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Tuesday, December 6, 2016

By Alan Zarembo, Los Angeles Times

Nearly one in five U.S. soldiers had a common mental illness, such as depression, panic disorder or ADHD, before enlisting in the Army, according to a new study that raises questions about the military’s assessment and screening of recruits.

More than 8 percent of soldiers had thought about killing themselves and 1.1 percent had a past suicide attempt, researchers found from confidential surveys and interviews with 5,428 soldiers at Army installations across the country.

The findings, published online Monday in two papers in JAMA Psychiatry, point to a weakness in the recruiting process, experts said. Applicants are asked about their psychiatric histories, and those with certain disorders or past suicide attempts are generally barred from service.

“The question becomes, ‘How did these guys get in the Army?’ ” said Ronald Kessler, a Harvard University sociologist who led one of the studies.

A third study looked at the increased suicide rate among soldiers from 2004 to 2009. The study, which tracked nearly 1 million soldiers, found that those who had been deployed to Afghanistan or Iraq had an increased rate of suicide.

But it also found that the suicide rate among soldiers who had never deployed also rose steadily during that time. The study did not explain the cause.

The Pentagon did not make officials available Monday to discuss the studies.

The three studies are the first from a massive research initiative started in 2009 by the Army and the National Institutes of Mental Health in response to the surge in suicides.

In 2011, a representative sample of soldiers was extensively questioned and assessed for a history of eight common psychiatric disorders.

Traditionally, the Army has been psychologically healthier than the rest of society because of screening, fitness standards and access to health care. Soldiers committed suicide at about half the rate of civilians with similar demographics.

But researchers found that soldiers they interviewed had joined the Army with significantly higher rates of post-traumatic stress disorder, panic disorder and attention deficit and hyperactivity disorder than those in the general population.

Most notably, more than 8 percent of soldiers entered the Army with intermittent explosive disorder, characterized by uncontrolled attacks of anger. It was the most common disorder in the study, with a pre-enlistment prevalence nearly six times the civilian rate.

“The kind of people who join the Army are not typical people,” Kessler said. “They have a lot more acting-out kind of mental disorders. They get into fights more. They’re more aggressive.”

The researchers found that despite screening, pre-enlistment rates of depression, anxiety, bipolar disorder and substance abuse were on par with civilian rates.

Rates of suicidal ideation, planning and attempts were lower than in the general population but still significant, given the military’s practice of excluding recruits with a known suicidal history.