TIME Veterans

Veterans Offer Each Other Help as Iraq Falls Apart

A US marine from the 3/5 Lima company po
A U.S. Marine in Fallujah in November 2004. PATRICK BAZ / AFP / Getty Images

One group warns of “frustration” that could lead to suicide

More than 1.5 million Americans served in Iraq between 2003 and 2011. More than a few of them are upset with what’s happened to that country, where they fought and their friends died, over the past week.

That’s why the Wounded Warrior Project sent an email Tuesday to its 50,000 members acknowledging their sacrifices and offering mental-health services if they find the latest happenings from Iraq depressing.

“Your feelings are justified,” Ryan Kules, 
the project’s national alumni director and a double amputee, said. “If you feel frustration watching the news, remember that we did our duty and served admirably, coming home with the visible and invisible scars of that service.”

The reaction of those who fought, and whose friends died, in Iraq has been somber. There wasn’t so much bitter anger as a palpable sadness. Those who thought the invasion was a mistake consoled themselves by blaming President George W. Bush; others blamed President Obama for not fighting harder to keep some U.S. forces in the country after 2011 to try to ensure the lives of the 4,486 Americans who died there didn’t end in vain.

“So many of my friends died in a war that didn’t need to be fought, but that did ultimately provide a reasonable chance for a democratic Iraq in the center of the Middle East,” retired Army officer John Nagl says. “It now appears that all those lives have been squandered because of an unwillingness to pay an insurance premium of a few thousand advisers and some airpower.”

Such grim tidings can lead to despair, which is why Kules of the Wounded Warrior Project reached out. He urged troubled vets to seek help “if you are dealing with PTSD triggers because of current media coverage,” and gave a phone number—1-800-273-8255—for any veterans “struggling with thoughts of suicide.”

Michelle Roberts, the communications chief at the project, says the group reaches out when an event—like last year’s Boston Marathon bombing—might trigger adverse reactions among those who served. “We’re very aware of the conversations our alumni are having with each other, and our staff, about the recent developments and how they affect them,” she says. “We just felt it was a really appropriate time to communicate with them.”

Interviews with veterans echo that view. “I’m just heartbroken, tired and nearing mute,” says Alex Lemons, an Iraq vet and former Marine sergeant. “I never saw a concrete objective and, in consequence, a willingness to win on our part.”

Lemons pulled three tours in Iraq, and says the goal shifted with each:

I was told this at the beginning: `And our mission is to clear, to disarm Iraq of weapons of mass destruction, to end Saddam Hussein’s support for terrorism, and to free the Iraqi people.’ WMD? Nothing. Fiction. Al Qaeda and indigenous terrorism? Terrorists entered the country after we invaded and then recruited heavily amongst those Iraqis we alienated with de-Baathification and firings throughout the army. Even during the surge, we could not crush every insurgent group. Regime change? We mishandled the trial and subsequent execution of President Hussein. In some ways, the Maliki government is another Baath party in Shiite garb.

“All Americans who fought there want Iraq to succeed so that we can have personal closure and know our sacrifices were worth it even as the rest of America, like the Vietnam experience, wants to forget,” Lemons says. “But Iraq will never give us that.”

Even Army Gen. Martin Dempsey, chairman of the Joint Chiefs of Staff, feels the sting. “Many of you have served in Iraq or know friends and family who made great sacrifices there,” he said in a message sent to troops Thursday. “Like many of you, I was disappointed at how quickly the situation in Iraq deteriorated as well as the rapid collapse of many Iraqi units.”

“It was somewhat expected, yet still disappointing, says Rob Kumpf, who served in Iraq as an Army non-commissioned officer. “Fighting an asymmetric war with one hand tied behind your back, with poor planning and unengaged leadership, led to the current situation Iraq’s security forces face. We screwed up the end game when we withdrew, and will soon do the same in Afghanistan.”

But other veterans have shrugged off what is happening. “Iraq’s political situation is not the concern of individual veterans of the war,” says William Treseder, who deployed to Iraq and Afghanistan as a Marine sergeant. “Combat veterans should value their service based on what they did, not on what happened after the fact or in some larger international context.”

Those who haven’t fought don’t know how combat can change one’s perspective. “Love, loyalty, sweat, and blood are the currency of service—its beating heart. Politics is a dry husk that tries to cover and limit that vitality,” Treseder says. “I wish Iraq and Afghanistan the best as countries, but I do not give them the power to determine how I feel about my service to the United States of America. Nor do I think it’s wise for any other combat veteran to do so.”

