How a lack of veterans mental health services contributed to 2 police shootings in 18 months

Side effects of restless nights were creeping into the daylight hours: He was losing focus, or “spacing out,” at his job high off the earth in cell towers.

“Doesn’t that sound concerning?” his mother, Laurel White, recalled asking.

Compounding his symptoms was stress that accompanied a recent promotion.

No sleep. Scars of war. More stress.

Concerned, he visited a doctor in Wenatchee. Laurel White went with him but stayed in the waiting room during the exam.

Alex White returned to her with a counseling appointment in two weeks and lozenges to help him quit smoking.

Eight days later, on the Saturday morning of the Washington State Apple Blossom Festival’s 2022 Grand Parade, police were called to a church not far from where hundreds of marchers and performers would pass by in a few hours: A man in a white suit was seen shouting and firing gunshots into the empty building.

Alex White died on the church steps after a short confrontation with police nine days before his counseling appointment. He was 36.

Elements of the Alex White shooting were mirrored in December when authorities say Army veteran Troy McMaster in the midst of a mental health crisis fired into an empty Department of Veterans Affairs (VA) clinic in Wenatchee. He was later shot and wounded by police outside East Wenatchee.

The similarities of the shootings, particularly that each involved a veteran suffering an apparent mental health crisis, prompted The Wenatchee World to examine veterans’ mental services in the Wenatchee Valley.

What’s missing?

To psychotherapist Heather Hill, the crises experienced by Alex White and Troy McMaster were a symptom of a local mental healthcare system that’s stretched too thin.

“It was an inevitable ticking time bomb,” Hill said. “And that’s where we’re still at.”

Hill oversees Central Washington Veterans Counseling in Wenatchee. The counseling center is contracted by the state to provide counseling services to the area but doesn’t have enough counselors to meet demand.

With 147 clients and five therapists, she said Central Washington Veterans Counseling has a similar caseload to comparable counseling centers in larger population areas, like the Seattle Vet Center.

The VA’s Elwood “Bud” Link Community-Based Outpatient Clinic in Olds Station hasn’t had an on-site mental health therapist since June, according to Spokane’s Mann-Grandstaff VA Medical Center, which operates the clinic.

The shortage of in-person mental health providers is the result of increased demand.

“2020 is when the (wheels) came off the bus,” Hill said. “That additional pressure, and all those transitions that we went through during the pandemic, really exacerbated the symptoms that were already present.”

Industry research appears to back Hill’s observations.

A 2022 study by the American Psychological Association, the country’s largest professional organization of psychologists, found that 72% of psychologists had longer waitlists than before COVID-19.

A separate 2022 study by the association found that 38% of licensed psychologists reported they were working more than they did before the pandemic. Those who reported not being able to meet the demand rose from 30% in 2020 to 46% in 2022. Feelings of burnout increased too: 41% in 2020 to 45% in 2022.

The Grann-Manstaff hospital said demand for health care and benefits is on the rise.

“The nation’s public and private health care system, including VA, are challenged to find and hire qualified health care providers because of a tight labor market in healthcare especially since the pandemic,” the hospital said in a statement to The World. The shortage can create challenges for veterans seeking care, “perhaps particularly” in rural areas.

Hill has advocated for the VA to add a Vet Center in Wenatchee. The closest is two hours away in Yakima.

Vet Centers host a range of services to support veterans, including counseling for PTSD, military sexual trauma, and substance abuse.

According to David L. Willard, deputy director of the VA’s Pacific District, the VA is considering a Vet Center outstation in the Wenatchee area. An outstation would be smaller than a Vet Center and complement the healthcare services offered by the outpatient clinic.

The VA is “looking very closely at the growing needs among veterans in the Wenatchee Valley,” Willard said in an email.

U.S. Rep. Kim Schrier (WA-08) told The World she’s working with the VA to expand mental health services for veterans in the Wenatchee area.

“I have emphasized to the VA that this outstation needs to be a top priority, especially given recent tragic incidents of veterans in crisis in the Wenatchee Valley,” Schrier said.

