From David Crary, AP:

Far from the combat zones, the strains and separations of no-end-in-sight wars are taking an ever-growing toll on military families despite the armed services' earnest efforts to help. ...What makes today's wars distinctive is the deployment pattern — two, three, sometimes four overseas stints of 12 or 15 months. In the past, that kind of schedule was virtually unheard of. ...

An array of studies by the Army and outside researchers say that marital strains, risk of child maltreatment and other problems harmful to families worsen as soldiers serve multiple combat tours.

For example, a Pentagon-funded study last year concluded that children in some Army families were markedly more vulnerable to abuse and neglect by their mothers when their fathers were deployed in Iraq and Afghanistan.

In Iraq, the latest survey by Army mental health experts showed that more than 15 percent of married soldiers deployed there were planning a divorce, with the rates for soldiers at the late stages of deployment triple those of recent arrivals.

For the Army, especially, the challenges are staggering as it furnishes the bulk of combat forces. As of last year, more than 55 percent of its soldiers were married, a far higher rate than during the Vietnam war. The nearly 513,000 soldiers on active duty collectively had more than 493,000 children.

The Army's Mental Health Advisory Team V report arrived today chock-full of updated data on how our troops are fairing. From AP:

U.S. troops on the battlefield found it harder to get the mental health care they needed last year, when violence rose in Afghanistan and new tactics pushed soldiers in Iraq farther from their operating bases. A report the Army released Thursday recommends sending civilian psychiatrists to the warfront, supplementing members of the uniformed mental health corps.

Surveying a force strained by its seventh year of war, officials found that more than one in four soldiers on repeat tours of duty screened positive for anxiety, depression and other mental health problems. That was comparable to the previous year.

The report found more troops reported marital problems, an increased suicide rate, higher morale in Iraq, but a greater percentage of depression among soldiers in Afghanistan. "They do show the effects of a long war," said Col. Elspeth Ritchie, psychiatry consultant to Army Surgeon General Lt. Gen. Eric Schoomaker.

Added Maj. Gen. Gale S. Pollock, a deputy surgeon general: "I think the fact that they are doing as well as they are with the demands they are under speaks to a strength and resiliency of the men and women of America."

The report was drawn from the work of a team of mental health experts who traveled to the wars last fall. The experts surveyed more than 2,200 soldiers in Iraq and nearly 900 in Afghanistan.

From the Associated Press:

The Army's new acting surgeon general said Tuesday she is concerned about long-term morale because the military lacks money to hire enough nurses and mental health specialists to treat thousands of troops coming home from Iraq and Afghanistan.

"When the original plans were made, we did not take into consideration we could be in a long war," said Maj. Gen. Gale Pollock. She became surgeon general earlier this month after Kevin Kiley was forced to resign in a scandal over poor treatment of war-wounded at Walter Reed Army Medical Center. "We have not been able to do the hiring," Pollock told a House Armed Services subcommittee.

She testified at the first of two congressional hearings Tuesday on veterans care during which lawmakers expressed impatience with the Bush administration's efforts. They said years of communication gaps between the Defense and Veterans Affairs departments have yet to be fixed.

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Pollack is not the first military official to sound such an alarm.

In January, Navy Cmdr. Mark Russell warned that the military lacks enough mental health care providers to treat combat forces serving in Iraq and Afghanistan. He's been speaking out for three years of the coming mental healthcare crunch.

Low morale rate -- called 'compassion fatigue' or 'provider fatigue' by the Army -- isn't a problem we'll have to tackle in the future. It already exists today. In a recent internal military survey, "33 percent of behavioral-health personnel (counselors and psychiatrists) and 45 percent of primary-care specialists (doctors and nurses) complained of high or very high burnout."

First, a few stats that came out of testimony given to a recent Pentagon Task Force on Mental Health hearing:

•Mental health trauma is on the rise. Army studies show that more than a third of combat-deployed troops seek mental health care when they return home.

•Training for mental health professionals is inadequate. A survey by Russell of 133 military mental health providers done from 2003-05 shows that 90% of the psychiatrists, psychologists and social workers reported no formal training or supervision in four PTSD therapies recommended by the Pentagon and Department of Veterans Affairs.

