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Brusque military grapples with soldier suicides

/ Source: The Associated Press

Thousands of soldiers, their bald eagle shoulder patches lined up row upon row across the grassy field, stood at rigid attention to hear a stern message from their commander.

Brig. Gen. Stephen Townsend addressed the 101st Airborne Division with military brusqueness: Suicides at the post had spiked after soldiers started returning home from war, and this was unacceptable.

"It's bad for soldiers, it's bad for families, bad for your units, bad for this division and our Army and our country and it's got to stop now," he insisted. "Suicides on Fort Campbell have to stop now."

It sounded like a typical, military response to a complicated and tragic situation. Authorities believe that 21 soldiers from Fort Campbell killed themselves in 2009, the same year that the Army reported 160 potential suicides, the most since 1980, when it started recording those deaths.

But Townsend's martial response is not the only one. Behind the scenes, there has been a concerted effort at Fort Campbell over the past year to change the hard-charging military mindset to show no weakness, complete the mission.

There are Army doctors like Tangeneare Singh, reaching out to soldiers struggling silently from depression, trauma-related stress and other mental illnesses. There are staffers like Daina Cole, who tracks data collected from Fort Campbell's soldiers, looking for evidence of problems.

And there are platoon sergeants like Robert Groszmann, trained to listen carefully to the soldiers under his command to detect signs of trouble. He knows that the Army must deal with the deadly issues of some of its fighting men and women, though some disdain this "touchy-feely Army stuff."

"You have to get people to buy into this, because it really is a paradigm shift from the old Army that tells you to suck it up, rub some dirt on it and you'll be fine," Groszmann said.

Assigned push-ups instead of help

Spc. Adam Kuligowski's problems began because he couldn't sleep.

Last year, the 21-year-old soldier was working six days a week, analyzing intelligence that the military gathered in Afghanistan. He was gifted at his job and loved being a part of the 101st Airborne Division, just like his father and his great uncle.

But Adam was tired and often late for work. His eyes were glassy and he was falling asleep while on duty. His room was messy and his uniform was dirty.

His father, Mike Kuligowski, attributes his son's sleeplessness and depression to an anti-malarial medication called mefloquine that was found in his system. In rare cases, it can cause psychiatric symptoms such as anxiety, paranoia, depression, hallucination and psychotic behavior.

But instead of getting medical help, Adam got push-ups. One time, he got angry, throwing his gun on the ground and telling his command to send him to jail. He was given an Article 15 nonjudicial punishment for misconduct and assigned kitchen duty during his days off.

The final straw, his father said, was when his first sergeant threatened to take away his security clearance and take him off his intelligence job.

Adam wrote a note telling his dad, "Sorry to be a disappointment." Then he shot himself inside a bathroom stall with his rifle.

When the Army closed their investigation into the soldier's suicide, his father said an investigator told him that the Adam's problem was that he was unable to conform to a military lifestyle. Mike Kuligowski did receive a personal note from the division's commanding general: "We don't know why this happened," he wrote.

Kuligowski was not appeased. "It reminds me that officers know absolutely nothing about the plights of the soldiers who are under their command," he said. "What kind of leadership is that?"

But Robert Groszmann is convinced that the right kind of leadership is at hand.

Groszmann was one of the first NCOs to be trained in the Army's new resiliency program at the University of Pennsylvania, part of the Army's movement to provide more holistic training for today's soldiers. The training emphasizes one-on-one conversations between leaders and soldiers about how to think positively, become more self-aware, build character and be prepared for stress.

The staff sergeant knows which soldiers in his unit are struggling. It's the soldier who got arrested recently for a domestic situation and now faces criminal charges. Or the soldier whose father died during her deployment and left her with creditors looking for money.

It's his job to step in and help them through these rough patches, because sometimes soldiers don't have anyone but the Army to rely on, said Groszmann, a 30-year-old noncommissioned officer in the division's 4th Brigade Combat Team.

The ingrained fear of admitting a weakness often comes from a soldier's own peers — the tight-knit group of warriors that represent his or her military family, Groszmann said.

"That other specialist is going to eat you alive if he sees any weakness and that's where it's on people like me to say, 'You guys need to lay off of him.'"

