Wednesday, January 31, 2007

Army's Suicide Struggles Continue


The suicide rate among soldiers in Iraq remained high in 2006 and could reach record levels for the war, with 22 deaths ruled as self-inflicted and more than a dozen other cases still under review, according to Department of Defense records.

A report this month by the military's Defense Manpower Data Center shows 81 confirmed self-inflicted deaths in the Army in Iraq - 22 more than the number of Army suicides reported by the military through 2005.

The number of confirmed suicides in 2006 matches the number in 2005, when the Army's suicide rate in Iraq reached 19.9 deaths per 100,000, the highest rate since the war began.

With as many as 17 other Army deaths still pending a final cause, the 2006 rate is likely to exceed the 2005 level. The total number of deployed soldiers did not change significantly over the two years and declined slightly during some months of 2006.

Veterans' advocates said the continued increase in suicides was troubling, given that the military has made safeguarding soldiers' mental health a priority. In 2006, suicide accounted for more than one in four of all non-combat Army deaths in Iraq.

Among the 2006 confirmed suicides was Tina Priest, a 21-year-old soldier from Austin, Texas, who killed herself in Iraq after reporting she was raped by a fellow soldier and then being placed on antidepressants, investigative records obtained by The Courant show. An Army psychologist deemed her stable just days before her death.

Steve Robinson, director of government relations for Veterans for America, said he was particularly disturbed by suicides in the war zone because combat troops are supposed to be screened for mental health issues before they join the military, before they are deployed and throughout their careers.

"These people aren't the kind of people that you would think would take this step," he said.

Robinson said the military has made some improvements to mental health care, but needs to do more, including making mental health checks as routine - and free of stigma - as vehicle or weapons inspections.

"This discussion about who's having problems is the same thing as checking out your equipment. You've got to check out the human body system. And they're just not doing it," Robinson said.

Col. Elspeth Ritchie, psychiatry consultant to the Army surgeon general, said the Army was making a "concerted effort" to reduce the number of suicides in the war zone, including revising suicide-prevention training, with specialized programs targeted to recruits, commanders and deployed soldiers.

"We are always concerned about any suicides. Every one is a tragedy," Ritchie said in a written statement to The Courant.

She said the revised training emphasizes "the importance of taking care of one's buddies. We also remind leaders that they must encourage help-seeking behaviors, recognize warning signs of suicidal behavior, and refer for care, if needed."

Other initiatives put in place recently include new deployment guidelines that expand mental health screening for troops heading to war and set limits on when troops with psychiatric problems can be kept in combat.

The guidelines were issued in November, in response to congressional legislation prompted by a May series in The Courant. The Courant found that some troops with pre-existing mental conditions were being sent into combat and that others who developed problems in the war zone were being kept there, in some cases with fatal consequences.

Investigative records show that Priest shot herself in Iraq in March, days after being diagnosed and treated for "Acute Stress Disorder consistent with Rape Trauma Syndrome." The records show she was prescribed the antidepressant Zoloft, the antipsychotic Seroquel and the sleeping aid Ambien.

Her family reported that she was in good spirits before her deployment, the records say. But friends and relatives told investigators that Priest's mental health declined sharply after the rape, and particularly after the soldier she accused was not confined pending his trial.

"Priest stated that she can't do it anymore, that she just wanted everything to be over with," a fellow soldier told investigators, recounting a conversation with Priest days before her death.

Earlier this month, The Associated Press reported that an Army private charged with raping a young Iraqi woman and slaughtering her family last year was found to have "homicidal ideations" by a combat-stress team, three months before the attack, but was prescribed an antipsychotic and retained in combat.

Top Army officials have been watching the suicide rate in Iraq closely since the early months of the war, when a spike in self-inflicted deaths prompted them to assemble a team of experts to examine ways to improve the mental health care of deployed troops. When the number of suicides dropped in 2004, to 10.5 deaths per 100,000 troops, military leaders credited their renewed prevention efforts.

But when the numbers climbed back up in 2005, Army Surgeon General Kevin C. Kiley and others downplayed the significance of the suicide rate, saying they expected some variation from year to year.

Still, at a Pentagon briefing last month, Army officials made clear that they hope to see suicide numbers fall off in 2007, as the new deployment policy and other initiatives take effect. They said they had appointed a suicide prevention coordinator for Iraq, and were in the process of establishing a unit that will more closely analyze each suicide.

Kiley and Col. Edward Crandall, head of the Army's team of mental health experts, have said they believe that most suicides are triggered by relationship and other personal problems, and that troubled soldiers are receiving appropriate care in the war zone.

Because the military does not identify victims of suicide, it was not clear how many of the soldiers who killed themselves in 2006 were serving second or third tours in Iraq, and how many were deployed for the first time.

