An American soldier who killed five fellow troops at a clinic was poorly monitored and had been unraveling for nearly two weeks before the shootings, but the military lacked clear procedures for handling the volatile situation, a report into the incident has stated.

Sgt. John M. Russell is accused of shooting and killing five soldiers at a military counseling center at a U.S. base last May. The shooting deaths drew attention to the issues of combat stress and morale among troops serving multiple tours in Iraq.

The extensive 325-page report, issued Friday and obtained by The Associated Press Tuesday, included detailed witness statements describing the events leading up to the shootings, paints a picture of soldier on his third deployment who began to show obvious signs of unraveling nearly two weeks before the shootings at the clinic.

The report offered a detailed step-by-step accounting of Russell's behavior and actions at Baghdad's Camp Liberty on May 11 in the hours leading up to the shootings.

Russell, who's faces charges of murder and aggravated assault, had been making his fourth visit to a mental health clinic in Iraq when the appointment was cut short because Russell was "verbally noncompliant," the report stated. Clinic personnel then called the military police, who declined to arrest him and ordered him returned to his unit.

Less than an hour later, Russell managed to grab a loaded M-16 rifle from a fellow soldier and steal a vehicle. He then went back into the counseling facility and shot and killed four soldiers and one sailor.

In the days leading up to the incident, many of Russell's fellow soldiers had noticed that his behavior appeared to be "deteriorating," the report stated.

On the morning of May 11, Russell was taken by a member of his worried unit to the clinic after being "irritable" and telling other members of his unit to "get away from me," according to the report.

The report said although the unit knew of Russell's suicidal thoughts at least 3-4 days prior to the incident, little appeared to have been done to effectively monitor him.

One person interviewed by investigators said that Russell's roommate would keep an eye on him when he was around, but otherwise there was not enough personnel to completely monitor him.

"There is no clear procedure or established training guidelines in any of the references for managing soldiers identified as 'at risk for suicide' or the proper way to conduct suicide watch," the report stated.

A breakdown in communication also contributed to the deadly series of events. One section of the report describes how units responding after Russell stole the weapon, instead of than reacting immediately, had to first meet up in person to coordinate their actions because radio communication was poor.

Additionally, nobody alerted the counseling clinic that Russell had stolen a weapon and a vehicle, the report said.

The U.S. military in Iraq did not immediately respond to an Associated Press request for comment regarding the findings or what steps were taken to implement recommendations in the report.