Battleland

Dr. Peter J. N. Linnerooth, 1970–2013

How an Army psychologist, who won a Bronze Star in Iraq for keeping troops from killing themselves, couldn’t save his own life

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Courtesy Brock McNabb

Dr. Peter Linnerooth, right, on a cigar break with Army mental-health colleagues in Baghdad, 2007.

Dr. Peter Linnerooth spent nearly five years wearing an Army uniform, including the bloodiest 12 months in Iraq at the height of the surge. As a mental-health professional, his top mission was to keep troops from killing themselves. After he returned home, he spent another two years trying to save the vets he loved, working for the VA in California and Nevada.

Few who wore the uniform in the nation’s post-9/11 wars better understood the perverse alchemy that can change the rush and glory of combat into a darkening cloud of anxiety, depression and posttraumatic stress. But strikingly, all that understanding — and the knowledge, education and firsthand experience that nurtured it — didn’t save Linnerooth.

“Pete struggled with PTSD and depression after his deployment to Iraq,” an Army comrade says. “Pete is a good example of how serving in combat can change someone. Pete was one of us,” he adds. “He’s the first Army psychologist that I know who killed himself.”

(MORE: Battling PTSD and TBI)

Linnerooth died in Mankato, Minn., on Jan. 2. He was 42.

He spoke eloquently in recent years about the need to care for the troops’ mental woes. He also warned of the grinding stress that providing such care inflicted on Army mental-health workers like him. He talked of it in the pages of TIME, and the New York Times. He was the lead author of a 2011 piece on such “professional burnout” among his peers who, like him, had gone off to witness the worst of war, day after day, patient after patient.

“Despite the resilience that may result from training and experience, it is reasonable to assume that professional burnout occurs at a relatively high rate among the vulnerable and overstretched population of clinical military psychologists,” Linnerooth wrote in an American Psychological Association journal. He was, eerily, telegraphing his own fate.

Linnerooth was a captain in the Army from 2003 to 2008. He served as the mental-health officer in charge of the 2nd Brigade Combat Team (Dagger), 1st Infantry Division (the Big Red One), in and around Baghdad from August 2006 to August 2007. The Army awarded him a Bronze Star for exemplary service at the end of the deployment.

(MORE: Study: 911 Dispatchers Experience PTSD Symptoms Too)

The Lives He Touched

Word of Linnerooth’s death last week spread quickly among those with whom he had served, in Iraq and elsewhere. Dozens have posted memories on a Facebook memorial page. “Pete helped more than a thousand soldiers through direct counseling” in Iraq, said Angela Sales Landchild, whose Army medic husband served alongside him in Iraq. He “improved the lives of countless more due to his tireless efforts to improve the mental health resources available to them.”

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Facebook

“Heartbreaking,” posted Sarah Murray, wife of the brigade nurse. “I will never forget his contribution to the mental health of the brigade.”

“What a terrible loss and tragedy!” said Colonel Keith Sledd, Linnerooth’s battalion commander, from Afghanistan. “Pete was an outstanding person, Soldier, and doctor.”

“I don’t know how many times in my current counseling sessions I mentioned Pete the ‘Wizard,’ ” Army medic Jedidiah Ayers said. “We will never know how many lives he has saved through his caring.”

He achieved a lot. But it came at a high cost, personally and professionally. “He was really, really suffering,” his widow Melanie says. “And it didn’t matter than he was a mental-health professional, and it didn’t matter than I was mental-health professional — I couldn’t help him, and he couldn’t help himself.”

(VIDEO: Are Female Troops More Likely to Get PTSD?)

It seemed there was no one to help an Army hero who spent his career helping others. “The resources aren’t what they should be,” Melanie says. “The death toll for suicide is now higher than combat, and he was very frustrated by that.”

