Police have not released a motive for the double-murder and apparent suicide Friday in Makiki, but court records show the alleged shooter was struggling with post-traumatic stress disorder related to combat.
Friends said Kristine Cass, 46, was trying to end a relationship with Clayborne Conley, who allegedly shot her and her 13-year-old daughter, Saundra, before shooting himself.
Conley was a former Hawaii National Guardsman, discharged more than three years ago after serving in Iraq in 2005. Before his deployment, he had no psychiatric problems, but after returning appeared socially withdrawn and made false statements, court documents said.
After returning, he suffered from insomnia, combat nightmares, startle reactions, morbid ruminations, suicidal thoughts, and alcohol abuse, court records said.
Fred Ballard, spokesman for the Department of Veterans Affairs in Hawaii, said PTSD can have a range of symptoms from insomnia to domestic abuse, but violent outbreaks are less common.
It’s not clear whether someone can get rid of the disorder, and treatment usually deals with teaching the person how to cope, he said.
Veterans Affairs has an eight-week intensive program for treating PTSD at Tripler Army Medical Center and gives those diagnosed with the disorder a "tool box" to deal with the problem, he said.
"It’s not like a broken leg," he said. "It never really heals. It’s just how you handle it."
In May, Conley passed a mental health review hearing, six months after being released from the Hawaii State Hospital.
According to court records, Conley, 43, was "doing fine" at the review hearing and was scheduled for a six-month review in December.
But a friend of the victim who knew Conley told the Star-Advertiser that Conley was missing his sessions for PTSD at Tripler and recently was feeling depressed.
Conley was committed to the state hospital in January 2009 after he was acquitted by reason of insanity of first-degree burglary and second-degree criminal property damage. He had allegedly entered a stranger’s apartment on Ward Avenue in January 2007 and thrown furniture off the lanai.
According to court documents, Conley said he heard a loud noise, thought he was under attack, heard voices telling him to attack and threw the items off the lanai to defend himself.
Two doctors on a court-appointed panel in the case diagnosed Conley with post-traumatic stress disorder, but a third said he was struggling with a drug problem.
Janice Okubo, Department of Health spokeswoman, said that after the courts commit a person to the hospital, the courts decide when the person can leave the hospital.
Mayra Grambs, executive director of Mental Health America of Hawaii, said the diagnostic criteria for PTSD does not include becoming violent and she didn’t know what percentage of those with PTSD become violent. But she said war has many negative effects on people, including issues with domestic violence, anger management, and substance abuse.
"There are a lot of consequences to the trauma of war, and what happened yesterday in Hawaii was one of those consequences," she said.
Ballard, with Veterans Affairs, said PTSD and traumatic brain injury are the predominant injuries of the current conflicts in the Middle East. Ultimately, he said, the veteran has to want to get treatment.