Features > August 29, 2007

Extending Tours, Stressing Troops (cont’d)

These findings raise two concerns. First, if it takes time for symptoms of depression or PTSD to manifest, then prolonged follow-up care for soldiers is vital. Military officials claim mental health care is available to soldiers both at home and in Iraq. But significant barriers stand in the way of accessing that care and personal testimony indicates it’s not always available. In his 2004 study, Walter Reed’s Dr. Hoge found that only about 40 percent of soldiers screening positive for combat-related mental health disorders had expressed interest in receiving help from the military. Of that 40 percent, only 23 to 40 percent had received counseling within the past year.

The second concern is that soldiers are being redeployed to Iraq before they have been diagnosed with PTSD or depression. Consequently they are serving second, third or even fourth tours suffering from undiagnosed stress disorders. In 2006, the under secretary of Defense responsible for Health Affairs, in a deviation from previous policy, announced that service members with diagnosed mental health problems and those taking psychotropic medications could be redeployed. Yet all available research indicates soldiers experiencing acute stress are more likely to harm Iraqi civilians and sustain mental health disorders.

No help on the horizon

Despite the studies clearly linking longer tours with higher rates of combat stress, Defense Secretary Gates is considering even further extending the tours of troops currently serving in Iraq—this time from 15 to 18 months. Gates says this is a “worst-case scenario,” but few other options exist if troops levels are to be maintained at current levels.

While members of Congress are quick to verbally support the troops, their words are not always followed up by action. In July, Sen. Jim Webb (D-Va.) introduced legislation specifying that active-duty soldiers receive at least the same length of time at home as their deployment in combat. Although this modest measure received 56 votes, that was still four shy of overcoming a Republican filibuster. On August 2, the House passed a similar measure, which included a provision allowing the president to disregard the new required rest time if deployment is necessary “to meet a threat to the national security interests of the United States.”

President Bush has threatened to veto the bill, and the House’s 229 to 194 vote margin lacks the two-thirds majority needed to override a presidential veto. Upon passage of the August 2 measure, the White House issued a statement saying the bill would “impose inappropriate, operationally unsound and arbitrary constraints on how the Department of Defense should prepare units to deploy.”

But the failure to redress troops’ mental health concerns hasn’t been solely the fault of politicians. After finding that only 5 percent of soldiers in Iraq take any rest and relaxation, the Army’s May MHAT study recommended that troops in high intensity combat receive one month of in-theater R&R for every three months of combat. The report says it has “long been recognized that mental health breakdowns occur after prolonged combat exposure,” and that the conditions under which today’s soldiers are fighting constitute an undue burden. “A considerable number of soldiers and Marines are conducting combat operations every day of the week, 10-12 hours per day, for months on end.” Shortly after the MHAT study’s release, however, Pentagon officials quickly rejected its recommendations as unworkable.

Often, programs are not only underfunded or politically unfeasible, but encounter real, structural problems. For example, two recently introduced programs—the Army’s Combat Stress Control program and the Operational Stress Control and Readiness program for the Navy and Marines—provide front-line combat stress relief by embedding mental health professionals within military units. In addition, the Army announced plans in June to spend up to $33 million to add 200 more mental health professionals to its ranks. But both proposals have ignored the observations of the American Psychological Association that roughly 40 percent of the funded positions for military mental health providers are vacant and cannot be filled.

And so it goes …

As for Thompson, he’s still in Baghdad, trying to make sense of what he’s been asked to do. He doesn’t see the U.S. military presence achieving its goals, especially when it comes to the business of “winning hearts and minds” that the Pentagon’s always talking about. For that, you need cultural exchange and interaction—something a military occupation makes impossible. “So much is lost when you hold a gun,” Thompson says. “You can’t just go to the bakery downtown and get some flat bread. You go to the bakery in a flak vest and helmet, with your M4 accompanied by vehicles and aerial support.”

Thompson says everyone he’s talked to feels the painful impact of the extensions. “Imagine having every facet of your life dictated to you—when to wake up, what to wear, where you’re going. It’s never something you liked, but you do it because you made a commitment. Then you find out you have to stick around for another year. Soon, that year becomes 15 months. And even when the media does talk about ‘the troops,’ no one ever discusses what soldiers live with every day. We are in a country where our friends are going to die, and we may or may not make it back to get married and go to college.”

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• Reader Comments

  There is no question that our troops have been stressed to the limit. Not only are they serving extended tours, they are doing it to attempt an impossible goal — reuniting a nation which has never truly been united nor a nation.

  We need to enlist the aid of other nations in the defense against radical Islamic terror and intimidation. Not just in Iraq, but wherever they surface.

  We just did not have the troops for pacification of 23 million people who live to hate each other. We need to admit it and seek additional international cooperation.

  Next time an administration proposes to cut the military just to make the economy look better, let’s remember the effect of the G.H.W. Bush and W.J. Clinton actions which took us down more than 30 percent.
  ---------------------

  The total commitment of George Jr. will no doubt cause him to reenlist as a pilot as soon as his current extended tour is completed.

  Posted by whattheheck on Sep 2, 2007 at 11:22 AM

  This is the sort of thing that feeds reincarnations of Tim McVeigh. PTSD isn’t the only psychological issue to be concerned with. I also have concerns about the mental states of those soldiers and marines who come back alienated, disillusioned, bearing feelings of betrayal, perhaps looking for paybacks. Not those who go to hospital and get ill-served by the VA or whomever, but those who never even seek treatment though they may need it.

  It will be only a few at most, but the small size of the conspiracy to blast the Murrah Fed Building in OK City didn’t affect the destruction a bit. It only needs a few guys in whom ordinary restraint has been scorched out.

  I imagine the litany in a young man’s mind, “why the fuck am i here and why won’t they let me leave”. A bit like being imprisoned, and we all know how doing a stretch can change some men, and not for the better. Serving in Iraq isn’t jail, but arbitrary dangers, hyper-vigilance for prolonged periods, punishing circumstances that can’t be escaped or avoided… learned helplessness takes a lot of forms, and also can bring a number of coping responses, including learned detachment. Take that mindset some way further, and you have one ugly potential.

  International help, yes, definitely needed (this unilateral bit is a losing game) but the problem is that almost no one else will go near the place, wouldn’t touch it with a 10-timezone pole. Can anyone blame them?

  Posted by Kuya on Sep 5, 2007 at 2:34 AM

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Also by Sarah Olson

• Extending Tours, Stressing Troops
  Despite a growing body of medical research, the Pentagon is extending tours of duty to their longest levels since World War II, precipitating the first time in history that active-duty soldiers will spend more time in combat than at home