Mentally Unfit, Forced To Fight — (The Hartford Courant)

SSRI Ed note: Soldier not fit for combat on multiple drugs including Prozac dies in sleep of heart problems.

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The Hartford Courant

May 14, 2006


Special Report

Both advisory team reports recommended that soldiers with mental health problems be kept in the combat zone in order to improve return-to-duty rates and help soldiers avoid being labeled unfit.

“If you take people out of their unit and send them home, they have the shame and the stigma,” said Ritchie, the Army’s mental health expert.

But with the suicide rate climbing, the emphasis on treating psychologically damaged soldiers in the war zone is raising new questions.

“You think it’s a stigma to be sent home from the Iraq war? That might be the line they’re using” to justify retaining troops, said Dr. Arthur S. Blank Jr., a psychiatrist who formerly served as national director of the Veterans Administration’s counseling centers. “I wouldn’t say that.”

Mental health specialists who have served in Iraq acknowledge that their main goal, under military guidelines, is to preserve the fighting force. Some have grappled with making tough calls about how much more stress a soldier can handle.

“You have to become comfortable with things we wouldn’t normally be comfortable with,” said Bob Johnson, a psychologist in Atlanta who counseled soldiers last year as chief of combat stress control for the Army’s 2nd Brigade. “If there were an endless supply [of soldiers], the compassionate side of you just wants to get these people out of here. They’re miserable. You can see it in their faces. But I had to kind of put that aside.”

Army statistics show that 59 soldiers killed themselves in Iraq through the end of last year — 25 in 2003, 12 in 2004, and 22 in 2005. Twelve Marine deaths also have been ruled self-inflicted.

The only confirmed Connecticut suicide is that of Army Pfc. Jeffrey Braun, 19, of Stafford, who died in December 2003. His father, William Braun, told The Courant he still did not have a full explanation of what happened to Jeffrey, but said,  “I’ve chosen not to pursue it or question it. It’s over and done with.”

Military data show that deaths in Iraq due to all non-combat causes, such as accidents, rose by 32 percent from 2004 to 2005. Of the more than 500 non-combat deaths among all service branches since the start of the war, gunshot wounds were the second-leading cause of death, behind vehicle crashes but ahead of heart attacks and other medical ailments.

While many families of service members who died of non-combat causes say they are not familiar with military deployment policies, some question whether the military knowingly put their loved ones at risk.

Among them are relatives of Army Spec. Michael S. Deem, a 35-year-old father of two, who was deployed to Iraq in January 2005 despite a history of depression that family members say was known to the military. Shortly before Deem deployed, a military psychiatrist gave him a long-term supply of Prozac to help him handle the stress, his wife said.

Just 3 1/2 weeks after he arrived in Iraq, Deem died in his sleep of what the Army later determined was an enlarged heart  “complicated by elevated levels of fluoxetine” — the generic name for Prozac.

Family members of some troops whose deaths have been labeled suicides complain that the military has given them limited information about the circumstances of the deaths. Some have had to wait more than a year for autopsies and investigative reports, which they say still leave questions unanswered.

Barbara Butler, mother of Army National Guard 1st Lt. Debra A. Banaszak, 35, of Bloomington, Ill., said she has trouble understanding why her daughter would have taken her own life in Kuwait last October, as the military has determined. She said that while Banaszak, the single mother of a teenage son, was proud to serve her country and had not complained, the stresses of the deployment may have exacerbated her depression.

“She was used to being in charge and being a leader, but never in these circumstances,” said Butler. “If the Army is right that she did this, it was nothing she would have done ordinarily. It was that war that brought it about.”

Recognizing Trouble

Some autopsy and investigative reports obtained by The Courant make clear that service members who committed suicide were experiencing serious psychological problems during deployment.

In the months before Army Pfc. Samuel Lee, of Anaheim, Calif., killed himself in March 2005, an investigative report says, the 19-year-old had talked to fellow soldiers about a dream in which he tried to kill his sergeant before taking his own life, and of kidnapping, raping and killing Iraqi children. Three times, a soldier recounted in a sworn statement, Lee had pointed his gun at himself and depressed the trigger, stopping just before a round fired.

But two of Lee’s superiors gave statements saying they did not realize Lee was having trouble until the day he balanced the butt of his rifle on a cot, put his mouth over the muzzle and fired.

But a number of other reports on 2004 and 2005 suicides indicate that military superiors were aware that soldiers were self-destructing.


Slipping Through The System

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The family of Army Spec. Michael S. Deem also questions the Army’s decision to send the 35-year-old father of two to war.

When Deem transferred from Texas to Fort Stewart in Georgia in 2004 to be closer to his 7-year-old daughter from a previous marriage, he knew he was transferring to a unit that was facing deployment to Iraq, his wife, Lynn Deem, said.

Deem accepted the consequences of his decision, but after his Georgia unit was called up, his longstanding depression and anxiety deepened, Lynn Deem said.

In the weeks before deploying, Deem saw a military psychiatrist for help in handling his heightened stress, his wife said. She said the doctor gave him “multiple drugs,” including “a year’s supply of Prozac.”

There was no discussion of his not deploying.

“The way he portrayed it,” she recalled, “it was not negotiable.”

The year’s supply of antidepressants would be wasted. Less than a month after arriving in Iraq, Deem, an information systems operator in the Special Troops Battalion of the 3rd Infantry Division, was found dead in his bunk at Camp Liberty in Baghdad.

The Army determined that he died of an enlarged heart “complicated by elevated levels” of Prozac — the very drug that was supposed to help him through his tour.

Saying the Prozac alone did not kill him and that there was no indication of suicide, the Army has classified Deem’s cause of death as “natural.” But months after the military has closed its investigation, Deem’s family still wrestles with questions.

“To know that he’s got a history of anxiety and depression and to load him up on pills and send him to a war zone — how could they do that?” asks his aunt, Mary Ann Warner, of Lakeland, Fla.

“Michael is someone who was sent with them knowing he had some mental health issues,” said Lynn Deem. “There’s no way they can say they didn’t know.”