Army Survey's Combat Veterans in War Zone

The Associated Press
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WASHINGTON (AP) - The Army's first-ever survey of mental health in a combat zone showed that soldiers in Iraq last year suffered from low morale, high stress and holes in the Army's support system.

In releasing survey's results Thursday, the Army also said its mental health specialists in Iraq were constrained in helping distressed soldiers because of shortages of anti-depressant and sleeping drugs, inadequate training in combat stress control and ill-defined standards of care.

Among the survey's findings:

Fifty-two percent of soldiers said their personal morale was low or very low, and 72 percent said their unit's morale was low or very low. The cohesiveness of units also was described as low. These are inexact measures of mental health, but senior Army officials told reporters that morale is one factor among many in the pattern of soldier suicides in Iraq.

"It was a pretty miserable set of circumstances'' facing soldiers there last summer, said Col. Virgil J. Patterson III, a social work officer who headed a 12-member team of psychologists and other mental health professionals who spent several weeks in Iraq and Kuwait last August through October.

Seventeen percent of soldiers were assessed to be suffering traumatic stress, depression or anxiety and were deemed to be "functionally impaired.'' Of that group, about three-quarters said they had received no help at any time in Iraq from a mental health professional, a doctor or a chaplain.

Twenty-three percent described themselves as feeling moderate to severe stress.

Only one-third of soldiers who wanted help actually got it.

At the time Patterson's team conducted its private interviews of 756 soldiers, living conditions in Iraq were harsh. Many soldiers had not yet been moved from tents to buildings with air conditioning; uncertainty about length of service in Iraq was widespread, and the anti-occupation insurgency that took hold in July was still killing one or two American soldiers a day.

Complicating matters was an inadequate system of mental health support, the Army report said.

More than half of mental health providers whose mission was "combat stress control'' told Patterson's team that they had inadequate supplies of anti-depressant and sleeping drugs. Half said they did not receive enough prewar training in combat stress, and more than half said they either did not know the Army's combat stress control doctrine or ``did not support it.''

The Army report, months in the making, praised the professionalism of its mental health specialists, who accepted risk in performing their duties. But it also said they lacked key resources.

"There was an unmet need for behavioral services,'' said the report.

>From April through December last year, 23 soldiers killed themselves in Iraq or Kuwait. The cause of death in three other suspected suicide cases is still under investigation. The 23 total equates to a rate of 17.3 suicides per 100,000 soldiers, which compares to an Army-wide rate last year of 12.8.

Of the 23 who killed themselves, all but two were males. Gunshot was the method of killing in all but one case, which was a result of drug overdose. The peak months were July, with five suicides, and November with four. So far this year, there has been only one confirmed suicide, according to Col. Bruce E. Crow, a member of the Iraq survey team and a specialist in suicide prevention.

At least seven other soldiers killed themselves last year after returning to the United States.

Dr. Paul Ragan, an associate professor of psychiatry at Vanderbilt University and a former Navy psychiatrist, said in a telephone interview Thursday that 23 suicides among the soldiers in Iraq is ``without question a highly statistically significant elevation of the number of suicides.''

"This is a milestone,'' he said.

The overall U.S. civilian suicide rate during 2001 was 10.7 per 100,000, according to the Centers for Disease Control and Prevention. The U.S. civilian rate for the 18-34 age group - the age range of most soldiers - is 21.5 per 100,000.

Patterson said his assessment team's visit to Iraq was the first time in the Army's history that such an effort was made in a combat zone. Thus, there is no comparative date from past wars on such issues as morale, stress and other mental health indicators.

On the Net:

The Army report at