Soldier Mental Illness Hits Vietnam Levels

THE BOSTON GLOBE
Thursday, July 1, 2004

Soldier mental illness hits Vietnam levels
Many returning troops suffer combat-related afflictions

By RAJA MISHRA

Nearly one in five U.S. combat troops returning from war-torn Iraq suffered from post-traumatic stress disorder, major depression or other serious mental afflictions, according to new data detailing the psychic costs of the bloodiest war in a generation.

A study conducted by the U.S. Army shows that combat-related mental problems have been higher among those who have served in Iraq than in any military action since Vietnam.

It also paints the first broad statistical picture of the battlefield horrors encountered by the American combatants on the front lines in Iraq. For instance, one in four U.S. Marines surveyed reported killing Iraqi civilians. About one in five Army members surveyed reported engaging in hand-to-hand combat. More than 85 percent of those in Marine or Army combat units said they knew someone who had been injured or killed. More than half said they had handled corpses or human remains. The figures were based on soldiers' responses; the military does not have statistics available to confirm them.

Up to 17 percent of these troops in Iraq suffered mental health problems, though less than half said they had sought professional help after ending their tours, according to the study, published today in the New England Journal of Medicine.

"There's no question that these service members have truly experienced the spectrum of things that happen during the war," said Dr. Charles Hoge, psychiatry chief at the U.S. Army Walter Reed Medical Center and lead author of the study. "This is real, sustained war."

The Pentagon's health affairs chief, Dr. William Winkenwerder, said it was premature to compare service in Iraq to Vietnam, but added, "We can certainly surmise there's plenty of stress."

With more than 800 U.S. soldiers killed and more than 5,000 wounded, Operation Iraqi Freedom has become the deadliest American military conflict since the Vietnam War, in which some 58,000 Americans died.

The new study's chief purpose was to gauge the effectiveness of mental health services provided by the military. The data indicated a dramatic improvement since the Vietnam era, when the military's mental health care was relatively unsophisticated.

But the study still revealed gaps in the system, chief among them a continued stigma about mental illness among troops despite considerable educational efforts by Pentagon brass over the past decade. Also, nearly half of Iraq veterans reporting mental symptoms said they had trouble scheduling a psychiatric appointment.

The mental trauma from the Iraq war appears to be approaching Vietnamlike levels for the 40,000-plus U.S. soldiers in the thick of daily violence, according to the new study.

Wartime psychology was in its infancy during the Vietnam conflict, and no comparable studies were done of soldiers during the war. Later research found that about 15 percent of troops who served there suffered PTSD.

The most recent studies found that about 30 percent of Vietnam veterans had developed psychological problems after the war, as condemnation of soldiers by stateside critics exacerbated combat stress in some.

The study found that 12 percent to 13 percent of troops returning from Iraq reported PTSD symptoms, and another 3 percent to 4 percent reported other mental distress. By contrast, PTSD estimates for veterans of the first Gulf War range between 2 percent and 10 percent. The rate is about 4 percent in the U.S. adult population. The new Army study found about 11 percent of troops returning from Afghanistan reported symptoms of mental distress.

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