He shared those frustrations. Linnerooth told TIME three years ago that he first realized that Army mental-health workers were overwhelmed during a two-month stint at Fort Hood, Texas, two years before he went to Iraq. It was early 2004, and the first troops to deploy to Iraq had just started coming home with mental problems. “We were told you have to hold soldiers to a higher standard of severity and symptoms to diagnose PTSD,” he recalled being instructed. “Meanwhile, I’m looking at the DSM 4 [Diagnostic and Statistical Manual of Mental Disorders, 4th Edition] — the standard of my profession — and saying ‘It doesn’t f—— say that here.’ ”

He said he was ordered to cut the standard 50-minute counseling sessions to 20 minutes. “You’d have to resist that,” Linnerooth said. But when he’d complain, the response was always the same: “This is a war,” he said his superiors told him.

The Army’s mental-health cadre, like other slices of the U.S. military, wasn’t prepared for a lengthy conflict. “You’re looking at 350 [clinical psychologists] to support the entire Army of about a half a million,” Linnerooth said in that 2010 conversation. “That’s way too little, and it’s led to way too much burnout.”

(MORE: Army Policy: Deferring Mental-Health Diagnoses in War Zones)

Marching Off to War

Then he went to Iraq. Once there, he said, he realized the situation was even more dire on the front lines. There was relentless pressure to get bodies into the fight. “When they tell you to make a soldier deployable, what are you going to do?” he recalled asking himself. “The Army has been criminally negligent — but I’m a captain — what am I going to say to a battalion commander who’s going to oppose my decision?”

baghdad xmas

McNabb

Dr. Peter Linnerooth, Baghdad, 2006

He said he wasn’t alone. “When we were in Iraq, a chaplain, almost with tears in his eyes, said the Army is criminally negligent in its mental-health care of soldiers,” Linnerooth recalled. “And I believed that to be true as well.”

He was haunted by the procession of bodies, alive and dead, that he witnessed coming into the Riva Ridge Troop Medical Clinic. Even mental-health workers had to pitch in to help after mascals — mass-casualty events. The recollection of an explosion that ripped into four Iraqis — two grownups and two kids — especially tormented him. “The adults died quickly, but the kids didn’t give up,” Melanie recalls Pete telling her. “So they screamed in agony for hours until they finally died. Their skin was falling off, and the bone was showing through and there was nothing these guys could do for them except try to manage their pain while they died.”

Headed Home

Linnerooth, according to friends and colleagues, came back from Iraq a different man. After leaving the Army, he taught psychology for a year at Minnesota State University at Mankato, but found it dispiriting. “I was tired of 19-year-old college kids bitching to me about how hard I graded them,” he said, “when the 19-year-old soldiers that I was used to working with were hoping they would survive to see the next day.”

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MSU

Dr. Peter Linnerooth in the faculty guide at Minnesota State University at Mankato, 2008.

In 2009, the Minneapolis VA awarded him 100% disability for PTSD. It worked out to about $2,300 a month, tax-free. His 17-year marriage fell apart.

So he headed to the California coast in late 2009, near Santa Cruz. He moved across the street from his Iraq war buddy, Brock McNabb, who had worked alongside Linnerooth as a combat medic specializing in mental health. The pair worked for the VA, tending to mentally ailing vets at the Santa Cruz County Vet Center center in Capitola.

Given their work and their shared background, dark thoughts were routine. “We talked about suicide all the time,” McNabb says. “It is something that many vets are comfortable with talking about. Especially the two of us, since we dealt with suicidal ideation and completed suicides in our careers. He was not afraid of death, I think he was just afraid that he wasn’t going to mean as much as he did in the Army for the rest of his life.”

(MORE: The Army’s Continuing Dearth of Mental-Health Workers)

A Fresh Start

Then he fell in love with Melanie and decided to move to her place in Reno, Nev., and work for the VA there. His PTSD had ebbed while he was living alone in California, but it returned when he moved to Reno to live with Melanie and her two kids and had visits from his two children. “He had more control over his environment in Santa Cruz,” Melanie says.

