Between suicides and homicides, the military in 2009 was forced to take a long, introspective look at the mental health of its servicemembers after years spent fighting prolonged wars in Iraq and Afghanistan.

In May, Army Sgt. John Russell fatally shot five fellow servicemembers inside a Baghdad combat stress clinic, where as a patient he reportedly told others he was suicidal. The investigation of the events leading up the shooting revealed widespread institutional failure to implement policies to help at-risk soldiers.

In January, fresh off a year of record suicides, the Army ordered a servicewide stand-down to focus on suicide awareness and launched a Suicide Prevention Task Force headed by Vice Chief of Staff of the Army, Gen. Pete Chiarelli. In May, Fort Campbell, Ky., held its own three-day standdown after nearly one soldier per week committed suicide at the base between January and March, and then two more did so in one week in May for a total of 11, giving the post the highest suicide rate in the Army. The pace of suicides started to slow in the latter half of the year, leading Chiarelli to say that the Army was making progress on the complicated problem.

But the progress was not enough. By November, the Army had set a record with 147 soldiers committing suicide to that point in 2009, breaking the previous mark of 140, set only a year earlier. The Marine Corps also saw a sharp rise in suicides, with an almost 20 percent jump over 2008 figures.

This year brought the Pentagon’s most concerted effort yet to combat the stigma associated with mental health issues and seeking help. The "Real Warrior" campaign features servicemembers opening up about their mental health problems, such as PTSD.

In a rarity for high-level officers, Gen. Carter Ham, the commander of U.S. Army Europe, admitted earlier this year to his own struggles with combat stress. While in Mosul in 2004, the general’s Humvee was hit by a roadside bomb, badly injuring the gunner, and shortly before his tour ended a suicide bombing in a dining hall under his command killed 22 people.

The mental health buzzword for 2009 was resiliency with the Army trying to train soldiers to bounce back mentally. Through the "Comprehensive Soldier Fitness" program, the Army aims to train soldiers from boot camp throughout their careers to have mental and emotional coping skills in much the same way as they do with physical fitness.

The services tested a host of new programs for dealing with mental health issues, such as virtual reality therapy to confront the memory of the trauma for those suffering from PTSD and live video therapy over the Internet.

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