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A silent killer stalks American soldiers in Iraq, sometimes even following them home from the battlefield, and the Bush Administration does not want you to know about it. That killer is suicide.
The issue first came to public attention several years ago in media reports that reported disturbingly high rates of suicide among American troops in Iraq. In 2003 and 2004 media outlets raging from CBS News to the Washington Post ran stories about our Iraq troops committing suicide. Type “Iraq War suicides” into a search engine to verify this spike. In a January 29, 2004 story titled “High Suicide Rate for Iraq War GIs,” CBS correspondent Bob McNamara reported:
The Pentagon counts at least 22 GI suicides in the Iraq conflict — 19 of those Army troops — most after major combat was declared over last May.
McNamara also noted:
An army study three years ago forecast an impending soldier-suicide crisis, but critics say it was largely ignored until more than 600 U.S. soldiers began being evacuated from Iraq for psychiatric reasons.
McNamara’s story featured the following exchange with Steve Robinson, a retired Army Ranger who is lobbying Congress to pressure the Pentagon to come clean with the true extent of the war’s psychiatric toll.
“This has the potential to be a bad news story,” he said.
“A bombshell?” asked McNamara.
“I think so,” Robinson replied.
On April 11, 2004, Lynda Hurst wrote in the Toronto Star, “Troops in Iraq on Suicide Watch.” Four months after McNamara’s story, her statistics showed:
Twenty-four Americans — 20 army personnel, two Marines and two sailors — are known to have taken their own lives in Iraq in the past year.
That means a suicide rate of 17.3 per 100,000, a figure far in excess of last year’s overall U.S. military rate of 12.8.
It doesn’t include the deaths of newly States-sided troops, which the Pentagon doesn’t count. There have been seven such suicides, including those of two soldiers who killed themselves while patients at Walter Reed Army Hospital.
Hurst quotes Seth Pollack, executive director of Veterans for Common Sense, who noted:
Uncertainty is the wild card…The military hasn’t created a coherent policy for troop rotation because it is responding to the unrealistic politics of the administration.
Several of these stories referred to research conducted by the Pentagon and others. In 2003, the alarming rise in suicides prompted the Pentagon to send a research team to Iraq to determine the whys of Iraq War suicides. The team concluded there was “no crisis” in Iraq; that the suicides could be explained by the victims’ personal circumstances — each had financial, domestic or legal problems.
In a breakfast meeting with Pentagon reporters, Dr. William Winkenwerder, the assistant secretary of defense for health affairs, stated:
We don’t see any trend there that tells us that there’s more we might be doing.
Winkenwerder also told the reporters that between 300 and 400 troops have been medically evacuated from Iraq for mental health problems.
The results of the survey, however, tell a grim tale. They report:
Of the 756 soldiers they interviewed, investigators reported that 72 per cent said their units suffered from low morale.
Nearly 75 percent said they had little faith in their immediate superiors; that officers “showed little concern for their well-being.”
Four years later, the situation had not improved. Last November Mental Health Advisory Team IV issued its report on Operation Iraqi Freedom. As one might expect, the report listed “the level of combat” as the “main determinate” of a Soldier (Soldier in caps is the report’s synonym for Army troops) or Marines’ “mental health status.” The other major finding was that “deployment length and family separation” were the major non-combat issues. Other findings include:
Multiple deployers reported higher acute stress than first time deployers. Deployment length was related to higher rates of mental health problems and marital problems.
2003-2006 OIF suicide rates are higher than the average Army rate, 16.1 vs 11.6 suicides per year per 100,000.
Forty percent (40%) of OIF Soldiers reported being uncertain about the re-deployment date compared to 35% of OIF 04-06 Soldiers.
Junior enlisted Soldiers who were multiple deployers reported lower individual morale (56% low or very low) compared to junior enlisted Soldiers who were on their first deployment (46% low or very low).
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.
This last finding may well be the smoking gun in the search for the silent killer. 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.
Curiously, the November report devoted an entire section to the suicide problem without touching on the deployment issue. It noted that in 2006 the military began requiring the Army Suicide Event Report (ASER) as “the reporting and tracking mechanism” for “completed suicides and non-lethal events.” However, 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. Yet even these data are eye-opening. According to the November report “there have been “72 confirmed Soldier suicides in Iraq.” The study notes these numbers are “higher than the U.S. Army’s 10-year average suicide rate” for three out of the four years from 2003-2006.
