BY MICHAEL MARTINEZ
Chicago Tribune
Dec. 25, 2003

LUFKIN, Texas -  - Army Spec. Joseph Suell had been distressed before. He missed his wife and their daughters so badly last year that he was granted a short visit home from his yearlong assignment in South Korea.

It was a different story this year. In March, five months after completing his Korean tour and right after re-enlisting, the 24-year-old was sent to Kuwait and then Iraq.

The day after Father's Day Suell died in Iraq, reportedly after taking a bottle of Tylenol. His death was classified as "nonhostile," but a military chaplain told Suell's wife, Rebecca, it was a suicide.

Suell's death comes at a time when the military is investigating the growing number of suicides by American forces in the Persian Gulf region. Since the U.S.-led coalition invaded Iraq last spring, 18 soldiers and two Marines have committed suicide, most of them after combat was declared over on May 1, the military said.

The Army is concerned about the deaths. Outside experts have said the rate is alarmingly high compared with the military's average suicide rates. A report by a 12-member team of military and civilian mental health professionals dispatched to Iraq in October to evaluate troops' mental health is expected to be released after the holidays, officials said.

Independent experts said they hope the team's report offers some insight into the suicides. Did they result from personal issues, such as the loss of close relationships or from legal and financial matters? Or did they involve larger, more sensitive issues about the U.S. mission in Iraq?

Those broader questions relate to the morale of troops in Iraq, many of whom have complained of a long deployment. And they bear upon whether the Bush administration is overstraining its standing army with such practices as deploying soldiers, such as Suell, on consecutive tours with insufficient family time, experts said.

Army officials have declined to comment on the potential contents of the report.

Suell's widow and mother don't believe he killed himself and wonder if the military did enough to address whatever medical problem he may have suffered.

Suicide experts with military backgrounds say the 20 suicides so far in the Iraq conflict is a very high number. Using the military's 12-month rate of a dozen suicides per 100,000 troops, self-inflicted deaths this year in Iraq should amount to no more than 13 at this point, according to Dr. Paul Ragan, who was a Navy psychiatrist for 11 years and is a Vanderbilt University associate professor.

Last year, the Army reported a 12-month suicide rate of 11.1 per 100,000 troops and is expected to report 12 per 100,000 this year, exactly like the military's overall rate.

The current count of 20, with the Army investigating more deaths as possible suicides, is worrisome, Ragan said.

"My educated, military, psychiatric guess is that 20 is definitely high, and it's something that needs attention. You don't sit around for months and months and see what happens," Ragan said. "In this case, there is a legitimate concern to move on this."

"If you extrapolate to a full year," added David Rudd, president of the American Association of Suicidology and a former Army psychologist, "it would seem to be potentially high."

While Army officials acknowledge that the suicide figure appears high, the overall number of 61 such deaths for that branch this calendar year is about average, officials said.

The Army's 130,000 troops in Iraq represent almost all the U.S. force there, an Army spokesman said.

The 61 Army suicides in 2003 compare with 68 Army suicides in 2002, 49 in 2001 and 63 in 2000, the military said. The Army's worst period in the last 13 years was 1991, the year of the Persian Gulf war, when it reported 102 suicides.

Figures before 1990 were unavailable, military officials said.

"Even with Iraq, our numbers at the end of this year aren't going to be out (of ) line with what they have been in previous years," said Army spokeswoman Martha Rudd, who is not related to David Rudd.

"Traditionally in wars, when soldiers are fighting in combat, there are very rarely suicides, because their survival instinct is active and their adrenaline is flowing," Martha Rudd said. "But once the (war) ceases, at first you are very busy in the aftermath ... setting up where you are, but then eventually you have time on your hands and you are miserable where you are."

Both the army's and the U.S. military's overall suicide rates are lower than a U.S. civilian figure altered to match the military's race, age and gender demographics, the military said. That adjusted civilian rate has been between 17 and 19 per 100,000. The unadjusted civilian figure is 10.7, according to the Centers for Disease Control and Prevention's latest statistics.

