PTSD suicides: How many could have lived?

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Volume 351:13-22
July 1, 2004
Number 1
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Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care
Charles W. Hoge, M.D., Carl A. Castro, Ph.D., Stephen C. Messer, Ph.D., Dennis McGurk, Ph.D., Dave I. Cotting, Ph.D., and Robert L. Koffman, M.D., M.P.H.

Only 31 percent of soldiers deployed to Afghanistan reported having engaged in a firefight, as compared with 71 to 86 percent of soldiers and Marines who had been deployed to Iraq

Soldiers and Marines who had returned from Iraq were significantly more likely to report that they were currently experiencing a mental health problem, to express interest in receiving help, and to use mental health services than were soldiers returning from Afghanistan or those surveyed before deployment (Table 3). Rates of PTSD were significantly higher after combat duty in Iraq than before deployment, with similar odds ratios for the Army and Marine samples (Table 3).

Significant associations were observed for major depression and the misuse of alcohol. Most of these associations remained significant after control for demographic factors with the use of multiple logistic regression (Table 3). When the prevalence rates for any mental disorder were adjusted to match the distribution of officers and enlisted personnel in the reference populations, the result was less than a 10 percent decrease (range, 3.5 to 9.4 percent) in the rates shown in Table 3 according to both the broad and the strict definitions (data not shown).

For all groups responding after deployment, there was a strong reported relation between combat experiences, such as being shot at, handling dead bodies, knowing someone who was killed, or killing enemy combatants, and the prevalence of PTSD. For example, among soldiers and Marines who had been deployed to Iraq, the prevalence of PTSD (according to the strict definition) increased in a linear manner with the number of firefights during deployment:
4.5 percent for no firefights,
9.3 percent for one to two firefights,
12.7 percent for three to five firefights, and
19.3 percent for more than five firefights
(chi-square for linear trend, 49.44; P<0.001).>

Close calls, such as having been saved from being wounded by wearing body armor, were not infrequent. Soldiers who served in Afghanistan reported lower but still substantial rates of such experiences in combat. The percentage of study subjects whose responses met the screening criteria for major depression, PTSD, or alcohol misuse was significantly higher among soldiers after deployment than before deployment, particularly with regard to PTSD. The linear relationship between the prevalence of PTSD and the number of firefights in which a soldier had been engaged was remarkably similar among soldiers returning from Iraq and Afghanistan, suggesting that differences in the prevalence according to location were largely a function of the greater frequency and intensity of combat in Iraq.

The association between injury and the prevalence of PTSD supports the results of previous studies.25 These findings can be generalized to ground-combat units, which are estimated to represent about a quarter of all Army and Marine personnel participating in Operation Iraqi Freedom and Operation Enduring Freedom in Afghanistan (when members of the Reserve and the National Guard are included) and nearly 40 percent of all active-duty personnel (when Reservists and members of the National Guard are not included).

The demographic characteristics of the subjects in our samples closely mirrored the demographic characteristics of this population. The somewhat lower proportion of officers had a minimal effect on the prevalence rates, and potential differences in demographic factors among the four study groups were controlled for in our analysis with the use of logistic regression. One demonstration of the internal validity of our findings was the observation of similar prevalence rates for combat experiences and mental health outcomes among the subjects in the Army and the Marine Corps who had returned from deployment to Iraq, despite the different demographic characteristics of members of these units and their different levels of availability for recruitment into the study.

The cross-sectional design involving different units that was used in our study is not as strong as a longitudinal design. However, the comparability of the Army samples and the similarity in outcomes among subjects in the Army and Marine units surveyed after deployment to Iraq should generate confidence in the cross-sectional approach. Another limitation of our study is the potential selection bias resulting from the enrollment procedures, which were influenced by the practical realities that resulted from working with operational units. Although work schedules affected the availability of soldiers to take part in the survey, the effect is not likely to have biased our results. However, the selection procedures did not permit the enrollment of persons who had been severely wounded or those who may have been removed from the units for other reasons, such as misconduct.

Thus, our estimates of the prevalence of mental disorders are conservative, reflecting the prevalence among working, nondisabled combat personnel. The period immediately before a long combat deployment may not be the best time at which to measure baseline levels of distress. The magnitude of the differences between the responses before and after deployment is particularly striking, given the likelihood that the group responding before deployment was already experiencing levels of stress that were higher than normal. The survey instruments used to screen for mental disorders in this study have been validated primarily in the settings of primary care and in clinical populations.

