As the Army Approaches a Breaking Point
By Maggie Mahar
Health Beat

February 25, 2008

Since 9/11, one Army division has spent more time in Iraq than any other group of soldiers: the 10th Mountain Division, based at Fort Drum, New York.

Over the past 6 years and and six months, their 2nd Brigade Combat Team (BCT) has been the most deployed brigade in the army. As of this month, the brigade had completed its fourth tour of Iraq. All in all, the soldiers of BCT have spent 40 months in Iraq.

At what cost? According to a February 13 report issued by the Veterans for America's (VFA) Wounded Warrior Outreach Program, which is dedicated to strengthening the military mental health system, it is not just their bodies that have been maimed and, in some cases, destroyed. Many of these soldiers are suffering from severe mental health problems that have led to suicide attempts as well as spousal abuse and alcoholism.

Meanwhile, the soldiers of the 2nd BCT have been given too little time off in between deployments: In one case they had only six months to mentally "re-set"; following an eight-month tour in Afghanistan - before beginning a 12-month tour in Iraq.

Then, in April 2007, Secretary of Defense Robert Gates decided to extend Army tours in Iraq from 12 to 15 months - shortly after the BCT had passed what it assumed was its halfway mark in Iraq.

As the VFA report points out, "Mental health experts have explained that 'shifting the goalposts' on a soldier's deployment period greatly contributes to an increase in mental health problems."

Perhaps it should not come as a surprise that, during its most recent deployment, the 2nd BCT suffered heavy casualties. "Fifty-two members of the 2nd BCT were killed in action (KIA)," the VFA reports and "270 others were listed as non-fatality casualties, while two members of the unit remain missing in action (MIA)."

This level of losses is unusual. "On their most recent deployment," the VFA report notes, "members of the 2nd BCT were more than five times as likely to be killed as others who have been deployed to OEF and OIF and more than four times likely to be wounded." One can only wonder to what degree depression and other mental health problems made them more vulnerable to attack.

When they finally returned to Fort Drum, these soldiers faced winter conditions that the report describes as "dreary, with snow piled high and spring still months away. More than a dozen soldiers reported low morale, frequent DUI arrests, and rising AWOL, spousal abuse, and rates of attempted suicide. Soldiers also reported that given the financial realities of the Army, some of their fellow soldiers had to resort to taking second jobs such as delivering pizzas to supplement their family income."

What has the army done to help the soldiers at Fort Drum? Too little.

In recent months, VFA reports, it has been contacted by a number of soldiers based at Fort Drum who are concerned about their own mental health and the health of other members of their units. In response, VFA launched an investigation of conditions at Fort Drum, and what it found was shocking.

Soldiers told the VFA that "the leader of the mental health treatment clinic at Fort Drum asked soldiers not to discuss their mental health problems with people outside the base. Attempts to keep matters 'in house' foster an atmosphere of secrecy and shame," the report observed "that is not conducive to proper treatment for combat-related mental health injuries."

The investigators also discovered that "some military mental health providers have argued that a number of soldiers fake mental health injuries to increase the likelihood that they will be deemed unfit for combat and/or for further military service."

The report notes that a "conversation with a leading expert in treating combat psychological wounds" confirmed "that some military commanders at Fort Drum doubt the validity of mental health wounds in some soldiers, thereby undermining treatment prescribed by civilian psychiatrists" at the nearby Samaritan Medical Center in Watertown, NY.

"In the estimation of this expert, military commanders have undue influence in the treatment of soldiers with psychological wounds," the report noted. "Another point of general concern for VFA is that Samaritan also has a strong financial incentive to maintain business ties with Fort Drum - a dynamic [that] deserves greater scrutiny."

Because some soldiers do not trust Samaritan, the report reveals that a number of "soldiers have sought treatment after normal base business hours at a hospital in Syracuse, more than an hour's drive from Watertown ... because they feared that Samaritan would side with base leadership, which had, in some cases, cast doubt on the legitimacy of combat-related mental health wounds.

"In one case," the report continued, "after a suicidal soldier was taken to a Syracuse hospital, he was treated there for a week, indicating that his mental health concerns were legitimate. Unfortunately, mental health officials at Fort Drum had stated that they did not believe this soldier's problems were bona fide."

According to the VFA, the problem of military doctors refusing to back soldiers with mental health problems is widespread: "VFA's work across the country has confirmed that soldiers often need their doctors to be stronger advocates for improved treatment by their commanders and comrades. For instance, soldiers need doctors who are willing to push back against commanders who doubt the legitimacy of combat-related mental health injuries."

While talking to soldiers at Fort Drum, VFA also discovered "considerable stigma against mental health treatment within the military and pressure within some units to deny mental health problems as a result of combat.

Some soldiers who had been in the military for more than a decade stated that they lied on mental health questionnaires for fear that if they disclosed problems, it would reduce their likelihood of being promoted."

