I stumbled across the article today, and am greatly concerned as this happens more than people think. I am a firm believer that the legal system needs to treat this Veterans is PTSD differently, as they are not in the right frame of mind when things like this occur. Treatment should be considered over incarceration when dealing with Combat Veterans with PTSD.
Army vet with PTSD sought the treatment he needed by taking hostages – but got jail instead
By Megan McCloskey
Stars and Stripes
Published: August 18, 2011
FORT STEWART, Ga.–
“I’m Robert Anthony Quinones, but my friends call me Q,” the former Army sergeant told the ER medic as he pointed a 9 mm handgun at the medic’s head.
“Can I call you Q?” asked the nervous medic, Sgt. Hubert Henson.
“OK,” Henson replied. “Well, Q, if you put the gun away, I can take you upstairs to behavioral health to get help.”
Quinones scoffed, instead ordering Henson to carry his three bags: a shaving kit, a duffel stuffed with clothes and books, and a backpack bulging with two assault rifles, a .38-caliber handgun, knives and ammunition.
Fifteen months of carnage in Iraq had left the 29-year-old debilitated by post-traumatic stress disorder. But despite his doctor’s urgent recommendation, the Army failed to send him to a Warrior Transition Unit for help. The best the Department of Veterans Affairs could offer was 10-minute therapy sessions — via videoconference.
So, early on Labor Day morning last year, after topping off a night of drinking with a handful of sleeping pills, Quinones barged into Fort Stewart’s hospital, forced his way to the third-floor psychiatric ward and held three soldiers hostage, demanding better mental health treatment.
“I’ve done it the Army’s way,” Quinones told Henson. “We’re going to do it my way now.”
The standoff ended after two hours without any injuries, but Quinones’ problems were only beginning.
While in custody, Quinones threatened the lives of President Barack Obama and former President Bill Clinton, making his already bleak situation worse. Now he’s sitting in a jail cell awaiting his fate on a litany of federal charges while a court sorts out whether he should be prosecuted or committed.
Quinones’ story is one of an ordinary soldier who went off to war, came home broken, and then went over the edge after the government didn’t do enough to fix him. Even the three soldiers held at the point of Quinones’ guns today express more empathy than animosity for their captor.
To them, what Quinones did that day was the ultimate cry for help.
By all accounts from his comrades and superiors, Quinones was an excellent soldier. He had grown up around the Army with his career-soldier stepfather, who retired as a sergeant major after 30 years. Quinones was working on Fort Stewart as a warehouse foreman for the post exchange when he decided in 2004 to enlist shortly before he turned 24.
“I wasn’t a kid or anything. I knew what I was getting into,” Quinones told Stars and Stripes in a jailhouse interview.
He was assigned to 2nd Battalion, 3rd Infantry Regiment at Fort Lewis in Washington and “was always the first to volunteer to take care of whatever needed to get done,” one of his senior noncommissioned officers told Stars and Stripes.
A sergeant in his squad described Quinones as patient, kind and reliable, someone he never had to worry about getting in trouble. His NCOs said they were impressed from Day 1 with his military bearing, noting that unlike many other privates, Quinones didn’t require constant supervision or monitoring.
“He was not the selfish type,” an NCO said. “He was a team player.”
In July 2006, Quinones deployed to Iraq, where he spent the next 15 months during the bloodiest zenith of the war.
Baghdad was besieged by sectarian violence and overrun by militias. In January 2007, President George W. Bush had ordered in more than 21,000 U.S. troops to re-establish security.
Quinones’ unit was moved from Mosul to Baghdad, and the combat they experienced was intense.
“We’d see anywhere from 10 to 15 bodies laying on the ground in the neighborhoods on any given patrol,” one of Quinones’ senior noncommissioned officers said.
His infantry unit acted as what one soldier described as a SWAT team for much of the deployment, clearing the worst neighborhoods before other units would come in to establish a permanent presence. They engaged in a firefight almost every time they left the wire.