The results therefore do not represent definitive diagnoses of persons in nonclinical populations such as our military samples. However, requiring evidence of functional impairment or a high number of symptoms, as we did, according to the strict case definitions, increases the specificity and positive predictive value of the survey measures.26,27 This conservative approach suggested that as many as 9 percent of soldiers may be at risk for mental disorders before combat deployment, and as many as 11 to 17 percent may be at risk for such disorders three to four months after their return from combat deployment.

Although there are few published studies of the rates of PTSD among military personnel soon after their return from combat duty, studies of veterans conducted years after their service ended have shown a prevalence of current PTSD of 15 percent among Vietnam veterans28 and 2 to 10 percent among veterans of the first Gulf War.4,8 Rates of PTSD among the general adult population in the United States are 3 to 4 percent,26 which are not dissimilar to the baseline rate of 5 percent observed in the sample of soldiers responding to the survey before deployment. Research has shown that the majority of persons in whom PTSD develops meet the criteria for the diagnosis of this disorder within the first three months after the traumatic event.29 In our study, administering the surveys three to four months after the subjects had returned from deployment and at least six months after the heaviest combat operations was probably optimal for investigating the long-term risk of mental health problems associated with combat.

We are continuing to examine this risk in repeated cross-sectional and longitudinal assessments involving the same units. Our findings indicate that a small percentage of soldiers and Marines whose responses met the screening criteria for a mental disorder reported that they had received help from any mental health professional, a finding that parallels the results of civilian studies.30,31,32

In the military, there are unique factors that contribute to resistance to seeking such help, particularly concern about how a soldier will be perceived by peers and by the leadership. Concern about stigma was disproportionately greatest among those most in need of help from mental health services.

Soldiers and Marines whose responses were scored as positive for a mental disorder were twice as likely as those whose responses were scored as negative to show concern about being stigmatized and about other barriers to mental health care. This finding has immediate public health implications. Efforts to address the problem of stigma and other barriers to seeking mental health care in the military should take into consideration outreach, education, and changes in the models of health care delivery, such as increases in the allocation of mental health services in primary care clinics and in the provision of confidential counseling by means of employee-assistance programs. Screening for major depression is becoming routine in military primary care settings,12 but our study suggests that it should be expanded to include screening for PTSD. Many of these considerations are being addressed in new military programs.33 Reducing the perception of stigma and the barriers to care among military personnel is a priority for research and a priority for the policymakers, clinicians, and leaders who are involved in providing care to those who have served in the armed forces.

go here for the parts left out of this post http://content.nejm.org/cgi/content/full/351/1/13

These are some of the known suicides from 2004. How many of them would have lived if the DOD did what was known needed to be done? There were a lot more names found in my research but they were last listed as "under investigation" and I could not find the result.

Staff Sgt. Cory W. Brooks 32 Company A, 153rd Engineer Battalion, South Dakota Army National Guard Philip, South Dakota "Died of non-combat related injuries in Baghdad, Iraq, on April 24, 2004Among them was Army Staff Sgt. Cory W. Brooks, 32, of Philip, S.D., who shot himself in the head on April 24, 2004. In sworn statements, a major and first lieutenant acknowledged they had conducted ""counseling"" with Brooks, and a first sergeant ""detailed his knowledge of SSG Brooks' suicidal ideations.""


Capt. Joshua Byers of the 3rd Armored Cavalry Regiment. August 20, 2004 Report: Two Carson soldiers committed suicide in Iraq Associated Press FORT CARSON, Colo. Two Fort Carson soldiers who died in Iraq took their own lives, according to Army reports released this week.
http://www.armytimes.com/legacy/new/1-292925-314145.php

Spc. Tambo Cox, 20, shot and injured two women April 5 in a Sunland Park, N.M., home because he was angry that his ex-girlfriend ended their relationship. Investigators said Coxlater shot himself during a traffic stop April 6 along Interstate 10 near Deming, N.M. Fort Bliss officials said Cox, originally from Trinidad, has been in the Army since 2004. He served with 3rd Battalion, 43rd Air Defense Artillery.
http://www.armytimes.com/legacy/new/0-ARMYPAPER-1688474.php


