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Thursday, August 26, 2010

"Mental Health in the Army" An American doctor, and personal friend, serving in Iraq guest blogs at Adam's Zionist Journey (Pt. 9)


I am now safely back at Balad Air base and am back to my usual schedule which means I work 4 days shifts followed by 7 night shifts after which I will leave for another part of Iraq on a short term basis. Either to the green zone to do some work with a navy officer who is training Iraqi Special forces,a base called talil near Baghdad to train army medics, or just do some c-130 missions to pick up patients throughout Iraq.

As mentioned before I wanted to briefly write about mental health issues in the army as I have written about a suicide and a suicide attempt and have evacuated a very large amount of soldiers to Germany for mental health issues.

The facts are the following: The army has gone from having a suicide rate lower then the general population to having a suicide rate that is HIGHER than the general population. As casualties fall here mental health issues are on the rise. The army knows this is a problem and recently finished a very large intensive study about suicide and mental health in the army. They know it is a problem and are desperately trying to make a dent. Their findings (if you Google army suicide study you can read about it yourself) essentially placed the blame on support services and the higher level enlisted and officer corps for not being sufficiently attentive. But the study did not really talk about WHy this is happening. In my conversations with psychologists, enlisted, the medical community and the patients themselves I have gathered my own opinions.

Let me begin by saying the army has done a wonderful job here. They have born the brunt of the fight and have been responsible for really defeating the insurgents as a force that could fight and hold territory. The insurgents still cause frequent death and destruction but it is always via suicide bombings and roadside bombs and is extremely scattered. They do not threaten the political or social system like they did back in 2007-08..Additionally the vast majority of army troops seem to be in excellent mental health. Still, a growing number have very dire mental health issues. It seems important to understand the reason.

(1) Prolonged deployments-Where the AF deploys for 90 to 180 days the Army deployments are always for 12 to 15 months and occur very frequently. In a cumulative fashion these deployments cause family stress and difficulties with relationships. The Army understands this fact and has shortened tours from 15 months to 12 months and are trying to decrease further to 9 months.

(2)Lower operational tempo in Iraq-Paradoxically the changing war in Iraq has led to challenges from a mental health perspective. In the past Iraq was a very "hot" war. Soldiers were outside the wire (base) every day being shot at, knocking down door and going directly after the insurgents. These kind of operations were intense, made time go quickly, did not leave time for brooding about personal issue and helped the soldiers develop a strong feeling of camaraderie. The situation now is different in that they are mainly supporting the Iraqi army, going on patrols for months and months without enemy contact and doing 'busy work" at the base. Many soldiers report a lack of fulfillment in this job as well as large ammount of time to focus on problems at home. Also with the decreased sense of camaraderie (which came from being in combat together) relationships among the troops tend to fray. This increases the risk of mental health issues

(3) PTSD-some soldiers have underlying PTSD (post traumatic stress disorder) that is made worse by being back in Iraq. When they were in combat the PTSD sensations of being on the edge and being hyper alert was actually in some way beneficial. but with decreased combat but being back in Iraq their sensations are triggered in a more peaceful environment. This is obviously very stressful for those affected

(4)"YOUNG" Army-It is seems to me that a large portion of the young soldiers with mental health issues would not have been deployed 3 or 4 years ago. The army faced a need for more troops at a time when the war here was going poorly and the us economy was good. As a result some soldiers enlisted who may have not been allowed to enlist in prior years. The included some troops with prior histories of mental illness who (in retrospect) may have been more prone to have problems.

Again, the army is heavily engaged in reversing this problem. We have briefings constantly about mental health and suicide as well as pamphlets throughout the base and commercials around the clock on armed forces network. They have policies in place for all soldiers to meet with counselors and also to be confined to the home base upon return to be observed and meet with mental health teams.

On a lighter side..I have included some pictures of me being given a tour of an F-16 ("VIPER") by one of the pilots and a picture of us filming a commercial for the university of Pittsburgh to be played before the game on 11sept.


PS-almost 70% done!!

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