High cost of post-combat struggles

Last year, as the Iraq and Afghanistan wars began to wind down, releasing tens of thousands of soldiers, the Defence Secretary Leon Panetta voiced concern there was an "epidemic" of suicides. This is contested, but in 2012 more active-duty US soldiers killed themselves than were killed in combat: 177 against 176. The trend was reflected across the wider US military: 349 suicides, 295 combat deaths.

Military suicides have, in fact, been steadily escalating but were masked by high combat deaths, now falling. In 2010 and 2011, 499 and 417 US troops died in action, while military suicides averaged 300 a year.

A 2011 report, Losing the Battle, from the Centre for a New American Security, depicts a worsening crisis, with one suicide every 36 hours between 2005 and 2010. "The numbers continue to grow," says Phillip Carter, director of the CNAS Military, Veterans and Society Programme.

Carter says the task of reducing suicides is compounded by a hazy understanding of what pushes some soldiers, and not others, over the edge. "We know that there is a correlation between combat stress and suicide. But we don't know exactly what factors cause some people to commit suicide. There doesn't seem to be any obvious answer."

Numerous causes are cited, including post-traumatic stress disorder [PTSD], traumatic brain injury [TBI], depression, broken relationships, insomnia, legal issues, substance abuse or reluctance to seek help in a military culture that traditionally sees this as unmanly. One fear is suicides have yet to peak, especially among Iraq and Afghanistan veterans, who are 30 to 200 per cent more likely to kill themselves.

Then there is the challenge of reintegrating into civilian life, given that fewer than 1 per cent of Americans have served in Iraq or Afghanistan. Many veterans are left with a deep sense of isolation, unable to expunge anguish about horrible things they have seen or done.

A big problem is lack of empirical data. Last month the Veterans Affairs Department - criticised for doing too little, too late - released The Suicide Data Report 2012. On average 22 veterans (as against those still in uniform) kill themselves each day.

Robert Bossarte, who compiled the VA report, told the Washington Post the rise reflects a wider national trend, where suicides rose almost 11 per cent between 2007 and 2010.

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