Screenings needed four months after deployment


Karen Fleming-Michael
Army News Service

Soldiers returning from duty in Iraq to the Southern European Task Force complete mental health screens to detect symptoms of post-combat depression this past summer.

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FORT DETRICK, Md. — Asking most Soldiers who have just returned home from a deployment if they’re feeling “downhearted and blue” is probably premature.

Asking them three or four months later, though, seems to be the ticket to getting warfighters the help they need for combat-related depression, said Lt. Col. Paul Bliese, commander of the U.S. Army Medical Research Unit-Europe in Heidelberg, Germany. The research unit screened returning troops in Italy first at reintegration and again at 120 days and found that more Soldiers needed help after they had been home for a while.

“They spent a year in Iraq, they’re back, they’re alive, there’s a huge celebration. Then, three months into it, life intervenes. All of a sudden, they’re having to deal with going to work every day and having to deal with the responsibilities of being a parent, spouse and a Soldier,” he said.

A study reported in the New England Journal of Medicine in July 2004 said that 15.6 to 17.1 percent of military members who served in Iraq or Afghanistan typically screened positive for a mental disorder when they were surveyed three or four months after they got back to their home base. The study was conducted by researchers at the Walter Reed Army Institute of Research, parent organization to the U.S. Army Medical Research Unit-Europe.

While conducting research on a psychological screening tool, the research team from Heidelberg, led by Dr. Kathleen Wright, surveyed troops within their first two weeks of returning to Italy after serving in Iraq. They came up with a 6.5 percent positive rate for mental disorders for the 1,604 Soldiers they screened.

Warfighting commanders – most notably Col. William Mayville, commander of the 173rd Brigade, and Maj. Gen. Thomas Turner II, Southern European Task Force commander noted that, something just wasn’t right with those numbers, said Col. Richard F. Trotta, commander of the clinic at Vincenza, Italy. "

So Trotta asked the research unit to screen the Soldiers again 120 days after their return.

“We did that and, not surprisingly, those rates went back up to something closer to what was published” in the New England Journal of Medicine, Trotta said.

In fact, the rates were exactly 15 percent, Bliese said, adding that to be fair some of the increase might reflect the fact that different procedures were used at the latter time. The best indication of how Soldiers’ responses changed came from 509 Soldiers who provided data both times.

The responses from these Soldiers showed marked increases in psychological symptoms.

To quickly screen hundreds of Soldiers, the Heidelberg researchers used their psychological screening tool that could be completed and scored quickly before and after deployments.

The team started with research scales that had been tested and validated in the civilian world, and then put together a two-page questionnaire that hit the topics of traumatic stress, depression and problems with relationships, anger and alcohol.

“We’re sensitive to the fact that Soldiers don’t like filling out page after page after page of surveys,” said Capt. Jeffrey Thomas, who worked at the Heidelberg unit before moving to WRAIR. “We’re going with ... the least number of items that we can have to tap into the areas of stress. That’s where a lot of the number crunching has been done to make it as efficient and as lean as it can be.”

Soldiers can complete the “short screen” in 10 minutes or less, and mental health personnel can score it in a tenth of that time.

If Soldiers test “hot” for either the suicide or homicide question on the short screen, they’re immediately referred to a mental health professional. Others whose scores indicate they should get help can be contacted confidentially by mental health professionals on post.