Soldiers at Fort Drum are not alone. In an earlier report titled "Trends in Treatment of America's Wounded Warriors" VFA disclosed that leaders of the military mental health treatment system have been warning Department of Defense leadership of the magnitude of the mental health crisis that is brewing.

A report by the Army's Mental Health Advisory Team (MHAT) that was released last May found that the percentage of soldiers suffering "severe stress, emotional, alcohol or family problem[s]" had risen more than 85 percent since the beginning of Operation Iraqi Freedom. MHAT also found that 28 percent of soldiers who had experienced high-intensity combat were screening positive for acute stress (i.e., Post-Traumatic Stress Disorder, PTSD).

Finally, MHAT disclosed that soldiers who had been deployed more than once were 60 percent more likely to screen positive for acute stress (i.e., PTSD) when compared to soldiers on their first deployment.

VFA's most recent report notes points out that, despite these warnings, soldiers at Fort Drum do not have access to the care they need: "More than six years after large-scale military operations began in Afghanistan and, later, in Iraq, a casual observer might assume that programs would have been implemented to ensure access for Soldiers from the 10th Mountain Division to mental health services on base. Unfortunately, an investigation by VFA has revealed that [soldiers] who recently returned from Iraq must wait for up to two months before a single appointment can be scheduled ...

"Given the great amount of public attention that has been focused on the psychological needs of returning service members, a casual observer might also assume that these needs would have been given a higher priority by Army leaders and the National Command Authority - the two entities with the greatest responsibility for ensuring the strength of our Armed Forces. These needs have long been acknowledged but," the report concludes " there has been insufficient action."

Last month the army tried putting a band-aid on the problems at Fort Drum by sending three Army psychiatrists from Walter Reed Army Medical Center (WRAMC) to the Fort D on a temporary basis to treat the large influx of returning soldiers requiring mental health care. But, as the VFA points out, "this is only a temporary fix", as the Walter Reed-based psychiatrists will likely return to Washington, DC, within a few weeks.

Fort Drum will again be left with the task of treating thousands of soldiers with far too few mental health specialists. In addition, for those service members who were initially treated by psychiatrists from Walter Reed, their care will suffer from discontinuity, as their cases will be assigned a new mental health professional on subsequent visits."

And the war drags on. Earlier this month, the UK Times reported that "the conservative Washington think tank that devised the "surge" of US forces in Iraq [the American Enterprise Institute] now has come up with a plan to send 12,000 more American troops into southern Afghanistan.

A panel of more than 20 experts convened by the (AEI) has also urged the administration to get tough with Pakistan. "The US should threaten to attack Taliban and Al-Qaeda fighters in lawless areas on the border with Afghanistan if the Pakistan military did not deal with them itself, the panel concluded."

Where do conservatives expect to find those troops?

More soldiers are likely to suffer the fate of the soldiers at Fort Drum. They will be sent back to combat, again and again - until finally, they break. Soldiers suffering from post-traumatic stress syndrome, depression or a host of other mental problems are not in a good position to protect themselves. Sending them back only guarantees that fatalities will rise.



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Maggie Mahar is a fellow at The Century Foundation and the author of Money-Driven Medicine: The Real Reason Health Care Costs So Much (Harper/Collins 2006).
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Very interesting piece you wrote, but none of surprises me or shocks me. This country talks a lot about supporting the troops, but doesn't do nearly enough. They want an all volunteer military, sometimes calling it a "professional military". Unfortunately, joining the military is not like becoming a police officer of firefighter, both difficult jobs and dangerous as well, but they don't compare to being a soldier in many ways. I believe it's every Americans duty to prove they are willing to take a bullet for what most of us claim to believe in. And how about the conservatives getting in line first. After all, they are the ones who have gotten us into this mess in Iraq. It's a GOOD thing that every person in this country is NOT a conservative. If that were the case, we would be at war with half the world, but wouldn't have the troops to fight!

We don't have enough troops anymore because of these wars and the rapat deployments. I know of many men who have left the military not just army every branch because of the war. The ARMY has tried to entice other branches to leave and go ARMY for money cause they have no one hardly left.

you mean we're at the breaking point? I didnt get the memo.....

The articles that you post serve a purpose for someone I guess, but Im not real sure who that is.

Funny thing about the mental health professionals in the army, it is really simple to fake PTSD to the point of absurd. The things that mental health people LET pass thru their doors as bonafide would amaze and shock you to the point where you would find another long article to copy and paste on here entitled "soldiers fraud".

Did you know, of you course you dont, that all a male soldiers has to do or say to mental health to get out of the army is..... I cant get it up anymore. They dont need to prove it, just say it,,,, it's the new Im gay stratedgy used by those who joined for college money, since the Im gay thing doesnt work anymore.

Being a combat medic, I am the first person one of these soldiers, sick or faking, has to see.... I have personally taken a soldier to a suicide watch ward at a mental facility and stayed with him all day and nite until the real docs made me leave.