Things did not go well at the Reno VA, where he had been hired to help vets afflicted with PTSD. For one thing, he was coming up on the two-year deadline to get a state psychologist’s license since being hired by the Department of Veterans Affairs.

pete and brock, calif

McNabb

Battle buddies Brock McNabb, left, and Dr. Peter Linnerooth, working for the VA in California, 2010

“The Reno VA told him, ‘Don’t worry about it. Come on board even though you’re about to hit your two-year mark,’” McNabb recalls. Linnerooth’s VA bosses said the family-leave time he had taken while in California to spend time with his kids in Minnesota would extend the deadline, McNabb recalls. “But within a couple of weeks he was told by Reno’s human resources department, ‘Hey, we forgot to tell you, since you’re not licensed, we have to terminate you,’ ” McNabb says. “He was essentially fired.”

After that, his PTSD grew worse. The VA, McNabb said, denied his request to get help from a VA-funded private mental-health professional. “They wanted him to get treatment at the facility where he was supposed to work,” a second close friend says. “He just felt betrayed by the organization that was supposed to take care of him.”

McNabb recalls the Catch-22-iness of it all. “He was planning to go through a formal grievance process as a disabled veteran to get his job back,” McNabb says. “He said, ‘I obviously don’t want to see anyone there who I might end up working with in the future.’ ”

The VA said Jan. 14 it was “forced” to terminate Linnerooth after he failed to get the required license, but told him the agency would take him back once he got it. “To VA’s knowledge,” no one told him he’d get an extension because of the family leave he took, it added. “The Reno staff also says they did not limit his access to PTSD treatment,” the VA said. “They informed us they never would have done this.”

(MORE: Military Psychiatrists at War: True Life and Death Decisions)

Returning Home

As he spiraled deeper into PTSD, his second marriage began crumbling. He went to Oregon for a VA residential program, but it didn’t work out. So he headed back to Minnesota last summer. Melanie says that while the marriage was rocky, it wasn’t irrevocably broken. Pete visited her just before Christmas, and things went well. “He started getting some treatment and was becoming the person that I knew Pete was,” his widow says. “But he couldn’t quite get there fast enough.”

pete & melanie

Family photo

Melanie Walsh and her husband, Dr. Peter Linnerooth, 2011.

Yet Linnerooth kept trying. “He even started seeing a VA mental-health provider recently and thought it might go well,” McNabb says. But a combat veteran’s life can careen out of control in a flash. “More often than not, suicide is an impulsive act,” McNabb says, trying to explain what happened to his best friend. “It’s always a viable option in dealing with pain and loss. And it was for Pete.”

McNabb, now working for the VA in Hawaii, says his battle buddy found himself adrift, without a mission or even a job. “The only time that he felt that he truly mattered in his whole life wasn’t as the university professor or the VA counselor, but as the Army psychologist whose sole purpose in life was to help his soldiers get through just one more day,” McNabb recalls. “He once said, ‘See one more day past this one. That’s how you will make it through.’ I sure wish he did.”

His widow, who works for the VA in Reno, is profoundly frustrated by what happened. “We didn’t know,” she says, “how to get him the help that he needed.”

pete w: baby son

Family photo

Dr. Peter Linnerooth and his infant son in December 2012.

As is generally the case in suicides, there was no one cause. McNabb believes there were “many straws” involved. But the VA was part of it. “They could have given him more of a chance — all a person needs is that hope,” McNabb says. “Pete needed to feel like he still mattered. My God, he was a Bronze Star–winning Army psychologist. But the VA just looked at him as another psychologist who couldn’t get his licensure in two years.” McNabb knows about such things: he serves on a national VA special committee for PTSD.

But perhaps Linnerooth himself put it best in that 2010 chat with TIME. The military’s mission is to fight and win. “The Army is focused on the short term — ‘I need a warm body manning a gun in a Humvee,’ ” Linnerooth said. “That’s great — until that warm body is crazy and eats his gun.”

In the early morning hours of the second day of the new year, alone in his apartment, that’s just what Linnerooth did, after mixing Jack Daniels with Diet Coke with a telephone argument with his wife.