But some plainly do. “Your examples of valor and strength educate and inspire those around us,” Kules of the Wounded Warrior Project told them in his email. “Remember, you are not alone. Many of your fellow warriors make themselves available to help others…and WWP remains by your side to provide whatever support and assistance you need.
”

TIME

This Doctor Volunteers to Help Suffering Soldiers

The trauma war brings can become part of veterans, their families and communities

+ READ ARTICLE

Though her practice specializes in treating children, clinical psychologist Barbara Van Dahlen’s greatest influence may be getting fellow doctors to give their time and expertise to help soldiers returning from war.

Concerned about the mental health consequences of the wars in Afghanistan and Iraq, she founded in 2005 Give an Hour, a national network of mental-health professionals like herself who provide free services for American veterans, their loved ones and their communities.

TIME honored Dr. Van Dahlen as one of the 100 Most Influential People in the World in 2012. Former Chairman of the Joint Chiefs of Staff Admiral Mike Mullen said of Dahlen: “Barbara has tenaciously attacked the epidemic of post-traumatic stress disorder, helping break through the stigma that prevents many from seeking help. She has also created an opportunity for many who have not served in uniform to make a difference.”

TIME Military

How to Stop the Next Fort Hood Attack

U.S. Army Col. Kathy Platoni holds up her cap at her home in Beaver Creek, Ohio, Nov. 1, 2010.
Kathy Platoni holds up her cap with the names of colleagues killed at Fort Hood in 2009 written inside. Al Behrman—AP

Military mental-health experts argue it’s time for wholesale change—and more money

Fort Hood tore down nondescript Building 42003 a couple of months ago. But razing the building didn’t remove the horrors of that November 2009 day when Army Major Nidal Hasan murdered 13 people inside it. Now Specialist Ivan Lopez’s shooting spree is raising new concerns.

“We’re not real good at recognizing when danger exists,” says retired Army Reserve Colonel Kathy Platoni, who comforted psychiatric nurse Captain John Gaffaney as he lay dying nearly five years ago, shot multiple times in his effort to stop Hasan.

The Army, Platoni says, simply doesn’t have the funds and personnel to do mental health adequately. “If it doesn’t smell right as a mental health professional, you’ve got to look further—but we don’t have the manpower to do it,” Platoni says. “A five-minute interview to fill out a prescription isn’t going to cut it.”

Fort Hood Shooting Building
Building 42003 being demolished at Fort Hood in February. Fort Hood Public Affairs Office / AP

The Army’s top civilian offered additional details about Lopez Thursday. Until he pulled out his Smith & Wesson, he’d had no military record of bad behavior. Like many cases of military suicide, Lopez, who served the last four months of 2011 in Iraq but didn’t see combat, was seeking help. He knew something was wrong. “He was undergoing a variety of treatment and diagnoses for mental health conditions ranging from depression, to anxiety, to some sleep disturbance,” Army Secretary John McHugh said.

Lopez was taking “a number of drugs… including Ambien” to help, and had seen a psychiatrist last month. “We had no indication on the record of that examination that there was any sign of likely violence, either to himself or to others,” McHugh said. “So the plan [going] forward was to just continue to monitor and to treat him as deemed appropriate.”

McHugh added: “We have ordered all possible means of medical and investigatory support, as well as added behavioral health counselors” to Fort Hood.

Could dispatching “added behavioral health counselors” to Fort Hood before the shooting have made a difference?

Experts with years in the military mental-health field say that increased staffing—as well as wholesale changes in how the nation, and the Army, treat mental-health ailments—are needed to stop a third Fort Hood attack.

“We need to focus programs on dangerousness,” says psychiatrist and retired Army brigadier general Stephen Xenakis. “Dangerousness is a community-health issue. Military clinicians should make it routine to ask about guns, drug and alcohol problems, are there mood shifts, and are they explosive? It becomes very apparent when you are sitting with folks who might be dangerous.”

Lopez apparently sent such signals before he exploded. “We have very strong evidence that he had a medical history that indicates an unstable psychiatric or psychological condition,” Lieut. General Mark Milley, the top officer at Fort Hood, said Thursday. “We believe that to be the fundamental underlying causal factor.”

A trained mental-health professional can sense trouble, Platoni says. “You’ve got to develop trust and rapport with the soldiers so they can tell you what’s eating away at their soul,” she says. “People get really agitated, sometimes their eyes are red, they’re tapping their feet, they feel very uncomfortable within their own bodies,” she says, describing potential red flags. “They can’t focus, and have no tolerance for frustration,” Platoni adds. “These things don’t happen in a vacuum—there are always signs when it’s not quite right.”

