A series of bad policies and administrative failures shaped Dean Mellberg’s mental illness before he went on his murderous rampage.
One year later, the U.S. Air Force has changed some of its rules for monitoring and discharging mentally unfit airmen.
The biggest flaws in the system remain, critics say.
“It’s like they didn’t learn a thing,” said Susan Brigham, the wife of slain psychiatrist Maj. Tom Brigham. “The magnitude of the errors were so great and they’re just changing minutiae.”
Military officials say they are keeping better records on trainees, and it is harder for commanders to keep airmen who are diagnosed as disturbed.
But commanders still can disregard doctors’ advice to discharge people with mental health problems.
That happened three times in Mellberg’s 20-month career, as Brigham and other mental health experts diagnosed him as nervous, anxiety-ridden or even dangerous. Every time they recommended he be discharged, a squadron commander without medical training decided to keep him in the service.
A new Air Force rule says the next level of authority, usually a wing commander, must review a squadron commander’s decision.
But Susan Brigham pointed out that rule still gives the final say to commanders who aren’t trained to spot psychological problems.
Serving two masters
The changes don’t address a serious flaw in the military’s mental health system, Brigham said.
Military psychiatrists and psychologists perform a dangerous dual role, treating patients and reporting to their commanders whether they are fit for their jobs.
Civilian doctors have for years separated treatment and job evaluation, saying that trying to do both usually means neither is done well.
Sen. Patty Murray, D-Wash., and a dozen other members of Congress want Defense Secretary William Perry to review that system.
“I believe they need to have civilian experts look at the system,” Murray said recently.
Air Force Secretary Sheila Widnall, ordered by Perry to respond to congressional concerns, recently wrote Brigham that the service’s doctors “will continue that necessary and very important dual role.”
After the shootings, investigators discovered Mellberg often removed his medical file from base hospitals. While it was checked out, he may have purged it of reports he found unfavorable. Because of missing records, doctors and supervisors at his new bases didn’t know he was previously recommended for discharge for psychological problems.
Last August, the Air Force inspector general ordered all commands to review the rules on security of hospital records.
But patients still have easy and unmonitored access to their medical records. The wife of an Air Force member at Fairchild recently checked out her files, which included reports from the mental health office, and took them off base to demonstrate the problem.
“I could do anything I want to them and they’d never know,” said the woman, who arrived at The Spokesman-Review offices with the 2-inch file folder. She asked that her name not be used to protect her husband’s job.
Through the security gates
The Fairchild hospital complex is outside the base gates. Mellberg entered the area unchallenged, with his weapon hidden in a duffel bag, and began his rampage by killing his former psychiatrist and psychologist.
After reviewing security of the complex, Fairchild officials moved the mental health clinic to a building inside the gates.
But that switch would not necessarily have stopped Mellberg from killing his former doctors. When officials at Cannon Air Force Base in New Mexico gave him an honorable discharge - even though it was for a personality disorder - Mellberg received an identification card giving him two years of access to any military base.
After his discharge, security guards found him wandering around Cannon in the dark. Eventually they ordered him to stay away from that base.
Still, they couldn’t revoke his privileges at other bases and didn’t notify doctors or commanders at his previous bases that he had been discharged.
Military officials said ID cards provide access to medical care, temporary lodging and commissaries - all standard benefits for honorably discharged airmen.
No changes are proposed to revoke those privileges for the small number of people who are honorably discharged because of personality disorders.