WASHINGTON — Eight years of war in Afghanistan and Iraq have etched indelible scars on the psyches of many of the nation's servicemen and women, and the U.S. military is losing a battle to stem an epidemic of suicides in its ranks.
Despite calls by top Pentagon officials for a sea change in attitudes about mental health, millions of dollars in new suicide prevention programming and thousands of hours spent helping soldiers suffering from what often are called "invisible wounds," the military is losing ground.
The Department of Defense reported this month there were 160 reported active-duty Army suicides in 2009, up from 140 in 2008.
"There's no question that 2009 was a painful year for the Army when it came to suicides," Col. Christopher Philbrick, deputy director of the Army Suicide Prevention Task Force, said in a statement, despite what he called "wide-ranging measures last year to confront the problem."
While the military's suicide rate is comparable to civilian rates, the increase last year is alarming because the armed services traditionally had lower suicide rates than the general population did.
"I look at the numbers of each service, and that rate has gone up at the same rate across the services," Adm. Mike Mullen, chairman of the Joint Chiefs of Staff, told a recent gathering of military mental health professionals and advocates. "This isn't just a ground force problem."
Some of the suicides are young men, fresh from deployments and haunted by memories, who shoot themselves after they return from their second or third tours in Iraq or Afghanistan, or when romantic relationships turn sour.
Others are career officers who quietly nurse addictions to drugs or alcohol, and decide to silence their ghosts.
An increasing number are female troops, who rarely committed suicide before but now are killing themselves at a much higher rate.
"There does not appear to be any scientific correlation between the number of deployments and those that are at risk, but I'm just hard pressed to believe that's not the case," Mullen said.
The emotional wounds are so deep and the suicide rates are so high that top Pentagon officials broke a generations-long code of silence on the topic and have started speaking publicly and vehemently about the effects of mental illness.
The military's shift in attitudes was evident earlier this month during a joint Departments of Defense and Veterans Affairs suicide prevention conference, where uniformed attendees spoke about the stigma of seeking mental health care, the need for policy changes that will make help easier to get and the importance of supporting the families of troops suffering from mental illness.
"It's a joint DOD and VA conference; that alone says an awful lot about where we used to be and where we are now," Mullen said.
Fort Campbell's fight
With one of the highest suicide rates in the Army, Fort Campbell, a sprawling installation on the Kentucky-Tennessee line that's home to the elite 101st Airborne Division, illustrates the severity of the problem.
In 2007, Fort Campbell created a suicide task force after nine soldiers killed themselves, three during the first few weeks of October.
"As our soldiers fight terrorism, the sacrifices asked of them and their families have increased significantly," the 101st Airborne's commander, Maj. Gen. Jeffrey Schloesser, said in a letter to troops. "Regrettably, under such circumstances, it is natural for our people to feel the stress of these demands and to be overwhelmed at times. Tragically, these pressures too often end in suicide."
The following year, Fort Campbell's suicide rate jumped to 12.
The base hired a suicide prevention program manager and dispatched staffers to study trends, increased awareness training for troops and boosted the number of mental health professionals available to soldiers while in combat and after they return. Army officials say those efforts could prove useful servicewide.
Last year, Fort Campbell held a three-day "suicide stand-down," and top officials pleaded with soldiers to get help if they needed it assuring them that seeking help wasn't a sign of weakness and wouldn't affect their careers.
The number of suicides increased to 14 in 2009.
"It's been discouraging to say the least," said Joe Varney, the suicide prevention program manager.
Stemming the rise in suicides will take more than conferences, task forces, training and studies, said Col. Elspeth Ritchie, director of behavioral health for the Office of the Army Surgeon General. The military also will have to grapple with the easy availability of handguns, a topic that's sure to be unpopular, she said.
"It's amazing to me when you see Fort Campbell, which is at the top of suicide lists. They have a beautiful gun shop in the middle" of the Post Exchange, Ritchie said. "I'm troubled by what I see as a mixed message."
Some soldiers who receive counseling are still committing suicide, and many think — with good reason, given previous military policies and attitudes about mental health — that seeking treatment could ruin careers, she said.
"We cannot change stigma until we change policies that contribute to stigma," Ritchie said. "In many ways we talk out of both sides of our mouths."
The Obama administration, at the behest of a small bipartisan congressional group that includes Rep. Hal Rogers, R-Somerset, is reviewing a longstanding unofficial policy that bars the president from sending condolence letters to families of service members who commit suicide.
Family members of soldiers who've committed suicide said changing the policy would go a long way toward removing the stigma because the military already provides a full military burial for soldiers who commit suicide.