Army fights stigma of mental care


BAGHDAD – A military culture that values strength and a "can do" spirit is discouraging thousands of soldiers from seeking help to heal the emotional scars of war in Iraq and Afghanistan, despite top-level efforts to overcome the stigma, commanders and veterans say.

Up to one-fifth of the more than 1.7 million military members who have served in Iraq or Afghanistan are believed to have symptoms of anxiety, depression and other emotional problems. Some studies show that about half of those who need help do not seek it.

"It's a reality that for some — certainly not all, but for some — there's a stigma to stepping forward for behavioral health," Maj. David Cabrera, who runs counseling services at a military hospital in Germany, told The Associated Press.

"Our goal is to eradicate the stigma," he said. "We're not there yet."

Encouraging more soldiers to seek help, and training leaders to spot signs of trouble, have taken on new urgency since the fatal shooting last Monday of five U.S. service members at a counseling center at Baghdad's Camp Liberty.

Army Sgt. John M. Russell has been charged with five counts of murder. He was finishing his third tour in Iraq and had been ordered to seek counseling at the center, the Army said.

Sergeants on their third or fourth assignments to Iraq or Afghanistan are more than twice as likely to suffer mental health problems as those on their first assignment to a combat zone, according an Army study last year.

Combat stress is common in every war — including "battle fatigue" cases in World War II and the lasting trauma still suffered by thousands of veterans of the Vietnam conflict.

What makes the current conflicts different are the frequent, repeating rotations. Most soldiers spent just one or two assignments in Vietnam, but many American soldiers and Marines are on their third or fourth tours in Iraq and Afghanistan.

Units return home to the United States or Germany, only to begin soon preparing for their next deployment, adding strains on both the soldiers and their families.

Military officials insist they are keenly aware of the growing stress problem in the ranks and are moving quickly to expand counseling facilities not only in war zones but at bases in the U.S. and Europe for troops who return from the fighting.

Most major bases in Iraq maintain combat stress clinics, where soldiers can visit counselors and relax for a few days away from the pressures of their jobs.

Two of the officers killed last Monday at the counseling center had been visiting units in the Baghdad area in the weeks before their deaths, explaining programs the counseling centers offer and encouraging soldiers to take advantage of them.

"The only way we're going to keep our soldiers fit to fight, if you will, is to make sure it is a holistic approach, not just the physical but mental readiness," Lt. Gen. Kenneth W. Hunzeker, an Iraq veteran and corps commander in Germany, told AP.

Some senior officers, notably Gen. Carter Ham, who now commands U.S. Army forces in Europe, have spoken openly about suffering from combat stress, including sleep problems and exaggerated emotions, after going through traumatic experiences on the Iraqi battlefield.

Ham, who commanded U.S. troops in the northern Iraqi city of Mosul during major fighting there, said he spoke out to encourage others to face the emotional scars of war.

"Frankly, it's a little weird to me that people are making a big deal about it," Ham told the Stars and Stripes newspaper in an interview last January. "Like lots of soldiers I needed a little help, and I got a little help."

Associated Press Writers Patrick McGroarty and Matt Moore in Berlin and Hamza Hendawi in Baghdad contributed to this report.





The top of a dandelion seed head is seen in Marysville, Pa. AP/Carolyn Kaster

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