On Combat

Last month’s publication of the Operation Iraqi Freedom (OIF) mental health assessment indicates a long-term problem for American warriors: repeat deployments are drawing from a finite well of courage, and the well isn’t re-filling between deployments.

Last month the Army Surgeon General’s office posted its fourth OIF Mental Health Assessment Team (MHAT) report dated November 2006. This brave step opens a window on the mental health of soldiers on repeat combat deployments. The report finds that mental health problems are directly related to intensity and duration of heavy combat (time “outside the wire” in Iraq)–those engaged in high intensity combat are more than twice as likely to encounter anxiety and depression than those encountering light combat, and are nearly four times as likely to encounter acute stress (PTSD symptoms) than those exposed to light combat.

This probably isn’t shocking news to most, the major revelation in the report is that repeat deployers are one and a half times more likely to screen for acute stress than first-time deployers. This indicates that there is residual stress that is not going away in the time back home between deployments (median time deployed was 9 months out of 3 years median service in MHAT IV soldiers surveyed).

Lord Moran, British a battalion surgeon in WWI, introduced the notion of a finite well of courage in the heart of each warrior: “in the trenches a man’s will power was his capital and he was always spending…When their capital was done, they were finished.” To many, Moran sounds anachronistic; today’s soldiers backed by modern science and medicine could certainly do better than the doughboys in the trenches.

Modern evidence from MHAT IV suggest Moran may have been right–a harsh reality for a small volunteer military facing a prolonged fight on the ground. With a conscript military (as we had in Vietnam), short enlistments precluded multiple combat deployments; soldiers did their duty and were released as new soldiers were drafted as replacements.

Commanders at all levels are loath to return to a draftee force with its inherent motivation, training, and professionalism problems, but this preference does not lessen the fact that we either have the wrong strategy for the military we have, or we have the wrong military for the strategy we have.