Preventing Breakdowns on the Battlefield
About 300,000 American military personnel are expected to be deployed to the Persian Gulf -- the largest mobilization in more than a decade. But the armed forces have changed in many ways since Desert Storm. For one thing, they're savvier about the mental stress that can impair soldiers' performance. NPR's Richard Knox spent time with an Army stress-control unit stationed at Fort Hood, Texas. As Knox reports, its job is to monitor soldiers' mental health and prevent breakdowns.
Over the past month, nearly 30,000 of the 42,000 soldiers stationed at Fort Hood have received orders to deploy to the Middle East. Among them is one small unit, the 85th Medical Division, with a unique mission: combat stress control. Led by Lt. Col. Ann Hohner, a psychiatric nurse, the unit is responsible for keeping soldiers mentally fit to fight. The 43-member unit is trained to diagnose soldiers at risk and intervene early so they can keep doing their job.
The unit contains soldiers of various ranks. That's no accident. A stressed-out private is more likely to confide in another private than an officer. But it means that most of the Army's stress-control specialists do not have advanced training in mental health -- although some members did join the unit with the express intent of helping their comrades. Pfc. Betty Woods says that when she enlisted, she told the Army she wanted to be a counselor of some sort.
"I was looking for a job where I could help people," Woods says. "I did it all my life through school, you know, with my friends and stuff, always talking to people and helping people. I thought, 'Wow, you know, I'm pretty good at this. Let's make it a career.'"
Because they will be deployed close to the front line, members of the unit receive training in such safety issues as avoiding landmines, preparing for biological and chemical attacks, dealing with the media and injecting the antidote to nerve gas.
But the unit also receives training in dealing with the home front. In today's Army, more soldiers are married than single. According to Capt. Bobby Sidell, who holds a doctorate in clinical psychology, factors such as rocky relationships and children's school problems cause soldiers more anguish than the stresses of actual combat. Sidell cites one soldier he was asked to evaluate in Kuwait.
"He started the whole spiel of, I'm going to kill myself -- if I don't get to go home and see my family now I'm going to kill myself," Sidell says of the man.
In that particular case, Sidell decided the soldier was depressed and not suicidal. But he says that, in a situation where everyone carries a gun, the Army takes such threats very seriously. At its worst, Sidell notes, combat stress reactions can lead soldiers to mutilate enemy corpses, massacre civilians and attack their own officers. But short of that, a zoned-out soldier can put his entire unit in danger. That's why units like the 85th were created. The Army has three combat stress-control units, and other service branches also have their own versions, all established in the 1990s.
"Combat stress control basically is treating all the mental health issues of the American soldier," Sidell says. "That can be anything from basic fatigue factors from being in a combat environment to severe issues like PTSD. The brutality of war can really impact a person's psyche."
Combat stress specialists do not claim they can prevent post-traumatic stress disorder. Their mission is more immediate and pragmatic -- to try to spot soldiers before they get into serious trouble. To do that, unit members talk to commanders. They network with chaplains, who often hear about problems soldiers don't confide to officers. And most importantly, they mingle with the soldiers to gauge their mood.
The goal is not fixing deep-rooted issues but getting soldiers back to their units and back to work, Sidell and others say. That poses an uncomfortable conflict for mental health professionals, but it's one Sidell says he's come to terms with.
"Any small part I can do, whether it's just giving them a safe place to vent, if that helps them get over the hump, to go down and do what they have to do, then it's an honor on my part to talk to them," Sidell says.
NPR producer Rebecca Davis contributed to this report.
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