He will be buried at Fort Snelling National Cemetery in Minneapolis on 11 a.m. Monday.

He is survived by his widow, and three children — a son, 10, and a daughter, 6, from his first marriage, and a four-month-old son from his second — his mother, Gayle, and a sister, Mary Linnerooth Gonzalez. He is also survived, among the hundreds he treated for the PTSD that killed him, by an unknowable number – one? two? dozens? – of the grunts he loved, whose names are known but to God.

In His Own Words: Dr. Pete Linnerooth writes about a tough day at war. [link]

In His Own Words: Dr. Pete Linnerooth speaks to TIME in 2010: 

21 comments
jst4horses2
jst4horses2

Counselors are supposed to have counseling, and it is confidential and in groups of their peers. Police and other first responders, as well as soldiers and counselors to first responders and active duty and veterans need to have support counseling, NOT you are nuts counseling. There is no excuse for Dr. Pete dying except paperwork, bureaucracy and lack of care from a nation that send out young, smart, patriotic Americans out to be killed, maimed and mentally destroyed for us, but does not give a damn about their needs when they return, look at this TWENTY comments. There should be millions, outraged, and demanding change for our veterans and their doctors (and other staff, overwhelmed and trying to help).

GrammaBear
GrammaBear

Our deepest sympathies on the loss of this great man!   How very sad for this good doctor/veteran, as well as for his family, friends, and all of those whom he may have helped in the future.  It is truly everyone's loss in that sense. The comments about the VA worry me a bit, especially when I think the government will now be running all aspects of our national healthcare.  It's not going to go well if this is any indication.   

How could the VA possibly expect the doctor to go for counseling in the same facility where he may later end up working with that counselor as a colleague again?  It's a known fact that every now and then counselors need a counselor themselves to help cope with all stresses of that job - - even when they are not working in a war environment.  The VA should have had crisis teams, off site, to work with the psychologists who need to talk to someone - - or they should have vouchered his care by a private professional off site.  

So, I agree with PavingTheRoadBack's comments completely!  This is a travesty, and it should never have happened.  If he was expressing thoughts of sucide, someone should have arranged an admission and a 48-hour evaluation/observation.  That way, Dr. Linnerooth could have been thoroughly evaluated before they sent him back home alone.  Instead, they did nothing to help him?  Really.  Is this the best we can do for our nations' heroes?  I for one think they deserve better care than that.  Hearing that we lost someone like this fine man breaks my heart, especially when it may have been prevented with improved VA policy and planning to treat the expected effects of combat stress on our helpers.   

iversongregory
iversongregory

Thanks Mr Thompson for telling Pete's Story in a respectful way.

Sales, Thanks for protecting him as you always did our Soldiers. 

When we were creating a combat stress team for our BCT, Pete volunteered for our mission in Iraq because of his desire to take care of our Soldiers in our unit and because of his belief that he could gather information (which he, brock and Travis did faithfully)  to help future units. 

Pete, I love your soul.  We will miss your deep, hardy laugh, your foul mouth, your great smile and the ease at which you made friends.  Your sacrifice for our country is no less than that of Ross McGinnis.  In the end, you gave it all for the lives of your comrades.   I am deeply sorry, that I did not stay in touch with your after our time at Riva Ridge.  Just like the casualties we worked on there, I will remember (and see your face) each day and wonder if there was something more that we could have done.  

I am comforted in knowing that you could have had no greater man as your Battle Buddy than SGT McNabb.  God bless you Brock!