Quinones’ vehicle was hit by more than a dozen roadside bombs, and he lost friends to improvised explosive devices and snipers.
The grief of those losses and images of their bodies would come to haunt him, Quinones said.
When Quinones returned from Iraq in September 2007, his leaders noticed he wasn’t the same. He had a hard time readjusting. The hypervigilance just wouldn’t go away. He was anxious all the time and plagued by insomnia. He roamed the hallways at night while the rest of the barracks slept.
When he did sleep, he had nightmares. He dreamed of clearing endless rooms, beset by the anxiety of not knowing what was behind each door.
“I’m back in Iraq when I’m in those nightmares,” Quinones said. “Being scared and it’s … am I up to the challenge of actually kicking in that door?”
After years of occasional drinking, he started hitting the bottle hard, first with friends and then by himself.
“When we got back from Iraq it was every weekend,” he said. “And every weekend turned into a little longer. And that turned into every single day just to cope.”
PTSD had taken a hostage of its own.
The third floor of Fort Stewart’s Winn Army Community Hospital has an ocean theme. On the wall across from the administration desk is a mural of happy-looking orange fish swimming in the sea.
A few feet past the desk, the hallway ends and to the left are locked double doors leading to the in-patient psychiatric ward, known as 3A. To the right are another set of locked doors, which go to the behavioral health ward, called 3B.
Returning from a smoke break to the in-patient ward where he worked as a tech, then-Spc. Nicholas Anderson saw a man holding a gun on Henson.
“What’s going on here?” Anderson asked.
Anxious and twitchy, Quinones announced that he wanted to enter the in-patient ward.
Anderson told him no.
Quinones stepped closer to him and held the gun just inches from Anderson’s head. His finger was on the trigger and the hammer was back, cocked and ready to shoot.
“Let me in,” he barked.
Anderson shook his head.
Maj. Shabon Shelton, a behavioral health nurse who was the nursing supervisor, was in the back of 3B in his office doing paperwork, nearing the end of his 7 p.m.-to-7 a.m. shift. Suddenly, soldiers ran to his door, shouting that a gunman was on the third floor. He went to investigate the situation, peering out the narrow windows in the doors.
Shelton hesitated, thinking, “Lord have mercy, I don’t want to go out there.” But he was also cocky, sure he had the skills to de-escalate anybody.
He took what he remembers as the longest 10-second walk of his life.
“Sir, the guy has a gun, you can’t go out there!” a sergeant yelled as Shelton pushed through the doors, leaving behind the safety of the locked ward.
Quinones greeted him with the barrel of his gun.
“Come on around here,” he directed Shelton, having him join Henson and Anderson, the in-patient psych tech.
Quinones acted like the well-trained infantryman he was, positioning himself so he was protected from behind and could see all angles. Keeping watch on his hostages, he stood by a seagull painted on the wall.
A cigarette hung from the corner of his mouth. He had been chain smoking since he got there, digging with one hand in his front jean pocket for his pack and using the old cigarette to light the next, the gun never lowering.
He was agitated, bouncing on the balls of his feet.
Shelton recognized the look on his face. He’d seen many troubled soldiers at Walter Reed Army Medical Center in the midst of a psychotic break flash those same deranged eyes, but this was the first time the soldier was holding a gun.
“This probably won’t end well,” he thought to himself as the gravity of his decision to walk out there hit him.
Readying for the role he needed to play, he took a deep breath and put on a facade of composure.
“How can I help you?” he asked Quinones.
“I need to see a psychiatrist or someone right now.”
“I’m a psychiatric nurse,” Shelton replied.
“You better start counseling.”
From the start, PTSD was a ruthless captor, dominating Quinones’ every move.
The disorder delayed his transfer to Fort Benning, Ga., and after he made the cross-country move in June 2008, the doctors said the upheaval destabilized him.
He tried to commit suicide immediately after his arrival and spent his first week at the base in the hospital’s psych ward.
Quinones showed up for duty with 1st Battalion, 29th Infantry Regiment with a profile that said he was not permitted to be around weapons, rendering him an infantryman in name only.
