Jim Haus barreled down a dusty road to Kuwait, piloting an M816 recovery truck. Sitting behind the wheel of the 5-ton machine, with rockets exploding nearby as the vehicle tore through the desert, Haus wasn't anxious. It was his first charge into combat. It was fun.
A mortar hit close to the truck and dislodged a piece of the hood. Shrapnel knifed through the windshield. Glass caught Haus' upper lip, and metal lodged in his Kevlar vest.
"My buddy looked at my vest and was like, 'Damn, you could have died,' " Haus says. "But there was nothing damaged, nothing bleeding, so I just kept going."
When he joined the Army at 18, Haus wasn't following a legacy of military service in his family. He just wanted to get out of house, get out of Des Moines, Iowa. His first assignment took him to Germany, where he darted through forests and kicked in the doors of old missile silos, practicing urban assault tactics. By the time he was 22, he was ready for the real thing: the Gulf War in 1991.
The fight was lopsided. The Americans' weaponry far outclassed the Iraqis' Russian relics. "We were just slicing through it like butter," Haus says. Even so, the conflict had an unexpected impact on the eager sergeant.
Leaning back in a beige recliner in his Belton home, Haus paws a TV remote control as he speaks. His legs are tightly crossed, but his feet bounce awkwardly. At first, he recalls his Gulf War experience in an excited voice, his eyes wide. Then his expression shifts, and a subtle shadow of nausea replaces the animated look on his face.
"There was this one particular road into Kuwait, where the Iraqi guard and army were trying to flee from the Americans," he says. "We had bombed the shit out of them, basically, and they had left all the vehicles there burning. We had to hook them up and drag them to the side of the road, but the only way to get them to move was to reach in and put them in neutral. Some of the bodies were still in there, burned, bullet-riddled, in 120-degree heat. A body doesn't deal well with that. I remember reaching up inside of one and realizing what a depleted uranium round does to a tank. It causes a nice vacuum that turns everything into Jell-O."
His hands moved through the melted human flesh.
"That was the most devastating," he says.
Haus didn't realize how deeply the war had affected him. "Drinking was my way out," he says. "At the time, I didn't think I needed counseling. To me, if command found out, I would be a marked person. And a marked person doesn't get promotions."
Haus is part of a rapidly growing population of soldiers the Army is now struggling to help: traumatized men and women returning from war and reluctant to seek mental-health care, even as their lives unravel.
In 2008, 140 active-duty soldiers committed suicide. That's 75 percent more than the number in 2003 and the highest rate since the Army started keeping track three decades ago.
Jim Haus was almost one of the casualties.
In a Fort Leavenworth classroom, Staff Group 1D sits around a horseshoe of gray tables heaped with thick textbooks and three-ring binders. These Army officers, all of them majors, have come from different bases across the country to train at Fort Leavenworth's Command and General Staff College, the Army's primary leadership institution. They began the class together in February. On this July day, they're all on a first-name basis, and they aren't shy when they have something to say. The lunch-hour topic is suicide.
Maj. Cynthia Blevins speaks first. "At Fort Stewart, there was a soldier that came to PT formation one morning and shot six soldiers," she says. "He shot the platoon leader, the first sergeant and killed himself. There were signs, but no one took the necessary actions."
Maj. George Bratcher says a soldier in his brigade committed suicide in Iraq. "We're a week away from coming back. Some people had already left, packed their bags — we're going home — and this guy goes into the latrine and puts a bullet in his head," he says.
Maj. Bill Meredith was stationed at Fort Hood, Texas, in November 2008. "The post was averaging a suicide a week," he says. "That's unfathomable."
Unfathomable but not surprising. David Rudd, a professor at Texas Tech University and an expert in suicide, says nobody in the Army anticipated a two-front war that would tax its ranks for more than six years. The combat stress of multiple deployments has created an overwhelming number of soldiers returning from conflict with post-traumatic stress disorder, depression and traumatic brain injury.
