Assessing soldiers for mental health problems upon their return from the
war in Iraq is helping to identify areas where particular services are needed,
according to Col. E. Cameron Ritchie, M.C.
Ritchie, a psychiatrist who consults to the U.S. Army surgeon general,
addressed the military's response to mental health challenges at the annual
Mental Illness Awareness Week symposium on Capitol Hill last month sponsored
by APA and the National Alliance for the Mentally Ill (NAMI).
"We have been at war for four years, and we are tired, but we have
learned a lot," she said.
Among the mental health lessons the military has learned so far is the
realization that troops suffering from combat-induced stress may display a
wide range of reactions. That stress, she said, affects those deployed and
The military has found that its attempts to improve the diagnosis and
treatment of stress-related reactions in areas where combat troops are
deployed frequently produced positive results among soldiers and Marines
stationed in Iraq, according to the 2004 findings of the Army surgeon
general's Mental Health Advisory Team, on which Ritchie served.
"We found things have improved, but more work is needed to improve
access to care," Ritchie said. For instance, the team found a 96 percent"
return to duty rate" among soldiers treated by military
behavioral health care providers close to where their units were deployed. The
team also found that a sufficient number of behavioral health personnel were
deployed in Iraq and Kuwait overall, but the smaller, forward-operating bases
The armed forces also are trying to improve the mental health care
available for soldiers after they return. The military's research found that
among returning troops risky behaviors increase, as do substance abuse and
domestic violence, Ritchie said.
A mental health program known as Post-Deployment Health Reassessment is in
pilot testing at Fort Hood, in Killeen, Texas. The program, which will be
applied to all active-duty and reserve units beginning in January 2006, aims
to assess the mental health of soldiers three to six months after they return
from combat deployment, after the so-called honeymoon period. The program
intends to identify and treat soldiers with mental health problems that may
not manifest for months after returning from combat.
According to the initial findings from the pilot test, up to 19 percent of
soldiers and marines tested positive for mental health problems three to six
months after they returned from Iraq.
Assessing the presence and significance of mental health problems in troops
is complicated by the "redeployment window" in which they serve
multiple combat tours, Ritchie said.
Military health officials continue to examine complicated questions,
Ritchie said, such as what level of psychiatric symptoms should preclude
troops from redeployment.