View Full Version : Long tours in Iraq may be minefield for mental health

05-05-07, 07:47 AM
Long tours in Iraq may be minefield for mental health
The Pentagon finds that misconduct increases when stress does. Last month the Army extended duty by 90 days.
By Julian E. Barnes, Times Staff Writer
May 5, 2007

WASHINGTON — Fewer than half of U.S. soldiers and Marines serving in Iraq would report a fellow service member for mistreating an Iraqi civilian, and about 10% of those surveyed admitted they had abused noncombatants or damaged their property, according to a Pentagon report released Friday that examined battlefield ethics.

The report said that misconduct occurred more frequently as stress levels increased, and that longer wartime deployments could erode morale and negatively affect mental health.

Soldiers who screened positive for mental health problems, for example, were twice as likely to hit or kick a noncombatant as those who screened negative.

The Pentagon report was based on a mental health survey of 1,320 soldiers and 447 Marines in Iraq.

The report found that soldiers — whose tours were about twice as long as Marines' — had lower morale, more marital problems and higher rates of mental health disorders.

The military decided last month to extend Army tours by 90 days.

The report also found that soldiers on repeat tours were more likely to suffer acute stress, and that mental health problems correlated with higher rates of battlefield misconduct.

"The team found that soldiers with high levels of anger, who experienced high levels of combat, or who screened positive for a mental health symptom were nearly twice as likely to mistreat noncombatants as those who reported low levels of anger," said Maj. Gen. Gale Pollock, the acting Army surgeon general.

The Army in particular has struggled with deployment lengths throughout the Iraq war, ordering extensions and speeding deployments to sustain troop levels. The 90-day extension that Defense Secretary Robert M. Gates ordered last month, for active-duty Army units in Iraq and Afghanistan, stretches the typical tour to 15 months. The extension will allow the current buildup to continue without forcing returning units to forgo rest and retraining periods.

Experts said the report raised concern about the possibility of more incidents like the November 2005 massacre of civilians at Haditha or the mistreatment of detainees at Abu Ghraib as tours lengthened.

"What it says to me is we should get out of Iraq before a real disaster happens for us," said Cindy Williams, a security-studies researcher at the Massachusetts Institute of Technology who is an expert on military personnel policies. "Iraq is already in chaos, but for us to stay there and continue to wreck our Army over this is a big mistake."

The Pentagon mental health survey, the fourth since the war started, is the first to include questions about battlefield ethics and the treatment of Iraqi civilians. Current military strategy emphasizes a need to make the Iraqi populace feel safe.

Fewer than half of the service members questioned agreed with the statement "All noncombatants should be treated with dignity and respect."

Forty-four percent of Marines and 41% of soldiers said torture should be allowed if it would save the life of a fellow service member. Army Field Manual rules prohibit physical contact during questioning.

At a news conference to discuss the report, Pollock urged that the responses about the use of torture be viewed in the context of the war.

"These men and women have been seeing their friends injured, and I think that having that thought is normal," Pollock said. "But what it speaks to is the leadership that the military is providing, because they're not acting on those thoughts. They're not torturing the people."

Williams said she worried that incidents of abusing Iraqis might become more frequent if the tours of duty were not shortened, because soldiers were being "stretched to the snapping point."

"What these numbers are telling us is that the longer a person stays, the more likely he or she is to exhibit signs of mental stress," Williams said. "The more an individual is under acute stress, the more likely an individual is to carry out acts that will shame the country."

Pollock acknowledged that the longer tours would increase stress. But in the wake of the report, she said, the military is doing more to train leaders to support troops and reduce stress. She suggested the real solution was a larger Army.

"The Army is spread very thin," she said, "and we need it to be a larger force for the number of missions that we were being asked to address for our nation."

The report recommends that after a deployment, soldiers be given 18 to 36 months at their home station before being sent abroad again. The demand for soldiers in Iraq, however, has meant that few combat units are allowed to remain home for more than a year. Pollock acknowledged that for now the Army could not give soldiers that much time at home.

"Ideally, the war would be over; wars around the world would stop," Pollock said. "But we serve as an instrument of the nation, and when the nation calls, we will serve."

The report also contained data about suicides. Whereas the average suicide rate for the Army as a whole is 11.6 per year for every 100,000 soldiers — lower than that for male civilians in a comparable age group — the rate is 16.1 per 100,000 for soldiers serving in Iraq. Military officials said the report found that the suicide prevention efforts being carried out in Iraq were not designed for a war zone.

The report drew distinctions between soldiers and Marines who spent most of their time working on a base, and those who spent the bulk of their time on combat patrols. The report found that 28% of those involved in high levels of combat experienced acute stress, compared with 6% involved in low levels of combat.

Previous surveys had shown little difference in stress between soldiers who had served multiple tours and those on their first deployment. But the new report showed that 27% of soldiers who had been on multiple tours experienced mental health problems, compared with 17% who were serving in Iraq for the first time.

Michael J. O'Rourke, assistant director of healthcare policy for the Veterans of Foreign Wars, said the military should move to shorter tours, even if that increased the frequency of tours.

"The tip of the spear is very sharp, and the more you use it the duller it gets," he said. "Repetitive, constant vigilance has a psychological impact. Many individuals come back with physical scars, and many come back with psychological scars."

The survey was conducted Aug. 28 to Oct. 3. The report was completed in November 2006, months before the decision to extend Army tours.

A Pentagon spokesman attributed the delay in the study's release to the time it took to brief senior leaders on results. The previous version of the report took longer to release.