Comparisons between military and civilian rates, however, are problematic, experts said. The military screens applicants, eliminating outright those with a history of suicidal tendencies, and then requires enlistees to attend suicide prevention classes, experts said.

But the military places its young adult personnel in high-stress situations, with soldiers having ready access to firearms and enduring hardship.

Military physicians say any suicide is distressing, especially as the armed services have stepped up suicide awareness campaigns.

Those initiatives are credited with reducing the number of such deaths. The Marines, whose two Iraq war-related suicides occurred in Kuwait, used to have one of the highest suicide rates, more than 20 per 100,000 in 1993. The figure now is about 12, according to Department of Defense figures.

"Our biggest obstacle is to make it acceptable to seek help without being seen as weak, unpromotable, or `mental.' ... Our research findings consistently show that most decedents have not made use of military support services (such as mental health, family support, chaplains, etc.) prior to killing themselves," Cmdr. Thomas Gaskin, a Marines staff psychologist, said in a statement.

As the all-volunteer military struggles to meet recruitment goals, it faces "a tension of accession standards," said Lt. Col. Elspeth Cameron Ritchie, a psychiatrist and associate professor at the Uniformed Services University of the Health Sciences in Maryland.

"There is a tension when, on the one hand, you are trying to bring as many people into the military as possible, and you are trying to exclude people who should not be brought in" because of psychological or physical reasons, said Ritchie, who said she believes the military's suicide rate "still is too high" considering the extensive screening and health care offerings.

Today back in Lufkin, what troubles Rebecca Suell, 22, is how commanders didn't seem to respond quickly when her husband showed signs of distress in Iraq.

Once he had arrived in Baghdad with his 3rd Field Artillery unit, based at Fort Sill, Okla., her husband asked her to call a commander to request another short leave. While her husband expressed urgency, Rebecca Suell said she never thought his despair was insurmountable.

The commanding officer she spoke with made no promises and told her he would see what he could do, she said.

"If I'm a wife and I talk to the commander, something's wrong: They didn't take the time out to see if there was a problem with my husband. They don't take time out to see what these people are going through. These people are concerned about staying alive - and they're stressed about their wife and children," said Suell, who at the time was working as a Wal-Mart cashier and raising their two daughters, JaKayla, 4, and Jada, 2, and her sister's 7-year-old son, whom the couple had adopted.

Back in the broad-lawned neighborhood where Joseph Suell's mother lives, Rena Mathis, 47, and Rebecca Suell described the soldier as an athletic young man who after high school graduation held a variety of jobs and helped his mother care for her bedridden father.

Suell joined the Army in February 2000 so he could have a steady job to care for his wife and raise a family.

Rejecting his suicide, his family wonders if he maybe lost count of the pills or he had a fatal reaction to a military inoculation. Whatever the cause of death, it certainly wasn't a suicide, an ignominious fate in his eastern Texas hometown where family and military remain proud Southern traditions, they said.

The death has put the family into an emotional spiral.

What upsets them most is that Joseph Suell, who wanted to be a career soldier and abhorred suicide, hasn't received a hero's burial from his hometown because of the suicide finding, the family believes. He was posthumously promoted to sergeant.

Mathis recently shared two of the last letters her son wrote. One arrived by airmail the day after his June 16 death.

That letter and the other show hope and despair. One asks his mother to help his wife pick out colors for a formal church wedding service; he and Rebecca had married in the local courthouse.

As for the unhappiness expressed in his letters, the family interpreted it as a lonely and tired soldier's wish to see his family again and not as morbidity.
 

"Hey, mama, how are you doing? I know you are worried about me, but I am doing just fine," he wrote before he left Kuwait for Baghdad. "I just hope to come home soon, I really miss all of y'all, and I need you to continue to pray for me, mama. I will do whatever it takes to get back home. Mama, tell (my brothers and sister) that I love them and you know I love you mama. Mama please call and check on Becca and the kids. ... See you later!  Your son,            Joseph Suell."

 

© 2003, Chicago Tribune.

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