Morale has fallen among soldiers in Afghanistan, where troops are seeing record violence in the 8-year-old war, while those in Iraq show much improved mental health amid much lower violence, the Army said Friday.
Soldier suicides in Iraq did not increase for the first time since 2004, according to a new study.
Though findings of two new battlefield surveys are similar in several ways to the last ones taken in 2007, they come at a time of intense scrutiny on Afghanistan as President Barack Obama struggles to come up with a new war strategy and planned troop buildup. There is also perhaps equal new attention focused on the mental health of the force since a shooting rampage at Fort Hood last week in which an Army psychiatrist is charged.
Both surveys showed that soldiers on their third or fourth tours of duty had lower morale and more mental health problems than those with fewer deployments and an ever-increasing number of troops are having problems with their marriages.
Depression, anxiety
The new survey on Afghanistan found instances of depression, anxiety and other psychological problems are about the same as they were in 2007. But it also said there is a shortage of mental health workers to help soldiers who need it, partly because of the buildup Obama already started this year with the dispatch of more than 20,000 extra troops.
Efforts already under way to get more health workers to the Afghan war could be hampered somewhat by last week's shooting. The psychiatrist charged with 13 counts of premeditated murder was slated to go to Afghanistan. Some of the dead and wounded also were to deploy there to bolster psychological services for soldiers.
Combat stress
A copy of the study obtained by NBC News also shows that more than one in five soldiers suffer some kind of combat stress, and that half of the soldiers in Afghanistan suffering psychological problems had trouble getting professional help for their problem. Despite the Army's efforts to provide soldiers on the battlefield with real-time mental health care, the report said, those barriers to care are "significantly higher" than they were several years ago.
The problem, the report added, is the Combat Stress units in Afghanistan are "undermanned." Also, there is not a single Combat Stress detatchment in the south of the country, where the majority of combat is taking place in an attempt to uproot the Taliban from their strongholds.
The report also cites a "high risk" of psychological problems among military guards at the Bagram prison facility, largely because of the strict restrictions put on the soldiers as to how they can deal with unruly or threatening prisoners.
In addition, the report reinforces the suspicion that multiple combat tours increases the risk of mental health problems.
Randomly selected
In Afghanistan, more than 1,500 troops in more than 50 platoons filled out the surveys from April to June, and the assessment team when through the same process from May through June.
In Iraq, some 2,400 soldiers in randomly selected platoons filled out surveys from December 2008 through March 2009 and a mental health assessment team went to the warfront for a month starting in late February to analyze the results and hold interviews and focus groups.
Mental health providers also were interviewed in each country.
It's the sixth such survey, a program that was groundbreaking when started in 2003 in that it was the biggest effort ever made to measure the health of troops — and the services they receive — right at the warfront.
The survey was different from previous ones in that it sampled two types of platoons. Some were maneuver units that warfighting groups engaged in combat-related tasks and others were support units such as aviation, engineering and medical elements less likely to have as much direct exposure to violence.
Other findings of the Afghanistan survey included:
- Junior enlisted soldiers reported significantly more marital problems than noncommissioned officers, stating they intended to get a divorce or that they suspected their spouses back home of infidelity.
- Exposure to combat, long recognized as a strong factor in mental health problems, was significantly higher this year than rates in 2005 and similar to rates in 2007 for the combat units.
- Combat units reported significantly lower unit morale in the last six months of their tours of duty, more evidence of the wearing affect of long deployments.
- Troops in their third or fourth deployment reported significantly more acute stress and other psychological problems, and among those married, reported significantly more marital problems compared to soldiers on their first or second deployment.
- Soldiers on their third or fourth deployment reported using medications for psychological or combat stress problems at a significantly higher rate than those on their first deployment.
- It was significantly harder to get behavioral health care this year than in 2005, a finding that may be owing to the fact that troops are spread out at hundreds of posts around the rugged terrain of Afghanistan.
- Troops who spent two to four hours daily playing video games or surfing the Internet as a way to cope helped lower their psychological problems, but spending time beyond that — three to four hours — had the opposite effect. Those who exercised or did other physical training decreased their mental problems, regardless of the time spent.
- Troops reported more and better training in suicide prevention and other mental health programs the Army has been increasing over recent years in an unprecedented effort to focus on the force's mental health.
- The mental health care system in Afghanistan is understaffed based on the Army doctrine of one mental health worker for every 700 troops.