•Staffing is down. Russell says vacancies remain for mental health providers in the Navy. In addition, psychiatrists and psychologists deployed overseas deplete resources at home, and burnout makes it hard to keep skilled therapists on staff, he says. His concerns were supported by a 2005 Army study showing one of three mental health providers deployed in the war zone report high burnout or low motivation or morale.

•The Navy has 72% of the psychologists and 62% of the psychiatrists it needs, although trainees will raise staffing levels to 85% for psychologists and 91% for psychiatrists.

•Army staffing levels for uniformed psychiatrists and psychologist are at 80%-85%, but the Army has contracted with large numbers of civilian mental health officials to help in assisting soldiers.

Two weeks ago, medical providers at Bethesda Naval Medical Center testified to a Pentagon review group formed by Defense Secretary Robert Gates in the wake of the Walter Reed scandal:

Lt. Cmdr. Brandt E. Rice, a family medicine practitioner at the naval hospital, testified that doctors are saddled with too many administrative duties, lack enough time to devote to patients and face bureaucratic hassles. "My vocalness about this need has been met by some degree of resistance and also retaliation," Rice said.

Ursula Henry, a former Navy worker at the hospital, said some staff members have been "so frustrated with the whole scenario that they left to go across the street" to work at the National Institutes of Health.

Of course, compassion fatigue is hardly limited to military mental health providers; caregivers in the wake of Hurricane Katrina were also found to suffer from it. Even the general public was said to have suffered from compassion fatigue following successive natural disasters: the Asian tsunami, the Kashmir earthquake.

So, what is compassion fatigue? From Military OneSource:

"Compassion fatigue" is a fairly new term that describes certain emotions and behavior that people, often clinicians such as psychologists and therapists, sometimes experience as the result of hearing about and knowing about the traumatic experiences of others. It is part of the "secondary post-traumatic stress" family of responses that people may have when they help trauma victims. The symptoms, which are similar to the symptoms of post-traumatic stress, can interfere -- sometimes profoundly -- with a person's personal and work life. Compassion fatigue has also been described as "vicarious traumatization."

Signs of possible compassion fatigue include nervousness and anxiety, irritability and anger, moodswings, flashbacks, difficulty concentrating, lowered self-esteem, feeling less trusting of others and the world, withdrawing, changes in appetite or sleep habits, physical changes and/or depression.

Advice for those dealing with compassion fatigue:

• Get support from people you love and trust.
  
• Participate in debriefing sessions specifically for clinicians.
  
• Try not to compare yourself with others.
  
• Set more boundaries during this stressful time.
  
• Avoid using alcohol or nonprescription drugs to handle your emotions or to relax.
  
• Take care of yourself.
  
• Crisis management may not be your primary area of expertise.
  
• Limit your news coverage.
  
• Exercise.
  
• Practice deep breathing.
  
• Try to make your office area as comfortable and soothing as possible.
  
• Write down your feelings.
  
• Consider joining a support group.
  
• Balance objectivity and empathy.
  
• Give yourself time.
  
• Know and honor your own limitations.
  
• Remember to focus on the powerful impact you're having on the people you're helping.
  
• Seek professional help if you are not yourself.

Read the full description of above tips, available either online or via downloadable PDF.

You can find more tips in the Army's Battlemind brochure, 12 Tough Facts for Army Helping Professionals [downloadable PDF]. And to gauge your own stress level, the Compassion Satisfaction and Fatigue (CSF) Test is one handy tool you can use.


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From Newsweek:

Some experts call it "secondary PTSD" or "vicarious traumatization"; others prefer "compassion fatigue." The Army's term is "provider fatigue." Although it's not listed as an illness in the standard diagnostic manual, it can be seriously debilitating. Symptoms range from nightmares and "invasive thoughts" to anxiety, insomnia and hypervigilance. Case studies often mention a dread of work, including failure to keep appointments and carry out necessary follow-up with patients; in addition to absenteeism, effects often include errors in judgment, difficulty in concentrating, emotional numbness and religious doubts. The symptoms are part of everyday life to many Department of Veterans Affairs caregivers and to staff at military hospitals like the Walter Reed Army Medical Center.

