Army Spec. Jeffrey Henthorn, 25, of Choctaw, Okla., was sent back to Iraq for a second tour even though his superiors knew he had twice threatened suicide. When he killed himself in 2005, an Army report says, the work of his rifle was so thorough that fragments of his skull pierced the barracks ceiling.
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Army Pfc. David Potter, 22, of Johnson City, Tenn., was diagnosed with anxiety and depression while serving in Iraq in 2004. Records show Potter remained on active duty in Baghdad despite a suicide attempt and a psychiatrist’s recommendation that he be separated from the Army. Ten days after the recommendation was signed, he slid a gun out from under another soldier’s bed and shot himself through the mouth.
These deaths are among the most extreme failures by the U.S. military to properly screen, treat and evacuate mentally unfit troops, a Hartford Courant investigation has found.
Pressed by troop shortages, the military has increasingly sent, kept and recycled troubled service members into combat–practices that undercut past assurances that it would improve mental health care. Besides suicides, experts say gaps in such care can fuel violence between soldiers, accidents and critical mistakes in judgment during combat.
Among the newspaper’s findings:
– Despite a congressional order that the military assess the mental health of all deploying troops, fewer than 1 in 300 service members see a mental health professional before shipping out.
– Once at war, some unstable troops are kept on potent anti-depressants and anti-anxiety drugs with little or no counseling or medical monitoring, in violation of the military’s regulations.
– And some troops who developed post-traumatic stress disorder, or PTSD, after serving in Iraq are being sent back to the war zone, increasing the risk to their mental health.
Those practices helped fuel an increase in the suicide rate among troops serving in Iraq, which reached an all-time high in 2005 when 22 soldiers killed themselves–accounting for nearly 1 in 5 of all non-combat Army deaths.
The spike in suicides is a setback for military officials, who had pledged to Congress in late 2003 to improve mental health services after a spate of suicides in Iraq during the first seven months of the war. When the suicide rate improved in 2004, top Army officials had credited their renewed prevention efforts.
The Courant investigation found that at least 11 service members who committed suicide in Iraq in 2004 and 2005 were kept on duty despite exhibiting signs of significant psychological distress.
The newspaper obtained records under the federal Freedom of Information Act, including never-before-released pre-deployment screening data for thousands of troops and investigative reports into dozens of service members’ deaths. It interviewed more than 100 mental health experts, service members, family members and friends. While the military does not publicly identify suicide cases, The Courant was able to identify–in most cases for the first time–the service members who killed themselves in Iraq.
Troop shortage a factor
The Army’s top mental health expert, Col. Elspeth Ritchie, acknowledged that some deployment practices, such as sending service members diagnosed with PTSD back into combat, have been driven in part by a troop shortage.
“The challenge for us … is that the Army has a mission to fight. And, as you know, recruiting has been a challenge,” she said. “And so we have to weigh the needs of the Army, the needs of the mission, with the soldiers’ personal needs.”
But troubled troops often get lost in that balance.
Under the military’s pre-deployment screening process, troops with serious mental disorders are not being identified–and others whose mental illnesses are known are being deployed anyway.
A law passed in 1997 requires the military to conduct an “assessment of mental health” on all deploying service members. But the only “assessment” is a single, self-reported mental health question on a pre-deployment form filled out by service members.
Even using that limited tool, troops who self-report psychological problems rarely are referred for evaluations by mental health professionals, Defense Department records show. From March 2003 to October 2005, only 6.5 percent of deploying service members who indicated a mental health problem were referred for evaluations; overall, fewer than 1 in 300, or 0.3 percent, of deploying troops were referred for such screenings.
That rate is dramatically lower than the more than 9 percent of deploying troops that the Army acknowledges in studies have serious psychiatric disorders.
Military investigative reports and interviews with family members also show that some service members who committed suicide in 2004 and 2005 were kept on duty despite clear signs of mental distress, sometimes after being prescribed anti-depressants with little or no mental health counseling or monitoring. Those findings conflict with regulations adopted last year by the Army that caution against the use of anti-depressants for “extended deployments.”
The use of psychiatric drugs has alarmed some medical experts and ethicists, who say the medications cannot be properly monitored in a war zone.
`Time bombs’
“I can’t imagine something more irresponsible than putting a soldier suffering from stress on anti-depressants, when you know these drugs can cause people to become suicidal and homicidal,” said Vera Sharav, president of the Alliance for Human Research Protection. “You’re creating chemically activated time bombs.”
Although Defense Department standards for enlistment in the armed forces disqualify recruits who suffer post-traumatic stress disorder that lasts longer than one month, the military is redeploying service members to Iraq who fit that criterion.
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Eight months ago, Staff Sgt. Bryce Syverson of Richmond, Va., was so unsteady that doctors at Walter Reed Army Medical Center wouldn’t let him wear socks or a belt.
Syverson, 27, had landed in the psychiatric unit after a breakdown that doctors traced to his 15-month tour in Iraq as a tank gunner. He was diagnosed with PTSD and depression, and was put on a suicide watch and anti-depressants.
Today, Syverson is back in the combat zone, part of a quick-reaction force in Kuwait that could be summoned to Iraq at any time.
But he hasn’t quite managed to get his bearings.
“Nearly died out here on a nice and really mild night because of the medication that I am taking,” he wrote in a recent e-mail to his parents and brothers. “Head about to explode from the blood swelling inside, the lightning storm that happened in my head, the blurred vision, confusion, dizziness and a whole lot more.”
“I’m concerned that people who are symptomatic are being sent back. That has not happened before in our country,” said Dr. Arthur Blank, a psychiatrist who helped get PTSD recognized as a diagnosis after the Vietnam War.
Mental health specialists who have served in Iraq acknowledge that their main goal is to preserve the fighting force. Some have grappled with making tough calls about how much more stress a soldier can handle.
“You have to become comfortable with things we wouldn’t normally be comfortable with,” said Bob Johnson, a psychologist in Atlanta who counseled soldiers last year for the Army. “If there were an endless supply of soldiers, the compassionate side of you just wants to get these people out of here. They’re miserable. You can see it in their faces. But I had to kind of put that aside.”