March 17, 2007
Saturday AM

Here's a future scene from the Iraq battlefield, circa July 2007: A U.S. soldier battles against the enemy all day long. At night, after returning to base, he's troubled by what he's seen. But he knows better than to speak up.

Just outside the view of his fellow soldiers, he logs on to a virtual therapy Web site provided by the military called afterdeployment.org. He knows that if his comrades see him talking with one of the shrinks on base, they would lose trust in him, label him a head case. A medical file soon would contain records of the visit. If he ever wanted a promotion, he'd have to explain the weakness of his mind.

Or that's the thinking among the male-dominated, therapy-averse troops, according to researchers, therapists and military psychologists who met at the fifth annual Military Suicide Prevention Conference in Hollywood, Fla., last week. Attendees discussed how to stem military suicides - in 2005 alone, the last year for which there are confirmed figures, 22 service members killed themselves in Iraq, Kuwait and Afghanistan.

Although the suicide rate among soldiers in combat is comparable to that of the general male population of the same age group, concern is growing in the military that, due to the traumatic events of recent U.S. wars, both active soldiers and veterans are psychologically vulnerable. A study of troops returning from the Iraq war, published in the January issue of the American Journal of Psychiatry, showed that 16 percent of them met the criteria for post-traumatic stress disorder within one year of returning home. The disorder has been defined as a lingering anxiety or depression triggered by past extreme traumatic events, such as serving in combat.

Since the military is 85 percent male and the majority of its members are ages 17 to 24, conference attendees hailed the planned July 1 launch of afterdeployment.org as the best way to reach a group skeptical about counseling and most prone to suicide.

"If you told me to try therapy when I was 22, I would have told you you were the crazy one," said Keith Armstrong, a family therapist at UC San Francisco who spoke at the conference. He is one of the authors of the recently published "Courage After Fire," a book that helps families and soldiers cope with post-traumatic stress disorder.

Armstrong said the military's Web site, which will include an on-screen therapist who can appear in video workshops, will not have the nuance and feel of face-to-face meetings between client and therapist. But, he added, "If a large portion of your population won't step foot into a therapist's office in the first place, maybe this is the precursor to therapy that's necessary."

The Web site has been under construction for two years as part of a Congressional mandate to address post-traumatic stress disorder and after studies showed that soldiers in Iraq and Afghanistan were reluctant to visit field counselors for fear of being stigmatized by their peers, said Air Force Col. Dr. Robert Ireland, program director for mental health policy in the Office of the Assistant Secretary for Health at the U.S. Department of Defense.

In 2003, the Office of the U.S. Army Surgeon General conducted a study of military suicides after five soldiers in Iraq killed themselves within a month. The new Web site would allow soldiers in the field and veterans at home to log on anonymously. Since the Web site is considered self-help rather than professional therapy, soldiers won't receive medical advice or prescriptions for anxiety-relief drugs. Ireland said traffic on the site would not be tracked, nor would the Department of Defense monitor it.

"We won't know what's going on unless they contact a provider and say they used the site," Ireland said.

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