Sol­dier Sui­cides at Record Level

In­crease Linked to Long Wars, Lack of Army Re­sources

The Washington Post - - Front Page - By Dana Priest

Lt. El­iz­a­beth Whiteside, a psy­chi­atric out­pa­tient at Wal­ter Reed Army Med­i­cal Cen­ter who was wait­ing for the Army to de­cide whether to court-mar­tial her for en­dan­ger­ing an­other sol­dier and turn­ing a gun on her­self last year in Iraq, at­tempted to kill her­self Mon­day evening. In so do­ing, the 25-year-old Army re­servist joined a record num­ber of sol­diers who have com­mit­ted or tried to com­mit sui­cide af­ter serv­ing in Iraq or Afghanista­n.

“I’m very dis­ap­pointed with the Army,” Whiteside wrote in a note be­fore swal­low­ing dozens of an­tide­pres­sants and other pills. “Hope­fully this will help other sol­diers.” She was taken to the emer­gency room early Tues­day. Whiteside, who is now in stable phys­i­cal con­di­tion, learned yes­ter­day that the charges against her had been dis­missed.

Whiteside’s per­sonal tragedy is part of an alarm­ing phe­nom­e­non in the Army’s ranks: Sui­cides among ac­tive-duty sol­diers in 2007 reached their high­est level since the Army be­gan keep­ing such records in 1980, ac­cord­ing to a draft in­ter­nal study ob­tained by The Wash­ing­ton Post. Last year, 121 sol­diers took their own lives, nearly 20 per­cent more than in 2006.

At the same time, the num­ber of at­tempted sui­cides or self-in­flicted in­juries in the Army has jumped six­fold since the Iraq war be­gan.

Last year, about 2,100 sol­diers in­jured them­selves or at­tempted sui­cide, com­pared with about 350 in 2002, ac­cord­ing to the U.S. Army Med­i­cal Com­mand Sui­cide Pre­ven­tion Ac­tion Plan.

The Army was un­pre­pared for the high num­ber of sui­cides and cases of post-trau­matic stress dis­or­der among its troops, as the wars in Iraq and Afghanista­n have con­tin­ued far longer than an­tic­i­pated. Many Army posts still do not of­fer enough in­di­vid­ual coun­sel­ing and some sol­diers suf­fer­ing psy­cho­log­i­cal prob­lems com­plain that they are stig­ma­tized by com­man­ders. Over the past year, four high-level com­mis­sions have rec­om­mended re­forms and Congress has given the mil­i­tary hun­dreds of mil­lions of dol­lars to im­prove its men­tal health care, but crit­ics charge that sig­nif­i­cant progress has not been made.

The con­flicts in Iraq and Afghanista­n have placed se­vere stress on the Army, caused in part by re­peated and length­ened de­ploy­ments. His­tor­i­cally, sui­cide rates tend to de­crease when sol­diers are in con­flicts over­seas, but that trend has re­versed in re­cent years. From a sui­cide rate of 9.8 per 100,000 ac­tive-duty sol­diers in 2001 — the low­est rate on record — the Army reached an all-time high of 17.5 sui­cides per 100,000 ac­tive-duty sol­diers in 2006.

Last year, twice as many sol­dier sui­cides oc­curred in the United States than in Iraq and Afghanista­n.

Col. El­speth Cameron Ritchie, the Army’s top psy­chi­a­trist and au­thor of the study, said that sui­cides and at­tempted sui­cides “are con­tin­u­ing to rise de­spite a lot of things we’re do­ing now and have been do­ing.” Ritchie added: “We need to im­prove train­ing and ed­u­ca­tion. We need to im­prove our ca­pac­ity to pro­vide be­hav­ioral health care.”

