Army combat stress is up Afghanistan, down in Iraq

Soldiers deployed to Afghanistan reported more combat stress this year, while troops in Iraq reported a decrease, according to mental health reports released by the Army on Friday.

The findings reflect the increased intensity of combat in Afghanistan, and less fighting in Iraq, said Lt. Col. Paul Bliese, an Army psychologist and director of the division of psychiatry and neuroscience at the Walter Reed Army Medical Center in Washington, during a Pentagon press briefing.

Multiple deployments exacerbate combat stress, according to the reports. Soldiers on "their third and fourth deployments report significantly more acute stress [and] psychological problems," said the executive summary. The Army's Mental Health Advisory Team issued the reports, the sixth such package, since 2003.

The team also concluded that soldiers who spend little time at home, or dwell time between deployments, have a high incidence of mental health problems.

Army Surgeon General Lt. Gen Eric Schoomaker told reporters that troops who spend more time at home between deployments experience less stress and better mental health. He said soldiers who spend 24 months at home have a "near return to garrison rates of mental health…."

Currently, soldiers remain home between deployments from one year to 18 months, said Adm. Mike Mullen, chairman of the Joint Chiefs of Staff at a Government Executive leadership breakfast earlier this month.

Mullen added that more time at home in the future will depend on how many additional troops President Obama plans to send to Afghanistan during the next year. The United States currently has 68,000 troops in Afghanistan; Army Gen. Stanley McChrystal, the U.S. commander there, wants an additional 40,000 troops deployed within the next year.

Multiple deployments also increase stress on marriages, according to reports from the military services. Navy Corpsman Petty Officer 1st Class Richard Martinez told Government Executive in a recent interview that in his role as a psychology technician, he spent more time treating troops with marital problems than combat stress. Martinez returned from Iraq in October.

Fred Mael, a Baltimore, psychologist said the Army's assessments make sense, because multiple lengthy deployments do not provide any relief from combat stress. He suggested the Army could better manage stress and troop requirements with three-month deployments.

The combination of multiple deployments and insufficient time at home is "demolishing" the Army, said Paul Sullivan, executive director of Veterans for Common Sense. He urged the service to require that all troops spend a minimum of 24 months at home before redeployment.

The Army has increased dramatically the number of behavioral health professionals since 2007, when there were only 350 psychologists on active duty in the entire Defense Department, Schoomaker said.

Lt. Col. Edward Brusher, an Army behavioral health specialist, said the service currently has 2,700 uniformed and behavioral health specialists. This includes 643 civilian and 178 active-duty psychologists, and 121 military and 194 civilian psychiatrists. Brusher said the Army has 43 behavioral health providers in Afghanistan and 227 in Iraq, and plans to add another 65 providers in Afghanistan.

Schoomaker said the Army plans to use technology to provide behavioral health services to remote camps and forward operating bases in Afghanistan, and also has started a pilot test of Internet-based diagnostics and counseling services at the Tripler Armed Medical Center in Honolulu.

Mael said he endorsed such an approach as a "good deal of counseling can be done just using the phone and e-mail."