Strong stigma in macho world

While commander of Fort Campbell's hospital, Brig. Gen. Richard Thomas saw thousands of soldiers returning from war, some with physical and some with emotional injuries. But something was preventing his medical staff from getting them early treatment: the stigma that those injuries carried in the macho world of the military.

What he learned was that many soldiers would open up about symptoms if they were given the opportunity to talk one-on-one with a counselor right after coming home, rather than just fill out a survey, he said.

Now an assistant surgeon general, Thomas says the Army is piloting a project to provide counseling time to entire battalions and brigades immediately after completing deployments. A similar approach is being applied to detecting mild traumatic brain injuries, which can lead to increased risk for mental health problems, he said.

"What we are doing is focusing on the early symptoms of traumatic brain injury and post traumatic stress disorder so we can get treatment earlier, rather than waiting for these guys to have chronic, long-term problems," he said.

Some soldiers will never step foot inside a behavioral health clinic; they fear the stigma, and they fear also that a diagnosis could lead to a medical discharge, said Dr. Tangeneare Singh, a combat veteran herself and chief of the department of behavioral health at Fort Campbell.

So any soldier who walks into one of the several medical clinics on post, whether it's for a twisted ankle or trouble sleeping, is screened for depression and PTSD symptoms.

Soldiers who report such symptoms to their primary doctors are assigned a case manager, like Tina Robertson, a licensed nurse.

On a recent day, Robertson described for Singh the symptoms of a soldier who came into a clinic showing minor signs of depression. Robertson explained that his stress stemmed in part from his marriage. "He had some previous marital problems prior to deployment, which has gotten worse since he returned," Robertson said.

Singh said his symptoms sounded like an adjustment disorder and recommended that he be monitored for any changes in mood or behavior over the next couple of weeks and be enrolled in a marital therapy class.

Her message to those who seek help: "It's OK to be upset over things that have happened in the war. It's OK to have anger stemming from that, but you need to learn how to modulate that when you get home."

60 percent rise in soldiers seeking help

The number of patients being treated at the behavioral health clinic has increased by 60 percent, from 25,400 in 2008 to nearly 40,000 in 2009. To handle the expanded need, they've also increased the number of counselors in that clinic to 60 last year, compared to 36 in 2008. In all, Fort Campbell has about 100 counselors, some of whom work in areas like social work, family advocacy, substance abuse and children's behavioral health.

Singh and Robertson both say they've seen an increase in soldiers coming in with signs of stress as the 101st Airborne Division's next deployment nears; nearly 20,000 soldiers from the division are leaving for another deployment, the fourth or fifth tour for most of these units.

During this time, alcohol and drug abuse can intensify, as well as spousal abuse or domestic incidents, she said.

"Soldiers are anxious about what's going to happen," she said.

Authorities at the post are more vigilant about indications that something is amiss. Last summer, Daina Cole was looking at data that showed a large amount of alcohol-related incidents, like drunken driving, in a particular unit.

Cole, as the installation's risk reduction manager, tracks high-risk behaviors such as arrests or reports of domestic abuse among the installation's 30,000 active-duty soldiers. She also looks at two surveys soldiers fill out after returning from a deployment, answering questions like, "Do you have upsetting memories or dreams of stressful events that happened during your deployment?"

This data creates a kind of emotional snapshot of individual units that is being used to uncover and treat shared stress or behaviors among their soldiers.

For this particular unit, Cole was concerned that the already high number of alcohol-related incidents could skyrocket over an upcoming holiday weekend.

After presenting the data to the unit's command, the soldiers were enrolled in a drinking and driving prevention program. After the weekend, the data showed no major spike in drinking incidents, she said.

"It worked because it targeted that demographic. It spoke their language and it got their attention," she said.

Groszmann, the NCO, is getting ready to deploy with his soldiers this summer to Afghanistan. He's planning to test the Army's resiliency training while in combat. He plans to travel around to the tiny, remote outposts and remind his soldiers that while may be shot at and sleep deprived, they can make it through these temporary hardships.

The hard part is getting soldiers to believe that they can heal from any wound, whether physical or mental.

"When you make a bad decision, when you have one bad night, and you're able to bounce back from that," Groszmann said, "then we've won."

Associated Press reporter Sharon Cohen contributed to this report.