I have no doubt that long deployments hurt. they hurt marraiges (when the wife or husband back home decides to turn into a sl-t) it hurts moral in the middle of a deploymet to hear that they just tacted on 3 more months, especially knowing that the wimpy air force only does 4 months and sometimes extends to 6, that the gay navy does 6 and sometimes extends to 8, and the wanna be killer marines only do 6..... it isnt the fact that we are deployed that gets us down, its the fact that we are the only ones seriously doing the heavy lifting and pulling more than our share.

Beware of articles written with an agenda, they are full of distortions and out right lies. Beware of an article written by someone who has only read other articles about some place he or she hasnt been. it would be akin to me telling you how child birth or abortion feels like because i read an article about it one time written by a nun who had never experienced either.

your thick headed, and for some that might be attractive, but the issues on which the thickness prevails makes you seem like you have no honest clue about what you are doing or saying, almost as a reach out and cry for help...... do you need to see our mental health providers or are you just faking it?

I will continue to take your personal insults as the fact you have a hard time expressing yourself properly.

This is an issue that all should know about. I can post real soldier stories to confirm this if you would like. My views are no more skewed then the warmongers who want to continue to war an illegal war just to get some sick jollies of some kind.

As for baby shrub we all know where his mind has been through all of this and it sure as hell was not on the betterment of security for us Americans, nor was it this fake war on terror that he is brainwashing all about.

So be whatever you think what you think, you seem to have some issues yourself.

your postings are of isolated issues that you morph into "its happening everwhere". they are full of peoples opinions that you scew into making believe they are fact.

if you have issues with someone pointing that out then maybe you should talk to, not read, real soldiers who have done the things that you say are illegal and immoral. the issues I have are not mental issues unless getting aggrevated at liars is a mental one.

how about you post something with which you are the subject matter expert on, because lady I know more about this particular topic than you do,,, thats not boasting, it is FACT.

personal insults? what because i disagree with the crazy propaganda that spews forth from you copy and paste finger tips. where is the everyone is invited to the democrat party inclussiveness that I hear so much about, all veiws excepted...NOT

here is a story about one of ohio's

companies that has an unusually high mortality rate

here is a piece of the article

From 28 February to 30 September 2005, Lima Company, 3rd Battalion, 25th Marines, went where they were told and did what was expected of them. The unit lost 23 of its 184 members, an unusually high percentage that makes them, tragically, “famous”.

for the outrage or lack there of depending on the message

you need to read the article

i find this a bit educating

so if you do not want to learn something

do not read it

bigsmile bigsmile bigsmile

hey doc

drinker drinker drinker

doc has more than enough talent to express himself.....maybe what you don't like is his bluntness talking about the way it is...and maybe you don't like the fact he is talking from personal hands-on experience which leaves you in a position of SOL with your bleeding heart copy and paste "stories"...

I still keep thinking back to what Hussein told Dan Rather, In so many words, Hussein wanted to avoid the war for his people and offered for him and George Bush to each have a gun ,and the two of them settle it between the two of them. MY< MY ,I thought that , that was a splendid idea , I believe that is the way it should have been settled, but of course , it appears that, George would rather do like the Khazars , start the trouble, then stand back, and let you and him fight.

SMO, please this to heart..... your pretty much a crazy person arent you?

I think Dragoness has raised a good point and doc sometimes you do have to listen to the experts. i am not saying this because I think it doc but you could be about as credible as all those fake GI letters to the editors the army was caught sending home as legitimate, or you could be as legitimate as the Tillman story or the Jesica Lynch rescue fable. the lies spread by the government are endless and so amaturish that most everyone is now hip to them. I do not blame anyone for being skeptical of anything said about this war.

marines do a 12 month tour, actually a buddy of mine just got back from a 14 month tour
and the navy thing, thanks bro

no marine unit has ever deployed for 14 in iraq. if your buddy was there for 14 then he must have volunteered. they dont do 12 either.

where are you on a boat or something, its different on the ground, i wouldnt want to trade you tho, i guess a little queezy on the water,,,haaha

I have no problem with your opinion, I understand not being able to communicate without wanting to call people stupid, I have to fit the urge myself.

I have already said, you have my permission to say whatever you want to me with no judgement because of your service to this great country of ours, it is appreciated.

I can give you post after post of soldiers who agree with my opinion of all of this if you would like. You would believe them better than me?

I never said anything that the soldiers do it illegal or immoral, others may have but I have not. I believe soldiers are pawns in this illegal war, they do what they are told to do to the best of their ability, no shame in that at all. I only have issues with the iniators of this illegal war. They are wrong.

thanks for your permission to speak ma'am. you did say if it ever went to court we could all be tried as war criminals tho.

I can be very communicative, and even cordual at times. But I can not be coerced into being a passive passer by when I see a percieved wrong.

one for you, one for me.