Ritchie’s team con­ducted more than 200 in­ter­views in the United States and over­seas, and found that the com­mon fac­tors in sui­cides and at­tempted sui­cides in­clude failed per­sonal re­la­tion­ships; le­gal, fi­nan- cial or oc­cu­pa­tional prob­lems; and the fre­quency and length of over­seas de­ploy­ments. She said the Army must do a bet­ter job of mak­ing sure that sol­diers in dis­tress re­ceive men­tal health ser­vices. “We need to know what to do when we’re con­cerned about one of our fel­lows.”

The study, which the Army’s top per­son­nel chief or­dered six months ago, ac­knowl­edges that the Army still does not know how to ad­e­quately as­sess, mon­i­tor and treat sol­diers with psy­cho­log­i­cal prob­lems. In fact, it says that “the cur­rent Army Sui­cide Pre­ven­tion Pro­gram was not orig­i­nally de­signed for a com­bat/de­ploy­ment en­vi­ron­ment.”

Staff Sgt. Gla­dys San­tos, an Army medic who at­tempted sui­cide af­ter three tours in Iraq, said the Army ur­gently needs to hire more psy­chi­a­trists and psy­chol­o­gists who have an un­der­stand­ing of war. “They gave me an 800 num­ber to call if I needed help,” she said. “When I come to feel­ing over­whelmed, I don’t care about the 800 num­ber. I want a one-on-one talk with a trained psy­chi­a­trist who’s ei­ther been to war or un­der­stands war.”

San­tos, who is be­ing treated at Wal­ter Reed, said the only ef­fec­tive ther­apy she has re­ceived there in the past year have been the one-onone ses­sions with her psy­chi­a­trist, not the group ses­sions in which sol­diers are told “Don’t hit your wife, don’t hit your kids,” or the other groups where they play bingo or learn how to prop­erly set a ta­ble.

Over the past year, the Army has rein­vig­o­rated its ef­forts to un­der­stand men­tal health is­sues and has in­sti­tuted new as­sess­ment sur­veys and new on­line videos and ques­tion­naires to help sol­diers rec­og­nize prob­lems and be­come more re­silient, Ritchie said. It has also hired more men­tal health providers. The plan calls for at­tach­ing more chap­lains to de­ployed units and as­sign­ing “bat­tle bud­dies” to im­prove peer sup­port and mon­i­tor­ing.

In­creas­ing sui­cides raise “real ques­tions about whether you can have an Army this size with mul- tiple de­ploy­ments,” said David Rudd, a for­mer Army psy­chol­o­gist and chair­man of the psy­chol­ogy de­part­ment at Texas Tech Univer­sity.

On Mon­day night, as Pres­i­dent Bush de­liv­ered his State of the Union ad­dress and asked Congress to “im­prove the sys­tem of care for our wounded war­riors and help them build lives of hope and prom­ise and dig­nity,” Whiteside was doz­ing off from the ef­fects of her drug over­dose. Her case high­lights the Army’s con­tin­u­ing strug­gles to re­move the stigma sur­round­ing men­tal ill­ness and to make it eas­ier for sol­diers and of­fi­cers to seek psy­cho­log­i­cal help.

Whiteside, the sub­ject of a Post ar­ti­cle in De­cem­ber, was a high­achiev­ing Univer­sity of Vir­ginia grad­u­ate, and she earned top scores from her Army raters. But as a medic in charge of a small prison team in Iraq, she was re­peat­edly ha­rassed by one of her com­man­ders, which dis­turbed her greatly, ac­cord­ing to an Army in­ves­ti­ga­tion.

On Jan. 1, 2007, weary from help­ing to quell ri­ots in the prison af­ter the ex­e­cu­tion of Sad­dam Hus­sein, Whiteside had a men­tal break­down, ac­cord­ing to an Army san­ity board in­ves­ti­ga­tion. She pointed a gun at a su­pe­rior, fired two shots into the ceil­ing and then turned the weapon on her­self, pierc­ing sev­eral or­gans. She has been at Wal­ter Reed ever since.