"It's arguable that, after all other factors are considered, suicide is the outcome of undiagnosed, untreated or undertreated mental illness," he says.
A 2008 Rand Corp. Study backs up Rudd's thesis. According to Rand's report, nearly 20 percent of soldiers returning from Iraq and Afghanistan reported symptoms of PTSD or depression. Only half of them sought mental-health treatment. The study also suggests that soldiers dealing with PTSD were significantly more likely to think about and attempt suicide.
Researchers in Missouri recognized that trend before the Army did, says Abdoulaye Bah, director of the Center for Suicide Prevention, Research and Studies at Lincoln University in Jefferson City. At the start of the war in Iraq, his center sent a proposal to the Army to take stock of its suicide-prevention programs. In 2005, the Army paid the center $573,000 for the study.
"Although there were programs here and there, they didn't seem to be synchronized," Bah says. "Different installations had different rules. They seemed to think mental weakness isn't part of the Army."
Bah continued to press for more research. In 2007, the Army paid the university more than $1 million to develop a new tool for suicide prevention: a graphic virtual-experience DVD.
But even as the Army commissioned research, Bah says, some Army officials seemed reluctant to admit a problem. "We were the one institution at the forefront saying, 'This is going to be a problem,' " Bah says. "They didn't put it in writing, but I could see in the conversations I had — they had an attitude of 'Get out of our way. We don't have a problem.' "
By late 2008, that attitude had changed. Soldiers were committing suicide at a record rate. Denial wasn't an option.
Amanda Cherry met Jim Haus at a National Guard post in Des Moines. Cherry didn't want to give him her phone number. He was aggressive and short-tempered — behavior she had seen before.
Cherry was raped on Valentine's Day 1987. She was 19 years old, in the middle of her first year at Central College in Pella, Iowa. When she attempted suicide a year later, her psychiatrist diagnosed PTSD. Cherry started volunteering at a local veterans hospital, where she recognized many of her own symptoms in the men who had served in Vietnam.
Because of her suicide attempt, Cherry needed a waiver when she joined the Army in 1992. That document was supposed to be a sealed letter in her file, she says, but a company clerk opened it. Her platoon sergeant read it, too.
When Cherry met Haus four years later, she saw in him the symptoms of PTSD, but she understood why Haus wasn't eager to deal with a formal diagnosis. In 1997, the two married in Texas. They celebrated their courthouse wedding with dinner at a McDonald's. "I pretty much knew when I married him that he had PTSD," Cherry says.
By the time the couple was assigned to Germany two years later, the marriage was tense. When Haus wasn't away in the field, Cherry says, he stayed out and drank heavily. When he was home, he flailed in his sleep, reacting to violent nightmares. "He'd wake up in the middle of the night, shake me, hit me," she says.
For two months, they lived in separate apartments. After they met with a marriage counselor, Cherry returned to Haus, resigned to the fact that her husband wasn't ready to seek his own treatment. In late 2003, Haus joined a medical unit based in Belton because it offered more long-term stability and had a low risk of deployment. That was key for Cherry: She didn't want Haus back in a war zone.
But in March 2004, he left for a 15-month deployment to Afghanistan.
Five years later, recalling the experience makes Haus visibly uncomfortable. He can't talk about much of what he did or where he went because it's classified. "I did some things on missions that ...." He pauses. "I told her I killed a few people. I'll admit that." He had to have surgery to remove shrapnel from his left buttock.
The compound where he was stationed was flanked by hills occupied by Afghan fighters. "Basically, the Taliban would light up with .50-caliber machine guns and grenade launchers, and we'd call in air strikes to obliterate them," he says. "Out in the mountains, you'd find bits and pieces of them."
He rushed out from the compound when a helicopter landed and helped carry wounded soldiers into the operating room. Some didn't make it that far. Haus remembers one man who took a bullet to his skull. "His head turned, and everything fell onto my boots," Haus says.