Barely holding it together, he hardly spoke to anyone. He was depressed, prone to panic attacks and incapable of staying for long in public places.
At first he was assigned to participate in graduations for basic training. The ceremonies were crowded, loud affairs with explosions and smoke. Quinones said they triggered flashbacks.
Being around Stryker vehicles also set him off, so he was relegated to a desk job. Soon he stopped showing up at all, ignoring requests from his NCOs and pleading texts from his mother to check in.
He saw an Army therapist twice a week, and he was prescribed high doses of medications to treat anxiety, panic attacks, insomnia and depression. In March 2009, his psychiatrist completed the Army’s Warrior Screening Matrix, a tool implemented by the service to determine when a soldier should be assigned to a Warrior Transition Unit, a medical unit for injured soldiers.
The doctor answers questions about a soldier’s ability to perform his duties, his behavioral health, treatment needs, drug or alcohol abuse, suicide history, medical compliance, life stressors such as divorce and whether the illness or injury affects self-worth.
Each answer gets a corresponding number, which are all totaled for a score.
Less than 29: no need for the WTU.
Between 30 and 199: Possible need for the WTU.
Between 200 and 999: Needs to go to the WTU.
A score of 1,000 or above: Failure to assign a soldier to the WTU is likely to hurt treatment.
Quinones scored 2,331. The psychiatrist underlined it twice on the paperwork.
He left a voicemail for Quinones’ company commander, but in the Army’s system, medical professionals are largely consultants. The decision on how to proceed is up to the commander.
Quinones was never sent to the WTU.
Neither of the two captains who commanded Quinones’ company during his time with the unit responded to requests from Stars and Stripes for an explanation.
Quinones’ off-the-charts score required the signature of a lieutenant colonel, but that box on his paperwork is blank.
“This is what pisses me off,” Shelton, the psychiatric nurse Quinones held hostage, said during an interview with Stars and Stripes. “It’s an example of how the system is broken.”
Doctors and nurses are the experts, but they have relatively little power, he said.
“Why not just have the guy at Burger King decide?” Shelton said. “Why even have doctors if commanders are going to make the decisions for what’s best for the health of the soldier?”
Another behavioral health nurse at Benning said there’s often a breakdown in the soldier’s care because the provider plays such a limited role.
“Our influence is just a recommendation,” she said. As a result, “there are some gaps there.”
Quinones said he doesn’t know why he was never sent to the WTU. His commanders told the doctors they were in the process of getting him assigned to one, according to multiple medical forms.
However, in the personnel file the Army gave Quinones when he left the service, there is no record that his commanders submitted the necessary paperwork to WTU leadership so they could consider Quinones for the unit.
Having to jump hurdles to gain access to a WTU is a widespread problem, according to the Recovering Warrior Task Force, which was mandated by Congress to review how the services care for wounded servicemembers.
Part of the problem in the Army is that the service only loosely follows its own criteria for admitting wounded soldiers, especially when it comes to psychological issues like PTSD, said Rene Campos, a retired Navy commander who works on wounded warrior issues for the Military Officers Association of America.
Although Quinones was denied access to a WTU, his unit let him ride for the most part, freeing him to spend most of his time going to his mental health appointments.
In April 2009, his commander initiated a medical board review for disability and retirement. Quinones, the captain wrote in his evaluation, “is not a problem maker — he just has a condition that doesn’t mesh with the Army.”
Still, despite accommodations from his leaders that were better than what many soldiers with PTSD receive, Quinones said he was left adrift in a unit where he no longer belonged and was robbed of an opportunity to have a supervised focus on getting better.
At a WTU, he said, “that’s what the priority would have been.”
Though the medical transition units have struggled over the years, they were devised to give the soldier time and space to heal, often something that can’t be accomplished in a regular operational unit.
“One cannot underestimate the value of an environment that makes healing” the No. 1 priority and assigns “a recovery team to help them achieve their medical and non-medical goals,” according to the Recovering Warrior Task Force’s draft 2010-11 report released in July.
