A Flawed System:

By Mary Shinn
Originally published in The Gazette, Jan 12, 2025; https://gazette.com/news/a-flawed-system-how-army-special-forces-mental-health-care-is-failing-elite-soldiers/article_0f4a0992-ceb9-11ef-845f-bbfd6e33314a.html; reprinted with permission.

Numerous combat deployments, a cultural reluctance to seek help, and a structure that allows commanders to pressure mental health professionals led to mental health care failings within U.S. Army Special Forces, according to an expert and advocate of the troops.

Retired Special Forces Sgt. 1st Class Greg Walker, who also advocated for the care of Special Forces troops as a civilian case manager with Special Operations Command’s Care Coalition, detailed what he said were the dynamics of those problems following the high-profile suicide of Master Sgt. Matthew Livelsberger, a Green Beret, who traveled from Colorado Springs to Las Vegas and blew up a Tesla Cybertruck in front of President-elect Donald Trump’s hotel on New Year’s Day.

Problems with Special Forces mental health care have also been highlighted in government reports that found these elite troops died by suicide at higher rates than the broader armed forces and the general population. A Defense Suicide Prevention Office presentation showed that suicide deaths have increased among Army Special Operations Command troops with 18 deaths in 2022, up from six in 2017 and 12 in 2018.

A 2020 report on suicides within the Special Forces community found elite troops did not seek help because they feared “being separated from their unit or singled out for problems.” The report called for reforms including better suicide prevention, saying online training was seen as just a check in the box.

In addition to a cultural reluctance to come forward among Special Forces soldiers, Special Forces Group commanders have also directed their embedded mental health professionals to minimize conditions to ensure more soldiers can continue to deploy, Walker charged. Mental health providers might overlook drinking too much, or swap out medications to ensure troops could still deploy, he said.

The attitude became: “Anything you can do to make sure a guy stays in the fight is OK with us,” Walker said. “It’s had hideous results.”

There are strong hints that Livelsberger’s death and the explosion that injured seven people can now be counted among those failings. Writings found on Livelsberger’s phone and observations from a former girlfriend that he was in touch with in his final days, also underscore his poor mental state of mind.

“There was not a time during my two years in Afghanistan where I had a clear understanding or rational feeling in my heart of why my brothers were fighting and dying. We failed and the credibility of military and political leadership was shredded and no one was held accountable,” he said in a note on his phone released by the Las Vegas Metropolitan Police Department.

At the time, Livelsberger planned to kill himself at the Grand Canyon, he wrote.

Army Special Operations Command did not respond to questions about whether the suicide prevention training had changed or about the problems with group commanders overseeing providers.

Long-term pressure

The first significant emphasis on behavioral health and substance abuse in Special Forces started in 2005 after multiple deployments started to take a significant toll on frontline troops and they began to act out in serious ways, such as committing acts of domestic violence and getting DUIs.

Special Forces was not designed to assume the operational tempo experienced during the War on Terror, a frequency that has continued to this day, Walker said. In one case, he served as case manager and advocate for an Army Ranger who was deployed to combat 14 times, he said. A 2020 independent study found that it’s not unusual for an operator in Special Forces to have 15 deployments over 10 years.

To address the problem, Army Special Operations Command and its parent group Special Operations Command, which oversees the joint force, started embedding mental health and substance dependency programs so that soldiers could talk about the classified events they had been a part of with professionals who also had clearance. It also functioned as an incentive for Special Forces soldiers to seek help within their own unit.

As Special Forces started to address the problem, more troops needed to be moved into support roles or to receive longer-term care, Walker said, and it created a shortage of people to carry out missions.

Starting in 2011, the high number of combat deployments to fight the War on Terror caused increased behavioral health and substance dependency issues among the troops, Walker said, reducing the number of people available to carry out missions.

“The group commander is now carrying people on the rolls he can’t do anything with. … There’s only so many support slots you can put them in,” Walker said, and long-term care can easily be upward of a year if the unit is intent on keeping the operator as a useful asset. “It’s a conundrum.”

That’s when the pressure to start minimizing mental health and substance dependency issues on the individual level started, he said.

As a former Special Forces senior enlisted officers who served for 20 years and later a civilian advocate for Special Forces, Walker said he saw how a good idea to embed mental health providers has been manipulated and contributed to a system that does not function well.

Walker retired in 2005 before working for the Warrior Care Program under Special Operations Command to advocate for Special Forces troops who suffered serious physical and mental health injuries. This program, also known as the Care Coalition, functioned well because it did not face the same pressures as embedded providers, he said.

Walker retired fully in 2018, but remains well connected to the Special Forces community.

Since group commanders oversee their embedded mental health professionals, those providers’ ability to follow Army policy — as their counterparts in the broader force do — can be and has been compromised, Walker alleged, and as a result the embedded programs do not have proper oversight.

Broad questions about mental health care and substance abuse treatment within Special Forces are typically only raised when high-profile events such as Livelsberger’s suicide happen, he said.

Walker said that the traumatic brain injury (TBI) symptoms and post-traumatic stress disorder that Livelsberger’s ex-girlfriend said he experienced are hallmark “invisible wounds” within Special Forces.

A 2020 observation study published in a scientific journal found that 85% of Special Forces operators experience TBI from training alone, based on anecdotal estimates. It also found the high number of deployments contribute to a consistent pattern of struggles, including depression and suicide, among many other symptoms.

Peer leader’s suicide

The pressure that embedded mental health providers face eroded the trust among Special Forces troops in their mental health care, Walker said, as favoritism and “working the system” with approval from the command became apparent.

