WASHINGTON — Eight years of war in Afghanistan and Iraq have etched indelible scars on the psyches of many of the nation's servicemen and women, and the U.S. military is losing a battle to stem an epidemic of suicides in its ranks.
Despite calls by top Pentagon officials for a sea change in attitudes about mental health, millions of dollars in new suicide prevention programming and thousands of hours spent helping soldiers suffering from what often are euphemistically dubbed "invisible wounds," the military is losing ground.
The Department of Defense Friday reported that there were 160 reported active-duty Army suicides in 2009, up from 140 in 2008. Of these, 114 have been confirmed, while the manner of death in the remaining 46 remains to be determined.
"There's no question that 2009 was a painful year for the Army when it came to suicides," said Col. Christopher Philbrick, the deputy director of the Army Suicide Prevention Task Force, in a statement, despite what he called "wide-ranging measures last year to confront the problem."
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While the military's suicide rate is comparable to civilian rates, the increase last year is alarming because the armed services traditionally had lower suicide rates than the general population did.
"I look at the numbers of each service, and that rate has gone up at the same rate across the services," Adm. Mike Mullen, the chairman of the Joint Chiefs of Staff, told a gathering of military mental health professionals and advocates this week. "This isn't just a ground force problem."
Some of the suicides are young men, fresh from deployments and haunted by memories, who shoot themselves after they return from their second or third tours in Iraq or Afghanistan, or when romantic relationships turn sour, sometimes due to long separations or post-traumatic stress.
Others are career officers who quietly nurse addictions to drugs or alcohol and finally decide to silence their ghosts.
An increasing number are female soldiers, who rarely committed suicide before but now are killing themselves at a much higher rate.
"There does not appear to be any scientific correlation between the number of deployments and those that are at risk, but I'm just hard pressed to believe that's not the case," Mullen said.
The emotional wounds are so deep and the suicide rates are so high that top Pentagon officials broke a generations-long code of silence on the topic and have started speaking publicly and vehemently about the effects of mental illness.
At Fort Benning, Ga., which defense experts say ranks among the top installations for effective mental health screening, retired Brigade Command Sgt. Maj. Samuel Rhodes' speech to troops about how he considered suicide after serving for 30 months in Iraq encouraged other soldiers to come forward.
The military's shift in attitudes about mental health was evident during this week's joint Departments of Defense and Veterans Affairs suicide prevention conference, where uniformed attendees spoke openly about the stigma of seeking mental health care, the need for policy changes that will make help easier to get and the importance of supporting the families of troops suffering from mental illness.
"It's a joint DOD and VA conference, that alone says an awful lot about where we used to be and where we are now," Mullen said.
With one of the highest suicide rates in the Army, Fort Campbell, a sprawling installation on the Kentucky-Tennessee border that's home to the elite 101st Airborne Division, illustrates the severity of the problem.
"Our issues here at Fort Campbell identically mirror the issues mirroring the Army as a whole. The demographics are almost exactly: white males 18-29 who commit suicide (using handguns)," said Joe Varney, the Fort Campbell suicide prevention program manager.
In 2007, Fort Campbell created a suicide task force after nine soldiers committed suicide, three during the first few weeks of October, and 101st Airborne's commander, Maj. Gen. Jeffrey Schloesser, reached out to soldiers and their families.
"As our soldiers fight terrorism, the sacrifices asked of them and their families have increased significantly," Schloesser said in a letter to troops. "Regrettably, under such circumstances, it is natural for our people to feel the stress of these demands and to be overwhelmed at times. Tragically, these pressures too often end in suicide."
The following year, Fort Campbell's suicide rate jumped to 12.
The base hired a suicide prevention program manager and dispatched staffers to study trends, increased awareness training for troops and boosted the number of mental health professionals available to soldiers while in combat and after they return. Army officials say those efforts could prove useful service-wide.
Last year, Fort Campbell held a three-day "suicide stand-down," and top officials pleaded with soldiers to get mental help if they needed it and assured them that seeking such help wasn't a sign of weakness and wouldn't affect their careers.
The number of suicides increased to 14 in 2009.
"It's been discouraging to say the least," Varney said.
Stemming the rise in suicides will take more than conferences, task forces, training and studies, said Col. Elspeth Ritchie, the director of behavioral health for the Office of the Army Surgeon General. The military also will have to grapple with the easy availability of handguns, a topic that's sure to be unpopular, she said.
"It's amazing to me when you see Fort Campbell, which is at the top of suicide lists. They have a beautiful gun shop in the middle of the (Post Exchange)," Ritchie said. "I'm troubled by what I see as a mixed message."
Some soldiers who receive counseling are still committing suicide, and many think — with good reason, given previous military policies and attitudes about mental health — that seeking treatment could ruin careers, she said.
"We cannot change stigma until we change policies that contribute to stigma," Ritchie said. "In many ways we talk out of both sides of our mouths."
The Obama administration, at the behest of a small bipartisan congressional group, is reviewing a long-standing unofficial policy that bars the president from sending condolence letters to the families of servicemen and women who commit suicide.
Family members of soldiers who've committed suicide said that changing the policy would go a long way toward removing the stigma because the military already provides a full military burial for soldiers who commit suicide.
"That policy reflects the heartlessness to those who served. They've been inflicted with hidden wounds, but it doesn't mean they're any less lethal," said Kevin Lucey, of Belchertown, Mass., whose son Jeffrey, a 23-year-old Marine, hanged himself less than a year after he returned from Iraq. The government settled with the family for $350,000.
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