The military is looking for solutions to the provider-fatigue problem. A 2006 internal advisory on health care for troops in Iraq reported that 33 percent of behavioral-health personnel (counselors and psychiatrists) and 45 percent of primary-care specialists (doctors and nurses) complained of high or very high burnout. The rate among chaplains was 27 percent. Last summer the Army launched a pilot "provider resiliency" program to help cope with secondary PTSD, and Maj. Edward A. Brusher of the U.S. Army Medical Command says the plan is to take the program worldwide. Landstuhl Regional Medical Center in Germany—usually the first stop for wounded troops coming out of Iraq—set up some of the first provider-fatigue workshops after the war began. Similar therapy groups are scheduled for May at Walter Reed.

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From USA Today:

From his distant vantage point treating Marines at a base in Iwakuni, Japan, [Navy Cmdr. Mark] Russell, 46, has been speaking out for three years that the U.S. military faces a mental health crisis in the treatment of its combat veterans.

He has fired off memos to higher command and has gone public with his views, an unusual step for many in the military. Russell discussed his concerns in phone and Internet interviews. "We cannot provide the standard of care to treat PTSD via psychotherapy when we can barely keep up with new referrals and have to manage crises while filling in for the staffing gaps and vacancies due to deployment, attrition or no billeting," Russell says. "This is why I have been so outspoken."

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Russell testified at the Pentagon's Task Force on Mental Health hearings in San Diego recently, pointing to the following problems:

•Mental health trauma is on the rise. Army studies show that more than a third of combat-deployed troops seek mental health care when they return home.

•Training for mental health professionals is inadequate. A survey by Russell of 133 military mental health providers done from 2003-05 shows that 90% of the psychiatrists, psychologists and social workers reported no formal training or supervision in four PTSD therapies recommended by the Pentagon and Department of Veterans Affairs.

•Staffing is down. Russell says vacancies remain for mental health providers in the Navy. In addition, psychiatrists and psychologists deployed overseas deplete resources at home, and burnout makes it hard to keep skilled therapists on staff, he says. His concerns were supported by a 2005 Army study showing one of three mental health providers deployed in the war zone report high burnout or low motivation or morale.

Klam says the Army and Navy have emphasized providing mental health counseling in war zones at an unprecedented level. As a result, he says, the military has a record of returning more than 98% of troops with emotional issues back to their units.

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Two new studies have arrived on the scene this first week of the New Year. Main findings:

A groundbreaking study of 1,946 male veterans of World War II and Korea suggests that veterans with symptoms of post-traumatic stress disorder are at greater risk of heart attacks as they age. The new study is the first to document a link between the stress disorder symptoms and future heart disease, and joins evidence that veterans with the stress disorder also have more autoimmune diseases such as arthritis and psoriasis.

A second study, funded by the Army, found that soldiers returning from combat in Iraq with post-traumatic stress disorder reported worse physical health, more doctor visits, and more missed workdays. The Army study is based on a survey of 2,863 soldiers one year after combat.

"The burden of war may be even greater than people think," said the first study's lead author, Laura Kubzansky of the Harvard School of Public Health.

Kubzansky goes on to say that the results may be due to the repeated release of adrenaline in those who deal with PTSD after a traumatic event. This may end up wearing down the cardiovascular system over time.

Click on 'Article Link' below tags for more PTSD study results...

Another study, looking at the link between memory and trauma via experiences of those closest to the World Trade Center on September 11, may shed some light on PTSD flashbacks:

Most Americans remember where they were on the morning of Sept. 11, 2001. But a new brain-scan study suggests that not all those memories were created equally. "If you were near the World Trade Center, your memories are qualitatively different from other people -- even those who were elsewhere in Manhattan," said lead researcher Elizabeth Phelps, a professor of psychology at New York University.

