In 2009, 21.4 percent of the soldiers in Afghanistan were suffering from depression, anxiety and post-traumatic stress, compared with 10.4 percent in 2005. In Iraq, the figure was 13 percent in 2009, the lowest level of that war.
There were seven confirmed suicides in Afghanistan in 2008; as of May 31 of this year, there had been five. According to Army statistics, 133 active-duty soldiers committed suicide from January to October this year.
However, the Army's effort to get more mental health workers to the front lines is confronting a national shortage of mental health professionals that hasn't spared the military.
Maj. Nidal Malik Hasan, 39, the Army psychiatrist who's accused of shooting 55 people at Fort Hood, Texas, on Nov. 5, and killing 13 of them, was set to deploy to Afghanistan. He was one of 121 Army psychiatrists, and the military is investigating whether the shortage of mental health doctors may have prompted officials to keep Hasan in the Army despite some of his colleagues' concerns about his own condition.
Some Army officials who worked alongside Hasan during his tenure at Walter Reed Army Medical Center in Washington said his performance was subpar. He was transferred to Fort Hood in July.
The study found that the biggest factors contributing to mental illness are repeated combat tours, shorter times between tours and the amount of combat a soldier sees during his or her tour. The study also found that the effectiveness of a soldier's leaders was one of the biggest factors in mitigating the threat of depression or other mental illness.
The study also found that soldiers complained that they have a difficult time finding mental health workers, and access to mental health care is particularly difficult in Afghanistan because the terrain and weather limit travel. In addition, because the military is fighting the Taliban by spreading forces throughout the country, soldiers are often sent to remote bases.
There are 40 Army mental health workers in Afghanistan, and roughly 200 in Iraq, which has 120,000 U.S. troops.
The goal, Army officials said, is to get to a ratio of one mental health worker for every 700 troops in Afghanistan, which would require an additional 60 professionals, by December. That would provide enough support for the 68,000 troops deployed there now. Officials couldn't say, however, whether they could get more workers to Afghanistan if President Barack Obama sends more troops, a decision that he's currently deliberating.
"We have got to make the soldier understand this is real. They are not weak. They are not imagining," said Lt. Gen. Eric Schoomaker, the Army Surgeon General and the commander of the U.S. Army Medical Command.
However, Schoomaker insisted that the military wouldn't compromise quality "just to get a body out in the field." Army officials didn't say whether they'd employed more stringent criteria since the Nov. 5 rampage at Fort Hood, saying that case is under investigation.
Although Secretary of Defense Robert Gates has pushed to remove the stigma within the military for those who seek mental health counseling, the study found that soldiers still aren't convinced.
Despite its effort tackle suicides and growing mental health needs, the Obama administration still hasn't nominated an assistant or deputy assistant secretary of defense for health affairs.
The study is the sixth of its kind conducted by the Army, which surveyed 2,400 troops in Iraq and 1,500 in Afghanistan.