Army reports significant jump in stress levels for combat troops

Army combat troops deployed to Afghanistan in 2010 had significantly higher levels of acute stress than in 2009, the service said in a Mental Health Assessment Team report released Thursday.

But the MHAT report, completed in February, shows much lower levels of depression than in troops surveyed in post-deployment health assessments over the past year, as documented in a March report by the Armed Forces Health Surveillance Center, based on data compiled by the Defense Medical Surveillance System.

The center also reported last month that throughout the Defense Department there were more hospitalizations for mental disorders than for any other major category of illnesses or injuries.

Col. Rebecca Porter, chief of behavioral health for the Army surgeon general, said the Armed Forces Health Surveillance Center reports cannot be compared to the MHAT report as the MHAT report dealt only with troops deployed to Afghanistan.

Col. Paul Bliese, head of the MHAT team, said the MHAT report and the Armed Forces Health Surveillance Center reports probably produced different results because they used different survey instruments.

The new MHAT report showed 17.4 percent of the 900 soldiers in Army ground maneuver units surveyed from July to September 2010 reported acute stress, up 24 percent from the 13.2 percent who reported acute stress in the 2009 report.

Lt. Gen. Eric Schoomaker, the Army surgeon general, said that despite the reported increase in stress, only 3.7 percent of soldiers took medications -- a lower percentage than in the civilian population, where 4.59 percent of 21- to 34-year-old men took antidepressants.

The mental health team also surveyed Marines for the first time since 2007 and reported that their acute stress levels had more than doubled from 6.9 percent in 2007 to 16.9 percent in 2009.

Prepared by the Army Office of the Surgeon General in cooperation with the Air Force and Navy Surgeon Generals, the Medical Officer of the Marine Corps, and the U.S. Central Command Surgeon General, the MHAT report said higher levels of combat contributed to troop stress and other mental health problems. "Psychologically, it is hard to imagine that these elevated levels of combat are not taking a toll on soldiers," the report said.

Schoomaker said that the report reflected the "historically high level of combat exposure" and added that it also showed the effects of multiple deployments on the mental health of soldiers.

He said that increasing the time between deployments to 24 months could go a long way toward restoring the psychological health of troops.

The MHAT report, the seventh in a series over the past decade, said the depression level of soldiers increased to 7.9 percent from 5.9 percent in 2009, while anxiety levels jumped to 8.8 percent in 2010 from 6 percent in 2009. The Marines surveyed showed only a modest increase in depression, from 3 percent in 2007 to 3.4 percent in 2010, while 4.2 percent reported anxiety in 2010, up from 3 percent in 2007.

But the Armed Forces Health Surveillance Center said between March 2010 and February 2011, 30.6 percent of active-duty soldiers evaluated 30 days after returning from deployment suffered with depression, and in a follow-up, that number increased to 32.2 percent.

The center also reported that 7.6 percent of active-duty soldiers had other mental health problems such as combat stress and substance abuse in an initial post deployment assessment, which more than doubled to 17.1 percent in a reassessment required within 180 days of returning home.

The Armed Forces Health Surveillance Center, in its April 2011 Monthly Medical Surveillance Report, said 10,100 soldiers were hospitalized for mental health disorders in 2010, or 18 percent of the 42,000 soldiers admitted to the hospital for any condition that year. The center reported 2,192 Marines were hospitalized in 2010, 10.8 percent of the 10,371 hospitalizations last year.

The center said the recent sharp increase in hospitalizations for mental disorders likely reflects the effects of many factors, including repeated deployments and prolonged exposures to combat stresses, as well as increased screening for and detection of mental disorders after combat-related service and other traumatizing experiences.

An Army doctor, who declined to be identified, said that self-reported data has low validity, particularly in combat theaters or immediately post-deployment, which leads to an underestimation of health issues.

The doctor added that, "Bottom line is that we shouldn't be relying on flawed and invalidated survey instruments administered annually to take the pulse of mental health issues in theater. We should be studying hard electronic outcome data -- prescriptions, evacuations, hospitalizations, and all outpatient care encounters -- electronically and in near real-time."