By then, Haus says, Army officials were starting to make mental-health care more available. But he was wary. "You could go to mental health, but me, being the hardheaded person I was at that time, I was like, 'I don't need this.' "
"He was attached to a medical unit, but he was a mechanic," Cherry says. "He was not used to seeing the things coming through the hospital, carrying dead bodies to the morgue."
When he returned, Haus knew that he could slip under the Army's medical radar. The post-deployment health assessment included a form with questions about mental health. He finished the paperwork on a computer in less than 20 minutes. "To see a psychiatrist, you really have to want help," he says.
Haus didn't want help, but he needed it.
"He came back joking that he had lost his mind," Cherry says.
More than 1.5 million men and women in the Army know Spc. Kyle Norton. The 19-year-old served in Iraq, clearing bombs from city streets. In the middle of his deployment, his girlfriend broke up with him in an e-mail, then cleaned out his bank account. A few days later, Norton's best friend was killed in an ambush.
Norton is the cornerstone of the Army's new campaign to curb suicides.
In October, Bah unveiled the result of the million-dollar grant that the Army had awarded Lincoln University: a video featuring Norton that's like a Choose Your Own Adventure book. It pauses at key moments, asking the viewer to decide the young soldier's next course of action. Choosing the wrong answers pushes the young soldier to restless desperation. During the past six months, everyone in the Army has seen the DVD and decided whether Norton seeks help or shoots himself in the head.
The DVD weaves trends from Army suicides into its story. In 2008, nearly all of the soldiers who committed suicide were male, and two-thirds had a history of deployment. More than 70 percent of the suicides involved a relationship issue. Another common thread among suicide victims was a record of reckless off-duty behavior such as drinking, speeding or infidelity, says George Wright, a spokesman for the Army.
The officers in Staff Group 1D have seen the DVD and been through the new training, but they still have questions. They're not sure that the rigors of the Army are entirely at fault.
"Is the up-tempo causing your marriage to fall apart, or was it already in bad shape?" Maj. Michael Wood asks. "Deployment can certainly exacerbate it, but is it the root cause? I'm no expert, but I have a hard time believing that's the root cause."
"We're dealing with a large statistical population. Is this a blip that pops up once and then we don't see it again for several years?" Wood wonders.
Maj. Scott Granger, with the National Guard, doesn't buy the skepticism.
"It's doubled in the last four years," he says of the suicide statistic. "We're focused on the Army, but every service has seen increases."
Some of that increase, Granger adds, might be traced to a system that has been easy to game. Every soldier sits through post-deployment medical screenings, he says, "but everyone knows which question on the surveys will get you flagged."
"Yeah, guys know, 'Hey, if I answer this way, I'm going to have to go to an hour with a shrink, and it's going to waste my time,' " Meredith explains. "The problem is trying to make 400,000 guys and gals go to mental health when there's not enough people to see them."
"At Fort Pike, it was tough to find someone in central Louisiana who even knew psychiatrist starts with a p," Wood says with a wry laugh.
"Yeah, but do we want to treat these soldiers like children?" Maj. Christopher Nunn notes, cringing. "We've got to allow them a certain amount of integrity. Over there, they're taking responsibility over other people's lives and doing all kinds of extremely high-level stuff, and when they come back, we say, 'Now you've got to go to mental health so we can make sure you're not crazy'? That's very frustrating."
Maj. Bjorn Holmquist breaks in.
"Hey, we're talking about suicide prevention and mental health, but we've all used the word crazy in this conversation," he says.
That could be the biggest problem of all.
When he returned from Afghanistan in 2005, Haus couldn't leave the house without feeling anxious and jittery. "You don't know if that woman or that man or that kid is wearing a bomb, you know?" he says. "Or if Ahmed talking on his cell phone is saying, 'Hey, I've got 12 Americans here, bring in a V-bed.' "
"Vehicle-born explosive device," Cherry translates.
He slept constantly but couldn't rest. He mumbled and yelled in his sleep so much that Cherry moved to another room.
Haus admits now that he was contemplating suicide. His speech is clipped when he talks about it, his eyes rigid and metallic. "I had my way, trust me," he says. "There are plenty of things in this house that would get the job done." Then the hardness vanishes from his eyes. He looks away and cries.