A December report by the mental health team found that soldiers surveyed in 2005 - especially those who had served more than one deployment - were more likely to report acute stress symptoms than those surveyed in 2004. The Courant's analysis of 2004 and 2005 suicides had found that some soldiers had exhibited clear signs of combat-related stress before they killed themselves, while others had serious mental health problems before they deployed.

The mental health survey found that the stigma associated with seeking mental health care was lifting, with fewer than 30 percent of soldiers worried that they would be perceived as weak. But more than half the soldiers surveyed also said the suicide-prevention training they received was not sufficient to help them identify fellow soldiers at risk. And, complicating the military's efforts to improve services to soldiers, about a third of the mental health care providers serving in Iraq reported experiencing a high "burnout" level.

Jay White, a former Army combat-stress counselor from Cromwell who recently returned from Iraq, said he battled burnout during his second deployment.

"I know that I definitely experienced it. No doubt about that," said White, who now counsels returning veterans at the Hartford Vet Center in Wethersfield. "You don't feel like going to work. You wish you could call in sick, but there was never any of that. Or you'd see people and you're like: `Oh my God, I don't feel like talking to anybody today.' You'd just rather go hide in your trailer or something."

White said he saw evidence that some soldiers with pre-existing mental health problems were being sent into combat - a problem highlighted by The Courant, which found that fewer than 1 in 300 service members saw a mental health professional before shipping out, despite a congressional order that the military assess the mental health of all deploying troops.
"You can't help but wonder what the screening policies are before sending people over," White said. "There are people who have personality disorders - maybe they're just more mild [so] they're not seen before they get there - and then they get there and you're like, `Whoa, this is somebody who probably shouldn't be here in the first place.'"

The new deployment guidelines issued in November include a directive that troops who develop mental health problems during combat tours should be sent home if their conditions do not significantly improve within two weeks of treatment. It also directs that troops with mental illnesses not expected to resolve within one year should be considered unfit for military duty and evaluated for discharge.

Because the guidelines are still relatively new and allow clinicians considerable discretion, it is not clear how they are being applied. A task force headed by Kiley is expected to make recommendations for further improvements to mental health screening and treatment when it issues a report to the secretary of defense this spring.

The Army's 2005 suicide rate in Iraq was higher than the rate of 18.8 deaths per 100,000 troops in 2003, when the spike in suicides had prompted alarm and action from Army mental health officials. The 2006 rate also is expected to exceed the 2003 level.

Throughout the Army, the suicide rate rose from 10.8 per 100,000 troops in 2004 to 13 in 2005, the highest level since 1993.

The military this month released details of a separate, military-wide 2005 survey showing high levels of stress and depression among active-duty service members - both those who have deployed and those who have not. The survey of more than 16,000 service members found that those who had deployed in the previous three years had greater stress, higher rates of depression and anxiety, more alcohol and drug abuse and twice as many suicide attempts.

In recent months, Army officials have enlisted the help of a network of clergy to watch for warning signs of suicide. In an August letter to Army chaplains, Maj. Gen. David H. Hicks, the chief of chaplains, said an "increase in suicidal behavior on the part of our soldiers suggests that the pressures on our Army may be greater than ever." He urged chaplains to assist commanders, soldiers and families in learning to "recognize warning signs and identify at-risk people. One suicide is too many."

Contact Lisa Chedekel at

Tuesday, January 30, 2007

Two Sets of Books?

From the New York Times:

January 30, 2007
Agency Says Higher Casualty Total Was Posted in Error
For the last few months, anyone who consulted the Veterans Affairs Department’s Web site to learn how many American troops had been wounded in Iraq and Afghanistan would have found this number: 50,508.

But on Jan. 10, without explanation, the figure plummeted to 21,649.

Which number is correct? The answer depends on a larger question, the definition of wounded. If the term includes combat or “hostile” injuries inflicted by the enemy, the definition the Pentagon uses, the smaller number would be right.

But if it also applies to injuries from accidents like vehicle crashes and to mental and physical illnesses that developed in the war zone, the meaning that veterans’ groups favor, 50,508 would be accurate.

A spokesman for the veterans’ department, Matt Burns, said the change in the count was made simply to correct an error. Mr. Burns said the department posted the higher figure by mistake in November, when an employee who was updating the site inadvertently added noncombat injuries listed by the Defense Department. The Pentagon Web site had the correct total all along.

The previous total on the Web site was 18,586, strictly for combat injuries. Apparently, no one noticed the sudden leap.

The 50,508 figure caught the attention of the Pentagon when Prof. Linda Bilmes of Harvard mentioned it in an opinion article on Jan. 5 in The Los Angeles Times. A few days later, said Professor Bilmes, who teaches public finance, she had a call from Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs, challenging the number.

Professor Bilmes explained that she had used the government tally, the one on the “America’s Wars” page of the veterans’ department Web site. She faxed him a copy.