Last fall, the Army Inspector General found that soldiers who were in the process of medically retiring and weren’t assigned to a WTU were disadvantaged by less information, less access to care and a longer evaluation process.
In Quinones’ case, Campos wonders, “if the doctor thought a WTU was best, why didn’t the system?”
Staring at the wired soldier with a gun, Shelton needed to prove to Quinones he was who he said he was — a trained psychiatric nurse — and more importantly, someone who could help.
The hallway standoff became a counseling session as Shelton prodded Quinones in a calm, therapeutic voice to share what was bothering him. Quinones unleashed his frustrations with the mental health system.
“Every time I go to see a doctor, they throw medicine at me. No one will talk to me. No one wants to listen to me.”
“What meds are you taking?” Shelton asked.
Quinones gave him the laundry list: Seroquel for sleeping. Clonazepam for panic attacks. Prozac for depression. And on and on.
“They just keep increasing my doses.”
Shelton asked Quinones about his background. As they talked, Quinones became more even-keeled, calm almost, but his finger never left the trigger of his gun.
“Have you been getting counseling?”
“No, no one will listen to me.”
Quinones suddenly lost focus on the conversation, turning to Anderson, the tech who worked on the in-patient ward, and once again put the gun inches from his head.
“I don’t like you.”
“This guy is making me nervous,” Quinones said.
Shelton talked him into letting Anderson go.
There were three of them now: Quinones; Shelton, the psychiatric nurse; and Henson, the medic who carried Quinones’ bags from the ER.
In August 2009, four months after the doctor recommended Quinones should be assigned to a WTU, Quinones overdosed twice on alcohol and medication and was admitted to the psych ward at Fort Benning’s hospital.
He also had started cutting himself on his forearms.
He told the doctors that news of his former unit deploying to Iraq again had triggered a downward spiral.
At the end of his second in-patient stint, he was sent to an intensive outpatient treatment program for alcohol abuse. The 28-day program helped him for a while, but since it didn’t tackle the underlying reason he drank — PTSD — he soon was back to square one.
In February 2010, Quinones was allowed to medically retire from the Army, diagnosed with chronic PTSD and major depression. But soon, his ailments pushed him further down a black hole.
At 29, he moved in with his parents near Fort Stewart. Their house and the base were his safe zones, the only places he felt comfortable.
He would lock himself in the master bedroom, which his parents had turned over to him, eating and sleeping in a leather recliner.
Bookcases barricaded the windows. Scores of Post-it notes were stuck everywhere around the room because he had trouble remembering things. His mother, Janet Gladwell, learned to knock softly.
Each time the doctors increased his medications — and he often took more than prescribed — he would suffer periodic blackouts. His family describes episodes when he would be in a stupor, unaware of what he was doing. Once, his sister found him in the kitchen slurping cereal out of the sink.
He only left the house when his mother drove him to the VA and when he went to work at the Shoppette on base, a familiar environment with people he knew before he joined the Army. That was the only job he could handle.
On the day before Quinones stormed the hospital, his mother took him to Walmart just a few miles from the house. She said he scanned the side of the road for bombs and chewed his fingers with anxious energy. He was home on the safe roads of a suburban military community, but he couldn’t relax.
Quinones had all but surrendered to PTSD.
Getting an initial appointment with the VA took four months after Quinones left the Army.
In June 2010, Quinones traveled two hours by car to Augusta, Ga., for a mental health assessment consisting only of a questionnaire. Though the VA had his medical records from the Army, which avoided a roadblock most veterans face, Quinones still had to start over with a new assessment from the VA to determine his treatment.
The closest VA center for his regular appointments was in Savannah, about a 50-minute drive.
He was seen a month later to assess his medications. The following week, he had his first counseling session with the VA — five months after he’d last been seen by the Army therapist at Fort Benning.
He was surprised to be taken to an empty room containing a TV and a chair.