Specifically, people who were within about two miles of Ground Zero on that day now retain especially vivid, detailed recollections of the scenes and events of that morning -- a kind of recall that experts call "flashbulb memories." Brain imaging suggests that these memories are especially strong because the amygdala -- a brain area focused on fear and memory -- kicked into high gear as these people watched that morning's catastrophic events unfold.

Nearly all of the study participants who had been in lower Manhattan on 9/11 said they experienced first-hand the sights, sounds and smells of that day. And many said they feared for their own safety. All of that may have played a role in imprinting these highly potent memories in their brains, Phelps said. "This isn't unique to 9/11," she added, noting that flashbulb memories can be laid down in any kind of traumatic event, be it personal or very public....

The subdued parahippocampal function seen in the Downtown group might play a role in PTSD, Phelps said. "The amygdala helps you form a very strong memory," she explained. But in the normal brain, the hippocampus acts as a counterweight, "giving you the ability to keep it all in the right context."

With PSTD, the hippocampus' ability to reign in frightening memories may get lost. "We know that there are differences in the hippocampus in people that will go on to develop PTSD and those who will not," Phelps said.

Researchers are also examining the relationship between PTSD and pain:

PTSD may alter the way the brain handles pain, a new study shows. The researchers included Elbert Geuze, PhD, of the Netherlands' Department of Military Psychiatry. Their study appears in the Archives of General Psychiatry.

Geuze and colleagues studied 24 male Dutch veterans who had served on U.N. peacekeeping missions in Lebanon, Cambodia, or Bosnia. ... The veterans rated how much pain they felt when their hands were briefly subjected to heat at temperatures ranging from 104-118 degrees Fahrenheit. Those with PTSD had a higher tolerance for the heat, compared to those without PTSD.

The veterans also got brain scans using functional magnetic resonance imaging (fMRI) while they took the heat test. Those brain scans showed different patterns of brain activity between the veterans with and without PTSD. For instance, the veterans with PTSD showed less activity in part of their amygdala, a brain area that's involved in the brain's pain response.

Last week, the Army released the following "snapshot of the morale and mental health" of our troops:

The recent data on troops who have deployed to Iraq, released in a Dec. 19 report, paints a stark picture. For example, the suicide rate among soldiers supporting Operation Iraqi Freedom almost doubled in 2005, going up to 19.9 per 100,000 troops from 10.5 per 100,000 the year before.

Yet the data from 2003 show the rate that year to be 18.8 per 100,000 troops, which makes officials cautious about drawing conclusions. “We haven’t made a connection between the stress on the force with a significant increase in suicides,” said Lt. Gen. Kevin Kiley, Army surgeon general, who discussed the data Dec. 20 at the Pentagon. “That isn’t to say there aren’t any. [But] I don’t have any evidence that there is a correlation between PTSD and suicides.”

The report also found that troops who have deployed to Iraq more than once reported higher levels of acute stress symptoms as well as higher levels of anxiety and depression than those serving their first tours. Almost 19 percent of troops with at least one prior tour in Iraq reported acute stress symptoms, compared with 12.5 percent on their first tour.

On the plus side, troops say getting help in theater is now easier and the stigma of seeking that help is decreasing. The study was compiled the Mental Health Advisory Team III, established at the request of Multi-National Force-Iraq, using data collected in October and November 2005 in theater. Similar assessments were made in late 2003 and 2004.

Last year, European researchers measured the effect personality has on the incidence of PTSD:

[O]ne study suggests that, whether a veteran of combat or a victim of accident or crime, your chances of facing the anxiety or depression of post-traumatic stress disorder (PTSD) may hinge as much on your personality as on your experience.

Inge Bramsen, a psychologist at Vrije Universiteit in Amsterdam, tested 572 men who participated in the United Nations Peacekeeping Force in the former Yugoslavia for PTSD. Men who reported seeing the highest number of stressful events—shootings or dead people, for example—showed the most severe symptoms. But those who rated highest on personality traits such as negativism and paranoia before deployment also tended to show more signs of PTSD later. A hostile person may see more personal menace in events than others do, says Bramsen. An anxious person may also cope with stressful situations less effectively.