PFC Nicholas A. Davis Born April 27, 1986 - July 13, 2005 Dates of service: Jan. 20, 2004 - July 13, 2005 US Army He died at Ft. Knox, KY From his Nick definately died from the results of PTSD. He fell 1250 feet when his parachute failed and was only treated for a broken ankle. From what I can tell, he never received a CAT scan or MRI to check for further damage. He had flashbacks and nightmares and was punished for asking for help. On his final day he asked for help several times and others asked for help for him. Those around him were concerned for him but those in charge did nothing. And that evening he was dead. The records tell how his personality changed for the worse, he became a different person. He also began suffering from tremors and toward the end of his life he began having siezures. Several witnesses put that into their statements...that his superiors did not help him they "put him into a room until he calmed down". He was being discharged and coming home in less than 24 hours. He was found hung by a shoelace on the hook of a latrine stall door.
http://www.killingourown.homestead.com/

Sgt. Michael E. Dooley of the 3rd Armored Cavalry Regiment August 20, 2004 Report: Two Carson soldiers committed suicide in Iraq Associated Press FORT CARSON, Colo. Two Fort Carson soldiers who died in Iraq took their own lives, according to Army reports released this week.
http://www.armytimes.com/legacy/new/1-292925-314145.php

Curtis Green 25 FORT RILEY 12/6/2004 "Over my dead body are they going to make me go back." "I knew he was having dreams, nightmares," Lisset said. "He would wake up at night really sweaty." On Dec. 6, he showed up for work, his uniform pressed, his boots polished. He sang cadence. That night, he was found hanging in his barracks. Sgt. Curtis Greene, 331st Signal Company, was 25
http://www.commondreams.org/cgi-bin/print.cgi?file=/headlines05/0214-09



JEFFREY LUCEY 23 BELCHER, MA HANGING 6/22/2004 'Something happened to Jeff' Jeff Lucey returned from Iraq a changed man. Then he killed himself. By Irene Sege, Globe Staff March 1, 2005 BELCHERTOWN -- Less than three weeks before he committed suicide, Jeffrey Lucey, lance corporal in the Marine Reserves, veteran of Operation Iraqi Freedom, totaled his parents' Nissan Altima.
http://www.boston.com/yourlife/health/mental/articles/2005/03/01/jeff_lucey_returned_from%20_iraq_a_changed_man_then_he_killed_himself/

Private Peter Mahoney On August 10, the funeral of Private Peter Mahoney, a soldier with the Territorial Army (TA) who served for six months in the war against Iraq in 2003, was held at St. Aidan’s church in his hometown of Carlisle, England. On August 3, the 45-year-old father of four had committed suicide by gassing himself in his family car. He died of carbon monoxide poisoning after attaching a hosepipe to the exhaust of the car parked in his garage at his home in Botcherby, on the outskirts of Carlisle. Mahoney was wearing his old TA uniform and had shaved his head in a regulation military style.
http://www.wsws.org/articles/2004/aug2004/army-a23.shtml


1st Class Andre McDaniel was a military accountant 40 COLORADO SPRINGS, CO GUNSHOT 9/1/2004 McDaniel, 40, a father of two, shot himself in August 2004, six weeks after he returned from Iraq. He had recently been arrested for allegedly arranging to have sex with an undercover officer who had posed on the Internet as a 13-year-old girl.
http://www.armytimes.com/legacy/new/1-292925-1166922.php

BRIAN MCKEEHAN 37 FORT EUSTIS HANGING 10/12/04 AP: Soldier Just Back From Iraq Hangs Himself In Jail Police say Brian McKeehan hanged himself with a bedsheet early Saturday in the Virginia Peninsula Regional Jail in James City, about 12 hours after being arrested on a charge of assaulting his wife at their York County home.
http://www.indymedia.org/en/2004/10/861771.shtml

MICHAEL PELKEY FORT SILL, OK GUNSHOT 11/5/2004Capt. Michael Jon Pelkey However, it would become tragically obvious that Michael's worries were not over. Michael met with the therapist on a Monday; the couple celebrated their third wedding anniversary on a Tuesday; and on Friday, November 5, 2004, Stefanie came home to find her husband laying on the bed, dead from a self-inflicted gunshot wound to the chest
http://www.usmedicine.com/article.cfm?articleID=1154&issueID=79

