WAGING INTERNAL WAR --

WAGING INTERNAL WAR --

The Army's suicide rate is at a

high, and kin say that multiple deployments are to blame.

Some troops with mental illnesses are cleared to serve in Iraq.




Deemed suicidal in boot camp, Virgadamo was still shipped to Iraq with a prescription for Prozac when he turned 18. After continuing to struggle with depression in Iraq, his prescription was switched and he was put on a week of "stress management," his grandmother said. When his gun was returned to him, he shot and killed himself. (photo: Special to The Denver Post )



For a previous story about Travis Virgadamo, click here...
http://www.vawatchdog.org/08/nf08/nfMA
R08/nf030408-3.htm

Story here... http://www.denverpost.com/news/ci_10310152


Waging internal war
The Army's suicide rate is at a high, and kin say that multiple deployments are to blame. Some troops with mental illnesses are cleared to serve in Iraq.
By David Olinger and Erin Emery
The Denver Post

Chad Barrett's war on terror started in the hours after the Sept. 11, 2001, attacks, when he was called to help dig bodies out of a smoking Pentagon.

It ended Feb. 2, 2008, in Mosul, Iraq, when his roommate awoke to find him gasping and gurgling, with foam coming from his mouth.

Barrett had been cleared for a third combat tour in Iraq despite a recent suicide attempt, crushing headaches and a mental illness treated with medication for anxiety and depression. Two months after he arrived, he killed himself by swallowing an unknown number of pills.

He was the sixth soldier from Fort Carson to commit suicide in Iraq. At least 10 others have killed themselves in the U.S., nine after returning from the war.

"There is no way in hell he should have been deployed. The Army saw him as just another set of boots on the ground," said Barrett's widow, Shelby. "From the second tour on, he changed 180 degrees. Three deployments is two too many. The Army took my husband from me. The Army destroyed my husband."

After five years of war in Iraq, Army suicide rates have reached their highest level since the Army started keeping such records in 1980. Reported suicide attempts jumped 500 percent from about 350 in 2002 to 2,100 last year, an increase the Defense Department says may be partly attributable to better compliance with reporting requirements.

Personal issues such as relationships, work and financial problems are among the main causes of suicide, Army officials say. But they also acknowledge that multiple deployments are contributing to the suicide rate — and to the stress in personal and family relationships.

"Army leaders are fully aware that repeated deployments have led to increased distress and anxiety for both soldiers and their families," said Secretary of the Army Pete Geren.

In response to a Freedom of Information Act request, the Army provided The Denver Post with names of 123 soldiers who killed themselves in Iraq and Afghanistan from 2003 to early 2008.

An analysis of the information showed that:

• Army suicides in Iraq tripled in three years, from 10 in 2004 to 32 in 2007.

• In 2006 and 2007, 20 of the 59 soldiers who killed themselves in Iraq were deployed from a single base — Fort Hood in Texas.

• Fourteen of the soldiers who killed themselves in Iraq were 19 years old. Nearly half were 23 or younger.

This year, the Army reported that 76 percent of suicide attempts in Iraq and Afghanistan were deployment-related, and 61 percent of the soldiers who killed themselves in 2007 had been deployed at least once to Iraq or Afghanistan.

"There appears to be a direct relationship between the incidence of suicide and the number of deployments, which, of course, is no surprise," said Dr. Bob Scaer, a neurologist who served as medical director at the Mapleton Rehabilitation Center in Boulder.

Army leaders say they are striving to reduce suicide risks, identify signs of stress and encourage troubled soldiers to seek help.

"The Army is making great strides in treating soldiers with post-traumatic psychological symptoms as well as decreasing the stigma associated with treatment for these symptoms," Brig. Gen. Rhonda Cornum said when its yearly suicide report was released in May.

Some soldiers and their advocates question whether that message is getting through, particularly at Fort Hood.

Bryan Hannah, a soldier being treated for post-traumatic stress disorder at Fort Hood, said two people at its mental-health center told him, "We're not here to make you better; we're here to make you deployable."

At Fort Hood, anyone seeking mental- health treatment "can kiss any hope of promotion goodbye," he said. "Everyone treats you like crap. There's a huge stigma to asking for help."

Carissa Picard of the Fort Hood-based group Military Spouses for Change agreed.

She said soldiers tell her that if they go for help with PTSD, the clinic looks for other problems first — such as alcoholism. " 'Oh, you've got a drinking problem. You go through that first, and then you can come back to mental health,' " she said. "But the real problem is the PTSD. The real problem is the mental-health condition."

Col. Elspeth Ritchie, a psychiatrist and medical director of the Army Strategic Communications Office, said the Army does not treat soldiers simply to redeploy them.

"The goal is to make them better," she said. "Now making them better may mean taking them from a non-deployable to a deployable status. Obviously, there's a war going on, but the goal is making them better."

A second opinion to deploy

On Sept. 11, 2007, an Army psychologist decided Chad Barrett might get better if he left the Army. Barrett had been deployed to Iraq twice and attempted suicide once. The psychologist recommended discharging him for medical reasons.

