Army suicides on the rise

Growth raises questions about mental health care provided to service members.

The Army confirmed in a Thursday report that 99 soldiers committed suicide last year, the highest number in a single year since 1991.

The figures also showed that of the 44 soldiers who have so far committed suicide in 2007, 17 were in Iraq or Afghanistan.

Although occupational issues may have contributed to some of the suicides, the report said soldiers also suffered from failed relationships and legal and financial trouble. The overall suicide rate for soldiers in 2006 was 17.3 per 100,000 soldiers, up from 12.8 per 100,000 in 2005 and 10.8 per 100,000 in 2004.

The military has stepped up mental health efforts in response to the suicide rate, which has risen steadily since shortly after the war in Iraq began. New initiatives include an increase in the number of caregivers assigned to units deployed for more than six months and commander training in suicide intervention.

Soldiers also will be encouraged to associate with battle buddies and attend relationship building seminars, as part of a movement to decrease the stigma of requesting mental health care.

Some veterans' advocates say the military's efforts still are inadequate.

"They're not educating people about suicide," said Susan Avila-Smith, director of Women Organizing Women, a group that counsels female military personnel who have been victims of sexual assault. Avila-Smith, who worked with the military as a Chinese linguist, said she was posted at a barracks with a high suicide rate, but didn't know it at the time.

"They brush the statistics under the rug," she said, "so I didn't realize [depression or post-traumatic stress] could happen to me, to the guy next to me." She also said post-traumatic stress disorder "isn't a mental illness," but rather "a normal response to the extreme pressures soldiers face."

Avila-Smith said numerous battlefield stresses, including disillusionment with the military's methods, might contribute to an active duty soldier's decision to commit suicide. "[Commanders] say 'Here's the rules,' but you turn around and they're not playing by the rules and that's scary because your reality is different and you don't know who to trust," she said.

It's difficult for soldiers to confide in chaplains, who are traditionally appointed as counselors to active personnel, if soldiers suspect the chaplains might report comments back to their superiors, Avila-Smith added.

She also noted that women soldiers, who are technically forbidden from serving on the front lines, have trouble securing treatment. "[Doctors] don't recognize that women have been in combat but they have, driving Humvees," she said.

Recruitment pressures have forced the Army to extend tours of duty or increase the number of tours so soldiers return to the field after brief stays at home, also contributing to stress.

Army Chief of Staff Gen. George Casey Jr. acknowledged in a Tuesday speech at the National Press Club that the wars in Iraq and Afghanistan have strained the Army's resources, including those for mental health.

"Soldiers, families, support systems and equipment are stretched and stressed by the demands of repeated deployments and insufficient recovery time," Casey said. "Army support systems -- for example, health care, education systems and family support systems -- were designed for the pre-9/11 peacetime Army, and we need to expand those and adapt them to sustain an Army at war."