Whiteside’s two im­me­di­ate com­man­ders brought charges against her, but Maj. Gen. Eric B. Schoomaker, the only physi­cian in her chain of com­mand and then the com­man­der of Wal­ter Reed, rec­om­mended that the charges be dropped, cit­ing her “demon­stra­bly se­vere de­pres­sion” and “7 years of cred­i­ble and hon­or­able ser­vice.”

The case hinged in part on whether her men­tal ill­ness prompted her ac­tions, as Wal­ter Reed psy­chi­a­trists tes­ti­fied last month, or whether it was “an ex­cuse” for her ac­tions, as her com­pany com­man­der wrote when he prof­fered the orig­i­nal charges in April. Those charges in­cluded as­sault on a su­pe­rior com­mis­sioned of­fi­cer, ag­gra­vated as­sault, kid­nap­ping, reck­less en­dan­ger­ment, wrong­ful dis­charge of a firearm, com­mu­ni­ca­tion of a threat and two at­tempts of in­ten­tional self-in­jury with­out in­tent to avoid ser­vice.

An Army hear­ing of­fi­cer cited “Army val­ues” and the need to do “what is right, legally and morally” when he rec­om­mended last month that Whiteside not face court-mar­tial or other ad­min­is­tra­tion pun­ish­ment, but that she be dis­charged and re­ceive the med­i­cal ben­e­fits “she will des­per­ately need for the re­main­der of her life.” Whiteside de­cided to speak pub­licly about her case only af­ter a sol­dier she had be­friended at the hospi­tal’s psy­chi­atric ward hanged her­self af­ter she was dis­charged with­out ben­e­fits.

But the U.S. Army Mil­i­tary Dis­trict of Wash­ing­ton, which has ul­ti­mate le­gal ju­ris­dic­tion over the case, de­clined for weeks to tell Whiteside whether oth­ers in her chain of com­mand have con­curred or dif­fered with the hear­ing of­fi­cer, said Matthew Ma­cLean, Whiteside’s civil­ian at­tor­ney and a for­mer mil­i­tary lawyer.

Ma­cLean and Whiteside’s fa­ther, Thomas Whiteside, said the un­cer­tainty took its toll on the young of­fi­cer’s men­tal state. “I’ve never seen any­thing like this. It’s just so far off the page,” said Thomas Whiteside, his voice crack­ing with emo­tion. “I told her, ‘If you check out of here, you’re not go­ing to be able to help other sol­diers.’ ”

Whiteside re­cently had be­gun to take pre­req­ui­site classes for a nurs­ing de­gree, and her men­tal sta­bil­ity seemed to be im­prov­ing, her fa­ther said. Then late last week, she told him she was hav­ing trou­ble sleep­ing, with a pos­si­ble court-mar­tial weigh­ing on her. On Mon­day night, she asked her fa­ther to take her back to her room at Wal­ter Reed so she could study.

She swal­lowed her pills there. A sol­dier and his wife, who live next door, came to her room and, af­ter a while, no­ticed that she was be­com­ing groggy, Thomas Whiteside said. When they re­turned later and she would not open the door, they called hospi­tal au­thor­i­ties.

Yes­ter­day, af­ter hav­ing spent two nights in the in­ten­sive care unit, he said, his daugh­ter was trans­ferred to the psy­chi­atric ward.

Whiteside left two notes, one ti­tled “Busi­ness,” in which her top con­cern was the fate of her dog. “Ap­point­ment for the Vete­nar­ian is in my blue book. Ad­di­tional pa­per­work on Chewy is in the closet at the apart­ment in a folder.” On her sec­ond note, she penned a post­script: “Sorry to do this to my fam­ily + friends. I love you.”

BY MICHEL DU CILLE — THE WASH­ING­TON POST

Lt. El­iz­a­beth Whiteside — with her fa­ther, Thomas Whiteside, in Novem­ber — at­tempted sui­cide this week at Wal­ter Reed Army Med­i­cal Cen­ter.

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