Gen. Peter W. Chiarelli participates in a question-and-answer forum following his speech at the 131st Annual National Guard Association of the United States conference in Nashville, Tenn., Sept. 13. Chiarelli highlighted several steps the Army is taking to address increasing soldier suicides and mental health issues.Mental health problems plague soldiers returning from mideast battles.
While the mass shooting at Fort Hood, Texas occurred less than a month ago, a narrative is already forming about the tragedy that casts the alleged shooter, Nidal Malik Hasan, as a freakish outsider whose actions have few implications for the military. While it may turn out that Hasan, an Army major who, according to some accounts, is a devout Muslim opposed to the wars in Iraq and Afghanistan, was motivated to kill by religious fervor or anti-war sentiment, he is far from an outlier in a military that is overstressed from two long wars and underserved by mental health professionals.
Indeed, in May an incident occurred that bears striking similarities to the Fort Hood slayings: a stressed-out soldier opened fire in a combat stress clinic at Camp Liberty in Baghdad, leaving five service members dead and three wounded. The alleged gunman, Sgt. John M. Russell, was serving his third tour in Iraq and had visited the clinic four times before the shootings and had even threatened suicide. Russell's behavior had become so erratic that, according to a report on the incident by the Multi-National Corps Iraq, his unit's commander had removed the bolt from his weapon just days before the stress clinic shooting.
Though Hasan had not served in the theater in Iraq and Afghanistan, he, like Russell, showed signs of stress long before the shooting. Hasan reportedly told relatives he feared a deployment to Iraq and Afghanistan and even sought a discharge from the Army.
Fortunately, while soldier-on-soldier shootings are rare, serious mental health problems — from major depression to post-traumatic stress disorder (PTSD) — are frighteningly commonplace among service members. In 2009 alone, 133 active-duty Army soldiers were reported to have committed suicide; in mid-November, the Army acknowledged the number of suicides this year will likely exceed last year's tally (140) — then a record high for the Army.
Homicides committed by Iraq and Afghanistan veterans, though still rare, also are becoming alarmingly frequent: 14 soldiers from a military base in Fort Carson, Colorado have been charged or convicted in at least 11 slayings since 2005. A recent study from Stanford University found that up to 35 percent of those serving in Iraq and Afghanistan will seek treatment for PTSD. Using Stanford's statistics, the veterans advocacy group Veterans for Common Sense (VCS) estimates that more than 665,000 veterans of the wars in Afghanistan and Iraq will seek PTSD treatment. According to VCS, the epic scope of the mental health epidemic can be attributed in part, ironically, to advances in military technology (advanced body armor and mine-resistant ambush-protected vehicles). Such technology has resulted in more troops coming home — but as VCS notes, they are "coming home...in drastically varied degrees of wholeness." In Vietnam, according to VCS, there was one soldier killed for every 2.6 wounded, while in the Iraq and Afghanistan conflicts there is approximately one killed in action for every 11.5 wounded. So, VCS concludes, when wounded soldiers come home, "their journey has just begun."
In an environment where so many vets are coming home with mental and physical ailments (or both), VCS estimates that 454,000 Iraq and Afghanistan veterans have already sought medical care from the Department of Veterans Affairs (VA). So it's no surprise that other veterans experts predict that the numbers of vets seeking help for mental health problems ranging from major depression to PTSD will skyrocket.
"I see a tsunami coming," Shad Meshad of the National Veterans Foundation recently told
One would think the military establishment's response to this mental health tsunami would be robust when our country is engaged in two wars which require multiple deployments and the highest levels of readiness among its troops that. But just the opposite is happening: the military brass has been painfully slow in recognizing the severity of the mental health crisis. The Defense Department established a Suicide Task Force just this September. The Army, similarly, does not nearly have an adequate number of mental health professionals required to treat our stressed out soldiers: the Army has 408 psychiatrists for its force of 545,000 people. And when soldiers do seek help, care is often inadequate; a 2008 RAND Corporation study found that even among vets who seek out help for PTSD or major depression, only about half receive treatment that RAND's researchers consider even "minimally adequate" for their illnesses.
RAND's assertions ring true based on more than two years of interviews I conducted with Iraq war veterans while researching Shake the Devil Off, about Zackery Bowen, a Sergeant with the Army's 527th Military Police Company who came home to New Orleans from a tour in Iraq and, after surviving the federal flood in 2005, committed a gruesome murder in the French Quarter and then took his own life. I discovered Bowen had significant mental health problems — including major depression and symptoms consistent with the onset of PTSD — just before being given a "general" discharge from the Army in 2004 which jeopardized his post-military benefits administered by the VA. Sadly, while reporting the book I found Bowen was far from alone in experiencing significant stress after a deployment to Iraq and facing the consequences of a military failing to properly care for vets at home.
I talked to a sergeant with severe anger management issues who had inexplicably been prescribed Ritalin, a stimulant used to treat attention-deficit hyperactivity disorder, the side effects of which include increased aggression; a severely injured specialist who has been fighting with the VA over his disability rating and who believes his battle to receive benefits had led to worsened post-deployment stress; and a sergeant who has lamented the fact that he has lost more of his fellow soldiers stateside (to everything from alcoholism to suicide) than he did on the battlefield in Iraq and Afghanistan.
It is long past time for the military to significantly boost its efforts in the battle against mental health demons such as PTSD and depression among its ranks: it should vastly increase the number of psychiatrists to treat service members; urge psychiatrists and therapists in private practice to volunteer their time to help counsel troops; and it should closely scrutinize the VA to insure that its doctors are properly diagnosing PTSD and engaging in therapy instead of simply prescribing anti-depressants. President Barack Obama, meanwhile, should encourage the public to more meaningfully engage the veterans of the wars in Afghanistan and Iraq whose stress is often augmented by feelings of alienation as they fight long conflicts only to come home to a disengaged civilian population. As retired Colonel Andrew Bacevich, author of The Limits of Power, told Frontline recently: "We've accepted the proposition that the burden of waging this open-ended war should fall on the backs of roughly one-half of one percent of the population. And the other 99.5 percent of the population carries on as if there were no war."
This small sliver of our citizenry carrying the burdens of our long wars deserve much more of our attention — and they deserve mental health care worthy of their extraordinary sacrifice.
Ethan Brown is the author of several books, most recently the critically acclaimed Shake the Devil Off. He lives in New Orleans.