The Army is losing its battle to stem suicides among troops serving in Iraq, with a new report showing that 32 soldiers killed themselves in the war zone last year — a record high since the war began five years ago.
The number of suicides in Iraq in 2007 climbed 18 percent from 2006, despite multiple new efforts by military officials to improve training and education in suicide prevention and mental health. Suicide was a leading cause of non-combat deaths in Iraq last year, accounting for nearly one in three non-hostile Army fatalities.
Army officials who released the report Thursday were reluctant to draw a link between combat exposure and suicide, repeating assertions made in past years that failed personal relationships, along with legal and financial problems, were the main factors driving suicides. But they did acknowledge that long and repeated tours of duty were wearing down soldiers' mental resilience.
"Is it the war? It's unquestionable that the high op-tempo, the multiple deployments and long deployments put a real strain on relationships," said Col. Elspeth Ritchie, the Army's top psychiatrist, in a conference call with reporters. "There's also normal, girlfriend-boyfriend breaking up, irrespective of the war, marital difficulties that arise in both civilians and soldiers. ... We're not seeing a clear relationship between conflict increase and suicide."
Ritchie and Brig. Gen. Rhonda L. Cornum, assistant surgeon general for force protection, said Army leaders would continue to emphasize training programs that alert commanders and soldiers to signs of stress and that encourage troubled troops to seek professional help.
"One of the things that I believe is happening, looking at these reports, is that the Army is very, very busy, and perhaps we haven't taken care of each other as much as we'd like to," Ritchie said.
The increase in suicides in the war zone was one factor driving an overall increase in suicides among active-duty soldiers last year. The Army released figures Thursday showing 115 confirmed suicides in 2007, both stateside and abroad — the highest number recorded since the Army began keeping such records in 1980. In 2006, 102 suicides were reported. The numbers do not include suicides among veterans who left the service.
The active Army suicide rate reached 18.8 suicides per 100,000 soldiers last year — also the highest rate on record and an increase over the 2006 suicide rate of 17.5 per 100,000.
Army leaders said they had scrambled in recent months to hire 180 new mental-health workers to treat troops at home bases, but they did not announce plans to beef up the contingent of counselors treating troops deployed in Iraq. Despite the rising suicide numbers in Iraq, the ratio of mental-health counselors to soldiers in the war zone has dropped — from one provider for every 387 troops in 2004, to one for every 734 last year.
The Army has made a number of changes to its suicide-prevention and mental-health programs in the past several years, some prompted by a Courant series in 2006 that found the military was failing to adequately screen and treat troops with psychological problems. New policies adopted since then call for closer monitoring of troops on psychiatric medications and limits on keeping troops with mental-health problems in combat zones.
The new suicide report shows that a quarter of the 115 active-duty soldiers who killed themselves last year had never deployed, while 43 percent had completed one or more tours and returned home. Twenty-four percent committed suicide during their first deployment, while only 7 percent committed suicide during a second or subsequent tour.
"We certainly understand that the Army is very stressed, with multiple and prolonged deployments," Cornum said. "But I'm not sure we can say that — in fact, looking at the numbers, we cannot say — that the people who are multiple deployers are at greater risk."
Fueling the strain on the Army last year was the extension of deployments from 12 months to 15 months — a practice slated to end later this year. Ritchie said she was hopeful that "all of our indicators of quality of life get better as the deployments get shorter and there's more dwell time back at home."
Besides completed suicides, the Army report shows that at least 935 active-duty soldiers made suicide attempts in 2007 — a dozen fewer than were reported the year before. Fifty-five percent of those who attempted suicide had been seen by outpatient mental-health providers before the attempt — 35 percent less than a month before.
The report also shows that 34 percent had been prescribed psychotropic drugs. Those percentages are similar to the Army's suicide findings from 2006.
The report also shows that during 2006 and 2007, at least 166 soldiers attempted suicide while serving in Iraq and Afghanistan, compared with 120 during 2005 and 2006.
Among those deployed soldiers who attempted suicide in the past two years, nearly two-thirds had been seen by outpatient mental-health workers before the attempts, and 46 percent had been prescribed psychotropic medications, the report showed.
Army officials have been concerned about the suicide rate in Iraq since the early months of the war, when a spike in self-inflicted deaths prompted military leaders to send teams of mental-health experts into the war zone.
The suicide rate dropped sharply in 2004, but rebounded to record levels in 2005 and has continued to climb.
Contact Lisa Chedekel at lchedekel@courant.com.
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