Another study appears to show the gradual development of PTSD over time:

A study released in October by the American Journal of Psychiatry .. of 613 U.S. soldiers revealed that as time goes by after war service, PTSD becomes more evident, particularly in veterans with physical injuries. When the soldiers in the study first returned from overseas, the level of PTSD was 4 percent. After four months, that rate rose to 12 percent. Of those who were diagnosed with PTSD after seven months, 78.8 percent had screened negative for the condition at one month.

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From Newsweek:

For Staff Sgt. Duane Leventry, the culture shock hit him full force in an Anchorage, Alaska, supermarket.

Shortly after returning home from 16 months in Iraq, he found himself staring at an aisle full of steak sauce and marinade, paralyzed by the sheer volume of choices. “I must have stood there for 10 minutes trying to figure out what to get,” says Leventry, who arrived home in Anchorage last Saturday, Nov. 25, to his wife Kelly and 3-year-old daughter Alexia. “Do I want this? Do I want that? It took us about two hours to get out of the store.”

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For Spc. Shawn Mott, it happened on his first night home at a restaurant in Fairbanks, where the 172nd Stryker Brigade’s home base of Fort Wainwright is located. “The waitress walked up to me and I didn’t know what to do. I sat there for like 15 minutes going ‘What do I want?’” says Mott. “Having choices is overwhelming to me. All I ate in Iraq was chicken tenders and fries.”

After nearly a year and a half of combat duty, the returned soldiers of the 172nd are trying to adjust to life at home in Alaska. The Army has prepared the soldiers for the big things—how to watch for symptoms of posttraumatic stress disorder, how to reintegrate themselves into family life after what has been for some an unbearably long absence. But for the soldiers of the 172nd, who started arriving home last weekend, it’s the little things that have caught them by surprise.

This, by the way, is the same Stryker Brigade force that went through July's helter-skelter deployment extensions.

From the Stryker Brigade News:

First Arctic Wolves Return to Alaska After 16 Months in Iraq

By Brian Lepley and Spc. L.B. Edgar, AFPS

FORT RICHARDSON, Alaska, Nov. 27, 2006 – Two days after Thanksgiving, the families of the 172nd Stryker Brigade Combat Team had a lot to be thankful for as three planeloads of the “Arctic Wolves” returned from a 16-month deployment to Iraq.

Fort Wainwright welcomed more than 620 soldiers and Fort Richardson welcomed another 215 troops Nov. 25. More flights through this week and next were expected to get more than 3,720 Stryker soldiers back home by Dec. 5. For many of the returning soldiers, the homecoming was a bit of a déjà vu. Some 380 of the 172nd soldiers came home to Fort Wainwright in July before their unit’s deployment was extended four additional months.

More than 300 of the soldiers rejoined their units in Iraq, this time to conduct combat operations in Baghdad. They had previously been operating in the northern provinces of Iraq, mainly in Anbar, Rawaha and Mosul.

Back to Newsweek:

Next month, Leventry, 27, will leave the Army and intends to apply for the Anchorage police force. He never planned on a military career, but says the long, stressful deployments “definitely contributed” to his decision to leave the service. He was supposed to have gotten out in October but couldn’t because of the extension.

Shawn Mott, 26, still hasn’t decided whether to re-enlist. He is drained by his 16-month tour and says some of the worst stress of his time in Iraq came after the 172nd was suddenly transferred to Baghdad and had to deal with the resentment of other Army units already in the capital. Rivalries quickly developed between the members of the elite 172nd and the Fourth Infantry Division and the 101st Airborne. The Stryker soldiers were furious at their last-minute extension and felt they’d been diverted to Baghdad because the other units hadn’t done their jobs. The other units seemed to resent the swaggering, informal style of the Stryker soldiers. “It was a real culture clash,” Mott says. “Me and the Army don’t get along too well right now.”

For now, Mott is both reveling in his reunion with his fiancée, Nina Herrera, as well as dealing with feelings of “weirdness” at being out of Iraq. When Mott arrived in Fairbanks on Saturday after a 13-hour flight from Kuwait, there was no one to greet him: “There was no one to hug,” says Mott. “It was lonely.” More>>

Welcome Home, 172nd. To a happy and successful transition back into civilian life, surrounded by your loved ones.

