Army Spec. Jeffrey Henthorn, 25, of Choctaw, Okla., was sent back to Iraq for a second tour even though his superiors knew he had twice threatened suicide. He shot himself with his rifle in 2005, an Army report says, fragments of his skull piercing the barracks ceiling.
Army Pfc. David L. Potter, 22, of Johnson City, Tenn., was diagnosed with anxiety and depression while serving in Iraq in 2004. Records show Potter remained on active duty in Baghdad despite a suicide attempt and a psychiatrist's recommendation that he be separated from the Army. Ten days after the recommendation was signed, he slid a gun out from under another soldier's bed and shot himself.
These deaths are among the most extreme failures by the U.S. military to properly screen, treat and evacuate mentally unfit troops, a Hartford Courant investigation has found.
Faced with troop shortages, the military has increasingly sent, kept and recycled troubled service members into combat -- practices that undercut past assurances that it would improve mental healthcare. Besides suicides, experts say, gaps in such care can lead to violence between soldiers, accidents and critical mistakes in judgment during combat operations.
Among the newspaper's findings:
* Despite a congressional order that the military assess the mental health of all deploying troops, fewer than 1 in 300 service members see a mental health professional before shipping out.
* Once at war, some unstable troops are kept on potent antidepressants and anti-anxiety drugs with little or no counseling or medical monitoring, in violation of the military's regulations.
* Some troops who developed post-traumatic stress disorder after serving in Iraq are being sent back to the war zone.
These practices seem to have fueled an increase in the suicide rate among troops serving in Iraq, which reached an all-time high in 2005 when 22 soldiers killed themselves -- accounting for nearly one-fifth of all noncombat Army deaths.
The investigation found that at least 11 service members who committed suicide in Iraq in 2004 and 2005 were kept on duty despite exhibiting signs of significant psychological distress.
The Army's top mental health expert, Col. Elspeth C. Ritchie, acknowledged that some deployment practices, such as sending service members diagnosed with post-traumatic stress disorder back into combat, have been driven in part by the troop shortage. "The challenge for us is that the Army has a mission to fight. And, as you know, recruiting has been a challenge," she said.
Under the military's pre-deployment screening process -- routinely no more than a single, self-reported mental health question on a form -- troops with serious mental disorders are not being identified, and others whose mental illnesses are known are being deployed anyway.
The Army acknowledges in studies that more than 9% of deploying troops have serious psychiatric disorders.
Military investigative reports and interviews with family members also show that some service members who committed suicide in 2004 and 2005 were kept on duty despite clear signs of mental distress, sometimes after being prescribed antidepressants with little or no mental health counseling or monitoring. Those findings conflict with Army regulations adopted last year that caution against the use of antidepressants for extended deployments.
"I can't imagine something more irresponsible than putting a soldier suffering from stress on [antidepressants], when you know these drugs can cause people to become suicidal and homicidal," said Vera Sharav, president of the watchdog Alliance for Human Research Protection. "You're creating chemically activated time bombs."
Although Defense Department standards for enlistment disqualify recruits who suffer post-traumatic stress disorder, the military is redeploying service members to Iraq who fit that criterion.
Eight months ago, Staff Sgt. Bryce Syverson, of Richmond, Va., was so unsteady that doctors at Walter Reed Army Medical Center wouldn't let him wear socks or a belt.
Syverson, 27, had landed in the psychiatric unit after a breakdown that doctors traced to his 15-month tour in Iraq as a gunner on a Bradley fighting vehicle. He was diagnosed with post-traumatic stress disorder and depression, and was put on suicide watch and antidepressants.
Today, Syverson is back in the combat zone, part of a quick-reaction force in Kuwait that could be deployed at any time.
But he hasn't quite managed to get his bearings.
"Nearly died ... out here on a nice and really mild night because of the medication that I am taking," he wrote in a recent e-mail to his parents and brothers. "Head about to explode from the blood swelling inside, the lightening storm that happened in my head, the blurred vision, confusion, dizziness and a whole lot more. Not the best feeling in the entire world to have after being here for two days."
Dr. Arthur S. Blank Jr., a psychiatrist who helped to get post-traumatic stress disorder recognized as a diagnosis after the Vietnam War, said: "I'm concerned that people who are symptomatic are being sent back. That has not happened before in our country."