Americans received a grim reminder this week that, as the wars in Iraq and Afghanistan drag on, death doesn't always come at the hands of an enemy. On Monday, Sergeant John M. Russell shot and killed five fellow servicemen at a mental health clinic at Camp Liberty in Iraq after his commanding officer recommended that he receive psychological counseling and confiscated his weapon.
Russell directed violence at others, but more and more often service members aim weapons at themselves. In 2008, over 140 service members committed suicide, far more than in any year since the statistic has been tracked. This internal wave of violence is a signal that the emotional and mental costs of war are taking a severe toll on American soldiers.
To reduce effects of combat stress, Admiral Michael Mullen, chairman of the Joint Chiefs of Staff, said he would consider increasing time between deployments. This must be tied with an effort to decrease the number of deployments, particularly since the Army's mental health assessment found that soldiers on a third deployment were at much higher risk of mental health issues.
But the stigma of mental health problems prevents too many soldiers from getting help. According to his father, Russell was concerned that by sending him to the clinic, his commanding officer was "setting him up" for discharge. Accessing mental health services must not be seen as a reason for demotion. Already, some leaders are taking initiative to change this. General Carter Ham, the commanding general for the Army in Europe, admitted that he sought counseling after his return from Iraq and told soldiers that he believed he was "a better general because I got some help." These messages from leaders signal that vulnerability to combat stress is part of the job.
Combating stigma must also involve better access to resources. All soldiers get a health assessment after their deployment, but most soldiers only fill out questionnaires. An experimental model at Fort Lewis in Washington called the Soldier Wellness Assessment Pilot Program gives returning soldiers a minimum of a 15-minute face-to-face mental health interview. Doctoral-level medical providers and other services are immediately available for those with symptoms of stress. However, this program is funded not by the Department of Defense, but by a grant from the surgeon general's office. The Pentagon ought to adopt the model more widely.
Until regular care becomes part of the regimen, the burden of identifying service members in mental distress falls on their colleagues and loved ones. This just isn't enough. The profound psychic wounds of those we send to war must be identified and treated in a systematic way.