Over the past year there has been an unusually high number of suicides among U.S. troops in Iraq, and hundreds of soldiers experiencing stress-related psychological problems have been evacuated from the country. Given a recent burst of urban warfare in places such as Fallujah and the Pentagon's decision to extend the tours of duty of thousands of soldiers, the problem is likely to get worse.
Recognizing that something had to be done, the military has increased the use of combat stress-control teams, established a toll-free crisis hotline for service members having problems dealing with stress, and set up recuperation centers where soldiers can chill out for a few days before returning to the front lines.
But military analysts -- and critics -- ask whether these actions are too little, too late. And they wonder whether the military has made adequate plans for treated soldiers when they return home.
Twenty-four soldiers -- 20 Army personnel, two Marines, and two sailors -- have taken their lives during the past year in Iraq and Kuwait. In addition, there have been seven suicides among newly statesided troops, including two soldiers who killed themselves while patients at Walter Reed Army Medical Center, the Toronto Star recently reported.
The suicide rate for army troops in Iraq has been 17.3 per 100,000 soldiers, compared with the overall Army rate of 11.9 per 100,000 between 1995 and 2002. The rate is higher than that for all branches of the military during the Vietnam War (15.6 per 100,000) and higher than that during the 1991 Persian Gulf War (3.6 per 100,000).
"The higher suicide rate in Iraq can be attributed to the higher percentage of married and reserve troops and the lower amount of stress training and screening in basic training for noncombat troops," says military analyst James F. Dunnigan, author of The Next War Zone: Confronting the Global Threat of Cyberterrorism.
Dr. David N. Tornberg, deputy assistant secretary of defense for clinical and program policy, told American Forces Radio and Television Service that the suicide deaths are a "primary concern" for his office. "It's very important for anyone who is feeling stressed to come forward, to speak to their chaplain, to speak to a mental-health practitioner or physician, to speak to someone in your line of authority," he said.
Coming forward, however, often carries a high price: Staff Sgt. Georg-Andreas Pogany, an interrogator for the 10th Special Forces Group, was charged with cowardice after suffering a panic attack in Iraq, the Denver Post recently reported. Although "the cowardice charge was [eventually] dropped ... Pogany's case at Fort Carson is still unresolved."
The recent announcement by Secretary of Defense Donald Rumsfeld to extend the tours of 20,000 soldiers came a few weeks after the Army issued a report on the mental health of troops serving in Iraq. A previous "after-action" report, written in October 2003 and obtained by United Press International, indicated that the Pentagon had "'inappropriately' deployed soldiers to Iraq who already were diagnosed with mental problems."
"Variability in pre-deployment screening guidelines for mental health issues may have resulted in some soldiers with mental health diagnoses being inappropriately deployed," the earlier report stated. That could "create the impression that some soldiers develop problems in theater, when, in some cases, they actually have pre-existing conditions."
Dunnigan says the report was "mostly about reservists who did not keep their medical profiles up to date [lest they be forced out of the National Guard or reserves].
"The Army did not screen closely because the reserves were supposed to keep the records current on all their people," Dunnigan says. "Things do get a bit lax in the National Guard, but that's another story."
The larger Army study -- which was based on a six-week visit to Iraq and interviews with soldiers at Landstuhl Regional Medical Center in Germany and Fort Stewart, Ga. -- was released in late March. It was intended to evaluate and offer "recommendations on Operation Iraqi Freedom-related mental health services, soldier access to those services in theater and after evacuation, and effective suicide prevention measures for soldiers in active combat."
Steve Robinson, executive director of the National Gulf War Resource Center, a Silver Spring, Md.-based organization that lobbies on behalf of veterans of the Persian Gulf War, told UPI that he has tried to get the Pentagon to use more thorough screening methods. Robinson, a former Army Ranger, said that the recently revealed "information indicates that pre-deployment, during-deployment and post-deployment screening is critical. If done properly, it will rule in -- or rule out -- the deployability of service members.
"It is time to stop having congressional hearings on what needs to be done and have the Department of Defense step up to the plate and perform the screenings as required by law."
Cognizant of the difficult conditions U.S. troops deployed in Iraq are facing, the military has developed "regimental recuperation centers" to help soldiers with combat-stress symptoms. For as long as three days, the soldiers receive counseling at the centers, warm meals, showers, and clean clothes before being sent back to the front.
Taking care of troops in Iraq is one thing. What happens when they return home? According to medical officials interviewed by the Denver Post, "Between 8 and 10 percent of all soldiers returning from Iraq will suffer from post-traumatic stress disorder or will need some counseling once stateside."
But taking care of the wounded and the sick after they arrive home has not been the Pentagon's strong suit, according to news reports. In October, UPI's Mark Benjamin wrote an award-winning series of groundbreaking stories exposing the horrendous treatment soldiers wounded in Iraq were receiving at overcrowded, understaffed facilities in the United States.
Too often, soldiers and their families receive inadequate care after tours of duty are completed, said the National Gulf War Resource Center's Robinson.
"We fall short on getting them the proper care, compensation, and readjustment services that they need to recover from the wartime experience," he said.
"So if we're going to commit them to fighting for the nation, we need to commit to providing every resource for them when they come home. It's a covenant."
This story was distributed by AlterNet, the news service of the alternative press.