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U.S. Air Force airmen transport patients from a military plane to an ambulance during a medical evacuation mission in Afghanistan in 2009.

Did the Cop-Killers Have PTSD?

We may never know, because “it is so easy to fall through the cracks.”

The two men who targeted and murdered law enforcement officers in Dallas and Baton Rouge had at least one other thing in common: both had been members of the military deployed to the Middle East, service that has sent thousands of men and women home with post-traumatic stress and other mental health issues, including anger and aggression.

It is unknown if Micah Johnson and Gavin Long experienced post-traumatic stress symptoms or other difficulties adjusting to life as civilians, or if their experiences in Iraq and Afghanistan contributed to a violent mindset.

But PTSD is “one of the signature injuries of the U.S. conflicts in Afghanistan and Iraq,” concluded two National Academy of Science reports published in 2012 and 2013. As many as 20% of veterans of these wars have PTSD, researchers found. They cautioned the numbers may be an underestimate as they don’t account for people who don’t seek help because of stigma or whose symptoms don’t meet the threshold for diagnosis but still interfere with everyday life.

Irritable behavior, angry outbursts and reckless or self-destructive behavior are hallmarks of PTSD, according to the Diagnostic and Statistical Manual, which catalogues psychiatric illnesses, and studies have shown a clear link between combat deployments and problems with anger and physically aggressive behavior back home.

The safety net that awaits military veterans when they get home is also stretched and frayed.

The National Academies reports, as well as an Inspector General’s report about access to mental health care at the Veterans Affairs, chronicle an agency with many programs to address PTSD, but almost no tracking to determine which are effective, treatments that vary widely depending on which therapist or doctor one happens to see, and long waits for evaluation and treatment.

“The committee has serious misgivings about inadequate and untimely clinical follow-up and low rates of delivery of evidence-based treatments, especially therapies to treat PTSD, depression, and substance use disorder,” the report said.

“It is so easy to fall through the cracks,” said Mike McMichael, who deployed to Iraq several times between 2003 and 2005 as part of the North Carolina Army National Guard.

When McMichael was coming home, he filled out a PTSD screening checklist. “‘Did you see dead bodies?’” he recalls it asking. “Check. ‘Did you see dead soldiers?’ Check. ‘Did you see dead civilians?’ Check. ‘Did you see dead children?’ Check. If you said yes to any one of those you’re supposed to sit down with a counselor or chaplain. I said yes to every single one of them.” Yet he was never sent for a mental health evaluation. McMichael lost a string of jobs, contemplated suicide, and almost got divorced before he finally sought help, he said, and has since founded an organization called Outside the Wire to help veterans like him. “Our VA system is just overwhelmed,” he said.

The report also found that unemployment and underemployment are “acute problems for military veterans,” many of whom began returning home just as the 2008 recession hit.

“In the United States we valorize our vets with words and posters and signs, but we don’t give the what’s really important to Americans…jobs,” anthropologist Sharon Abramowitz told journalist Sebastian Junger for his new book, Tribe: On Homecoming and Belonging. “All the praise in the world doesn’t mean anything if you’re not recognized by society as someone who can contribute valuable labor.”

Junger identifies a sense of alienation among soldiers who leave the battlefield — where they sleep “shoulder-to-shoulder with other people that you would die for” — and arrive home to carpools, nuclear families, and individualism. This transition can lead to a sort of existential crisis that is often mistaken for PTSD, Junger argues.

What little is known about Johnson, who shot at police officers, sniper-style, during a Dallas protest on July 7, seems to indicate he suffered many of these issues.

Johnson, an Army Reservist, served in Afghanistan for nine months in 2013 and 2014, according to Army spokesman Wayne Hall. The 25-year-old became a “hermit” after he returned, his mother told The Blaze, and never re-entered the traditional workforce. He was paid to take care of his autistic brother. It’s not clear whether he was ever treated for post-traumatic stress. But news reports say that even getting an appointment at the VA for a back injury felt insurmountable to him. “He became overwhelmed by the hassle and paperwork and gave up,” the Dallas Morning News reported.

Johnson’s transition home may have been even more troubled because it was coupled with a loss of community. He was disciplined, separated from his unit, and ultimately discharged from the Army as a result of a sexual harassment claim by a former friend and unit-mate, according to several news reports. “He broke down after that a little bit because they ostracized him,” one soldier told the Dallas Morning News. “All of his friends started unfollowing him on Facebook. They wouldn't deal with him, they wouldn't talk to him.”

The sense of alienation and disconnect on return may be compounded among African-American soldiers, who risk their lives for their country only to come home to a drumbeat of news about African-Americans killed by police.

This may have been the case with Long, a former Marine who shot six officers in Baton Rouge on Sunday, killing three. He deployed to Iraq for seven months in 2008 and 2009, according to Marines spokeswoman Yvonne Carlock. In emails, YouTube videos, and other social media posts, Long wrote about the July 5 killing of Alton Sterling by Baton Rouge police, and advocated armed resistance to the oppression of African-Americans.

Long, 29, told friends he suffered from PTSD, CNN reported Wednesday.

Neither Long nor Johnson held combat positions. Johnson was a carpentry and masonry specialist who did construction work at a forward operating base, and Long was a data network specialist. But research shows even deployments off the battlefield can lead to PTSD and other problems transitioning home.

Two soldiers exposed to the same conditions can have wildly different responses. Whether someone develops persistent PTSD seems to depend on a range of factors, including whether they have suffered childhood trauma and whether they are religious. Understanding why these two men made the tragic choices they did “is ultimately going to come down to is understanding these individuals in much more granular detail,” says Dr. Kenneth Kizer, a Professor of Medicine at UC-Davis who co-authored the National Academies reports.

An earlier version of this article incorrectly identified the Department of Veterans Affairs as the Veterans Administration.