The question about the accuracy of the suicide data for Iraq War troops reverberates through questions about the War like a grim chorus. To show how different the data can be, the Iraq Coalition Casualty Count database–a widely-used and respected source–lists only eleven suicides, far less than the Pentagon’s own total. When you couple the Pentagon’s finding that Iraq War suicide data can be off by as much as 33% with the issue of suicide underreporting there is little doubt, the number of Iraq War suicide deaths is probably considerably higher. In a publication on suicide in America, the Centers for Disease Control observes:
It is generally agreed that not all deaths that are suicides are reported as such…Many studies suggest that the actual suicide rate is considerably higher than recorded. (Clark et al., 1992; Gibbs et al., 1988; O’Carroll, 1989).
Furthermore there is little incentive for military officials to report suicides. Because of the stigma attached to suicide officials may want to spare a family further grief and simply list the cause as unknown. Military officials also have little reason to count suicides since the higher the total, the more it reflects negatively on the mission. Finally, from a medical point of view, it is known suicides can cluster, as one suicide may trigger others. The Iraq data tend to show these clusters. On its national suicide web site the Centers for Disease Control addresses what it terms “suicide contagion:”
Direct and indirect exposure to suicidal behavior has been shown to precede an increase in suicidal behavior in persons at risk for suicide, especially in adolescents and young adults.
The recommendations of Mental Health Advisory Team IV concerning suicides seem to focus more on obtaining reliable data than on how to prevent them. In what may be the saddest comment yet on the Iraq War, four years after the Pentagon recognized that suicides were a problem it still cannot get accurate data. As for recommendations, the report probably avoids making them since its data shows that the Bush Administration’s shell game with Iraq deployments is the biggest non-combat-related cause of mental health problems among our Iraq troops.
Last month researchers at the University of California, San Francisco and the San Francisco VA Medical Center only added to the concerns about the mental health of our Iraq troops. The study concludes:
Nearly a third of veterans returning from Iraq and Afghanistan who received care from Veterans Affairs between 2001 and 2005 were diagnosed with mental health or psychosocial ills…More than half (56 percent) were diagnosed with two or more disorders.
Perhaps the most extensive data on the psychological health of our troops can be found–where else–at a blog, PTSD Combat. One of the most valuable features of the site is that in has links to all the major mental health research studies of our soldiers in Iraq. Run by Ilona Meagher, author of Moving a Nation to Care: Post-Traumatic Stress Disorder and America’s Returning Troops, the site is an invaluable resource for researchers and veterans alike.
In her book, Meagher places the blame squarely on Bush Administration officials:
In the end, Rumsfeld’s greatest failure was not one of strategy but of morality, as he neglected the most important responsibility given to a defense secretary, that of properly protecting and supplying the troops in his care.
Two studies cited by Meagher come from the prestigious New England Journal of Medicine and the Journal of the American Medical Association. Published in July 2004, the NEJM article “Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care” focused on Post Traumatic Stress Disorder (PTSD). Although the language is dry and academic, the findings still pack quite a wallop. The article reported:
The percentage of study subjects whose responses met the screening criteria for major depression, generalized anxiety, or PTSD was significantly higher after duty in Iraq (15.6 to 17.1 percent)than after duty in Afghanistan (11.2 percent) or before deployment to Iraq (9.3 percent); the largest difference was in the rate of PTSD.
Of those whose responses were positive for a mental disorder, only 23 to 40 percent sought mental health care.
Those whose responses were positive for a mental disorder were twice as likely as those whose responses were negative to report concern about possible stigmatization and other barriers to seeking mental health care.
Written two years later, the JAMA article, Mental Health Problems, “Use of Mental Health Services, and Attrition From Military Service After Returning From Deployment to Iraq or Afghanistan,” found similar results:
The prevalence of reporting a mental health problem was 19.1% among service members returning from Iraq compared with 11.3% after returning from Afghanistan and 8.5% after returning from other locations.
Thirty-five percent of Iraq war veterans accessed mental health services in the year after returning home.