The full report can be found at www.medicine.army.mil/new...at-iv.cfm. >


05-05-07, 07:59 AM
Troops at Odds With Ethics Standards
Army Also Finds More Deployment Means More Mental Illness

By Thomas E. Ricks and Ann Scott Tyson
Washington Post Staff Writers
Saturday, May 5, 2007; A01

More than one-third of U.S. soldiers in Iraq surveyed by the Army said they believe torture should be allowed if it helps gather important information about insurgents, the Pentagon disclosed yesterday. Four in 10 said they approve of such illegal abuse if it would save the life of a fellow soldier.

In addition, about two-thirds of Marines and half the Army troops surveyed said they would not report a team member for mistreating a civilian or for destroying civilian property unnecessarily. "Less than half of Soldiers and Marines believed that non-combatants should be treated with dignity and respect," the Army report stated.

About 10 percent of the 1,767 troops in the official survey -- conducted in Iraq last fall -- reported that they had mistreated civilians in Iraq, such as kicking them or needlessly damaging their possessions.

Army researchers "looked under every rock, and what they found was not always easy to look at," said S. Ward Casscells, the assistant secretary of defense for health affairs. The report noted that the troops' statements are at odds with the "soldier's rules" promulgated by the Army, which forbid the torture of enemy prisoners and state that civilians must be treated humanely.

Maj. Gen. Gale S. Pollock, the acting Army surgeon general, cast the report as positive news. "What it speaks to is the leadership that the military is providing, because they're not acting on those thoughts," she said. "They're not torturing the people."

But human rights activists said the report lends support to their view that the abuse of Iraqi civilians by U.S. military personnel was not isolated to some bad apples at Abu Ghraib and a few other detention facilities but instead is more widespread. "These are distressing results," said Steven R. Shapiro, national legal director for the American Civil Liberties Union. "They highlight a failure to adequately train and supervise our soldiers."

The study also found that the more often soldiers are deployed, the longer they are deployed each time; and the less time they spend at home, the more likely they are to suffer mental health problems such as combat trauma, anxiety and depression. That result is particularly notable given that the Pentagon has sent soldiers and Marines to Iraq multiple times and recently extended the tours of thousands of soldiers to 15 months from 12 months.

"The Army is spread very thin, and we need it to be a larger force for the number of missions that we were being asked to address for our nation," Pollock said.

The authors of the Army document argued that the strains placed on troops in Iraq are in some ways more severe than those borne by the combat forces of World War II. "A considerable number of Soldiers and Marines are conducting combat operations everyday of the week, 10-12 hours per day seven days a week for months on end," wrote Col. Carl Castro and Maj. Dennis McGurk, both psychologists. "At no time in our military history have Soldiers or Marines been required to serve on the front line in any war for a period of 6-7 months."

And although U.S. casualties in Iraq are far lower than in the Vietnam War, for example, military experts say that Iraq can be a more stressful environment. In Vietnam, there were rear areas that were considered safe, but in Iraq there are no truly secure areas outside big bases. "The front in Iraq is any place not on a base camp" or a forward operating base, the report noted.

The authors recommended that soldiers be given breathers during combat tours and intervals of 18 to 36 months between such tours, substantially longer than they are allowed now.

Overall, 20 percent of the soldiers surveyed and 15 percent of the Marines appeared to suffer from depression, anxiety or stress, the Army reported. That was in keeping with findings of past surveys, as was the conclusion that more than 40 percent of soldiers reported low morale in their units.

Strains on military families also are intensifying. About 20 percent of soldiers said they were planning a divorce or separation, up from 15 percent in the previous year's survey. Marital problems seem to grow with the length of a deployment, the survey found. Ten percent of soldiers deployed for less than six months reported that infidelity was a problem in their marriage, compared with 17 percent among those who had been in Iraq longer than that.

"The story I heard from my wife and daughter a lot is, 'You're not the same person that left to go over there,' " said retired Sgt. Coby Thomas, who developed post-traumatic stress disorder after serving in Iraq. "People expect you to be like you were and pick up where you left off, and they're not prepared for the changes."

Thomas, who suffered a traumatic brain injury while protecting a convoy south of Baghdad in December 2004, agreed that the stress on soldiers is increasing with multiple tours of duty. "You're talking about fourth deployments; it's the same people going over again and again," he said.

Retired Air Force Tech. Sgt. Scott Shore said multiple deployments over a 19-year military career left him with severe post-traumatic stress disorder. His last deployment was in 2004 in Iraq's Sunni insurgent stronghold, Anbar province, where he provided medical care and saw combat.

"That seemed to be the straw that broke the camel's back," Shore said in a telephone interview from Browns Mills, N.J. Shore said he has suffered flashbacks and nightmares that contributed to the breakup of his first marriage. "I don't go into crowds, I don't like driving, I don't like doing a lot of different things because I'm always on the lookout for the next ambush, the next IED," he said.

The Army has surveyed mental health issues in Iraq three times before, but this was the first time that Marines were included and that ethical questions were posed. Those were added by order of Army Gen. George W. Casey Jr., who until February was the top commander in Iraq. The surveyors did not say why Casey, who is now chief of staff of the Army, made the changes, but they came following revelations about Marines killing 24 civilians in November 2005 in Haditha, Iraq, and about their commanders not seeing reason to investigate.

Military officials sought to boost troops' awareness of ethical issues, first after the Abu Ghraib prisoner-abuse scandal broke in the spring of 2004 and again after news of the Haditha killings emerged.

Asked for his reaction to the data indicating that the majority of Marines would not report wrongdoing, Rear Adm. Richard R. Jeffries, the Marine Corps' chief medical officer, answered gingerly. "I know the Marine Corps is concerned that this may be of some significance," he said, "and they're looking very closely at this with several groups and several teams that have now taken in consideration to see what this means and what we may do differently if there is a problem here."

Pollock said that, in response to the report, completed last November, the Army has altered training to place more emphasis on "Army values, suicide prevention, battlefield ethics and behavioral health awareness."