The couple's marriage was disintegrating. When Haus had to have surgery for a pinched nerve in his elbow in September 2005 — a product of weightlifting three times a day to deal with the stress in Afghanistan — Cherry got a call from a woman asking about her husband. Cherry already knew that he had cheated, and she had chalked up his infidelity to the chaos of his mental health. They were trying to work through it.
But that day, she says, she hit the roof.
"We were in the middle of a huge argument," Cherry says.
"I just broke down," Haus says.
"He sat down and said, 'I don't want to do this anymore. I just want to go to sleep and I don't want to wake up."
Cherry didn't let the comment slide. After almost a decade of marriage, she knew he was serious. "The mindset in the military is, I'm the problem, and the easiest way to fix the problem is to take me out of the equation," Cherry says.
"I knew I was at rock bottom," Haus says. "I knew I needed to get the help or I couldn't save my marriage — or myself."
First he made Cherry promise that she wouldn't tell his commander. Then she drove him 60 miles to Fort Leavenworth. A doctor at the Munson Army Health Center determined Haus to be a suicide risk, but the post didn't have an inpatient facility. Haus checked into a VA hospital instead.
Every day included counseling. There were group sessions with other veterans from the Afghanistan and Iraq conflicts. In his one-on-one sessions with a psychiatrist, Haus was told that he had PTSD. After two weeks, he was discharged with a handful of prescriptions: Prazosin and Zoloft for depression and anxiety, Lorazepam for bouts of anger.
When he was reassigned to Sioux Falls, South Dakota, a year later, in September 2006, Haus had made progress. He felt stable. Still, Cherry could sense the trepidation in his voice when he called one night in February 2007.
"I said, 'Hi, honey,' and she immediately said, 'No, you're not,' " Haus recalls. "And I was like, "Yes, I am. I'm being deployed to Iraq."
"I was ready to go back to the VA and say, 'Call whoever you have to. Tell them he can't go,' " Cherry says.
Medical privacy laws kept Haus' hospital record from entering his general Army file. Haus didn't want to play his mental health as an excuse. And the redeployment carried a promotion. He couldn't turn it down.
He tried to reassure Cherry that he wouldn't be in danger. He was wrong.
On March 3, officers at Fort Leavenworth's Command and General Staff College filed into Eisenhower Auditorium. It was still early in the Armywide suicide-prevention "stand down," but this presentation wasn't part of the standard workshop.
At the front of the cavernous venue, Chris Scheuerman, a North Carolina resident and 20-year Army veteran, told his son Jason's story. In 2005, while serving in Iraq, the 20-year-old private stepped into his barracks' closet and shot himself in the head.
Jason hadn't tried to mask his depression, but his symptoms earned reprimands from his commander and the label of a problem soldier. When he sought help from an Army psychiatrist, the doctor dismissed Jason's behavior as exaggeration. Even after he sent a suicide note to his parents, the psychiatrist suggested that Jason was trying to manipulate his commanders by claiming mental illness. Three weeks later, he shot himself.
Scheuerman laid the blame for his son's death at the feet of commanders like those in the auditorium. What killed his son, he said, was a "toxic leadership environment" that didn't care enough to save him.
Months after that presentation, the officers in Staff Group 1D agree that they need to step into uncomfortable territory. An officer has the authority to compel a soldier under his or her command to see a counselor or a psychiatrist.
"I think that we need to not be afraid to come forward if we see a particular behavior," Blevins says, "not be afraid to say something because we don't want to ruin someone's career."
That prospect is still a clear deterrent. Until last year, soldiers were required to disclose any mental-health-care history on an application for the security clearance needed for many military positions. The Department of Defense has acknowledged that the question could keep soldiers from getting help and has changed the wording so treatment for combat-related issues is exempt. But that's a small push against the mentality of an armored institution.