A few days later, the number on the Web site was changed.

A spokeswoman for Dr. Winkenwerder confirmed that he had called the veterans’ department to have the figure corrected and that the worker had misunderstood the Defense Department figures.

For her purposes, Professor Bilmes said, the higher figure was the relevant one because she was writing about the future demands that wounded veterans would place on the veterans’ health care system. Many of the veterans would be treated in the system regardless of whether they had been injured in combat or in vehicle crashes.

About 1.4 million troops have served in Iraq or Afghanistan, and more than 205,000 have sought care from the veterans’ agency, according to the government. Of those, more than 73,000 sought treatment for mental problems like post-traumatic stress disorder.

No one disputes that more 50,000 troops have been injured in Iraq and Afghanistan or that nonhostile injuries can be serious. Of the more than 3,000 deaths that have occurred, 600 have been listed as nonhostile.

The Pentagon generally directs reporters to, which lists counts of the wounded and dead. The deaths are divided into hostile and nonhostile, but the injuries include just those “wounded in action.”

Another site on the Web, http :// /CASUALTY/castop.htm, shows diseases and nonhostile injuries. It is the source of the higher counts.

“The government keeps two sets of books,” said Paul Sullivan, director of research and analysis for Veterans of America. Until last March, Mr. Sullivan was a project manager in the Veterans Affairs Department who monitored the use of disability benefits by Afghanistan, gulf war and Iraq veterans.

He suggested that the differing numbers might be cleared up by a bill that has been introduced in the Senate to improve the collection of health information on Afghanistan and Iraq veterans.

Monday, January 29, 2007

This Marine's death came after he served in Iraq

Reprinted with the permission of the author:

This Marine's death came after he served in Iraq
When Jonathan Schulze came home from Iraq, he tried to live a normal life. But the war kept that from happening.

By Kevin Giles, Star Tribune

At first, Jonathan Schulze tried to live with the nightmares and the grief he brought home from Iraq. He was a tough kid from central Minnesota, and more than that, a U.S. Marine to the core.

Yet his moods when he returned home told another story. He sobbed on his parents' couch as he told them how fellow Marines had died, and how he, a machine gunner, had killed the enemy. In his sleep, he screamed the names of dead comrades. He had visited a psychiatrist at the VA hospital in Minneapolis.

Two weeks ago, Schulze went to the VA hospital in St. Cloud. He told a staff member he was thinking of killing himself, and asked to be admitted to the mental health unit, said his father and stepmother, who accompanied him. They said he was told he couldn't be admitted that day. The next day, as he spoke to a counselor in St. Cloud by phone, he was told he was No. 26 on the waiting list, his parents said.

Four days later, Schulze, 25, committed suicide in his New Prague home.

Citing privacy laws, Veterans Affairs officials wouldn't comment specifically on the case, nor would they confirm or deny the Schulze family's account. However, Dr. Sherrie Herendeen, line director for mental health services at the St. Cloud hospital, said Thursday that under VA policy, a veteran talking about suicide would immediately be escorted into the hospital's locked mental health unit for treatment.

She also said that after hearing of Schulze's death, the hospital is doing an internal review of its procedures.

Schulze's father and stepmother, Jim and Marianne Schulze of rural Stewart, Minn., say their son would be alive today if the VA had acted on his pleas for admittance. They say they heard him tell VA staff in St. Cloud that he felt suicidal -- in person on Jan. 11 at the hospital, and over the phone on Jan. 12.

On the evening of Jan. 16, Schulze called family and friends to tell them that he was preparing to kill himself. They called New Prague police, who smashed in the door and found him hanging from an electrical cord. Police attempted to resuscitate him, but it was too late.

Schulze's family doctor in Stewart, a farming crossroads in McLeod County, said he was convinced that Schulze suffered from post-traumatic stress disorder, a disabling mental condition that can result from military combat.

"Jonathan was a classic," said Dr. William Phillips, who said he first examined Schulze in October 2004 when Schulze was home on leave from Marine duty.

Phillips said Schulze was reliving combat in his sleep, had flashbacks when he was awake, couldn't eat, felt paranoid, struggled with relationships and admitted to drinking alcohol excessively. Phillips prescribed medication to calm his nerves and help him sleep.

The doctor also asked Schulze to seek counseling at Camp Pendleton, the Marine Corps base in California where he was assigned. Phillips said he was unable to learn whether Schulze had done so.

"We don't have a system for this," Phillips said this week. "The VA is overwhelmed, and we're rural doctors out here trying to deal with this. Unfortunately, we're going to see a lot of Jonathans."

