Risk of PTSD Rises Sharply for Longer and Repeat Iraq War Deployments

Air Force Times

A recently released survey of soldiers and Marines puts concrete numbers behind problems experts have worried about since the wars in Iraq and Afghanistan began.

Suicides are up among combat vets, mental health issues are worse among those who deploy often and for longer periods, and one out of 10 service members surveyed said they have hit or kicked non-combatant Iraqis or destroyed their property.

Only half said they would report another service member for hurting or killing an Iraqi civilian.

The survey also comes with a recommendation from mental health workers that seems to fly in the face of the recently extended deployment lengths and troop surge: “Extend the interval between deployments to 18 to 36 months or decrease deployment length to allow time for soldiers [and] Marines to mentally re-set.”

The findings come from an April 18 briefing prepared for Marine Commandant Gen. James Conway by Mental Health Advisory Team IV, operating under the auspices of Multi-National Force-Iraq, a copy of which was obtained by Military Times. MHAT IV used anonymous surveys and focus groups to analyze morale, health and well-being, and the ethical issues of deployed U.S. troops.

Soldiers and Marines who have faced the most combat situations, deployed for longer periods of time, and deployed more than once face more mental health issues, according to a survey of 1,320 soldiers and 447 Marines. Of those on a second, third or fourth deployment, 27 percent screened positive for mental health issues, compared to 17 percent of first-time deployers. And 22 percent of those in-theater for six months or more screened positive for mental health issues, compared to 15 percent of those who had been there fewer than six months.

The level of combat, the PowerPoint presentation states, is the “main determinant of mental health status.” More than three-quarters of the service members surveyed said they had been in situations where they could have been injured or killed, and two-thirds said they know someone who has been seriously injured or killed.

Army combat vets also have higher suicide rates — 16.1 per 100,000 compared to 11.1 per 100,000 for nondeployed soldiers. And, according to newly released data, the Army’s suicide program is not built ideally to help deployed soldiers.

Many soldiers and Marines are heading for their third or fourth trips to Iraq. The survey found that people who have deployed the most often are most likely to hurt noncombatants. Only 25 percent said they would risk their own lives to help an Iraqi civilian in danger.

Marines had fewer complaints about deployment length and family separation, which soldiers named as their top noncombat issues. Marines fared better in rates of mental health issues, except when matched for numbers and lengths of deployment. Marines generally have shorter tours than soldiers do.

The survey found morale among soldiers remained about the same as in a study from 2004 to 2006, though complaints of marital problems for soldiers have gone up.

As these problems seem to worsen, the presentation also states that behavioral health care workers need more combat stress training before deploying to Iraq, and that there is “no standardized in-theater joint reporting system” to monitor mental health or suicide in Iraq or Afghanistan. Behavioral health providers require additional Combat and Operational Stress Control (COSC) training prior to deploying to Iraq; very few attended the course.

There is some good news: Service members who rated their sergeants highly were less likely to have mental health issues.

Among MHAT IV’s recommendations:

-All soldiers and Marines should receive Battlemind Training before they deploy — a recommendation that has already been put in place.

-Develop ethics training specifically tailored to the mission in Iraq so troops understand what not to do and what they must report.

-Use scenario-based training and the buddy-aid system in a suicide prevention program.

-Require counselors and chaplains to attend combat stress control training.

-Make sure soldiers and Marines who work outside base camps get adequate R&R.

-Treat mental health commanders’ briefings the same way as wounded soldier briefings.

-Develop standardized procedures for conducting in-theater Battlemind Psychological Debriefings to replace Critical Event Debriefings.

-Focus on units that have been in theater for longer than six months.

-Include mental health training in all junior development courses.

Many of the recommendations are in progress, but not the ones that seem most key: shorter deployments and longer recovery times.

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