In Brief

Marital discord, stress of separation and concern that seeking counseling could harm soldiers' careers were all factors in a spate of five homicides at Fort Bragg in North Carolina last summer, finds an Army report that psychologists helped write.

Four of the deaths involved women allegedly murdered by their soldier spouses. Three of the cases involved Special Operations soldiers who had recently returned from Afghanistan.

After the series of murders, the Army convened several review panels, including an epidemiological consultation team that included four psychologists and issued the report. While the team noted that the overall homicide rate at Fort Bragg was similar to the national rate, they wrote that the "model of behavioral health services [was] found flawed" because it discouraged "therapeutic engagement of marital problems" at early stages of conflict. In fact, none of the couples involved in the incidents had sought counseling, according to the study's coordinator, psychiatrist Col. Dave Orman, MD.

"There was a perception that accessing behavioral health services was detrimental to a soldier's career," says Col. Edward O. Crandell, PhD, a psychologist with the Medical Service Corps and a contributor to the study. "As a result, soldiers who need help avoid seeking it until the situation becomes highly problematic and difficult to resolve."

In response, the report recommended that the Army:

  • Commission a study of how deployment frequency, duration and intensity affect soldiers and their families.

  • Initiate pilot programs for workplace-oriented behavioral health care, prevention programs and unit-based marriage education.

  • Formalize the process to assist soldiers who have problems during deployment, such as counseling as soldiers reunite with their families after lengthy absences. Fort Bragg has already instituted immediate counseling for soldiers returning from areas such as Afghanistan.

  • Revamp the Army's behavioral health services by integrating them and ensuring that it's "career-safe" to access them. At the study's release, Orman suggested placing mental health workers in combat units to increase soldiers' access to care and reduce the stigma associated with seeking help.

  • Improve information sharing among the Army's various behavioral health agencies.

"Army psychologists will continue to address the issues raised in the report and engage in the process of developing improved behavioral health clinical policies and programs," says Crandell. In fact, he adds, the Army has increased the number of slots for psychologists by 18 percent in recent years.

--D. SMITH