A woman visits a makeshift memorial outside Sparetime Bowling Alley,...

A woman visits a makeshift memorial outside Sparetime Bowling Alley, the site of a mass shooting, Oct. 28, 2023, in Lewiston, Maine. Army heath expert, Col. Mark Ochoa, reported to a panel investigating the mass shooting on Thursday, June 13, 2024, that there are limitations in health care coverage for reservists compared to full-time soldiers. Credit: AP/Robert F. Bukaty

PORTLAND, Maine — An Army health official told a panel investigating a mass shooting by a reservist who was experiencing a psychiatric breakdown that there are limitations in health care coverage for reservists compared with full-time soldiers.

There are no Army hospitals in New England, and reservists generally don’t qualify for care through Veterans Administration hospitals, so they are likely to use private health care — but such providers are barred from sharing information with the Army command structure without a patient's permission, said Col. Mark Ochoa, command surgeon from the U.S. Army Reserve Command, which oversees the Psychological Health Program.

Gaps in communication could leave the commander who bears ultimate responsibility for the safety and well-being of soldiers without a full picture of their overall health, his testimony suggested.

Ochoa couldn’t speak to the specifics of the 40-year-old gunman, Robert Card, who killed 18 people and injured 13 others in October in Lewiston, but he gave an overview of services available to soldiers and their families in a crisis.

While there are extensive services available, the Psychological Health Program cannot mandate that a reservist get treatment — only a commander can do that — and Ochoa noted that there can be communication breakdowns. He also acknowledged that soldiers are sometimes reluctant to seek treatment for fear that a record of mental health treatment will hurt their careers.

“Hopefully we’ve demonstrated to the public and to ourselves that this is a complicated and complex process,” Daniel Wathen, the commission’s chair and a former chief justice for the state, said when the session concluded.

The independent commission established by the governor is investigating facts surrounding the shooting at a bowling alley and at a bar and grill. Card’s body was found two days after the shooting. An autopsy concluded he died by suicide.

The gunman’s family and fellow Army reservists told police Card was suffering from growing paranoia in the months leading up to the shooting. He was hospitalized during a psychiatric breakdown at a military training last summer in upstate New York. One reservist, Sean Hodgson, told superiors in September, a few weeks before the attacks: “I believe he’s going to snap and do a mass shooting.”

In the aftermath, the state Legislature passed new gun laws that bolstered Maine's “yellow flag” law, which criminalized the transfer of guns to people prohibited from ownership and expanded funding for mental health crisis care.

The commission intends to release its final report this summer.

In a preliminary report, the panel was critical of the police handling of removal of Card’s weapons. It faulted police for giving Card’s family the responsibility to take away his weapons — concluding police should have handled the matter — and said police had authority under the yellow flag law to take him into protective custody.

Mental health experts have said most people with mental illness are not violent, they are far more likely to be victims of violent crime than perpetrators, and access to firearms is a big part of the problem.

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