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Psychiatric Times. Vol. 26 No. 7
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Death of Psychiatrist and Other Soldiers Triggers Inquiry Into Military’s Mental Health Care

By Arline Kaplan | July 6, 2009

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Alarmed by the rising suicide rate among soldiers returning from Iraq and Afghanistan and “wanting to help,” Matthew “Matt” Houseal, MD, a psychiatrist with the Texas Panhandle Mental Health Mental Retardation Center (TPMHMR), reenlisted as an Army Reservist and volunteered to serve in Iraq.

Last month, Houseal, 54, of Ama­rillo, Tex, and Navy Cdr Charles “Keith” Springle, PhD, 52, a clinical social worker from Wilmington, NC, were working in the combat stress center at Camp Liberty in Baghdad when Army Sgt John M. Russell allegedly opened fire. Houseal and Springle were killed along with 3 soldiers awaiting treatment: Pfc Michael E. Yates Jr, 19, of Maryland; Spc Jacob D. Barton, 20, of Missouri; and Sgt Christian E. Bueno-Galdos, 25, of New Jersey.

News reports and an interview with Jim Womack, Houseal’s former co-worker at TPMHMR, reveal that Houseal, father of 7 and husband of nephrologist Luzma Houseal, MD, was a compassionate and multitalented man. Houseal was board-certified in emergency medicine, psychiatry, and geriatric psychiatry and had helped establish a telepsychiatry network for rural regions of Texas. At TPMHMR, he had most recently been work­ing with patients with depression, schizophrenia, and bipolar disorder. A former Navy pilot, Houseal was known to fly himself to remote parts of the Panhandle to treat indigent patients. He had served as a “winter-over” physician at the US South Pole Station.

Like Houseal, Springle had volunteered for deployment in Iraq because, according to news reports, he felt that the greatest need for his services was at the heart of the battle. Springle had served as director of the Community Counseling Center at Camp Lejeune in North Carolina and helped train mental health workers, clinical clergy, substance abuse counselors, and others to recognize and assess individuals with PTSD. Springle was married 26 years and had a daughter and son. His son and son-in-law are Marines.

Houseal and Springle were assigned to the 55th Medical Com­pany in Indianapolis. Joe Sitler, the 55th’s unit administrator, told Psychiatric Times that 83 service members of the 55th, which included 6 psychiatrists and 62 other mental health workers, had been dispersed to various locations throughout Iraq. Houseal, on a 90-day rotation, was due to return home this month.

What happened?
The shootings at Camp Liberty marked the sixth incident in which a service member killed a comrade since Operation Iraqi Freedom began. It was the worst such attack.

As described in Army briefings, Russell, 44, a soldier from the 54th Engineer Battalion on his third Iraq deployment, had undergone some counseling within his unit. Roughly a week before the shooting, Russell had been referred to the combat stress center for outpatient treatment. His commanding officer had ordered that Russell’s weapon be confiscated. No details were available on whether Russell was taking any prescribed medication, said Maj Gen David Perkins, director for Strategic Effects, Multi-National Force–Iraq, during an Army briefing. According to Russell’s father, his son was facing financial difficulties and feared he was about to be discharged from the Army.

On May 11, Russell was escorted to the combat stress clinic. He became involved in a verbal altercation with staff and was asked to leave. Russell and his escort returned to a vehicle and began to drive away. Somehow, Russell wrested control of his escort’s weapon, ordered the escort out of the vehicle, drove back to the clinic—and began to shoot, news reports said.

Military police arrested Russell outside the clinic. Russell is now in pretrial confinement and is undergoing medical evaluation. He has been charged with 5 counts of murder and 1 of aggravated assault.

The US Army Criminal Inves­tigation Command is investigating. “We have many different accounts as to exactly what happened and the sequence in which it happened,” Perkins said during a press briefing.

An executive-level officer has been appointed to conduct an internal investigation to determine what happened, make recommendations for preventing similar incidents, and assess the general availability and delivery of behavioral health services, said Army Lt Col Brian Tribus, Multi-National Corps–Iraq media operations chief, in an interview with Psychiatric Times. In addition, the Army’s Inspector General has been asked to review all mental health services available to troops in Iraq.

Witnesses and others affected by the shooting received comprehensive psychological first aid immediately and in the days following the incident, Tribus said.

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