Pfc. David L. Potter 22 Company B, 115th Forward Support Battalion, 1st Cavalry Division Johnson City, Tennessee Died of non-combat related injuries in Baghdad, Iraq, on August 7, 2004 In another case, Pfc. David L. Potter was kept in the war zone despite a diagnosis of anxiety and depression, a suicide attempt and a psychiatrist's recommendation that he be separated from the Army. Potter, 22, told friends that he believed the recommendation had been overruled, leading to a deepening of his depression, a fellow soldier said. On Aug 7, 2004 - 10 days after the psychiatrist recommended he be sent home - Potter took a gun from under another soldier's bed and killed himself. Hartford Courant

Staff Sgt. Jeffrey Jerome Sloss a member of the South Carolina National Guard, seemed fine when he was serving in Iraq. But when he came home to his job as a state trooper, he had trouble concentrating. Sloss committed suicide on May 27, 2004 -- five weeks after his return.

ALEXIS SOTO-RAMIREZ 42 WALTER REED HANGING 1/12/2004 Then there's the case of Spc. Alexis Soto-Ramirez, who served with a unit of the Puerto Rico National Guard. Suffering from chronic back pain that became excruciating during the war, Soto-Ramirez was diagnosed with "psychiatric symptoms" that were "combat-related." He was sent to Walter Reed's "Ward 54"--the in-patient psychiatric unit--where he was supposed to get the best care the military had to offer. Instead, less than a month later, he was dead--having hanged himself with the sash from his bathrobe
http://www.counterpunch.org/colson06062005

ANDREW VELEZ 22 AFGHANISTAN GUNSHOT Spc. Andrew Velez 22 Corps Support Battalion, Theater Support Command Lubbock, Texas Committed suicide by shooting himself in Sharona, Afghanistan, on July 25, 2006. His brother, Spc. Jose A. Velez, was killed in Iraq in November 2004. His brother died the same month two years before.
Spc. Jose A. Velez 23 Company A, 2nd Battalion, 7th Cavalry Regiment, 1st Cavalry Division Lubbock, Texas Killed when his unit came under fire while clearing an enemy strongpoint in Falluja, Iraq, on November 13, 2004. His brother, Spc. Andrew Velez, committed suicide by shooting himself in Afghanistan in August 2006.

BOYD WICKS JR WILMINGTON, DE 2/1/2004 BOYD WICKS JR WILMINGTON, DE 2/1/2004 Please also remember those who came back after combat and died from post-traumatic stress disorder (PTSD) through suicide. My son, USMC Infantry Sgt. Boyd W. "Chip" Wicks Jr. died that way. After combat in Iraq from March-June 2003, he came back to the U.S. and was discharged in October 2003. In February 2004 he committed suicide. No one seems to want to care about him or the others who have died from PTSD after Iraq combat. Because they didn't die in a war zone or in uniform, they are forgotten, swept aside. They don't fit in anywhere during the services -- no one recalls these dead heroes, who also gave all. It's like having a special needs child in your neighborhood -- it's someone else's problem, it's someone else's heartache.Boyd W. Wicks Sr., Wilmington, Delaware
http://www.cnn.com/2006/US/05/26/ch.feedback/index.html


All three were given antidepressants to help them make it through their tours of duty in Iraq - and all came home in coffins.Warren,44, and Guy, 26, committed suicide last year, according to the military; Hobart, 22, collapsed in June 2004, of a still-undetermined cause.The three are among a growing number of mentally troubled service members who are being kept in combat and treated with potent psychotropic medications - a little-examined practice driven in part by a need to maintain troop strength.Interviews with troops, families and medical experts, as well as autopsy and investigative reports obtained by The Courant, reveal that the emphasis on retention has had dangerous, and sometimes tragic, consequences


Again, these are just from 2004. Timothy Bowman, Jonathan Schultz, Joshua Omvig and all the others should make us wonder how many more of these men and women serving this nation could have lived if the results from above had been taken seriously and the DOD and VA Mental Health care was increased enough to carry the load of actually doing it?

Mental Health Advisory Team IV Findings Released
News & Media - News Releases - May 2007 News Releases
by Jerry HarbenUS Army Medical Command Public Affairs
A team of Army experts who studied the mental health of Soldiers and Marines in Iraq between August and October last year concluded that there is a "robust" system in place to provide mental health care, but issues continue with the stress of a combat deployment. This was the first time Marines had been included in this Mental Health Advisory Team study.