A career soldier, Barrett fought to stay. In mid-November, he met with military doctors, asking them to stop his medical evaluation and let him return for a third combat tour in Iraq.

At a post struggling to find enough healthy soldiers to fill a brigade, Barrett found a willing taker. Fort Carson doctors re-evaluated him and cleared him to go. He left for Iraq with prescriptions for Ambien and Lunesta to sleep; Klonopin, for anxiety; an antidepressant, Pamelor — and a medical profile specifying that he should not carry a weapon or go anywhere "remote from definitive psychiatric care," his wife said.

In March 2003 — 18 months after witnessing the carnage from the Sept. 11 attacks — Barrett had been assigned to a unit that invaded Iraq. During that tour and a second, he "saw some pretty horrific things," and "anything that burned reminded him of the sights and sounds of picking up bodies at the Pentagon," his wife said.

A gunner, he was exposed to numerous blasts from improvised explosive devices. After two tours, "Chad would get very severe migraines that would knock him to his knees," his wife said.

In June 2007, he tried to kill himself for the first time, swallowing an orange juice glass full of pills in front of his wife after she came home from a night out with friends. He survived at an Army hospital, then spent three days in a lockdown facility.

On his third tour, Barrett was assigned to work from 6 p.m. to 6 a.m. in the radio room at the Mosul base. On Jan. 28, 2008, he came in to hear choked-up voices crackling over the radio. A convoy had been hit by a roadside bomb, and when the survivors jumped out, they were sprayed by machine-gun fire from a mosque. Five soldiers died.

When he called his wife two days later, "he was definitely wigged out," she said. "He knew three of the five."

He called again on Feb. 1 to wish his wife a happy birthday and to tell her that he loved her. That was his last call.

His roommate found him dying at 9:20 the next morning. His wife said an autopsy ruled his death a suicide from "multiple-drug intoxication" and "heavy lungs." Two drugs were found in his system: Pamelor and sleeping pills.

"He died a hero," his wife said. "He served his country for 12 years. He went through more hell in one year than you and I will in a lifetime."

Army officials would not comment directly on Barrett's death.

But "the Army takes suicide prevention very seriously. We are honor-bound to ensure we do everything possible to minimize potential risks," spokesman Paul Boyce said — including training for soldiers and leaders to recognize signs of suicidal behavior and helping people at risk.

Psychiatric visits via HDTV

To meet growing demands for mental- health treatment, the Army has added more than 190 contract behavioral-health providers to work on its installations. It is also treating more soldiers with "telepsychiatry" — providing a psychiatrist by video conference on a high-definition television set instead of face-to-face meetings.

Jonathan Berry, a 19-year-old soldier from White Cloud, Mich., with a history of suicidal thoughts, had three weekly televised conversations with a psychiatrist last month while assigned to an Army behavioral-health clinic in Maryland, according to his fiancee and an Army source.

He jumped out of a window after the third, killing himself.

Marla VerDuin, Berry's fiancee, said he told her that he "just had to sit and talk to someone over a TV" once a week.

"I thought, well, if that's how they're going to treat you, at least you're talking to someone," she said. "Obviously, that didn't help him."

VerDuin said he had no roommate in his last days there and was not permitted to socialize with other soldiers. "I know that he was by himself. He sat in his room and played a video game."

Jeffrey Castro, a spokesman for the Army Criminal Investigation Command, said the command is investigating Berry's death and will not comment.

Ritchie and Dr. Michael Lynch, the director of Walter Reed Army Medical Center's telepsychiatry program, also said they could not discuss an individual case.

But they agreed the Army is increasing its use of telepsychiatry as a treatment tool, particularly when soldiers are stationed in places where psychiatric care is not readily available.

Lynch said some patients prefer televised conversations to face-to-face meetings, and a comparative Army study found "the outcome, as well as patient satisfaction, was the same."

Ritchie called telepsychiatry a useful tool that can serve an Army facility lacking psychiatrists, speed up a medical board evaluation or enable a pediatrician to consult a child psychiatrist.

But "it's not a magic bullet," she said, and there are disadvantages to telepsychiatry. For one, doctor-patient relationships are "a little harder to maintain or develop."

Visible warning signs

Parents of several of the soldiers who reportedly committed suicide after deploying from Fort Hood say warning signs were missed or overlooked by an Army bearing the brunt of a prolonged war in Iraq.

Two were women who had reported being raped. A third woman was killed by a jealous soldier who then killed himself.

When 19-year-old Amy Duerksen shot herself in Iraq, her diary was left open to a page describing how she had been raped at a training session before Fort Hood deployed her.

Her mother, Michelle Duerksen, said Amy's unit ignored clear signs that she was feeling suicidal.

"She had stopped eating," her mother said. "She was telling people she was going to kill herself."

Michelle and her husband, a retired Army chaplain, adopted Amy at age 4, a girl who had been severely abused and neglected and who would struggle with depression as a teenager.

After Amy was raped, "she had evidently told people about the history of abuse," because her commander knew about it, her mother said.

At the end, "her commander was yelling at her," she said. "She was laughing and singing — she was sent with a male to the chaplain. The chaplain couldn't speak very good English, told her to start obeying orders. It was a series of people who could have done something better."