About Alex

Alex White was the son of Laurel White, step-father Bruce White, and biological father John Alfano, and sister to Judy.

He grew up in the Wenatchee Valley and played soccer in his youth. In his late teens, he worked as a camp counselor at the Lake Wenatchee YMCA Camp.

“He was funny, he was caring. He worked really hard to try and just help people out when he saw people in need and … to be team player,” Laurel White said. “He was a good kid. And he was a wonderful brother.”

He was a talented artist with a knack for sketching and sculpting.

Alex White graduated from Eastmont High School in 2004 and then joined the Army six years later. He scored well enough on a pre-enlistment aptitude test to have his pick of just about any military job, but chose the infantry.

“He wanted to serve on the ground,” Laurel White said. “He wanted to make a difference.”

Alex White served from November 2010 to March 2014 as an infantryman, and then in the Washington National Guard from march 2014 to March 2015, according to Bryce Dubee with the Army’s Office of the Chief of Public Affairs.

He was deployed to Afghanistan from October 2011 to July 2012.

Roberto Flores was with Alex White when they served in Afghanistan’s Wardak province with 2nd Battalion, 5th Infantry Regiment.

Alex White was somebody you always wanted around, Flores said in an interview with The World in 2022. He made people laugh, kept a good attitude, didn’t complain when life was hard, and was up for anything. They called him “White Snake.”

“Everything I know about him is just a positive person,” Flores said. He added, “I can’t say anything negative about the guy.”

Alex White suffered a concussion one night after the vehicle he was traveling in drove at about 50 mph into a pit designed to deter American military forces, according to his mother. She still wonders if he sustained a brain injury and whether it affected him.

In hindsight, something was off after the Army.

“We do feel like Alex was fighting depression sometimes since after he came home from Afghanistan, but working hard to try and find meaningful work so that he wouldn’t be depressed,” Laurel White said.

He used GI Bill benefits to study commercial diving and welding.

But he wanted a family and decided against commercial diving, which can require time away from family. He opted against welding too because he felt he didn’t have the right connections.

Instead, he continued his education and attended the Lazy Q Line School in Texas, a pre-apprentice lineman program, and became a cell tower technician.

He worked mostly in Western Washington but returned home to East Wenatchee during his time off.

“He loved the career he had, he loved the work he was doing,” Laurel White said. “It seemed like it was a really good fit for him.

“But what he wasn’t expecting — we weren’t expecting — was something that would trigger his PTSD.”

Treating trauma

Rob Bates spent 20 years in the Army. He deployed to Iraq and Afghanistan as an infantryman and also served as a drill sergeant. Now he works as a psychotherapist in Quincy and often treats veterans.

Talking to them about their troubles takes some nuance.

“We have our own languages and then we have our own sub-dialects of those languages,” Bates said of veterans. “And even those sub-dialects have their own sub-dialects.”

Because of those barriers, a level of cultural competency is needed, or at least appreciated, to provide veterans with adequate mental health services.

“It is always easier to talk to somebody that is part of our social group than it is to talk to anyone else on the planet,” Bates said.

Understanding the source of the trauma is part of cultural competency.

Hill, Bates’ colleague in Wenatchee, served in the Army for six months before she was discharged with a foot injury. Her husband spent nine years in the Army and suffers from PTSD from his time in Iraq.

She explained that combat PTSD is unique compared to other forms of the disorder, beginning with the beginning: basic training.

“They start conditioning right off the gate,” Hill said. “They make you miserable, they strip away your identity. They condition you to have increased tolerance to misery, you start trauma-bonding to other people in your platoon or in your company.”

Chants and cadences can desensitize recruits to death and killing.

“It’s brilliant and it’s gross at the same time because it’s preparing you to have that mindset and it’s conditioning your mind for that to be embedded in your subconscious,” Hill said.

PTSD can develop as the result of a perceived threat — a fear that your life is in danger. Deployments can be yearlong life-threatening experiences.