GeorgeWingate
GeorgeWingate

When all is lost and you feel that you have no reason to be useful, that is when PTSD sets roots.  When you put all you have into something your heart and soul and it is gone, you loose the ability to rationalize your importance.  Alcohol, marital problems and a loss of face can lead to a tragic ending.  Before you end your life or hurt others by doing so, look up to God because he is the only Doctor that can prevent suicide.

pearlandgracey
pearlandgracey

These deaths are an inevitable effect of war and multiple deployments. Many go to war five to seven times or more -- and many were "Stop Lossed" or forced to extend their contract agains their will. The millions of Iraqi refugees in this country and those in Iraq and around the world and all the children with birth defects from uranium weapons -- and life-long PTSD -- all these people also desperately need help, money and otherwise. The US will see this suffering and loss for decades. Perhaps, there will be a time when traumatized soldiers can listen to and see the suffering that the Iraqis and Afghans also have endured and do endure. 

ShaniHeckman
ShaniHeckman

I am so sorry for you loss! I think the worst part of it is that b/c it was a suicide, his family gets no financial support! As suicide becomes more common and much more of a medical health emergency, we need to change insurance laws so that families aren't left with nothing. Clearly this man was with a health issue and it was ignored. His family should not be made to suffer further but should be financially compensated for this loss! 


PavingtheRoadBack
PavingtheRoadBack

I have not been able to get this story out of my mind all day.  As a psychiatrist at a VA, I not only find Dr. Linnerooth's story deeply saddening, but also nearly demoralizing.  First, I must say that I cannot join one of the commentators in that person's belief that it's not that common to "spiral deeper into PTSD."  To give that individual the benefit of the doubt, perhaps s/he is referring to the almost-fanatical obsession of many researchers, administrators, and treaters to "make sure that we don't expand the meaning of PTSD," as if somehow the nation's coffers and the psychological-science enterprise were depending on the narrowest of definitions for their very survival.  My experience, in contrast, is that War is War is War, and once it invades a soul, it doesn't pay much attention to DSM-IV (or V) lists of criteria.  Having met men who still scream at night remembering the horrors of the Tet Offensive over forty years ago, I suspect that many combat veterans aren't that impressed by the latest factor analyses as well.

What upsets me to the point of near-rage, however, is that (if the report is correct), Dr. Linnerooth was denied being "fee-based" (i.e., sent out) to a private therapist, but instead was going to have to work with a colleague!  I'll come out and say it in public:  might it be that there WASN'T a colleague there to whom Dr. Linnerooth would be willing to bare his soul?  Was there no one there with whom he could feel both vulnerable, and yet respected?  Why was he not allowed to be sent out?  I have no clue, but we might consider two hypotheses, both working concurrently:  1). no one wanted to pay for the therapy with "taxpayers funds" and 2). decision makers at the hospital, like many treaters and researchers, approach PTSD therapy more as a technique than as a relationship.  If it's a technique, after all, then it really shouldn't matter with whom you do it:  just do it!  People love to hem and haw around the edges when confronted with this point-of-view, but I so often come across treaters who have no clue what to do when emotions "spill out" over the edges of the evidence-based therapies--except, of course, to blame the combat veteran for "not being ready for the work."   One has to ask just exactly "who" is not ready for the work in such cases.

It doesn't take a college degree to know that Dr. Linnerooth, in bravely meeting the demons of others day in and day out, was having to combat his own simultaneously.  Good Lord, was there no one out there anywhere who respected and cared for the man enough to know both that he needed to be honored and encouraged for his work, while also that he needed to have a periodic, quiet take-aside, one in which his honor and his dignity and his professional skills could be respected, but also one in which his humanity--and the pain that arose directly out of that humanity--could be addressed and, yes, even given "special" treatment?  For Heaven's sake, the man was giving his life for others:  there was NO ONE who couldn't move Heaven and Earth to make sure that he got what he needed?

This is not just a tragedy.  This is a travesty.

gysgt213
gysgt213

This is one of the costs of war.  It's not pretty but this is what war does to a lot of people both the  military personnel prosecuting it but civilians as well.   

mtngoatjoe
mtngoatjoe

Treating a vet like this is akin to leaving a comrade on the battlefield. Enough is enough. Fund VA health care at the level that is needed. Raise my taxes if that's what it takes. But for God's sake, don't let this happen again!

btnkkd
btnkkd

So he wasn't licensed while serving as a psychologist during his deployment?  I didn't think that was allowed.