And the mentality works both ways. The front-liners who kick down doors and see their buddies cut down by snipers are the most likely to need mental-health services. But they're also the most determined to guard their tough-soldier reputations.
The stigma is evident in the small number of soldiers who seek mental-health treatment at Leavenworth's Munson Army Health Center. Col. Andrea Crunkhorn, the center's commander, says only 1 percent of soldiers filling out the post-deployment health assessment are being seen for mental-health issues. "There is a sense of an unmet need," she says. "We talk about a 30 percent incident rate, but we're not seeing that."
An Army pilot program, started in 2007, is moving to staff regular clinics with mental-health professionals. It hasn't reached Leavenworth yet. "One day, going in for mental health will be no different than going in for low-back pain," Crunkhorn says. "That's where we want to get."
"We'll be able to tell how much of this is changing if senior leaders admit mental-health issues and stillget promoted, still get commands," Nunn says. "If that happens, then we've hit the cultural tipping point. If not, everybody will just shut up."
For now, the urgent focus on suicide is over. By July 15, every soldier had received the new training with the interactive DVD.
During the first seven months of 2009, 96 active-duty soldiers committed suicide — 17 more than the same period in 2008.
Iraq was worse than Haus expected.
Cherry opened e-mails with pictures of her husband behind the bullet-riddled glass of a convoy truck. On the phone, he told her about the bombings at night, the rocket-propelled grenades.
By February 2008, Cherry could tell that he was slipping back into depression. One of the soldiers in his unit tried to commit suicide, swallowing a bottle of prescription pills. Rocket attacks claimed the lives of two other soldiers. Haus noticed that his hands and feet were starting to go numb, and he slipped on a patch of motor oil, tweaking his knee. At Landstuhl Regional Medical Center in Germany, doctors diagnosed Haus with degenerative disc disease in his back.
"I was confused," Haus says of his time at the medical center. He couldn't keep track of simple things, such as the day of the week. He couldn't sit still. His hands shook. When he called Cherry, he cried on the phone. Finally, he went to one of the medical center psychiatrists. "He goes, 'You've got severe PTSD,' and he put a big old stamp on my paperwork — 'You're done,' " Haus says.
When he got back to Missouri in 2008, he started meeting regularly with a psychiatrist. It wasn't until April 2009 that the doctor asked him if he had ever suffered a head injury or a concussion. Haus said he had lost count, and the doctor suggested that he take a test for traumatic brain injury.
"I failed," Haus says. "Big time."
He goes on: "It's not as severe a case as some soldiers you see who get rocked in a vehicle or something. But I'll be at work, and people I work with — I'll look at them and be like, 'I don't remember their name.' It's like having Alzheimer's."
Sitting across from him on the couch in their living room, Cherry sighs. "It's difficult to live with," she says. "I'm always on edge. I don't know what he's going to forget. No offense, I love you, but it's like being married to a 3-year-old."
Still, Haus hasn't contemplated a career change. He's been a soldier since he was 18 years old. He can't imagine another profession.
And the Army hasn't tried to push him out. In its view, the hospitalization, the PTSD and the mild brain injury haven't affected Haus' ability to serve. "I just had a physical, and I'm deployable," he says with a wry laugh. Even he sounds a little surprised that he could be sent back to a combat zone.
Cherry grimaces at that prospect. She left the Army in 2000. She had served in Bosnia and Kosovo and felt that she had done her time. Cherry quit her job at a Hallmark store when Haus came home from Iraq, in order to care for him. Now, she spends much of her time working with support groups, including Veterans of Modern Warfare.
She's glad that the Army is making suicide prevention a priority, but teaching soldiers to spot the symptoms isn't enough. Soldiers know how to hide their struggles. The people who should be seeing that DVD, she says, are the family members. "They have a wonderful resource," she says. "It's called the Army spouse. But we're kind of cut off."
So Cherry keeps a close watch on her husband. When they're not busy on the weekend, she'll find a chore for him to do, send him into the vegetable garden.
"I don't let him sit around a lot," she says.
She still worries where he goes when his mind is silent.
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