“It’s not like a one-and-done situation,” Hill said. “When you’re in a combat environment, you’re always concerned about your life and your safety. And that memory and those trauma memories are more embedded into your subconscious because there’s heavy emotion with it.”

Keith Meyer, counseling and wellness director for the Washington Department of Veterans Affairs (WDVA) cautioned that not all military-related PTSD stems from combat.

“I think one of the things that society takes for granted is the training is actually very dangerous,” Meyer said. “And bad things can happen — traumatic things can happen — just with the training itself.”

He also cited sexual assault as a common source of PTSD in women veterans. One in three women responded “yes” they’d experienced military sexual assault when screened by a health provider, according to the VA.

Trauma is evaluated on a spectrum: What’s distressing to one person may not be for another, and tolerance for trauma varies. An accumulation of symptoms, like anxiety or depression, can lead to a crisis.

“Some people get hit with a sledgehammer, it’s not a trauma for them because they’re OK,” Bates said. “Some people get touched with a piece of sandpaper and they break down. Trauma is trauma, whatever it is to that person.”

Helping Alex

Laurel White isn’t sure what intensified the symptoms of her son’s PTSD.

“The only thing we can kind of figure is that we know that not only bad stresses can trigger things, probably good stresses can trigger things too,” she said.

In his work on cell towers, White found a career that could provide the life he longed for.

“He was trying to move on to the next part of his life,” Laurel White said. “He wanted to find someone to get serious with and raise a family and get married, settle down here in the Wenatchee Valley.”

His struggles with sleep were adding up. Symptoms of what he believed was PTSD festered.

Not long before his death, Alex White was promoted to supervisor. In this particular job, his crew needed to stay together as a unit to complete their work.

“So he felt I think a really big responsibility to be there so that everybody could get paid,” she said.

He told his mother he was experiencing lapses in consciousness — moments where he “spaced out.” He began to lose his car keys on occasion, too.

His employer was worried. So was his mother.

In late April 2022, he came home early from work to for a medical appointment in the Wenatchee Valley.

The visit lasted five minutes or so. He was found fit to stay at work and a mental health appointment was scheduled in two weeks. The doctor also asked Alex White to check-in in a couple of days when he went back to work.

Laurel White doesn’t know everything that was discussed in the appointment, but she knows what wasn’t: sleep.

“I thought that was part of what they were going to be discussing was how he was spacing out and we had some concerns,” Laurel White said. She hoped they’d talk about renewing sleep medications. They didn’t.

Unsatisfied, the mother and son tried to visit a walk-in clinic the next day. They were turned away and directed to the emergency room. But that wasn’t the right option for Alex White.

“For veterans, sometimes the emergency room doesn’t sound like it’s going to be a place where you feel like your stress levels are going to go down,” Laurel White said.

Instead, they sat on a bench outside the hospital and called the consulting nurse listed on his health card. Alex White was asked a series of mental health questions, the same as he was asked the day before.

Laurel White later learned that help was available at the through a program called integrated services, which allows patients to see a medical doctor and a mental health specialist in the same day.

Laurel White declined to specify the healthcare providers used by her son.

What’s available?

Using mental health services isn’t something all veterans think they’ll need as they leave the military.

“Nobody thinks they’re going to jail. Nobody thinks they’re going to struggle with addiction,” Bates said. “Nobody thinks they’re going to be struggling with PTSD as they go through whatever it is from the horrors of combat. They all think they’re going to be superstars when they come back.”

But if symptoms do emerge, help is available through county, state and federal programs.

Many county governments employ veterans service officers to connect veterans to benefits and support services. They can also pick up on signs of PTSD or other mental health problems.

A conversation about disability benefits could transition into a conversation about depression, said Trent Mortensen, Chelan County veterans service officer.

“When you get to that point … it’s always kind of like, ‘Well, what can we do to help you further?’” Mortensen said. He added, “‘What is the thing that we can do to get you thinking in the right way, positive in the right way and going on and making sure you’re good until the next day.”