When she and her husband read the investigative report on their daughter's death, they learned one soldier had commented, "Duerksen finally did it," upon hearing the gunshot.

"Reading the investigation was just horrifying to us," Michelle Duerksen said. She regards her daughter's death as "friendly fire — because they failed to take care of a fellow soldier."

Last August, Paul Norris became the 20th Fort Hood soldier to commit suicide in Iraq, according to records provided by the Army.

Norris, a 30-year-old veteran of combat tours in Bosnia and Iraq, shot himself. But first he shot and killed Kamisha Block, a 20-year-old woman who had spurned him.

Military officials announced both deaths as "noncombat" incidents under investigation.

Kamisha's parents, Jerry and Jane Block, say Norris had stalked and assaulted their daughter before he killed her, and she had reported the assaults to the Army.

"He just kept doing it. He was 'in love' with her. She was trying to get away from him," Jerry Block said.

"He verbally and physically assaulted her. It was reported to the higher command," Jane Block said. "He was e-mailing her and e-mailing her and e-mailing her. She wouldn't answer his e-mails. He went into her room, killed her, and then he killed himself."

She said Army officials have never explained why officers who knew of Norris' assaults and harassment failed to protect her daughter. The Army did give them a hefty investigative report that included sworn statements from other soldiers "that he was out of control," she said.

"The last time he assaulted her, he drove around looking for her. That was probably a week or two before he killed her," she said. "I asked, 'After the second assault, what did y'all do then?' The only thing they told me was a lot of mistakes were made."

Suicide-prevention programs

Army officials did not respond to the comments of parents whose children killed themselves or were murdered after deploying from Fort Hood. Nor did they comment directly on the high number of reported suicides in two years among soldiers deployed from a single base.

Instead, they emphasized the efforts already underway — training for all soldiers on traumatic brain injuries and combat stress, policies to reduce the stigma of seeking help, family life chaplains, a video program called Battlemind that shows soldiers what they are likely to see, hear and feel in a war and how to cope as a warrior.

Fort Hood will soon launch a new ASIST (Applied Suicide Intervention Skills Training) program to broaden those efforts. Although that program has not officially begun, "chaplains are constantly working to prevent suicide at every level, most importantly at the soldier level," said Army spokesman Boyce.

In November 2006, the Defense Department issued new guidance for "deployment-limiting" psychiatric conditions and medications.

The new policy lists psychotic and bipolar disorders, and the medicines used to treat them, as disqualifying for deployment. It also states that "caution is warranted in beginning, changing, stopping and/or continuing" other drugs prescribed to stabilize or improve mood, mental status or behavior.

That policy — allowing deployment on psychotropic drugs with caution — enabled Chad Barrett to embark on a third combat tour with Klonopin and Pamelor.

It also enabled Travis Virgadamo, an 18-year-old soldier from Nevada, to take Prozac to Iraq.

Virgadamo's grandmother, Katie O'Brien, said he joined the Army as a 17-year-old after his father married a Filipino woman and moved to the Philippines.

At Fort Stewart, Ga., "he had a difficult time in boot camp," she said. "They sent him to anger-management classes. Feeling somewhat deserted by his father — he was so young. They had also put him in suicide watch in boot camp."

When he turned 18, "they deployed him to Iraq. Taking Prozac," she said. "That is a suicidal medicine, especially with teens. I was livid. I just couldn't believe they put him on Prozac."

The Army does not discuss suicides of individual soldiers. But spokeswoman Cynthia Vaughan said it is wrong to call Prozac a suicidal medicine.

While there is an increased risk of suicide in the early treatment phase for depression, particularly among young adults, "both Prozac and Paxil are in the class of medications called SSRIs, which are a very safe category of antidepressants," she said.

Virgadamo told his grandmother he was put on a suicide watch again in Iraq.

In July 2007, he came home for a rest-and-relaxation break. He talked to his grandmother about terrible things he'd seen and said he couldn't go back. He talked of fleeing to Canada. She asked if he wanted to spend the rest of his life as a fugitive, looking over his shoulder.

Virgadamo went back. Last August, on his 19th birthday, he called his grandmother from Iraq. She urged him to go to a doctor and demand to stop taking Prozac.

"Grandma, I did that," he told her, "and they put me on something else. They changed my medicine, gave me a week of stress management."

On Aug. 30, the Army gave Virgadamo his gun back, and "he killed himself that night," she said.

"I don't think he should have ever been sent there. Why would you deploy someone who was a danger to himself and maybe others? When they know, it's just unacceptable, pushing them out there."

Outside the Fort Carson gate, a stone memorial lists the names of all its soldiers who gave their lives in Iraq.

Shelby Barrett visited the memorial for the first time last month. She looked down the long list of names, recognizing those of a dozen soldiers she once knew. She knelt and ran her fingers over the name at the bottom of the last stone: Chad Barrett — Feb. 2, 2008.

That's when she noticed something odd. Her husband's name was out of sequence, chiseled beneath those of two other soldiers who died more than a month later.

"It looks like an afterthought," she said.
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