Also, I got the impression that his suicide had more to do with his marital and work problems than ptsd.

NoraEdwards
NoraEdwards

How many of these awful tragedies does it take before we wake up and solve our differences like adults? Our military no longer consists of family members of our decision members. They are treated as marginal and expendable. I am horrified at the consequences of these wars.

FSMpiratewannabe
FSMpiratewannabe

The problem with the VA is that you are not a person; they do not recognize the individual, they only recognize veteran.  There is no allowance made for the needs of a person.  In essence, you really are just a file, and VA protocols are based on treating a large number of indentity-less files.  


Yeah, they'll keep you alive in an emergency, but individualized treatment doesn't exist.  They are stretched to thin.  


At least, that has been my experience.

UncleJuneBug
UncleJuneBug

@ShaniHeckman you are wrong, life insurers are REQUIRED to pay on a suicide.

They are allowed a two year exclusion period when the policy is written.

JordanTabb
JordanTabb

@RodDeaton1 I agree completely. This article has devastated me. I am a veteran, a father, and an MSW Intern at a VA, providing outpatient therapy for veterans. It hurts to lose someone who we could just as easily known as a colleague, a friend, or a client - an article and passionate soul, and one of us! One of the helpers, one of those called to comfort and support those in need. It hurts to lose him, and I wish we could have done better for him, as a country and as an organization.

FSMpiratewannabe
FSMpiratewannabe

@RodDeaton1 Well, I'll tell ya.  I had a kidney stone two years ago.  I went to the VA.  They wanted to put a stent in my ureter.   they didn't tell me that up front.  When I met with the urologist, he gave me all the side effects, which weren't pretty, and then told me he could not tell me exactly how long the stent would be in place.  Infection, debilitating pain, incontinence are all side effects, and no end date?  I told him no thanks.  


I tried to get an answer as to how long it would take before the VA would have the stone removed.  I was told at least two months, but that I would not be given a date until I had the stent put in.   work for a living.  I'm a contractor.  Waiting would have cost me almost 30,000.00 in lost wages.  I paid for the procedure myself.  Cost me about 7500.00.  I asked the VA for assistance, just what it would have cost them to do it, not the full cost.  Nothing.


The VA doesn't do fee basis these days.  Not enough cash.  They'd rather you suffer.  My son pays for his own PTSD counseling out of pocket, because he actually gets help, not just drugs.  The VA needs help, period.  Washington would much rather ignore vets them help them; it costs less.

AngelaSalesLandchild
AngelaSalesLandchild

@btnkkd Of COURSE He was completely licensed during his deployment. I processed his licensure renewal myself. His licensure didn't lapse until several years after we returned.

bobell
bobell

And of course there was NO relationship whatever between his PTSD and his marifal problems, right?

Idiot.

Suresp77
Suresp77

@FSMpiratewannabe Its not just the VA though. As a society, we think that we can accomplish more by viewing great numbers of people not as people at all, but as dispassionate consumers. So if they are not served, we do not have to assume any responsibility for letting them down. The minute they change back to people, we work harder and take an interest in ensuring a better outcome. This is why we can talk policy with no shame while ignoring the real life consequences to actual, living people and still sound caring and educated. Its disgusting really, and then we speak of empathy- hah!

JaredWoody
JaredWoody

@AngelaSalesLandchild @btnkkd It also sounds like perhaps it wasn't so much even that it expired, but because he moved from California to Nevada, he had two years to obtain a valid Nevada based license, rather than continuing to use his California license.

btnkkd
btnkkd

@bobell I never said there was NO relationship between his ptsd and marital problems but im sceptical about attributing it all to ptsd that many years after his discharge/med board.  It's not common to "spiral deeper into ptsd" like that years afterwards.  That sounds more like depression.

Oh and since we're apparantly resorting to juvenile name calling: no u r teh idiot!1! 

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