The study, which showed increasing rates of mental health problems for troops on extended or multiple deployments, also said well over one-third of soldiers and marines believed that torture should be allowed to gain information that could save the lives of American troops, or knowledge about insurgents.
Of the 1,320 soldiers and 447 marines who took part, about 10 percent said they had mistreated civilians through physical violence or damage to personal property.
The study was conducted by Army medical experts from Aug. 28 to Oct. 3 last year.
“Soldiers with high levels of anger, who had experienced high levels of combat or who screened positive for mental health symptoms, were nearly twice as likely to mistreat noncombatants,” the acting Army surgeon general, Maj. Gen. Gale S. Pollock, told reporters.
The findings are posted at www .armymedicine.army.mil.
The survey data came out a month after Defense Secretary Robert M. Gates extended tours for soldiers in Iraq and Afghanistan to up to 15 months, from 12. American forces in Iraq are being increased under a security plan ordered by President Bush.
The report, the fourth prepared by the Army’s Mental Health Advisory Team since the war in Iraq began in 2003, showed that mental health problems like acute stress, anxiety and depression rose among troops facing longer deployments or their second or third tour in Iraq.
Over all, about 20 percent of soldiers and 15 percent of marines showed symptoms of anxiety, depression or acute stress. The rate was at 30 percent among troops with high combat experience.
Among soldiers, 27 percent of those with more than one tour of duty tested positive for a mental health problem, versus 17 percent for soldiers on their first deployment.
The rate of anxiety, depression and acute stress stood at 22 percent among soldiers deployed for more than six months and at 15 percent for troops in Iraq for less than six months. Army experts recommended that the Pentagon extend the interval between deployments to 18 to 36 months so that troops could recover mentally.
Mr. Gates said last month that troops in the region could expect to spend 12 months at home between deployments.
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Petraeus 'Concerned' by Ethics Report
By THE ASSOCIATED PRESS
Filed at 1:24 p.m. ET
NEW YORK (AP) -- The top U.S. commander in Iraq said Monday he was ''greatly concerned'' by a recent survey that concluded many combat troops in Iraq would not report a member of their unit for killing or wounding an innocent civilian.
Speaking to the annual meeting of The Associated Press, Gen. David Petraeus called for a ''redoubling of our education efforts'' to identify potential abuses among soldiers and anticipate problems related to combat stress.
''We can never sink to the level of the enemy,'' Petraeus said by video link from Baghdad. ''We have done that at times in theater and it has cost us enormously'' -- referring specifically to the torture and humiliation of prisoners at the Abu Ghraib facility west of Baghdad.
Petraeus said he was drafting a memo that would closer examine issues of battlefield ethics and ways pre-empt possible problems, adding that he was ''greatly concerned by the results'' of a Pentagon report last week by a special mental health advisory team assessing forces serving in Iraq.
''So the first step is that we've got ... make sure that folks remember that that's a foundation for our moral compass ... anything we do that violates that is done at considerable peril,'' he said.
The Pentagon report included a range of findings that pointed to potential violations of military codes and standards, including only 40 percent of Marines and 55 percent of Army soldiers interviewed saying they would report a member of their unit for killing or wounding an innocent civilian.
The survey also found that 47 percent of U.S. soldiers and 38 percent of Marines interviewed saying noncombatants should be treated with dignity and respect; and 44 percent of Marines and 41 percent of soldiers said torture should be allowed to save the life of a soldier or Marine.
Petraeus also reiterated his belief that Iraq's long-term stability cannot be achieved through military means and requires political reconciliation from its main groups: the majority Shiites, Sunnis and Kurds. But he noted that the government of Prime Minister Nouri al-Maliki remains focused on ''narrow agendas'' standing the way of unity and crucial U.S.-backed legislation, such as a law to share Iraq's oil wealth.
He said he plans to deliver a report to President Bush in the first two weeks of September on the future direction of Iraq, including the U.S.-led effort to try to reclaim Baghdad from extremist factions.
The battles will ''likely be harder in Iraq before it gets easier,'' Petraeus said just hours after two suicide car bombers attacked a market and a police checkpoint on the outskirts of Ramadi west of the capital -- an area where Petraeus noted some success in marshaling Sunni tribes to help fight al-Qaida insurgents. At least 20 people were killed in the attacks.
On Sunday, roadside bombs killed eight American soldiers, including six who died in a single blast in Diyala province -- a hotbed of the Sunni insurgency as many militants fled the Baghdad security crackdown.
New York Times, May 6, 2007
News Analysis
Stress on Troops Adds to U.S. Hurdles in Iraq
By BENEDICT CAREY
The detailed mental health survey of troops in Iraq released by the Pentagon on Friday highlights a growing worry for the United States as it struggles to bring order to Baghdad: the high level of combat stress suffered during lengthy and repeated tours.
The fourth in a continuing series, the report suggested that extended tours and multiple deployments, among other policy decisions, could escalate anger and increase the likelihood that soldiers or marines lash out at civilians, or defy military ethics.
That is no small concern since the United States’ counterinsurgency doctrine emphasizes the importance of winning the trust and support of the local population.
The report was provided in November to Gen. George W. Casey Jr., then the senior American commander in Iraq.
