Mark Benjamin commented on the spike in suicides among soldiers in April, noting that the number was equal to about half the deaths in Afghanistan during the same time period. The Army has been trying for several years to get ahead of the rising number of suicides. General Peter Chiarelli, the Vice Chief of Staff, is leading the effort, so there is no shortage of horsepower behind the work.
But there doesn’t seem to be significant progress, or more properly, there doesn’t seem to be a long-term success. During the first half of 2009, more American soldiers committed suicide than were killed in combat in Afghanistan and Iraq. In June 2010, an average of one soldier a day committed suicide. According to CBS news, 120 veterans commit suicide each week; this is double the rate of non-veterans. Since 2002, half of the veterans checking in to VA facilities needed mental health care.
The Army’s field manual for “combat stress” — the current term in vogue for mental-health problems in and after combat — offers some context for what PTSD has done to our ranks in the past. In Europe and Africa during World War II, the proportion of mental traumas among all casualties was close to one in four — one mental health case for every three blood wounds. On Okinawa island in the Pacific theater, the ratio for the 6th Marine Division (which suffered more than 2,600 wounded and added about 1,300 combat exhaustion casualties) was one in two, or half as many mental health evacuations as blood and bone wounds. This statistics varied wildly in Vietnam, but rose dramatically as the war went on. At first, proportions were roughly one mental trauma per 10 wounded. Later, neuropsychiatric cases constituted almost 60 percent of medical evacuations (though this number is skewed by the inclusion of drug and alcohol cases.) As many as one in five Vietnam veterans suffered PTSD, and even as late as 1990, one in 10 still did.
The wars in Iraq and Afghanistan are being fought by a tiny percentage of our population – less than 1% of Americans participate. Most soldiers and Marines I know have served multiple combat tours. Also, the day-to-day action is significantly different than our predecessors’ wars.
In WWII and Korea there was a front line and combat units were rotated up and back as needed to allow the men to rest and refit. In Iraq and Afghanistan, there is no front line. Every step out the front gate is a combat patrol; every conversation with a local is a political act. There’s no rest.
In Vietnam our troops served one-year tours and then went home. The combat tour was tough – don’t get me wrong – but when it ended, it ended. For our troops today, there is no end in sight. The idea of a draft has proven anathema to Congress and to most of America it seems, so we’re fighting two (or three) wars with the thinnest slice of the population imaginable. Soldiers are going to war two and three times, some even more.
On top of that, they don’t get sufficient time between rotations. Dwell time, the period of time spent at home after a combat tour, is too short right now. We need to adjust the combat rotation schedule – less time in the sandbox and more time at home. Until that happens, I think the number of mental health casualties and suicides will remain high.