Deployments take heavy toll; Stress symptoms rise with multiple tours

January 17, 2010 (Fort Wayne Journal Gazette) - The day after President Obama announced the Afghanistan surge, Spc. Curt Kelley got a letter from the Department of Defense.

It was a letter he’d received twice before: First, in 2005, foreshadowing a tame tour of central Iraq. And again in 2007, foreshadowing a far more dangerous deployment – the bloody kind that he says still haunts his dreams.

As a former active Army soldier with two years left in the U.S. Army Individual Ready Reserve, Kelley feels honor-bound to go back to Iraq a third time. But his other side, his civilian side, is concerned about how his next deployment will affect his sleeping problems, his anxiety and his changing personality – symptoms he chalks up to self-diagnosed post-traumatic stress disorder, commonly referred to as PTSD.

Soldiers who’ve experienced multiple deployments are more at risk for developing mental health problems, according to the U.S. Army surgeon general. A February 2008 study by the surgeon general’s office found mental health problems in 11.9 percent of soldiers with one deployment, 18.5 percent with two deployments, and 27.2 percent with three or four deployments.

Last month, the American Journal of Public Health published a study reporting that service members with previous military experience in Afghanistan and Iraq are more than three times as likely as others to screen positive for major depression and PTSD.

National Guard and Reserve troops are more vulnerable to mental health risks than active-duty troops, according to the study. Researchers didn’t speculate why, but veterans advocates suggest it’s because National Guardsmen and Reservists have to make tough adjustments between military and civilian life in a way that active-duty troops, whose domestic lives are entwined with the military, do not.

The findings trouble veterans advocates who point out that multiple deployments are becoming the norm for thousands of American troops. Of all troops deployed to Iraq since 2003, about 38 percent have been deployed more than once, and 10 percent have been deployed three times or more, according to the American Journal of Public Health.

“I’m really shocked,” said Kelley, a Homestead graduate, about receiving his orders, which instructed him to leave Fort Wayne for Fort Jackson, S.C., at the end of the month. “I’ve been trying to start a business. I’m going to school, putting my life on a successful track.

“There is 50 percent of me that says, ‘This is what soldiers do,’ then the other half of me, the civilian side, says, ‘Are you nuts?’ There’s a real conflicted feeling here.”

Back into battle

Kelley, a fit 30-year-old with short dark hair and a goatee, feels as if he’s done his time and said he has the mental side effects to prove it. But even if Kelley is diagnosed with PTSD, it might not prevent him from deploying.

PTSD symptoms range in severity. And many service members with the disorder are considered fit to serve, according to Dr. Donald Wilson, acting chief of mental health services at the Fort Wayne VA Medical Center.

Wilson doesn’t think that’s necessarily bad policy. Many capable veterans with PTSD are eager to jump back into battle, he said.

“I would hate to see someone’s career end because they have (PTSD),” he said. “The majority are able to function well and do what they need to do.”

Kelley enlisted in the Army in 2004 to impress his father, a Vietnam War combat veteran, and “get his life together.” Since then, he’s witnessed plenty of death and destruction: During his second Iraq tour, with a tank unit in the 3rd Infantry Division, he saw one of his closest friends fatally shot by a sniper, watched four soldiers burn to death in a Humvee and saw scores of dead Iraqi civilians.

By the end of his tour, his tanker company of 64 had lost nine men.

“All the time, it was horrible,” Kelley said. “But so often in war, you get to the point where you don’t care. It’s when you go home and you sleep with it – that’s when it bothers you.”

Kelley’s time in the active Army ended in 2008, but he had two years left in the IRR, which meant he could return to his civilian life but could still be summoned to serve. He returned to Fort Wayne and was able to function fine but says he eventually developed emotional problems.

Although he was never officially diagnosed with PTSD, he says he sought treatment at the VA for combat-related sleeping problems, nightmares, flashbacks, irritability and substance abuse. He started drinking to cope with his struggles – a habit that led to a drunken-driving conviction a year ago.

When Kelley arrives at Fort Jackson, he’ll receive a medical evaluation to determine whether he’s fit to serve.

If questions about Kelley’s mental health condition come up at the screening, the military will rely on a mental health specialist to evaluate him, consult military guidelines and make a recommendation, according to Maj. Jeffrey Williams, medical readiness processing officer for the Indiana Army National Guard, and other military officials. Kelley can also start his own appeal process before the screening.

More getting help

Still, veterans advocates like Paul Sullivan, executive director of Veterans for Common Sense, a non-profit veterans advocacy group, fear that too many traumatized service members are being asked to return to combat.

“We reviewed many news reports on service members and veteran suicides, and there appears to be an increase in suicides among soldiers in the U.S. when they are notified that they have to deploy again to the war,” he said.

“Sending service members over with mental health conditions can pose a risk to the soldier, to the unit and to the mission. The strong thing, the right thing, is to get help.”

It seems as if more local veterans are heeding his advice.

Wilson, of the Fort Wayne VA, did not provide specific numbers but said he’s seen a 25 percent increase in the number of patients using the VA hospital’s mental health services in the past six months, although it’s unclear what caused the jump.

Wilson thinks combat-related mental health problems are treatable. And after soldiers return from war, he said, VA hospitals provide a wide range of services, including a PTSD clinic, for veterans suffering from combat-related psychological problems.

“I don’t think PTSD ever goes away,” Wilson said. “But veterans can manage to decrease their symptoms. … Locally, we’re seeing a 20 (percent) to 30 percent decrease in the symptoms in the first few months after (combat veterans) come home.”

As widely available as these services are, Curt’s father, Phil Kelley, isn’t convinced they’ll do enough to help his son.

“I’m angry,” he said. “We don’t have the number of people necessary to fight these wars, so now you continually send these young men over and over again into combat.

“Suicide rates are above the roof. People get locked up; they get in all kinds of altercations, everything from killing boyfriends and girlfriends. No one seems to realize the pain and misery they are putting on these families. It’s devastating.”

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