Military lacks resources to thoroughly track blast-related brain injuries, report finds

DoD Struggles to Track Blast‑Induced Brain Injuries, GAO Report Finds

WASHINGTON — A new Government Accountability Office (GAO) report has revealed that the Department of Defense (DoD) is falling short of its own policies for monitoring brain injuries caused by blast exposure, citing a lack of trained staff and technology. The report, which was requested by Maine’s congressional delegation in 2024 and made mandatory by the 2025 National Defense Authorization Act, reviewed the DoD’s programs designed to measure and mitigate the effects of heavy‑weapon overpressure on service members.

The GAO study focused on policies introduced after the October 2023 Lewiston, Maine, mass shooting, in which Army reservist Robert Card killed 18 people before taking his own life. Investigations into Card’s brain tissue later revealed traumatic damage linked to the thousands of low‑level blasts he received while instructing grenade training in New York. Card’s deteriorating mental health in 2023, including psychotic episodes and auditory hallucinations, had been noted by police and his commanding officers, who sent him to a psychiatric facility for two weeks that summer.

In response to the tragedy, the DoD established a series of measures aimed at reducing blast exposure. These included mandated stand‑off distances when firing weapons, baseline cognitive assessments for all high‑risk active‑duty personnel, and entry‑level brain screening for new recruits. The GAO report notes that in 2025, 86 % of high‑risk active‑duty service members completed the required cognitive assessment, a sign that some progress has been made.

However, the study also identified critical gaps. “There is insufficient staff and technology to conduct the assessments, and a lack of industrial hygiene personnel to track the blasts themselves,” the GAO wrote. The shortfall has prevented the DoD from fully meeting its policy goals. The report further identified several factors that could improve the mental‑health threat posed by blast overpressure, including the influence of military hierarchy, unit culture, access to care, and the nature of interactions with health‑care providers.

In a statement to Congress, the DoD said it is actively determining what additional technology and staff are required to close these gaps. The department also announced a transition to a less resource‑intensive cognitive monitoring tool, an effort that may streamline data collection while still providing valuable insights. The 2027 National Defense Authorization Act, which emerged from the Senate Armed Services Committee, will impose additional oversight on the implementation of blast‑overpressure monitoring.

Senator Angus King, whose state was the site of the Lewiston shooting, has been a vocal advocate for addressing blast‑induced injuries. “You cannot fix a problem unless you can measure it,” King said during a Senate Armed Services Committee hearing in January 2025. “Thanks to the GAO survey, we now have more information and metrics to track progress in addressing this invisible danger that has been lurking for years.” King, who serves on both the Armed Services and Veterans’ Affairs committees, has pushed for research, legislation, and policy reforms in the wake of the tragedy.

The GAO report’s findings come at a time when the military is grappling with the broader implications of blast injuries for the long‑term health of its personnel. While the DoD’s new baseline screening program has improved coverage, the agency’s limited capacity to monitor blast exposure and assess cognitive changes remains a significant hurdle. The forthcoming oversight mandated by the 2027 NDAA may compel the department to expedite solutions.

As the DoD works to bridge its resource gaps, lawmakers and advocacy groups will likely keep a close eye on how quickly new technologies and staffing levels can be deployed. The hope is that, with better measurement tools and clearer data, the military can reduce the risk of blast‑related brain injuries and provide more comprehensive care for those affected.