WASHINGTON — The 21 confirmed military suicides in Iraq concerns the Pentagon’s top health official, who said the military has boosted the presence of mental health experts in theater to counter the problem.

William Winkenwerder Jr., the assistant secretary of defense for health affairs, said the Iraq wartime cases boost the Army’s annual suicide rate from 11 per 100,000 during peacetime, to now 13.5 per 100,000.

“We don’t see a trend there that would tell us we should be doing things different,” he told defense reporters Wednesday, but sees the need to strengthen current programs.

Last year, the Army sent an assessment team to Iraq to study the suicide issue, and now it has bolstered the presence of mental health experts in the field, to include nine Army combat stress teams around the country that provide counseling and medication to troops in need.

Of the 10,128 troops air-transported out of the theater for medical reasons — from asthma problems to routine pap smear tests for women — a “relatively small” 300 to 400 have been for mental stress, Winkenwerder said.

Instead, doctors are treating troops in country, based on studies that indicate on-site treatment is more effective, Winkenwerder said.

The Army also instituted changes in its process of redeploying soldiers, to include:

providing counseling to families to look for warning signs of depression and suicidesbeefing up counseling for returning troopsoffering a toll-free hot line for soldiers, family or friends to report problemsThese changes followed murder-suicide incidents at Fort Bragg, N.C., involving soldiers returning from Afghanistan.

In 2001, the Army spent $600,000 on a program to broaden the number of soldiers trained to recognize signs and triggers of suicide.

Instead of keeping the training chaplains and counselors, for example, the Army expanded the pool to include financial advisers, troop leaders and drill instructors.

The Navy and Marine Corps accounted for three of the suicides, with the remaining 18 were soldiers, Winkenwerder noted.

Pneumonia cases

Winkenwerder also provided updates on the pneumonia cases in Iraq. During the summer months, roughly 100 troops in the Middle East came down with the pulmonary ailment, including 19 who suffered such serious bouts they needed to be placed on ventilators. Two died from pneumonia.

For the majority of the cases, the cause was linked to the troops’ onset of smoking and breathing in the powder-fine dust of Iraq, Winkenwerder said.

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