But the Army only has the funds Congress—representing the U.S. taxpayer—gives it. “They send us to war, and then they don’t want to treat us,” Platoni says. “It’s another ‘no thanks for your service.’”

Retired general Pete Chiarelli was the Army’s second-ranking officer in 2009 when Nidal Hasan struck, and he championed mental health for soldiers as vice chief of staff. He says the Army—and the civilian world—haven’t made much progress in dealing with mental health in recent decades. The nation needs a mental-health Manhattan Project to study the mind and figure out how to fix it when it’s hurt. Instead, Chiarelli argues, it’s relying on antiquated methods that don’t always work.

Pete Chiarelli retired from the Army as its No. 2 officer in 2012. Army photo

“We have horrible diagnostics, we’ve got 20 questions in DSM-5, the psychiatric manual, based on a numerical score that tells us whether we have post-traumatic stress or not, the drugs that we’re prescribing to these kids are all 30-to-40-year old anti-depressants, they’re all off-label kinds of drugs, genetically, everybody reacts differently to them, and we’re short of health-care providers,” says Chiarelli, who retired in 2012. “So even when we do have some therapies that work, we don’t always have the time to apply them—does it become easier to prescribe something, or put him through 15 to 20 90-minute sessions of cognitive behavioral therapy?”

Too much research funded by the federal government remains locked up by the researchers who did it instead of being widely shared with others who might be able to build on it, Chiarelli says. “I had no idea when I signed the [$50 million suicide-prevention] contract with NIH [the federally-funded National Institutes of Health] that the data they collected wouldn’t be released to all the people who were studying suicide, and only released to those people who were part of the study,” he says. “The Army’s thrown $500 million against PTS [post-traumatic stress] research, and what have they got? They’ve still got DSM-5 and a bunch of anti-depressants—they have no new drugs.” Smarter research would go a long way to helping solve such mental-health woes, Chiarelli says—and not just in the Army.

“Go ahead and complain about this kid who had post-traumatic stress down at Fort Hood, Texas,” he says. “But there are all kinds of other people—as we saw at Newtown—who never served a day in the military who have this problem, and we don’t have what we need to help them. Whether it’s Newtown or the Navy Yard or Fort Hood, you have a gun—but you also had a person who had a severe mental issue,” Chiarelli says. “Now that we have the ability to crunch data and probably find diagnostics, and then treatment, for this stuff, God damn it, why aren’t we doing it?”

TIME Military

Here’s What’s Troubling American Troops in One Chart

Army

It's about 'combat experiences,' not length of deployment

This Army graph makes crystal clear what many U.S. troops, and their loved ones, have long suspected: the more combat events they experience, the more mental-health problems they will suffer. In fact, according to this illustration from a new Army report, there is a direct linear relationship between combat exposure and resulting mental maladies.

While that notion is hardly surprising, this chart confirms what troops have long believed.

“As would be expected, there is a dose-dependent relationship between levels of combat experiences and well-being indices,” the Army’s just-released ninth Mental Health Advisory Team report says. “This relationship is clearly demonstrated for the percentage of Soldiers meeting screening criteria for any psychological problem.”

After years of debating to what degree repeated deployments and other factors play a role in post-traumatic stress and traumatic brain injuries—and the anxiety, depression and suicidal tendencies they can trigger—this chart indicates that it is the number of combat events, more than the time deployed, that drives up mental-health problems (of course, the two tend to travel together, but not always).

The U.S. military has been plagued by epidemics of mental-health problems since the wars in Afghanistan and Iraq began. The graphic shows that while troops can withstand several of what the Army calls “combat experiences,” their mental armor begins breaking down once they experience 10 or more such events.

To produce the chart, the Army tallied

Threats (IED Exploded Near You)

Fighting (Shooting at Enemy)

Killing (Responsible for Death of Combatant)

and

Death (Member of Unit Became Casualty)

…and added them together to come up with an average number of “combat experiences” per soldier:

chart 2
Army

“Exposure to potentially traumatic experiences is one of the principal risk factors for behavioral health problems in combat settings,” the Army’s report says.

In a nutshell, repeated deployments lead to more combat experiences, which leads to more post-traumatic stress, traumatic brain injuries, anxiety, depression and suicide.

Bottom line: long wars require far bigger armies than the U.S. was willing to send to war post 9/11, assuming that keeping mental-health woes to a minimum was a priority.

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