Zogby International, tracking public opinion since 1984 in North America, Latin America, the Middle East, Asia, and Europe, has just completed a first-ever opinion poll of our combat troops serving in Iraq. The results are absolutely stunning. The poll, conducted in conjunction with Le Moyne College, is touched upon today in Nicholas Kristof's New York Times Op-Ed column, The Soldiers Speak. Will President Bush Listen? (subscription) . For those who don't subscribe to the NYT, I have all the details explored there (and more) for you here.

Click on 'Article Link' below tags for more...

From today's Zogby press release:

A new poll to be released today shows that U.S. soldiers overwhelmingly want out of Iraq -- and soon. The poll is the first of U.S. troops currently serving in Iraq, according to John Zogby, the pollster. Conducted by Zogby International and LeMoyne College, it asked 944 service members, "How long should U.S. troops stay in Iraq?"

Only 23 percent backed Mr. Bush's position that they should stay as long as necessary. In contrast, 72 percent said that U.S. troops should be pulled out within one year. Of those, 29 percent said they should withdraw "immediately."

• Le Moyne College/Zogby Poll shows just one in five troops want to heed Bush call to stay “as long as they are needed.”
  
• While 58% say mission is clear, 42% say U.S. role is hazy.
  
• Plurality believes Iraqi insurgents are mostly homegrown.
  
• Almost 90% think war is retaliation for Saddam’s role in 9/11, most don’t blame Iraqi public for insurgent attacks.
  
• Majority of troops oppose use of harsh prisoner interrogation.
  
• Plurality of troops pleased with their armor and equipment.
  
• While 89% of reserves and 82% of those in the National Guard said the U.S. should leave Iraq within a year, 58% of Marines think so.
  
• 7 in 10 of those in the regular Army thought the U.S. should leave Iraq in the next year.
  
• About 3/4 of those in National Guard and Reserve units favor withdrawal within six months, just 15% of Marines felt that way.
  
• About 50% of those in the regular Army favored withdrawal from Iraq in the next six months.
  
• 58% of those serving in country say the U.S. mission in Iraq is clear in their minds.
  
• 42% said the mission is either somewhat or very unclear to them, that they have no understanding of it at all, or are unsure.
  
• 85% said the U.S. mission is mainly “to retaliate for Saddam’s role in the 9-11 attacks.”
  
• 77% said they also believe the main or a major reason for the war was “to stop Saddam from protecting al Qaeda in Iraq.”
  
• 93% said that removing weapons of mass destruction is not a reason for U.S. troops being there.
  
• 68% believe the real mission became to remove Saddam Hussein.
  
• 24% said that “establishing a democracy that can be a model for the Arab World" was the main or a major reason for the war.
  
• 11% see the mission there as securing oil supplies.
  
• 6% believe we are there to provide long-term bases for US troops in the region.
  
• 80% said they did not hold a negative view of Iraqis because of insurgent attacks.
  
• 2 in 5 see the insurgency as being comprised of discontented Sunnis with very few non-Iraqi helpers.
  
• Less than 1/3 think that if non-Iraqi terrorists could be prevented from crossing the border into Iraq, the insurgency would end.
  
• 53% said the U.S. should double both the number of troops and bombing missions in order to control the insurgency.
  
• 4 in 5 said they oppose the use of such internationally banned weapons as napalm and white phosphorous.
  
• 55% said it is not appropriate or standard military conduct to use harsh and threatening methods against insurgent prisoners in order to gain information of military value.
  
• 3/4 of the troops had served multiple tours and had a longer exposure to the conflict:
  
• 26% were on their first tour of duty.
  
• 45% were on their second tour.
  
• 29% were in Iraq for a third time or more.
  
• 30% of troops said they think the Department of Defense has failed to provide adequate troop protections, such as body armor, munitions, and armor plating for vehicles like HumVees.
  
• 35% said basic civil infrastructure in Iraq, including roads, electricity, water service, and health care, has not improved over the past year.
  
• 3 of 4 were male respondents.
  
