IRAQ Army works to prevent suicides

At least 17 American servicemen in Iraq have taken their own lives.
ASSOCIATED PRESS
Rebecca Suell wants answers, and not the ones the U.S. Army is giving her.
Why does the Army keep calling the last letter her husband sent to her, the one he mailed from Iraq on June 15, a suicide note? Can taking a bottle of Tylenol really kill you? And how did he get his hands on a bottle of Tylenol in the middle of the desert, anyway?
The questions may differ, but experts say the desperate search for answers -- and the denial -- are usually the same.
Since April, the military says, at least 17 Americans -- 15 Army soldiers and two Marines -- have taken their own lives in Iraq. The true number is almost certainly higher. At least two dozen noncombat deaths, some of them possible suicides, are under investigation according to an AP review of Army casualty reports.
No one in the military is saying for the record that the suicide rate among forces in Iraq is alarming. But Lt. Gen. Ricardo Sanchez, the top American military commander in Iraq, was concerned enough, according to the Army Surgeon General's office, to have ordered a 12-person mental health assessment team to Iraq to see what more can be done to prevent suicides and to help troops better cope with anxiety and depression.
Army spokesman Martha Rudd said the assessment team returned from Iraq two weeks ago, but that it will take several weeks to come up with recommendations. Until then, she said, no one on the team will have anything to say to the press.
No basis for comparison
Whether the suicide rate among the troops should be considered high is impossible to say because there is nothing to compare it with, experts say. What would be considered a "normal" rate for an all-voluntary military force of men and women on extensive deployments to the Middle East, under constant pressure from guerrillas who use terror tactics?
Rudd said that by the Army's calculations, its suicide rate in Iraq is roughly 12 per 100,000 -- well below the civilian suicide rate for U.S. men of 17.5 suicides per 100,000. The comparison is misleading, however.
The civilian rate is an annual figure, and the Iraq figure covers only about seven months. Furthermore, the troops have not yet spent their first holiday season in Iraq -- a time when the risk of suicide is traditionally at its highest.
The troops in Iraq include thousands of women, who typically have a lower suicide rate than men. And the Army figure does not include possible suicides among the non-combat deaths yet to be explained.
Prevention program
Whatever the 12-month suicide figure turns out to be, the Army is not satisfied that it is low enough. The Army has an extensive suicide prevention program, with soldiers "all the way down the chain" of command trained to recognize the warning signs of suicide and how best to intervene, Rudd said.
"Zero suicides is our goal," she said. "We may not get there, but we're going to try."
In all, 425 U.S. troops have died in Iraq. The military has characterized 129 of the deaths as "non-hostile," including more than 100 since President Bush officially declared major hostilities over May 1. Most if not all the confirmed suicides occurred after May 1, according to the military. According to an AP analysis of military reports, noncombat deaths include 13 caused by a weapons discharge, two from drowning, one from breathing difficulties and one described only as "medical." An additional 13 are listed with no cause given.
Even among civilians, one of the common triggers "is a rupture of a relationship," said David Shaffer, a Columbia University psychiatrist and former consultant for the Department of Defense.
But there are always deeper reasons, usually far murkier and far more complex, experts said. Like the wars they fight, no two soldiers who commit suicide face the same mix of potentially deadly stress.
"In most previous conflicts you went, you fought, you came home," Rudd said. "In this one they went, they fought, they're still there."
Christmas season
Rudd said she knows of no studies that show a definitive correlation between length of deployment and military suicide rates. But Michelle Kelley, a psychiatrist who studies deployment-related stress for the Navy, said the longer the deployment, the greater the strain on a relationship with a loved one.
The military, she said, needs to be especially watchful for anxiety and depression among its troops in the weeks ahead. For civilian and soldier alike, the Christmas season and depression go hand in hand, Kelley said. But for a soldier, she added, a weapon is always at hand.
Soldiers, she said, must be encouraged to seek help when they need it. For that reason, she expressed concern about the case of Pfc. Georg-Andreas Pogany.
The soldier, assigned to a Green Beret interrogation team, began throwing up after seeing the severed body of an Iraqi civilian three days after being deployed to Iraq. After seeking help for a self-described anxiety attack, he was ordered back to the United States and became the first soldier since Vietnam charged with cowardice -- a charge later reduced to dereliction of duty.
That, Kelley said, is "the last thing you want to do" if you want soldiers to seek help in times of stress. ... You need to make it clear to those people who have witnessed something traumatic that they need to talk about it -- that they won't be stigmatized for doing so and that it's not going to follow them through their military career."
A comparison of the suicide rate among troops in Iraq with troops in other wars such as Vietnam are meaningless, Shaffer said, because the makeup of the fighting forces were so different. (According to the Army, there are no reliable statistics on the suicide rate during the Vietnam War.)
Shaffer said there is also some evidence that those who serve in the Army for a long time have a higher suicide rate than civilians. This is probably because "some longstanding servicemen do develop alcohol problems over time, and alcohol use is very strongly related to suicide," he said.