Pentagon officials have not explained why the public release of the report was delayed, a move that kept the data out of the public debate as the Bush administration developed its plan to build up troops in Iraq and extend combat tours. Rear Adm. Richard R. Jeffries, a medical officer, told reporters on Friday that the timing was decided by civilian Pentagon officials.
The survey of 1,320 soldiers and 447 marines was conducted in August and September of 2006. The military’s report, which drew on that survey as well as interviews with commanders and focus groups, found that longer deployments increased the risk of psychological problems; that the levels of mental problems was highest — some 30 percent — among troops involved in close combat; that more than a third of troops endorsed torture in certain situations; and that most would not turn in fellow service members for mistreating a civilian.
“These are thoughts people are going to have when under this kind of stress, and soldiers will tell you that: you don’t know what’s it’s like until you’ve been there,” said Dr. Andy Morgan, an associate clinical professor of psychiatry at Yale University who has worked extensively with regular and Special Operations troops. “The question is whether you act on them.”
The Pentagon’s analysis also identified sources of anger besides lengthy and repeated deployments that could lead to ethics violations, which would not be apparent from the outside: eight-day rest breaks that involved four days of transit; long lines to get into recreation facilities, especially for those who perform missions outside the relative safety of base camps; and inconsistent dress-code rules.
Most of all, there were uncertainties about deployment: 40 percent of soldiers rated uncertain redeployment dates as a top concern.
The military has evaluated the emotional state of soldiers in the past, from the cases of shaking and partial paralysis known as shell shock after World War I, to the numb exhaustion identified as combat fatigue in World War II. The flashbacks and irritability reported in the years after the Vietnam War came to define another diagnosis: post-traumatic stress disorder.
But since the Persian Gulf war in 1991 the Pentagon’s efforts to track mental health have become far more sophisticated, and now provide a deeper X-ray into the day-to-day realities of life on the ground, in real time — a glimpse of how the stresses of both combat, and policy decisions, can affect the behavior of troops.
When the administration decided in January to send more troops to Baghdad to try to reverse the spiraling sectarian violence in Iraq, it sought to ease the strain on the armed forces by announcing its intention to expand the active duty Army and Marine forces by 92,000 troops.
But it takes years to recruit, train and equipment an expanded ground force, and the decision to increase the size of the military was made too late to relieve the stress on the forces now in Iraq.
To sustain the current elevated troop levels, Defense Secretary Robert M. Gates announced in April that the Army was increasing combat tours to 15 months, rather than the traditional one-year tour.
“The Army is spread very thin, and we need it to be a larger force for the number of missions that we were being asked to address for our nation,” said Maj. Gen. Gale S. Pollock, the Army’s acting surgeon general and head of the Army’s Medical Command, on Friday, as the report was released.
To better cope with the current strains, the report recommended that suicide prevention program be revised, that soldiers and marines who have combat positions outside large bases have better opportunities for occasional rest and recreation, and that a more determined effort be made to teach battlefield ethics on dealing with civilians.
The military team that conducted the survey recommended that soldiers spend 18 to 36 months at home between deployments abroad, in contrast to the current Army policy of 12 months.
Col. Carl Castro of the Army, who led the team that carried out the survey, asserted that the military began to carry out the report’s recommendations immediately after it was completed.
The report noted a direct relationship between involvement in intense combat and soldiers who exhibited signs of anxiety, depression and acute stress. Almost 30 percent of soldiers who were engaged in “high combat” were discovered to be suffering from “acute stress,” according to the report.
But the length of tours in Iraq was another important factor. Soldiers who were deployed for more than six months were one and a half times more likely to exhibit depression or anxiety than those with shorter tours of duty.
Those who had repeatedly served in Iraq were also more likely to suffer from psychological ailments than those who were serving their first tour. The survey showed that 24 percent of those who had done multiple tours suffered from “acute stress,” compared with 15 percent who were on their first tour.
According to the survey, suicide rates for soldiers in Iraq from 2003 to 2006 were 16.1 per 100,000, compared with the average Army rate of 11.1.
In general, soldiers experience higher rates of mental health problems than do marines. The morale of the soldiers also tended to be lower than that of marines, who unlike those in the Army typically serve seven-month combat tours in Iraq.
The report said psychological ailments and built-up anger resulting from combat stress increased the likelihood that the troops would lash out at civilians. The survey noted that only 47 percent of the soldiers and 38 percent of marines agreed that noncombatants should be treated with dignity and respect. Troops who had high levels of anger were twice as likely to violate ethical standards, the report found. The survey found that 40 percent of troops who scored high on measures of personal anger reported insulting or cursing at a civilian, and 7 percent reported having hit or kicked a civilian. Among those low on measures of anger, only 1 percent said they had hit a civilian, and 16 percent reported insulting noncombatants.
The Iraq war, experts say, is a new kind of war — a 360-degree battle space, with no front or rear, no safe zone outside the large fortified bases, and the compounded physical uncertainty of roadside bombs and mortar attacks. The lack of any control over these factors, and the generally limited sense of progress, only intensifies the stress for troops.
“You can endure a lot of physical and mental exhaustion as long as you feel you’re having an impact, you’re accomplishing something and that you have some control over your situation,” Dr. Morgan said. “If you don’t feel you have any of that, you quickly get to a point where the only thing that’s important is keeping yourself and your buddies alive. Nothing else much matters.”
Michael R. Gordon contributed reporting.
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