Veterans who served in combat in Iraq or Afghanistan are offered mental health care upon re-entry to American communities, but the possibility of tragedy remains. Last Friday’s double-murder and suicide by a Hawaii veteran treated for post traumatic stress disorder is an extreme example of the need for more perceptive — even aggressive — measures to prevent violent outbreaks.

Clayborne Conley, a former Hawaii Army National Guardsman, shot and killed acquaintance Kristine Cass and her 13-year-old daughter, Saundra, before turning the gun on himself. Conley had been afflicted with insomnia, combat nightmares, morbid ruminations, suicidal thoughts and alcohol abuse upon his return to Hawaii from deployment in Iraq in 2005, according to court records.

In the years following his discharge, Conley was convicted of misdemeanors of assault and terroristic threatening. He was acquitted by reason of insanity in January 2009 of burglary and criminal property damage after entering a stranger’s apartment and throwing furniture off the lanai two years earlier. Conley was committed to the Hawaii State Hospital and released in May of this year.

Obvious in hindsight, Conley was that proverbial time-bomb set to explode — and did. Tragically for Cass and her daughter, fate could not have been more cruel than to have cast him into their life paths. Public horror resonates over his fatal actions — and the community at large cannot escape the fact that ignored symptoms can lead to violence outside of the military.

A friend of Kristine Cass said Conley was missing subsequent sessions for PTSD at Tripler Army Medical Center and feeling depressed leading up to the murder-suicide. The U.S. Department of Veterans Affairs has an eight-week intensive program for treating PTSD at Tripler. Hospital records are confidential, so we don’t know the extent to which Conley used those services.

About 1 million veterans of the two current wars are back in civilian society, according to the Veterans Affairs agency. Jim McGuire, a VA health care administrator, has cited statistics suggesting that 27 percent of active-duty veterans returning to civilian life "were at risk for mental health problems," including PTSD.

Compassion is warranted for veterans encumbered with post traumatic stress syndrome, drug dependency and other problems associated with their combat experiences. Some states, not including Hawaii, have created special courts for veterans to ensure treatment entitled by their service to the country. In overturning the death penalty last November for a Korean War veteran in Florida convicted of murder, the U.S. Supreme Court cited "the intense stress and emotional toll that combat took" on the defendant.

A U.S. Defense Department task force reported this week that suicide-prevention programs for combat troops have been inadequate. The same might be said, tragically, of programs for combat veterans who may be a danger to others.

Judges, prosecutors and mental health care providers need to recognize the danger that some veterans may create, albeit associated with their past service to country. At some point, tough care via stringent treatment and strict adherence is needed to prevent violence associated with mental injuries traceable to a noble cause.