Seeking help

Maj. Cynthia Rasmussen, the combat stress officer for the 88th Regional Readiness Command at Fort Snelling, said veterans returning to Minnesota who have problems often don't seek help until their civilian lives begin to fall apart. "Soldiers think if they go to get help that they're going to be seen as weak, but they also think their command won't have faith in them," she said.
Rasmussen said reasons for mental illness among returning veterans are many and complex, but often relate to personality changes that service members must make while in uniform -- and especially in combat zones -- and then try to readjust to civilian life.

After Schulze left the Marines in late 2005, he continued to have aching memories of combat.

"When he got back from Iraq he was mentally scattered," said his older brother Travis, who also served there with the Marines.

Much of Jonathan Schulze's anguish seemed to relate to combat in Ramadi in April 2004. Schulze, who carried a heavy machine gun, wrote his parents that 16 Marines, many of them close friends, had died in two afternoons of firefights and bombings. Twice he was wounded but didn't tell his parents, not wanting them to worry. He wrote them about dismembered bodies. About youth and combat and disillusionment. And about the bombs.

"I pray so much over here and ask God to keep me out of harm's way and to make it back home alive and in one piece," he wrote Jim and Marianne in May 2004. "I bet I easily pray over a dozen times a day and I always pray while I am on patrol as I am terrified of getting hit by an IED aka a bomb. Our vehicle elements and Marines on patrols are getting hit hard by these bombs the Iraqis plant all over and hide on the ground."

Schulze carried guilt that fellow Marines died. He wanted to return to Iraq to somehow redeem himself, said his father, who did three tours of duty in Vietnam.

Because of that, Schulze at first resisted counseling, Jim Schulze said: "Being a Marine, he was too proud to get help. They want to make you impervious of any emotion. And when you get out it's almost impossible to put it back the way it was."

When Schulze left the Marine Corps, he participated in military color guards, visited aging veterans in the state homes, helped anyone in need. He worked with his stepfather building houses. An unmarried father, Schulze bragged of adoration for his young daughter, Kaley Marie, on his MySpace website.

But the war always got in the way of a normal life.

Schulze was on an emotional roller coaster and couldn't get off, said his close Marine friend from Iraq, Eric Satersmoen, who with Schulze's stepbrothers described him as becoming uncharacteristically quiet.

"Lot of inner turmoil, lot of flashbacks, lot of nightmares," was how Jim Schulze described his son.

The Jan. 11 visit to the VA in St. Cloud came a few weeks after Jonathan Schulze waited for more than three hours at the VA hospital in Minneapolis, hoping to be admitted, Jim Schulze said. His son last saw a psychiatrist at the Minneapolis VA on Dec. 14 but someone there told him he couldn't be admitted for treatment until March, Jim Schulze said. They went to St. Cloud with the expectation that Jonathan could be admitted quicker.

Satersmoen and Travis Schulze think that Jonathan Schulze didn't intend to kill himself. They said that he was drunk and confused and speculate that he unintentionally blacked out before police arrived.

Secondary causes of death, said the Minnesota Regional Coroner's Office in Hastings, were post-traumatic stress disorder and acute and chronic alcoholism.

At the funeral in Prior Lake, Schulze lay in his Marine dress blues, two Purple Hearts and his other medals pinned to his tunic. Dozens of young men -- fellow Marines -- gathered in groups to tell stories. They called him Jonny. He was funny, they said. The life of the party.

Cold wind ripped across the cemetery in Stewart where he was buried. Veterans from the Hutchinson, Minn., VFW fired a three-volley salute. Travis Schulze, dressed in black, and Satersmoen, wearing Marine dress blues, removed the flag from the casket and folded it. Travis Schulze presented the flag to his father. And saluted him.

"He was a delayed casualty of the Iraq war," Jim Schulze said of Jonathan.

Kevin Giles • 612-673-7707 • ©2007 Star Tribune. All rights reserved.

Thursday, January 25, 2007

From the New York Post


January 22, 2007 -- The family of a New York sailor fatally shot in the head in Iraq last week demanded yesterday to be told the circumstances of his mysterious death.

"I want to know exactly what happened," said Barbara Alomar, of upstate Livingston Manor, the mother of Pretty Officer Joseph Alomar. "And I'm not being given any answers right now."

The military has told the family of the 22-year-old sailor only that he died from a "non-combat related incident" on Thursday - a bullet wound to the head - at Camp Bucca, a prisoner detention center.

"The military told me he was shot in a fire zone, that he was not on duty," said his dad, Joseph Figueroa, 44, of Brooklyn.

Aileen Encarnaction of Queens, the sailor's stepmom, said, "I feel numb. It's like a nightmare."
Alomar and his wife, Jennifer, have a 4-year-old daughter, Jaleeha. He had been in the Navy three years and was due to finish his service in April.

His sister, Sabrina Figueroa, 15, said Alomar used to complain of homesickness, "but he never said he had any problems in Iraq."