So, when a well-known former movie star and Special Forces soldier, Staff Sgt. Mike Mantenuto, who was also experiencing mental health and substance use problems, was authorized by his group commander to create a peer-support group and offered nonclinical counseling in 2016, it was embraced by the unit and foisted upon its embedded clinicians to support — contrary to all best practices, Walker said.

Mantenuto starred in the 2004 film “Miracle,” about the U.S. men’s hockey team upsetting the prohibitively favored Soviet Union team in the 1980 Olympics, before enlisting.

The peer approach appealed to soldiers, because it could keep their issues completely off the radar with the Army’s conventional mental health and substance dependency clinicians who were not under the influence or control of a Special Forces Group commander, Walker said. The leadership at the Washington state-based 1st Special Forces Group embraced, authorized, and promoted it for similar reasons, Walker said.

But it was completely unethical to allow someone with no formal training and a current mental health patient to start a program, he said. When Mantenuto died by a self-inflicted gunshot wound in a park at age 35 in 2017, it left soldiers feeling betrayed and abandoned. Army mental professionals reached out to those Mantenuto was talking with officially and unofficially, and discovered his influence reached well outside his parent group.

Several of these soldiers expressed renewed suicidal ideation in the wake of Mantenuto’s death.

Walker investigated the death as the military liaison for the private-sector hospital where Mantenuto received in-patient treatment as a referred patient by his group medical team. He then, along with the senior civilian program director at the hospital, met with the group commander and his staff, which was conducting an after-action report, given the high public profile of Mantenuto as a former actor and movie star before joining the Army and coming to Special Forces.

The Army report about Mantenuto’s death said he was not a patient, despite reaching out for concerns about attention deficit and hyperactivity disorder care shortly before his death because of problems concentrating and participating in Alcoholics Anonymous, points raised by those interviewed for the report.

‘We’re like flashlight batteries’

When it comes to Livelsberger, Walker believes the medical professionals at his unit in Germany could have taken preventive steps, such as not allowing him to leave his base in Germany for Christmas break if his true behavioral health issues urged caution over compassion.

“If he was well enough to return to Fort Carson, did his mental health provider in Germany conduct a warm handoff with the embedded behavioral health clinicians at Fort Carson, to include the group surgeon?” asks Walker. “Where was the clinical safety net for Matt Livelsberger who’d been in the Preservation of the Force and Family Program in Germany?”

The program includes a broad swath of physical and behavioral health care, such as brain health monitoring and access to embedded clinicians, as well as chaplains that provide counseling, among other services.

The Army released a statement last week that said Livelsberger did not display concerning behaviors while using the Preservation of the Force and Family programs. But the Army declined to say how long he received care through the program, citing privacy concerns. Since he was on leave when he died, he would not have necessarily been connected to mental health services.

While Mantenuto’s and Livelsberger’s cases received public scrutiny, Walker said, he wanted to speak out because there are so many soldiers who have experienced similar trauma and other medical issues who have likewise fallen by the wayside because of the shortcomings and manipulation of the embedded group clinical teams within Special Forces.

“As Matt’s ex-girlfriend has pointed out since his death,” offered Walker, “the Army does not ‘fix’ its soldiers per se. And especially in our Special Forces units. It uses them up until they break or become nonessential and then moves them out of the ranks and into the Department of Veterans Affairs medical system.

“We’re like flashlight batteries. They just put a new battery in once the old one is drained dry and it includes officers as well as enlisted service members.”

It’s a culture that’s led to losing many men and women to suicide, who did not need to die by their own hand, the veteran operator said.

Major reforms needed

Walker would like to see major reforms to help fix the problems within the Special Forces health care.

He believes that Special Operations Command could take some pressure off the group commanders to provide troops for missions if they are facing a shortage due to mental health and substance use concerns. “If they truly want to preserve the force, they need to be far more discerning in what missions are essential.”

He would like to see the command send out a directive that says: “We are not going to put guys in the field that are going to sooner or later break as a result,” he said.

Walker would also like to see the Army inspect the Special Forces’ embedded mental health units and, if gross manipulation of clinical findings is found, return the oversight of that care to the conventional mental health teams within the larger Army, he said.

Conventional-force clinicians can treat those with classifications with proper collaboration with unit doctors, he said. Commanders also must start listening to therapists and behavioral health teams.

“If they don’t, we will continue to see tragic and often preventable deaths like those of Mike Mantenuto and Matt Livelsberger take place,” he said.

Matthew Livelsberger’s Widow Breaks Silence, Refutes ‘Misinformation About My Family’

In an interview with Speak the Truth podcast host Matt Tardio, Matthew Livelsberger’s widow, Jennifer Davis, spoke out against what she sees as defamatory and untrue stories about her late husband and their family.

To view the interview on YouTube visit:
https://youtu.be/kklJUzDTXjY?si=9Y9SLGeK3Whfqjge

If you would like to support Jenn and her child, please click the following link: https://www.gofundme.com/f/hope-and-healing-for-jennifers-family

“It is understood that what occurred in Las Vegas is a complicated case involving local, State, and Federal authorities. It is also understood there will be no “one good answer” and that Livelsberger’s motivations, driven by his mental, physical, and spiritual states, represented a multi-layered mix of motives, associations, communications with family/friends/teammates and others yet identified.

This being said—the onus is on the Army, the Special Operations Command overall, and 10th Special Forces Group’s senior leadership as to what was missed, overlooked, downplayed, or outright ignored prior to Matt’s taking leave. And what is or will be corrected in a positive and healthy sense within the Command/and its SF Groups in specific regarding behavioral health/SUDCC issues—which the two suicides (Mantenuto and Livelsberger) reveal must take place to truly “preserve the Force and Family”