A few days ago I praised General Douglas Lute, the Deputy National Security Advisor for Iraq and Afghanistan, for openly acknowledging that the current deployment policy was causing undue stress for troops and their families. Today the Pentagon issued its report on Iraq War-related suicides and took at least two steps back. As the one who wrote an InDepth study of Iraq War suicides not that long ago, I was disturbed not so much by the report–which has its problems–but by statements from the Pentagon in their briefing about the report.
But first to the report. According to the Pentagon’s press release:
In 2006 there were 99 suicides within the Army, 30 of which occurred in Iraq or Afghanistan. This is an increase from 87 suicides in 2005 and 67 in 2004.
Pauline Jelinek of ABC reported:
The 2006 total the highest rate in 26 years of record-keeping and the largest raw figure in 15 years came despite Army efforts to set up new programs and strengthen old ones for providing mental health care to a force stretched by the longer-than-expected conflict in Iraq and the global counterterrorism war entering its sixth year.
It is EXTREMELY important to point out that these data come from the Army Suicide Event Report (ASER), a system used for tracking suicides. You can access an ASER online to see what one contains. These reports were cited in the November 2006 Mental Health Advisory Team Report IV for their inaccuracy. The November report pointed out unfortunately there is:
No mechanism to insure the accuracy of ASERs submitted for suicide attempts.
The consultant hired to examine the ASERs could only validate 67% of them, meaning the data we have for suicides among our Iraqi troops is woefully inadequate. Based on this we can assume the rate of suicides is much higher because the tendency is to under-report.
We will give the Pentagon the benefit of the doubt on this, since there is not doubt one reason for the inaccuracies lies with the desire of those charged with reporting suicides to class them as some other form of death in order to protect families. What I found eerie was that I was actually able to access an ASER report online and could have begun filling it out except that by that point I figured I had gotten myself in enough trouble.
It should also be pointed out the ASERs obviously do not cover soldiers who are discharged but commit suicide as a result of war-related Post-Traumatic Stress Disorder. PTSD is called just that because it can occur immediately after the incident or fester for some time after that.
Despite these problems with the report, it was not the report itself but the comments by Pentagon officials in a press briefing that left me deeply disturbed. When asked if there was a reason for the suicides Col. Elspeth Ritchie, psychiatry consultant to the Army surgeon general, told a Pentagon press conference that the primary reason for suicide is:
Failed intimate relationships, failed marriages.
Colonel Ritchie went on to point out:
However, we do know that frequent deployments put a real strain on relationships, especially on marriages. So we believe that part of the increase is related to the increased stress in relationships. Very often a young soldier gets a ‘Dear John’ or ‘Dear Jane’ e-mail and then takes his weapon and shoots himself.
I will let readers be the judge of how disturbing this statement must be for families and friends of Iraq War suicides. Suffice it to say none other than the National Institute of Mental Health notes in its research on survivors of suicide:
Referred to as “survivors of suicide,” family and friends grieving a suicide death often struggle with their own feelings in relation to the loss as well as the stigma that suicide confers.
The NIMH goes on to say:
Suicide survivors have not been found to suffer any greater psychiatric disability than individuals bereaved by the unexpected and violent loss of a loved one, but they are more apt to feel guilt, experience social discomfort, and struggle with understanding why it happened.
Finally they point out:
People who have had a suicide in their family also appear to be at greater risk for suicide.
In other words, Colonel Ritchie’s explanation appears to contradict NIMH.
But Colonel Ritchie did not stop there. She commented:
We have not yet seen an increase in suicides in multiple deployers or those who have been there longer; we may over time.
First, she obviously did not listen to what her superior officer, General Lute said last week. When asked by National Public Radio:
How heavy a toll is the war taking on American forces? Do you agree with other military leaders who have expressed worries that U.S. forces are near the breaking point.
The General responded as follows:
I am concerned that those men and women and the families they represent are under stress as a result of repeated deployments.
There’s both a personal dimension of this, where this kind of stress plays out across dinner tables and in living room conversations within these families, and ultimately, the health of the all-volunteer force is going to rest on those sorts of personal family decisions. And when the system is under stress, it’s right to be concerned about some of the future decisions these young men and women may make. I think our military leaders are right to be focused on that.
But even more damaging are the findings of the MHAT IV report. The most fascinating part of the report compares the concerns of Soldiers with those of Marines, so in essence one becomes a control group for the other. Here the findings on deployment become especially disturbing for they confirm that the Bush Administration’s deployment policy is a major factor in our troops’ mental health. Although the report does not criticize the Administration’s policy or advocate any changes in it, its findings are probably the most persuasive evidence to date that one of the major contributors to the silent killer lies in the White House’s conduct of the war.
In Iraq Marines have shorter deployment terms than Soldiers, a difference that had a direct impact on the troops’ mental health. The report states:
Due to shorter deployment lengths, Marines had fewer non-combat deployment concerns.
When matched for deployment length and deployment history, Soldier’s mental health rates were similar to those of Marines.
In other words, a simple change in deployment policy would have a considerable impact on the mental health of our troops. By implication it would lower the rate of Post Traumatic Stress Disorder (PTSD) as well as lower the number of suicides.
The Pentagon’s press release does refer to this obliquely:
While the data has not shown a correlation between those factors and suicides, other studies, such as the Mental Health Assessment Team, have found that longer and more frequent deployments have increased the rates of post-traumatic stress disorder, anxiety and depression, she [Ritchie] said.
This is a curious statement given Ritchie’s other comment and the unreliability of ASER data. The Colonel essentially compared apples and oranges in her reply. The ASER reports make no mention of deployment issues. So quite obviously they would not show a correlation between deployment and suicide. But MHAT IV does. So until further studies are conducted it remains the definitive source.
You don’t get to be a colonel and a consultant to the Army surgeon general if you don’t understand such an obvious distinction, so the only conclusion one can draw is that Ritchie was deliberately obfuscating the issue. Clearly the administration, as General Lute all but acknowledged, has placed the American military in an extremely difficult position by trying to fight multiple wars without an adequate number of troops. To resolve this problem will either require a change in the deployment policy or, as General Lute pointed out, reinstating the draft.
The most troubling aspect of today’s sorry performance by Ritchie and others lies in the Pentagon’s continued refusal to recognize the seriousness of Post-Traumatic Stress Disorder and its impact on our troops and their families. The Pentagon’s press release does note the Army is hiring 250 more mental health professionals (what they mean by that term is not clear), but that will only deal with the tip of a very large iceberg. The time has come for the Pentagon, the Bush Administration and Congress to stop playing games about PTSD.
As I wrote in an article about one PTSD-related suicide:
Until we realize that the minds of some veterans will always remain on a battlefield which they never can leave, especially at night, especially as they dream, then some of us will get letters like the one I received.
The only way to stop those letters is for each one of us to also honor the code [of leave no one behind], for in it there is an implicit understanding that the country that has sent its citizens into war will come for all combat soldiers. We need to do a better job of bringing all of them home, especially those whose minds still are on the battlefield. Above all, we must never forget them.
I said then that even one PTSD-related suicide is one too many. I feel even more strongly about that now.
You can help: PTSD is a bipartisan issue all Americans can and should support. Volunteer to work with veterans who have PTSD. Contribute to any veteran’s organizations working with military service personnel suffering from PTSD. Make others aware of PTSD. Write your Senators and Representatives to better fund PTSD services.Print
Posted by: publius