Military Ignoring Mental Illness?

**Bill** · 14 May 06,, 19:26

Report: Military Ignoring Mental Illness

HARTFORD, Conn. - U.S. military troops with severe psychological problems have been sent to
Iraq or kept in combat, even when superiors have been aware of signs of mental illness, a newspaper reported for Sunday editions.
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The Hartford Courant, citing records obtained under the federal Freedom of Information Act and more than 100 interviews of families and military personnel, reported numerous cases in which the military failed to follow its own regulations in screening, treating and evacuating mentally unfit troops from Iraq.

In 1997, Congress ordered the military to assess the mental health of all deploying troops. The newspaper, citing
Pentagon statistics, said fewer than 1 in 300 service members were referred to a mental health professional before shipping out for Iraq as of October 2005.

Twenty-two U.S. troops committed suicide in Iraq last year, accounting for nearly one in five of all non-combat deaths and the highest suicide rate since the war started, the newspaper said.

Some service members who committed suicide in 2004 and 2005 were kept on duty despite clear signs of mental distress, sometimes after being prescribed antidepressants with little or no mental health counseling or monitoring, the Courant reported. Those findings conflict with regulations adopted last year by the Army that caution against the use of antidepressants for "extended deployments."

"I can't imagine something more irresponsible than putting a soldier suffering from stress on (antidepressants), when you know these drugs can cause people to become suicidal and homicidal," said Vera Sharav, president of the Alliance for Human Research Protection, a New York-based advocacy group. "You're creating chemically activated time bombs."

Although Defense Department standards for enlistment disqualify recruits who suffer from post-traumatic stress disorder, the military also is redeploying service members to Iraq who fit that criteria, the newspaper said.

"I'm concerned that people who are symptomatic are being sent back. That has not happened before in our country," said Dr. Arthur S. Blank, Jr., a Yale-trained psychiatrist who helped to get post-traumatic stress disorder recognized as a diagnosis after the Vietnam War.

The Army's top mental health expert, Col. Elspeth Ritchie, acknowledged that some deployment practices, such as sending service members diagnosed with post-traumatic stress syndrome back into combat, have been driven in part by a troop shortage.

"The challenge for us ... is that the Army has a mission to fight. And, as you know, recruiting has been a challenge," she said. "And so we have to weigh the needs of the Army, the needs of the mission, with the soldiers' personal needs."

Ritchie insisted the military works hard to prevent suicides, but said that is a challenge because every soldier has access to a weapon.

Commanders, not medical professionals, have final say over whether a troubled soldier is retained in the war zone. Ritchie and other military officials said they believe most commanders are alert to mental health problems and are open to referring troubled soldiers for treatment.

"Your average commander doesn't want to deal with a whacked-out soldier. But on the other hand, he doesn't want to send a message to his troops that if you act up, he's willing to send you home," said Maj. Andrew Efaw, a judge advocate general officer in the Army Reserves who handled trial defense for soldiers in northern Iraq last year.

**Confed999** · 14 May 06,, 21:23

Ugh. Who makes up these policies?

**Shek** · 15 May 06,, 14:05

While there appears to be smoke, is there really fire? I don't know, as this article really is not in-depth enough to know.

Also, how representative was the FOIA request? Once again, we just don't know.

I do know that the best way to treat a soldier with a mental illness in a war zone is to do it as far forward as possible. I don't know what the standard prescription is for those about to redeploy, although once again, the article doesn't provide much detail about how severe the issues were or what the proper protocols are.

I also know that I had a soldier who became "mental" before we even deployed. Maybe his JRTC experience made him flip out

In any case, I think that there is definitely more than meets the eye in this case, and I'm not sure if the military got the raw end of the deal on this one.

Here's some commentary on this article that should provide some more background.

Also, a good book for anybody that is interested in the psychology of killing and basic mental treatment philosophies for soldiers is On Killing.

http://iraqnow.blogspot.com/2006/05/...arting-in.html

The article specifically refers to major depression, and makes mention of suicide rates, making much of the fact that 22 soldiers committed suicide in Iraq last year. And yes, that's the fault of commanders who don't send our complainers back to the rear when they get a case of the snivels.

The article fails to mention, though, that the average national suicide rate back home for males age 20 to 34 is 22.3 per 100,000. There are currently about 120,000 personnel in Iraq at any one time. Which means the expected number of suicides for that demographic would be 26 per year. Which means that despite the heat, the hardships, the separation from family and friends, the lack of creature comforts, and despite the fact that everyone has a weapon and ammunition 24 hours a day, seven days a week, and can blow their own brains out any time, day or night on a whim, the suicide rate for soldiers in Iraq is 15.3 percent lower than the national average!

**canoe** · 15 May 06,, 15:44

I know the police have had great success by making psychologists available to officers 24/7 to talk to if their having issues relating to their job or a tramatic incident.

The psycologists in these cases can infact remove the officer from duty if they feel hes a risk to himself or anyone else.

I don't think theres as much of an issue these days with piles of people trying to fake being mental in order to get out of the tour over there. Sure it will happen but I think the numbers will be relatively low. The army is a volunteer force now. The people who are over there wanted to do what they're currently doing.