Although neither study dealt with suicide among Iraq troops and veterans, the psychological data in both articles indicates the degree of stress suffered by those who serve in Iraq. The figures for PTSD in Iraq veterans compares with the 18.7% for Vietnam veterans reported in a recent study.
According to the Iraqi Coalition Casualty Count database, the most recent suicide in Iraq occurred on April 24. The database lists the cause of death for Specialist Jeremy E. Maresh as “Non-hostile – suicide.” The 24-year-old Maresh left a sixteen-month-old son. A 2001 graduate of Jim Thorpe High School, Maresh was a wrestler and member of the football team, but was most proud of his weightlifting accomplishments. He joined the Guard shortly after his graduation, in the heady days when Iraq was not even on the radar screen as a war zone.
After the Pat Tillman case, one must be extremely careful with such a story, especially since Maresh did military police work. A story on the NEWZPLUS.COM website stated:
“He died from an apparent suicide,” Lt. Col. Chris Cleaver, a spokesman for the Pennsylvania National Guard, said Thursday.
Cleaver went on to say the Army is investigating the cause of death. They would not release any further details. Several other sources mention the death as a “possible suicide.” Charles McHugh, director of the Carbon County Office of Veterans Affairs had tears in his eyes when he told a reporter:
No matter the circumstances of the death, Maresh will get a full military funeral with honors.
There is something about suicide in war that sends the head spinning. All the whys that accompany any death multiply in the case of a suicide, reverberating in the dark emptiness. While we may never know the whys of individual Iraq War cases, the high number of suicides in Iraq accompanied by the psychological data collected by the Pentagon and others suggests some possible answers.
In their cowardly attempt to avoid making Iraq a “real” war with a draft in which everyone bears the burden equally, the chickenhawks in the Bush Administration have instituted what is unquestionably the most draconian, unethical and immoral deployment policy in our nation’s history. Units are sent to Iraq and their time there determined by some inexplicable game of Russian roulette where a skeletal hand spins the cylinder. As the Pentagon’s own data points out, that many of the victims of this are not the regular soldiers of the Marines but National Guard troops, whose mission never focused on fighting wars on foreign soil, only compounds the immorality of the policy.
The current National Guard recruiting website states in bold letters “In my state, in my community, I serve my country.” It only obliquely refers to Iraq with its slogan “Heroes on Call” which features a female soldier next to ads for the Guard’s NASCAR racer and what has always been the Guard’s major recruiting ploy–paying for college.
A page on the Guard’s mission states:
Most likely, your assignments will be somewhere within your home state, because the Guard’s main focus is assisting in civil disturbances and natural disasters like blizzards, wildfires and hurricanes. Your tasks will include getting people to safety, delivering supplies, restoring order and other jobs as directed.
That is what Jeremy Maresh and thousands of others signed on for, but instead they wound up in Iraq where they served the whims of a president who at the stroke of a pen can change their deployment terms. For Maresh that pen signed his death warrant.
One is reminded of Catch-22, with its bomber crews caught in another absurd deployment policy. This one required them to fly missions over and over again, long past the point where they should have been grounded or sent home. What few Americans remember is that the architects of this policy were Robert McNamara and Curtis LeMay, who were distressed by the number of aborted missions. Rather than craft a humane and rational solution, the by-the-numbers McNamara and the off-the-deep-end LeMay (he of bombing Vietnam back to the “Stone Age”) responded by making the crews fly over and over.
The line marking this arrogance about the lives of soldiers runs straight through Catch-22 to Vietnam and Iraq. Now a White House full of policy makers who never served in Vietnam or saw combat calls the shots. This war has already become the War of Too Many Questions. The biggest question of all may be why the administration is allowed to follow a deployment policy so insane it forces soldiers to take their own lives? Surely this is the worst sort of madness.
There is plenty of blame to go around. The Bush Administration is the obvious target, but we forget the Democrats have acquiesced in the deployment policy just as they have acquiesced in so much else about this war. That the Iraq War funding bill passed without any reference to Bush’s despicable deployment policy is in itself inexcusable.
Paul Shollenberger, readiness officer for the Lehighton Armory where Maresh’s unit is headquartered, stated:
That’s the biggest shame, there’s a kid who won’t know his father.
It did not have to be that way. It does not have to be that way any more.
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