“Then I realize this is my appointment — sitting in front of a TV screen,” Quinones said.
His doctor was in Charleston, S.C., and his sessions would be conducted through video teleconferencing.
Matt Yoder, a psychologist with the VA in Charleston, said soldiers are referred to telehealth if there isn’t room in one of the PTSD therapy groups or if appointments aren’t available with the social workers or the sole psychologist at the Savannah clinic.
Yoder said that in the last three years, the Charleston-area VA has hired many mental health professionals and the region isn’t understaffed. Still, Quinones was left to talk to a TV screen.
He had two videoconferencing appointments before the hostage incident.
His mother said she brought a book with her each time but couldn’t finish even one chapter before Quinones was finished. The appointments lasted about 10 minutes.
She said her son would come out, head hanging, and shrug, saying, “He just upped my meds.”
Yoder said that if a patient asks for a different kind of PTSD therapy “they will get it and they will get it quickly.”
But that didn’t happen for Quinones. He said he tried to get more intensive, in-person counseling. He was told the Iraq and Afghanistan vet case manager would call him, but he said he never heard from her.
“I feel as though [the VA] didn’t care, that they were going through the motions with me,” Quinones wrote to Stars and Stripes before the jailhouse interview. “It was very hard to get people to pay attention. If I asked for help, I was always sent somewhere else.”
It was almost 6 in the morning. The hostage ordeal had lasted nearly two hours. Military police and a negotiator were deployed just down the hall.
Quinones had escalated the situation by ordering one of his hostages to assemble his rifle, announcing, “I’m ready to go out in a blaze of glory!”
He rocked back and forth with his three weapons and dismissed the negotiator’s attempts to get him to surrender. When the negotiator tried to persuade Quinones to trade a hostage for a Coke, Quinones called him out for implying that a soldier’s life was worth so little.
Shelton desperately waved away the negotiator, trying to keep Quinones calm.
“What can we do to end this?” Shelton asked Quinones.
“Where would I go after here?” Quinones replied.
The negotiator told Quinones that if he surrendered, he would probably be transferred to a mental health treatment facility.
Quinones was pacing. Cigarette butts littered the floor at his feet.
Shelton told Quinones to keep still and then moved in front of him to block Quinones from the police.
“If I go outside will they kill me?” Quinones asked.
“No, because I’ll walk with you,” Shelton said.
And then, one by one, Quinones handed his guns to Shelton.
The negotiator patted Quinones down and handcuffed him.
As Shelton escorted him down the elevators to the first floor and outside to the waiting squad car, Quinones sighed.
“I just embarrassed my family.”
Shelton assured Quinones the fight wasn’t over and promised he would do whatever he could for him.
Quinones has been held as a federal prisoner in a county jail in Statesboro, Ga., for the last 11 months.
He faces up to 20 years in prison on 13 counts of kidnapping, assaulting a federal officer with a deadly weapon and threatening the lives of Obama and Clinton.
After he was in police custody he revealed plans to assassinate the two presidents, according to the criminal complaint. His FBI and military police interrogators then asked him, “If given the chance, would you kill Presidents Clinton and Obama?”
“Yes,” Quinones responded. “On a scale of one to 10 about being serious, I am a 10.”
From the beginning, Quinones has claimed he doesn’t remember anything about the hostage incident because of the alcohol and sleeping pills he ingested. He said he could barely recall what he did in the days before then.
His only memories from that morning are of the flashing lights outside the hospital when he was in handcuffs, and snippets of the interrogation.
It wasn’t until a day or two later when he regained full alertness in jail that Quinones said he realized something serious had happened and he was told the details.
He told Stars and Stripes that he is torn up knowing “I had put people through that torture, and the pain and suffering I caused them.
“I apologize to them a million times over, because I would never hurt anyone — never,” he said. “And to know that I had done that is just horrible.”
He said he is completely befuddled about the threats against the presidents. That kind of talk is way out of character for him, friends and family said.
