Invisible Wounds: Mental Health and the Military

An understaffed mental-health corps is struggling to fight the stigma of therapy and bring relief to thousands of damaged soldiers

By Mark Thompson Sunday, Aug. 22, 2010
    • Gareth McConnell for TIME

    The base's medical team monitors the progress of recovery by seeing how soldiers would handle combat scenarios

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    Without doubt, those in the specialty feel under pressure. Sergeant Brock McNabb, who left the Army in 2008, was a mental-health technician operating out of a base near Baghdad; he endured nearly a year of 12-hour-plus shifts without a day off. "My marriage is going to hell. The commands aren't listening to a lot of the things we're saying when we're trying to take care of these guys," he recalls thinking. "It wasn't any huge, dramatic thing. I just decided, 'Yeah, today's the day I'm going to die,' and I was O.K. with that." He collapsed, fully clothed, on his cot. "I looked over at my 9 mm on this little hutch I'd made, and I started laughing hysterically," he says. "I was so exhausted after 10 months of all the s___ I'd been through, I was too tired to ... reach for the 9 mm and put it in my mouth." He passed out and awoke fine the next day.

    The Enduring Taboo

    McCord Pulled the two kids out of the minivan--the boy was still alive--and helped get them to a hospital. The Apache gunship killed a dozen men, including a pair working for the Reuters news agency; the episode became a video sensation after WikiLeaks released footage of it in April. Back at his base, McCord washed the children's blood off his uniform and body armor. That night, he told his staff sergeant he needed help. "Get the sand out of your vagina," McCord says his sergeant responded. "He told me I was being a homo and needed to suck it up." McCord says he never spoke to anyone about it after that because he didn't want to get in trouble and instead did what soldiers have done forever. "I decided to try to push it down and bottle it up," he says. But his anger, fueled by flashbacks to that day in Baghdad, kept growing. Any misstep by one of the soldiers on his team would set him off. "It was like a light switch," McCord says. "They'd do something wrong and I'd be screaming at them."

    Going to a psychiatrist is still seen as a sign of weakness in the Army; the chief fear is that it will work against promotion. That may be why only about half of those needing help seek care, according to a 2008 Rand Corp. study. And only half of those--25% of the total who need help--get "minimally adequate treatment," the Rand study found. Repeat deployments deepen the crisis. One in every 10 soldiers who has completed a single combat deployment has a mental ailment; that rate jumps to 1 in 5 with a second deployment and nearly 1 in 3 with a third. That means that more than 500,000 troops have returned home to the U.S. in the last decade with a mental illness.

    Complicating the Army's mental-health challenge is an increase in brain trauma. The two wars are revealing a connection between physical wounds and mental ailments. Advances in body armor protect soldiers' bodies but have left skulls and the gray matter inside them relatively defenseless. Schoomaker says the wars' biggest surprise is how traumatic brain injury (TBI) caused by roadside bombs has unleashed mental trauma. Bruised brains trigger "persistent stress-hormone releases" that can cause posttraumatic stress disorder. That, in turn, can lead to suicide. The Army has been battling a rising suicide rate for the past six years; June saw 32 suspected suicides, one of the highest monthly totals in Army history. Of those, 22 had served in combat, including 10 who had deployed two or more times.

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