in the Rose Garden Saturday, Bergdahl’s parents have returned home to Hailey, Idaho. When their son is ready, they will meet him in Texas, where they will spend months helping with his recovery as he enters Phase III.

Phase III is the longest part of reintegration. It involves “establish a perception of control of their life,” having “their emotions normalized” and reengaging “in a healthy life style with family, socially and with work.” It also involves gathering “time sensitive” and “strategic intelligence” and “evidence” to “prosecute criminals.”

Southern Command, which deals with all reintegration cases, developed this protocol after the Vietnam War to help with the flood of hundreds of returned POWs. Since 2007, they’ve treated an Army contractor held hostage in Ethiopia for three months, three Pentagon contractors held in Colombia for more than 5 years, an Army civilian held in Iraq for two months and a U.S. service member held in Colombia for over four months.

“So, yes, obviously this will be one of our longer cases,” says Col. Hans Bush, director of public affairs for U.S. Army South.

Bergdahl’s road home is complicated by an Army investigation into whether he defected or should be held on charges of going AWOL (Absent Without Leave) the June, 2009 night he walked away from his unit in Afghanistan. Normally, POWs who successfully finish Phase 3 return to service. Given the circumstances, though, Bergdahl could be returning to a court martial and potential jail time.

All of which is to say, Bergdahl almost surely won’t make it home for the June 28 “Bowe Is Home” celebration being planned in Haley to mark his release. The celebration was originally planned as a “Bring Bowe Back” event. So, while many questions remain, his family and friends can celebrate that he is, at least partway, back.

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