Terrible news  came from Afghanistan today about an American soldier slaughtering civilians. This is a tragedy for the victims, a tragedy for this soldier and his family and an event that will have an impact on the Sergeant’s unit, his commanders and the American military and public. Stories continue to come out of the military about the increase in suicide and domestic violence among active duty soldiers as well as our veterans.  The US Public Health Command recently published statistics showing an 80% increase in the number of suicides by army personnel between 2004 and 2008.  These events are a cause for substantial alarm. How can this happen? What is going on?  The nation is focused on these questions today.

For many years, my psychology office was located near a military base and I had the privilege of working with many active duty and retired military as well as their families.  From this experience I became very impressed with the quality of our military men and women. I admired  their sense of duty, their commitment to their country and to their fellow soldiers.  When I spoke with young soldiers their maturity and sense of purpose stood out compared to other young men and women. I came away with the awareness  that the training and support our military personnel was receiving were outstanding.

How, then, do such extreme behaviors develop?  There seems to be a significant difference compared to the World War II military veterans.  Some of this may be due to more extensive media coverage and more pressure on the Pentagon to report these types of statistics.  PTSD was more commonly reported after the Viet Nam war and we also heard about veteran suicides and substance abuse in the 60’s and 70’s.  What could be happening currently?

The length of our Middle East wars and repeated deployments are certainly a factor. War IS hell and it does have profound effects on the human psyche and the longer people experience it and the more extreme their circumstances the greater the risk for mental illness and dangerous behavior. The isolation of American military personnel is also a significant factor, I believe.  World War II had a universal impact on the United States.  Almost everyone was involved or affected by the war effort.  Almost everyone had a family member serving.  The war dominated people’s thinking and day to day lives so that when soldiers returned home their experience was not completely differentiated from everyday life.Their loved ones at home were also constantly thinking about and aware of what was happening overseas.  Now a very small percent of Americans serve in the military and while they are part of a community while serving overseas and while living on a military base their experiences are very removed from what most people experience in the public at large. I believe this contributes significantly.

War-whether you are in the military or a civilian in a war zone has the power to change anyone mentally and emotionally. Those who are psychologically frail to begin with are at the highest risk but anyone who is regularly exposed to threat and violence can be at risk of losing their mental health.  For many people that can lead to depression or anxiety or substance abuse.  For some, it leads to violence.  The possibility for violence increases in a wartime environment that legitimizes and teaches violence.  That risk will always be there.  The reasons someone cracks are not hard to fathom.  Experiences of being fired upon, feeling that your life is in danger, having a friend or loved one killed, the sights and sounds and smells of war, the constant fear can all damage a person’s resilience and ability to cope.  Some suicides of soldiers occur because of their feeling of wanting to hurt other people and the self-hatred that can stem from that.

Solutions are not easy but access to good mental health care is essential.  And increasing access also means reducing the stigma for seeking help.  Soldiers feel pressure to avoid getting help because it is viewed as weakness by others or by themselves.  Officers are reluctant to accept that the soldier for whom they are responsible may be unfit for duty because that reflects on them, reduces the strength and effectiveness of their unit and may put other soldiers at risk.  It is easier to look the other way and hope the problem is not that bad or that it will go away.  That was certainly the case in the Fort Hood shootings where co-workers were concerned but staff shortages prevented anyone from taking action.

We talk of supporting our troops.  Caring for their emotional well being is an essential part of that.  I believe we have come a long ways since the post Viet Nam era when an anti-war public included returning soldiers in their animosity for the war.  This added to the burdens those returning soldiers faced. There is currently a greater appreciation and acceptance of the soldiers serving in Iraq and Afghanistan.  We are all aware of the financial costs of war.  Let us not forget the human costs-not just lives lost, but lives irrevocably damaged.