**Shek** · 15 May 06,, 15:54

Originally Posted by canoe

I know the police have had great success by making psychologists available to officers 24/7 to talk to if their having issues relating to their job or a tramatic incident.

The psycologists in these cases can infact remove the officer from duty if they feel hes a risk to himself or anyone else.

I don't think theres as much of an issue these days with piles of people trying to fake being mental in order to get out of the tour over there. Sure it will happen but I think the numbers will be relatively low. The army is a volunteer force now. The people who are over there wanted to do what they're currently doing.

There are more than you think. It's probably a little bit on the decline by now, but those that signed up for 4, 5, 6 year enlistments on 10 September 2001 or before had no idea that they were signing up for an Army at war. Even those who signed up for a "safe" job in the rear after 9/11 had no idea that they would be in danger until the 507th Maintenance Company got waxed in An Nasiriyah in March 2003 and CSS units were getting the sh!t kicked out of them by IEDs later on in 2003 and 2004.

Also, you have the fact that deploying is a huge stress on a family, and nothing can bring a man to more desperation than mama telling Joe that she's leaving him if he deploys.

So, don't overestimate the fact that a person volunteered for a job that promised college benefits and a steady paycheck and free healthcare for his family. Patriotism figures in the equation, but it isn't a primary motivator for many.

**Bill** · 15 May 06,, 19:42

Originally Posted by shek

Also, you have the fact that deploying is a huge stress on a family, and nothing can bring a man to more desperation than mama telling Joe that she's leaving him if he deploys.

Or the dear jody letter she sends once he's already there.

Very few things in life are as frustrating as having the 'love of your life' walking out of your life on the other side of the world(or country), and not being able to not only leave to 'fix' things, but in many cases not even being able to call her in a timely fashion.

The hard parts about being a soldier no one even mentions......let alone talks about.

Push-ups are easy. Getting your fiancee's dear jody letter the day you're leaving for a long field problem(or overseas deployment, or war, or whatever) is like having all the mental trials of basic training all rolled up into one big brick and then dropped on your head.

**Shek** · 16 May 06,, 13:26

Here's the next article. The more they write, the less confidence I have in any of their conclusions . . .

Hartford Courant
May 16, 2006

Health Chief Responds

Assistant Secretary Of Defense: 'Comprehensive Process' Determines Fitness

By Lisa Chedekel and Matthew Kauffman, Courant Staff Writers

The Defense Department's top health official and the Army Surgeon General on Monday defended the military's screening and treatment of mentally troubled troops, saying the mental health of service members is a top priority for the Armed Forces.

Responding to a series of articles in The Courant, Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs, said he was satisfied that troops with serious mental illnesses are not being deployed to Iraq, and service members who develop mental problems in the war zone are receiving appropriate care.

"Our policy and our practice is to ensure that every deploying service member is fit, both physically and mentally," he said. "We have a very comprehensive process to do this."

The Courant's series, which concludes Wednesday, found that the military has increasingly sent, kept and recycled troubled troops into Iraq, sometimes in conflict with its own policies.

Although Congress ordered that every deploying service member receive an "assessment of mental health," The Courant reported that fewer than 1 in 300 troops receives a referral to a mental health professional before being sent to war. But a study by the military's own doctors estimated that 1 in 11 deploying troops suffer from major depression, anxiety or PTSD. Wow! What an effing surprise. I was anxious before deploying to Iraq. I guess I should have received some mental treatment and some meds. I guess that a normal person shouldn't be anxious about leaving a family behind with the possibility of never seeing them again

Winkenwerder said he believes the military's pre-deployment screening is adequate, and that the low number of mental health referrals "reflects the generally healthy status of the people that we have serving."

Both he and Army Surgeon General Kevin C. Kiley defended the use of a self-reported questionnaire, which includes a single mental health question, to screen deploying troops.

"I frankly do think we have met the intent of Congress," Kiley said. "There's only so much we can do for large numbers [of troops], and it's not like we wouldn't want to do more."

Winkenwerder said troops who indicate health problems on the questionnaire have "an interaction with a medical professional" before they are deemed fit for deployment. He also said commanders and troops do a good job flagging fellow service members' psychological problems.

Responding to cases reported by The Courant in which service members were deployed despite known mental problems, Winkenwerder said, "Have mistakes ever been made? Absolutely. We're not perfect, even though we try very hard to do a good job every time.

"We've deployed over a million individuals," he said. "Sometimes individuals with psychiatric problems hide them, or hide their symptoms ... so individuals with serious underlying disorders can escape full attention."

The Courant also found that at least 11 service members who committed suicide in Iraq in 2004 and 2005 had been kept in the war zone despite exhibiting signs of significant psychological distress. In seven of those cases, superiors were aware of the troops' mental problems. This is what the medical protocol is - treat people as far forward as possible; it's the exact same concept as "getting back in the saddle" ASAP after getting bucked off. I guess the Army should go against standard protocol.

Of those findings, Kiley said, "I'm not sure whether closer attention by the chain of command makes a lot of difference. It certainly would seem, in retrospect, that if commanders knew what was going on in soldiers' heads, certainly they could take steps to stop them."