• 63% of those surveyed were under the age of 30.

The troops have drawn different conclusions about fellow citizens back home. Asked why they think some Americans favor rapid U.S. troop withdrawal from Iraq, 37% of troops serving there said those Americans are unpatriotic, while 20% believe people back home don’t believe a continued occupation will work. Another 16% said they believe those favoring a quick withdrawal do so because they oppose the use of the military in a pre-emptive war, while 15% said they do not believe those Americans understand the need for the U.S. troops in Iraq.

A stunning poll.

USA Today reports on the strange uptick in workplace injuries at Robins AFB in Georgia. The base is responsible for repairing military aircraft. As the war raged onward, and the Defense Department demanded a leaner, meaner and more efficient military, the strain of meeting these demands resulted in a witches' brew of problems.

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The situation at Robins, where thousands of workers repair military aircraft, is a case study on how the war overseas has affected those serving on the home front. Here, a different kind of strain and battle fatigue has surfaced, often in startling ways.

The wounded came not from engaging the enemy, but from scores of workplace injuries that increased as the war intensified. The low morale was measured in rises in drunken driving and domestic abuse, discrimination complaints and lost productivity. Most dramatic were the suicides — double the national rate in 2004 — and murders on the base, the first in Robins' 65-year history. "We do have the rigors of a wartime mission," explains Lt. Col. Dan Mokris, the base safety officer. "We just have to do it right here." ...

After U.S. forces invaded Afghanistan and Iraq, the demands of war exacerbated the challenges of trying to modernize and streamline the military, Collings says. As a consequence, he says, the needs of those at Robins were neglected, and the troubles at the base began to swell.

"Whether you're talking about the soldier in the field who's getting ready to take the next bunker, the fighter pilot, the maintainer who is turning wrenches on the flight line, the engineer doing software development here or Ronnie who works in the paint shop," Collings says, "if you don't have their heart and their belief that you are leading them in the right direction, it's a non-starter."

The events at the Robins AFB form a cautionary tale. More...

Some statistics to share with you, taken from the National Veterans Foundation website. Figures from a wide range of sources offer a broad overview of the modern combat veteran's experience on and off the battlefield.

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In October of 2005, the VA reported that more than 430,000 U.S. Soldiers have discharged from the military following service in Afghanistan and Iraq. More than 101,000 of have sought help for medical or mental health issues from the VA to date.

• A 2003 New England Journal of Medicine Study found that 15-17 percent of US Iraq and Afghanistan Veterans were suffering from PTSD, and more than 60% of those showing symptoms were unlikely to seek help due to fears of stigmatization or loss of career advancement opportunities.
• In November of 2005, The U.S. Bureau of Labor Statistics reported that for the first three quarters of 2005, nearly 15 percent of veterans aged 20-24 are jobless -- three times the national average
• In 2005, the VA reported that 18% of Afghanistan Veterans, and 20% of Iraq Veterans were suffering from some type of service connected psychological disorder.
• A 2004 US Army Mental Health Advisory Team Study showed that more than half of all soldiers in Iraq described their unit morale as low, with the National Guard and Reserve forces struggling the most.
• The VA has seen a tenfold increase in PTSD cases in the last year. According to the VA, more than 23,889 Vets of Iraq and Afganistan have sought help for Mental Health Disorders.
• According to the Pentagon, since March 2003, 40 US Soldiers and 9 Marines had committed suicide in Iraq. At least 20 soldiers and 23 Marines have committed suicide since returning home.
• The Miles Foundation reports that calls to their Domestic Violence Hotline for Military Spouses has increased from 50 to 500 per month since the start of the Iraq War.
• According to U.S. Army data, the number of active-duty soldiers getting divorced has been rising sharply with the deployments to Afghanistan and Iraq. The trend is severest among officers. Last year, 3,325 army officers’ marriages ended in divorce -- up 78% from 2003 the year of the Iraq invasion, and more than 3½ times the number in 2000, before the Afghan operation. For enlisted personnel, the 7,152 divorces last year were 28% more than 2003 and up 53% from 2000 (USA Today, june 8, 2005).

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