By early February, according to a note in Valley’s medical records, his company leadership was informed that he was exhibiting depressive symptoms and suicidal ideation, but Valley still received no formal behavioral-health counseling. Instead, Fritch and another soldier told me, some of Valley’s squadmates were instructed to keep an eye on him. They did the best they could, making sure Valley ate his meals with them and went with them if they left the base to go out in town.
One weekend, one of Valley’s buddies managed to get them weekend leave, and they went to Berlin. During that trip, he seemed like his old self, his friend says. They went clubbing, got drunk and visited Checkpoint Charlie, the famous Cold War border crossing between East and West Berlin. When they got back, he seemed better, his friend says. He even talked about enrolling in college so he could become an officer. But after a few weeks, he was down again.
In early March, Valley’s girlfriend broke up with him. Valley, according to many of his friends, had a hard time accepting it. Around this same time, he was taken off mirtazapine and put on the antidepressant Celexa. Valley had been complaining that the mirtazapine no longer worked for him, but there are no notes in Valley’s medical records that explain why this switch was made or if the prescriber was aware of Valley’s psychiatric history.
Either way, several Army behavioral health care specialists I spoke with found the choice of Celexa troubling, as it is part of the class of antidepressants that comes with a black-box warning, because it can increase suicidal thinking in some young patients. “I’d argue that a 21-year-old soldier who has a history of suicidal ideation and is still adjusting to a new environment warrants a closer look before putting them on that drug,” says one B.H. officer informed of the details of the case.
“I’m losing my mind,” Valley texted one of his sergeants about a week after starting the Celexa. He begged for help: “I need an actual B.H. person.” On March 9, after three months of asking for therapy, Valley was finally given an appointment with Melissa Samio, one of the two B.H. providers embedded with the unit, who was now stationed in Bulgaria. Samio hadn’t seen Valley since she requested his waiver at Fort Riley in November. Now, during a video session, Samio asked Valley how he was feeling. “Really, really shitty, ma’am,” he said, according to her notes. He told her about his breakup and said that he had thought about suicide that morning. “Everything’s falling apart,” he told Samio. Concluding that he was an “intermediate risk” for suicide, Samio issued a new 30-day profile that barred him from carrying or firing a weapon. After the session, she reached out to the battalion primary care officer to arrange for Valley to be evaluated in person. The officer, Samio later noted, never called her back.