The Army’s Failing WTUs

The army set up Warrior Transition Units to deal with returning soldiers traumatized by their service in Iraq and Afghanistan, but in many instances it appears to being failing as badly as the system it was designed to replace.

A report in The New York Times chronicles the problems that led one soldier to say, “Being in the W.T.U. is worse than being in Iraq.”  (See, “In Army’s Trauma Care Units, Feeling Warehoused.”)

For one thing, the units emphasize medication to treat depression, anxiety, nightmares and other sleep disorders.  But often the medications cause the soldiers be disoriented and confused, undermining their ability to show up for their duties.  Sometimes them can’t keep track of the different drugs prescribed for them.  According to The Times, many of them resort to heroin as a cure-all, which not only further incapacitates them but also saddles them with the additional, intractable problem of addiction.

An over-emphasis on medication is a common failing in the U.S.  In this case it is doubly tragic because it serves as an excuse to abandon the returning soldiers.  They spend a lot of time in their rooms, staring at the walls or watching TV, forced to face their demons alone.

A closer reading of the report suggest that the underlying reason the program is failing is that it is run by officers who have no direct experience themselves of the tasks and the problems they are attempting to manage:  “At the top of the command are traditional Army officers, not health care professionals.”

If those managing a system lack clear understanding of the nature of the work the system is engaged in doing, the system is virtually doomed to failure.  Well-intentioned and even well-informed amateurs can’t really do the job:  they really can’t understand the issues faced down the line by those who actually do the work, while those who do it can’t easily approach and find the ways to communicate with them.  The system becomes over dependent on formal rules, standards and guidelines.  Inevitably those at different levels of authority will be emphasizing different things and work at cross-purposes, while deprived of the subtle and often unconscious cues that could tell them something is wrong.

This is true for any enterprise, but even more so for systems that provide human services.  Such systems reverberate with complex and sometimes contradictory resonances and cues.  To be effective in them you really have to be alert and open to knowing what you don’t know you know, and able to hear what others can’t so easily say.