At the request of the leadership in theatre, this team for the first time examined the ethical behavior of U.S. troops so that battlefield ethics training can be improved. They recommended training based on the Army Chief of Staff's "Soldiers' Rules," and such training is being developed by the U.S. Army Training and Doctrine Command as well as by the Marine Corps' Training and Education Command.

"Previous MHATs found that deployment lengths and multiple deployments impact on Soldiers' mental health," said Col. Carl Castro, chief of military psychiatry at Walter Reed Army Institute of Research, who led the Mental Health Advisory Team (MHAT) IV. COL Castro also said that suicide rates in theater remain high.
Castro and his team (psychologist Maj. Dennis McGurk and behavioral health specialist Spec. Matthew Baker) interviewed 1,320 Soldiers and 447 Marines and conducted focus-group sessions with Soldiers, Marines and behavioral-health providers.

The team recommended Soldiers and Marines receive the Army's "Battlemind Training" both before and after deployment. This training helps them identify signs and symptoms of mental distress and access the programs that provide help.
The central findings of the report are:

1. Not all Soldiers and Marines deployed to Iraq are at equal risk for screening positive for a mental-health problem. The level of combat is the main determinant of a Soldier's or Marine's mental-health status.

2. For Soldiers, deployment length and Family separations were the top non-combat deployment issues; due to shorter deployment lengths, Marines had fewer non-combat deployment concerns. The team recommended behavioral-health outreach efforts focus on units that had been in theatre longer than six months. Shorter deployments or longer intervals between deployments would allow Soldiers and Marines better opportunities to "reset" mentally before returning to combat.

3. Only 5 percent of Soldiers reported taking in-theatre rest and relaxation (R&R), even though the average time deployed was nine months. Policies need revision to ensure that those who work "outside the wire" receive R&R opportunities.

4. Soldiers and Marines reported general dissatisfaction with the creation and enforcement of garrison-like rules for such things as uniform appearance in a combat environment.

5. Soldier morale was lower than Marine morale, but was similar to Soldier morale in previous surveys.

6. Overall, Soldiers had higher rates of mental-health problems than Marines. When matched for deployment length and deployment history, Soldiers' mental-health rates were similar to those of Marines.

7. Multiple deployers reported higher acute stress than first-time deployers. Deployment length was related to higher rates of mental-health problems and marital problems.

8. Good NCO leadership was the key to sustaining Soldier and Marine mental health and well-being.

9. Marital concerns were higher than in previous surveys, and these concerns were related to deployment length.

10. Although demographic differences between the Soldiers in Iraq and the broader Army population make comparison difficult, 2003-2006 Operation Iraqi Freedom suicide rates are higher than the average Army rate, 16.1 versus 11.6 Soldier suicides per year per 100,000.

11. Suicide prevention training was not designed for a combat/deployed environment. Training has been revised to include theatre-specific scenarios that describe actions Soldiers or Marines can take to help each other.

12. Approximately 10 percent of Soldiers and Marines report mistreating non-combatants (damaged/destroyed Iraqi property when not necessary or hit/kicked a non-combatant when not necessary). Soldiers that have high levels of anger, experienced high levels of combat or screened positive for a mental-health problem were nearly twice as likely to mistreat non-combatants as those who had low levels of anger or combat or screened negative for a mental health problem.

13. Transition team members, those who advise and train Iraqi forces, have lower rates of mental-health problems compared to Soldiers assigned to U.S. brigade combat teams, although there was an unmet behavioral health care need. The transition team members tend to be more experienced.

14. Behavioral-health providers require additional Combat and Operational Stress Control (COSC) training before deploying to Iraq; very few attended the Army Medical Department Center and School's COSC Course. The Army Surgeon General now has mandated this training for all deploying behavioral-health personnel.

15. There is no standardized joint reporting system for monitoring mental-health status and suicide surveillance of service members in a combat/deployed environment.

"Each service now has its own system. In a joint command, a rollup of the force is difficult to get, because everyone is reporting something different," Castro said of the reporting system.

Besides assessing the state of the force's mental health and capabilities of the mental-health providers, this survey found that line leadership, especially team and squad leaders, had a great influence on their troops' mental condition.

"We used a leadership checklist of what were positive things they wanted leaders to do—such as treat everybody fairly, protect them from unnecessary taskings—and things they don't want leaders to do—such as not taking the same risks as the troops," Castro said.

The team recommended that all junior leader development courses should include behavioral health awareness training.