From there, he may refer them to a therapist, like Hill and Bates, or to Tony Sandoval, an Army veteran with the WDVA’s SSG Parker Fox Suicide Prevention Grant Program. The program focuses on early detection of veterans with suicide risk factors.

Sandoval, a former Chelan County veterans service officer, works in the same office as Mortensen on Orondo Avenue. During one week in December, three veterans visited the office who were “actively suicidal.”

Part of Sandoval’s role in those instances is to build a rapport and help the veteran build a support network.

“Most of the time the people just need to be seen,” Sandoval said. “... and once they’re seen it’s like, ‘OK, let’s work on this together.’”

The goal of the program, Meyer said, is to connect with veterans “long before they hit that crisis point. At minimum have real support during the crisis point or possibly avoid the crisis point, period.”

Veterans are also able to receive care for emergent suicidal care at VA or non-VA emergency rooms through the COMPACT Act. The VA will provide the treatment or cover the costs for treatment including transportation, inpatient or crisis residential care for up to 30 days, and outpatient care for up to 90 days.

In Wenatchee, the Mann-Grandstaff hospital said it’s currently attempting to fill two vacant behavioral health positions at its VA clinic.

Without an on-site therapist, patients at the clinic are treated through telehealth appointments with Mann-Grandstaff and a telehealth hub in Boise, or through Care in the Community referrals. Care in the Community is a VA program that allows veterans enrolled in its healthcare system to access non-VA healthcare in their community.

Response to telehealth counseling is mixed.

Douglas Wood, a Marine Corps vet who served from 1994-1998, likes the accessibility it provides.

“It’s convenient,” Wood said. He noted, “I can’t complain about any of the care I’ve gotten there.”

Bates has found some clients are warming to telehealth. For him, it allows him greater reach.

But telehealth isn’t for Dennis Brouwers, an Air Force veteran who served from 1970-1990.

“I don’t quite see how the doctor can actually see what the person is like by the phone,” Brouwers said.

Brouwers and Wood spoke with The World at the Wenatchee Valley Veterans Hall, 1206 N. Wenatchee Avenue.

Places like the veterans hall can offer fellowship and a peer group with shared experiences.

“Us vets, we understand it,” Brouwers said. “We know it.”

The Wenatchee Valley is also home to two service clubs — Veterans of Foreign Wars Post 3617 and American Legion Post 10 — and Vets Serving Vets, a nonprofit organization that offers conversation and help to veterans in need.

Losing Alex

Alex White wore a white suit the day he died. The formal nature of his attire led to speculation that he hoped to be killed.

Laurel White doesn’t buy that. He dressed in suits to church and, for them, church was on Saturdays.

“I believe that my son was very disassociated,” she said. “And that he was not in his right mind at the time that this all happened. This is not the way our son behaved, ever. Ever.”

He’d gone multiple days without sleep and got lost the day before during his drive home from the westside. A four or five hour drive turned into 10. Inside the vehicle, his family later found breakfast ingredients: eggs, potatoes for hash browns, shredded cheese.

“So I don’t really believe that this was something that was planned,” Laurel White said of Alex White’s behavior on May 7, 2022.

She thinks about what she now sees as warning signs: spacing out, losing keys, difficulty sleeping, the way he always kept the lights on at home.

They’re signs she wishes someone would have recognized.

Recalling the questionnaires her son completed, Laurel White said, “Those questions didn’t go deep enough to save my son’s life. That’s not any individual person’s fault. It’s a system issue.”

She believes adding veteran-specific topics to the exams could help.

Laurel White also wants the Chelan County Sheriff’s Office’s Behavioral Health Unit, established in two years ago, to become a permanent fixture of the department.

“The crisis team, in my opinion, is not something that should be a budget item that ever goes away,” she said. “My son’s life was worth having the right people know how to handle a crisis.”

Laurel White was thankful that Troy McMaster survived his confrontation with police outside East Wenatchee.

“I cried when I heard that the other veteran had his life spared,” she said.

Alex White asked for help. He didn’t get it on time.