Quinones lives on the block of the jail for those with mental troubles, but he doesn’t get any counseling, only medication.
The jail setting exacerbates his PTSD, he said. He never feels safe because he can’t control his door, which keeps him from sleeping. He’s never alone in jail, and the constant stimulation keeps his hypervigilance on overdrive, he said.
“When I was at home, I was able to seclude myself even from my family,” he said. “My room was my sanctuary.”
A few months after the incident, Gladwell, Quinones’ mother, wrote a letter to Shelton and the two other soldiers he held hostage, Henson and Anderson.
She still tears up when she thinks about “what they went through at the hands of my child,” and she wanted to apologize to them.
Quinones has found an advocate in Shelton, the psychiatric nurse who talked him down that morning. Shelton said he believes the Army has pushed the incident under the rug rather than examine why it occurred in the first place.
“That night it happened, I was not shocked,” Shelton said, noting that he thought the subjugation of medical providers to field commanders was bound to lead to problems. “It’s going to happen again.”
When he went off active duty this past spring, Shelton reached out to Gladwell.
The two have formed a tight bond, united in trying to get “Robby,” as they call Quinones, into a mental health treatment facility.
The other two soldiers held hostage that day also empathize with Quinones. They both have been in combat in Iraq and understand what it can do to a soldier.
“I’m not really angry at him,” Anderson said. “I don’t think it was the right way to go about getting help, but I guess he just snapped.”
Henson was greatly affected by the incident.
“He was upset about everything, but he views [Quinones’] side, too,” Henson’s wife, Tina, said. “He understands where he’s coming from and will stand up for him.”
After being held hostage by a soldier fed up with a broken system, Henson himself then ran into roadblocks getting mental health care to deal with the trauma he suffered. The runaround exasperated him and his family, showing them firsthand how the system fails soldiers.
“I hated the guy at first,” Tina Henson said of Quinones. “I don’t condone anyone pulling a gun on anybody, but I understand the frustration now.”
When Gladwell talked to her son’s doctor at the VA and told him what had happened, he said that maybe Quinones would have benefited from one of the VA’s more intensive programs, such as exposure therapy.
Gladwell is infuriated that it took a hostage incident for the VA to come to that conclusion. She hasn’t been told why those programs weren’t an option when her son first showed up at the VA.
Quinones said he doesn’t know why he went to the hospital that morning, but ventures that his subconscious took over and decided to cut through the red tape.
“I guess that’s the only thing I can think of,” he said. “ ‘I’m going to get this help and whether you want to help me or not, you’re going to help me.’ ”
Where Quinones goes from here is unclear.
“There is no archetype for a case like this,” said Quinones’ lawyer, Karl Zipperer.
His case is stalled while the court resolves two separate questions involving his mental health: whether he is mentally competent to stand trial, meaning he understands the process and can assist in his defense, and whether he was insane at the time of the offense.
Quinones has been evaluated, but the court has not made a decision.
If he’s found unfit to stand trial, Quinones could end up at a mental facility to try to restore his competency.
If he’s found mentally fit to stand trial but insane at the time of the offense, he could be committed to a mental hospital rather than be prosecuted in the criminal system, legal experts said. He would be hospitalized until the doctors and the judge agree he is well enough to be released.
If Quinones is found fit to stand trial and sane, then he could be prosecuted in federal court. During the trial, his lawyers still could dispute the sanity ruling and argue that Quinones was not criminally responsible at the time of the incident because of his PTSD, according to legal experts.
David Addlestone, co-founder of National Veterans Legal Services Program, said the best option would be a sentence of long-term probation that required treatment with stringent supervision and control.
“Putting a guy like that in jail would be a travesty,” he said.
This story was compiled from eyewitness accounts, a jailhouse interview with Robert Quinones, interviews with his family, a review of Quinones’ Army personnel and medical records, and interviews with medical personnel at Fort Stewart, the Department of Veterans Affairs and federal investigators. Neither of Quinones’ former company commanders responded to multiple requests from Stars and Stripes for comment.