With more information becoming known, I can't help thinking that the killer's behavior had little to do with his Army service and much with his childhood experiences and personality. His mother was a drug addict and he suffered many foster family placements. He had long been impulsive, having once thrown a foster brother down a staircase causing him two broken legs. He seems to have been an inadequate employee in civilian life though only fragmentary details have thus far been released and there are questions about the success of his military record,he appearing to be not the "hero" as he has been publicly described.He was thrown out of the treatment setting two weeks before his killings for carrying knives.
While hindsight is 20/20, the treatment of faulty ego capacities caused by inadequate parenting is accomplished through individual psychotherapy, and is not a short-term, light endeavor. Yet the VA facility was so short staffed that its manager sometimes slept in her office to cover a shift, this indicating funding problems. Moreover, the VA seems to push medication and fancy gadget research at the expense of individual therapy.
There is no conceptual difference between the psychological needs of PTSD suffering civilians and PTSD suffering veterans. Their symptoms in both cases indicate that the mind has a limited capacity to endure stress, the symptoms reflecting its attempt to re-integrate itself and heal, as should be explained to patients and is the first step towards healing..