After nearly nine years, America closed out its mission in Iraq last week with an official death toll of nearly 4,500 soldiers, plus another 30,000 wounded. Now most of the remaining soldiers there are returning home, and the Pentagon is gearing up to provide hundreds of thousands of them with a new congressionally mandated safeguard: individual screenings for mental/emotional wounds caused by combat.
But the military suicides - on average, one soldier has taken his or her own life every 36 hours between 2005 and 2010 - aren't slowing down yet, according to an alarming new report this fall that says the suicide rate could threaten the nation's continued hopes for an all-volunteer fighting force.
Troubled in large part by those suicides, Congress passed legislation two years ago requiring three mental-health screenings for each soldier within the two year period after he or she returns from combat.
"We have been working for years to develop better screening for signs of post-traumatic stress disorder, or PTSD, in our combat troops and veterans," said the bill's chief sponsor, Sen. Max Baucus, D-Mont. "The Montana National Guard led the way on this front with a successful pilot program. And in 2009 we passed a law to take the Montana model nationwide."
As of October, the Pentagon had hired nearly 3,500 health-care providers to screen its returning combat vets for elevated stress levels. The Army has already provided its initial examinations of the first 400,000 troops, although it hasn't announced the results of those exams yet.
"Before this law, many of our troops received only a paper questionnaire, and never received an individualized assessment," Baucus said. "Thanks to this law, they are now getting personal, and private, one-on-one attention from a trained health-care provider. And they get follow-up assessments for at least two years after they return."
The Congressional Budget Office estimated that enacting the legislation would cost taxpayers $60 million over a 10-year period.
Montana's junior senator, Jon Tester, also a Democrat, added a provision that the Department of Defense also provide a baseline mental-health exam for all troops before they deploy into combat arenas.
That followed a study reported in the American Journal of Psychiatry in which doctors screened more than 10,000 infantry soldiers from three brigades heading into combat in Iraq in 2007. The 74 soldiers at highest risk were barred from deployment, and doctors tracked another 96 at-risk soldiers and provided them with coordinated care. The study then compared the screened brigades' mental health problems with another 10,000 unscreened soldiers from three other brigades.
"Soldiers in screened brigades had significantly lower rates than those in unscreened brigades for suicidal ideation, combat stress, and psychiatric disorders, as well as lower rates of occupational impairment and air evacuation for behavioral health reasons," it concluded.
A study released last October by the Center for a New American Security found that approximately 14 percent of our military population is currently taking a prescription opiate. Furthermore, when military doctors change a civilian prescription, they're barred from requiring that soldiers turn in the excess medications. And it said 29 percent of our military suicides involve drugs or alcohol.