Recommendations also included giving commanders the same kind of information on their troops' mental health that is provided about physical wounds, and conducting Battlemind Psychological Debriefings to replace current debriefings after deaths, serious injuries and other significant events.

This was the fourth MHAT to study troops deployed for Operation Iraqi Freedom. Together, the surveys constitute an unprecedented attempt to measure troops' mental health and improve mental-health services during combat operations rather than waiting to evaluate after the war.
For immediate release, May 4, 2007.
http://www.armymedicine.army.mil/news/releases/20070504mhat.cfm

Mental health teams to visit Marines in Iraq
Chelsea J. Carter, Associated Press Writer
Monday, February 11, 2008
CAMP PENDLETON - Navy Chaplain Dick Pusateri has witnessed the stress of war on the faces of troops put in harm's way daily, in the strained relationships of families facing long deployments and the confessions of men shaken by the human cost of war.

For too long, chaplains were among the few people combat Marines felt they could turn to in a crisis.

The Navy and Marine Corps aim to change that by sending teams of mental health professionals to the front lines this month, after studies showed a jump in the past five years in cases of combat-related mental health disorders, primarily post-traumatic stress disorder.

"We've got a lot of knowledge about the way combat trauma affects people, and having somebody there to guide Marines through it in Iraq means we can respond to it more quickly," Pusateri said.

While psychologists and psychiatrists have long treated military service members on bases and in field hospitals, the deployment of teams of psychological professionals - one per regiment - next month to combat zones marks a new approach in identifying and treating mental health before problems arise.

The teams assigned to the 1st Marine Expeditionary Force - made up of about 11,000 Marines - will include a psychiatric technician, a chaplain and, in some cases, a Naval social worker. Psychiatrists or psychologists could deploy to forward operating bases and, in extreme cases, patrol with units.

Three top commanders of the U.S. Marine Corps' fighting forces recently asked to make the pilot program a permanent fixture.

"Now is the time to adjust fire," the generals wrote in a letter to the commandant. "We must shift the current direction of combat/operational stress control efforts to a more holistic, nested enabling strategy that provides a sound, unified approach."
Marine commandant Gen. James T. Conway is reviewing the request and a decision is expected later this year.

The Army adopted a similar approach last year, and has been deploying behavioral health specialists to patrol with its troops in Iraq and Afghanistan.

"What is probably new here is that we want to address it close on the front lines, and thereby return people both back to combat and back to society healthy," said Navy Capt. Mike Maddox, the 1st Marine Expeditionary Force surgeon.

The push to make the program permanent comes after a report by the Institute of Medicine found post-traumatic stress disorder is the most commonly diagnosed mental disorder among veterans. It affected an estimated 13 percent of those returning from Iraq and 6 percent from Afghanistan.

Figures released by the Marine Corps show a fourfold increase in the number of Marines diagnosed with PTSD - from 394 in 2003 to 1,669 to 2006.

"If we identify a stress and if we can treat it close to the unit, it's less likely that person will be sent back, medevaced out of there," said Cmdr. David Oliver, the 1st Marine Expeditionary Force psychiatrist.

Previously, Marines identified with possible combat-related mental health stress or disorders have been pulled from duty in Iraq and shipped to the U.S. or Germany for assessment and treatment.

Under the expanded program, mental health specialists would be in daily contact with troops at forward bases, working with chaplains to identify potential risks to troops, talking with squad leaders about their troops, and responding to IED explosions and other combat situations that could effect a Marine's mental health.

While certain combat-related mental health conditions may require extended care, most of the cases in Iraq can be treated or eased.

In some cases, Marines or sailors showing signs of stress, such as sleeplessness, anxiety or agitation, may just need a rest.
"In many cases, he's probably not going to have problems if he's given the chance to get some sleep, get some hot chow, take a hot shower," Oliver said.
http://www.redding.com/news/2008/feb/11/mental-health-teams-visit-marines-iraq/

Hot chow? Rest? Take a shower? After all the military has claimed they learned about all of this, this was said in 2008!

As for Battlemind, well, I guess it's better than nothing because it's the only thing they want to use even though if it worked, the numbers would go down and not up.

Senior Chaplain Kathie Costos

Namguardianangel@aol.com

www.Namguardianangel.org

www.Woundedtimes.blogspot.com"The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional to how they perceive veterans of early wars were treated and appreciated by our nation." - George Washington