Mentally Ill soldiers forced into fight

U.S. military troops with severe psychological problems have been sent to Iraq or kept in combat, even when superiors have been aware of signs of mental illness, a newspaper reported in its Sunday editions.

The Hartford Courant, citing records obtained under the federal Freedom of Information Act and more than 100 interviews of families and military personnel, reported numerous cases in which the military failed to follow its own regulations in screening, treating and evacuating mentally unfit troops from Iraq.

In 1997, Congress ordered the military to assess the mental health of all deploying troops. The newspaper, citing Pentagon statistics, said fewer than 1 in 300 service members were referred to a mental health professional before shipping out for Iraq as of October 2005.

Twenty-two U.S. troops committed suicide in Iraq last year. That number accounts for nearly one in five of all noncombat deaths and was the highest suicide rate since the war started, the newspaper said.

The paper reported that some service members who committed suicide in 2004 or 2005 were kept on duty despite clear signs of mental distress, sometimes after being prescribed antidepressants with little or no mental health counseling or monitoring. Those findings conflict with regulations adopted last year by the Army that caution against the use of antidepressants for "extended deployments."

Although Defense Department standards for enlistment disqualify recruits who suffer from post-traumatic stress disorder, the military also is redeploying service members to Iraq who fit that criteria, the newspaper said.

"I can't imagine something more irresponsible than putting a soldier suffering from stress on (antidepressants), when you know these drugs can cause people to become suicidal and homicidal," said Vera Sharav, president of the Alliance for Human Research Protection, a New York-based advocacy group. "You're creating chemically activated time bombs."

Commanders, not medical professionals, have final say over whether a troubled soldier is retained in a war zone. Col. Elspeth Ritchie, the Army's top mental health expert, and other military officials said they believe most commanders are alert to mental health problems and are open to referring troubled soldiers for treatment.

Ritchie acknowledged that some deployment practices, such as sending service members diagnosed with post-traumatic stress syndrome back into combat, have been driven in part by a troop shortage.

"The challenge for us ... is that the Army has a mission to fight. And, as you know, recruiting has been a challenge," she said. "And so we have to weigh the needs of the Army, the needs of the mission, with the soldiers' personal needs."

Ritchie insisted the military works hard to prevent suicides, but it is a challenge because every soldier has access to a weapon.

"I'm concerned that people who are symptomatic are being sent back. That has not happened before in our country," said Arthur S. Blank Jr., a Yale-trained psychiatrist who helped get post-traumatic stress disorder recognized as a diagnosis after the Vietnam War.

Maj. Andrew Efaw, a judge advocate general officer in the Army Reserves who handled trial defenses for soldiers in northern Iraq last year, said commanders don't want to send mentally ill soldiers into combat.

"But on the other hand, [the com mender] doesn't want to send a message to his troops that if you act up, he's willing to send you home," Efaw said.