Extra Iraq tours take mental toll, study says

More than a quarter of higher-ranking enlisted soldiers showed signs of mental health problems after being sent to war zones for the third or fourth time, a sharp increase over those on their first or second deployments, according to a military study issued Thursday.

The findings of a new Army report on the behavioral health of soldiers in Iraq are the first to quantify the stress of repeated deployments on combat soldiers. The data are likely to increase calls by senior Army leaders to cut the length of combat tours and increase the time soldiers have between deployments.

Although the Army has been measuring the mental health of troops in Iraq since the beginning of the war, the study is the first to draw clear conclusions about troops on their third or fourth tours, the authors said.

The report showed that 27.2% of noncommissioned officers -- the sergeants responsible for leading troops in combat -- reported mental health problems during their third or fourth tours. That was up from 18.5% of those on their second tour and 11.9% of those on their first tour. Mental health problems include signs of depression, anxiety and stress disorders.

The report showed a sharp decline in morale for those on their third and fourth tours -- with 15.6% saying they had “very high morale,” down from 27.1% for NCOs on their first deployment -- as well as a significant increase in problems doing their jobs.

“Soldiers are not resetting entirely before they get back into theater,” said Lt. Col. Paul Bliese, who headed the team that conducted the study. “They’re not having the opportunity to completely recover from the previous deployment when they go back into theater for the second or third deployment.”

Army healthcare officials said it was difficult to assess whether rates of mental health problems on third or fourth tours were abnormally high, noting that they had little information from other conflicts or the civilian world to compare.

Overall unit morale in Iraq was higher last year than in 2006, a change officials attributed to declining violence. In Afghanistan, where violence has increased, unit morale declined slightly. Last year was the first time the Army studied the mental health of soldiers in Afghanistan.

Col. E. Cameron Ritchie, the Army’s top psychiatrist, said that some mental health providers in the Army see the rates as a sign the military’s new mental health training programs are limiting the amount of behavioral problems.

“Some may say that’s a lot,” Ritchie said of the level of problems among NCOs. “In many ways, we consider that we’re doing our training, we’re doing things pretty well, in that three-quarters of NCOs on their third and fourth tour don’t have these symptoms.”

The Iraq study, based on anonymous surveys of 2,295 soldiers in Iraq in October and November, also was the first to look at how soldiers were affected by the 15-month combat tours implemented at the start of last year.

The longer tours had a mixed effect on soldiers’ mental health, the study found. In some areas, there were clear increases in problems.

Most strikingly, soldiers reporting they intended to separate from or divorce their spouses shot up over the course of the 15-month tours, with 30% of all junior enlistees saying they planned to break off personal relationships by the end of their deployment. Only 10% reported similar feelings at the start of their tours.

Similarly, the longer tours had a significant effect on soldiers’ ability to do their jobs effectively. Soldiers reported that they were increasingly less able to work carefully and were getting more complaints from their supervisors by the end of the 15-month tour.

Meanwhile, morale and mental health problems, while increasing in the middle of the tours, got gradually better by the end of the deployment.

“Some of them seem to top out and some of them seem to drop down a little bit in the months immediately before coming back,” Bliese said. “We think there’s some redeployment optimism here. Soldiers see the light at the end of the tunnel in those last three months.”

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peter.spiegel@latimes.com