BAQOUBA, Iraq | The U.S. commander of the Multi-National Force -- Iraq on Tuesday ordered a top-to-bottom review of mental health services for U.S. troops in the country after the worst act of U.S. soldier-on-soldier violence in the Iraq war.
Army Lt. Col. Brian Tribus, media relations chief for Multi-National Force - Iraq, told The Washington Times that Lt. Gen. Charles Jacoby ordered procedures "to look into [mental health] services available and delivery of those services."
Gen. Jacoby also requested that the Army inspector general review all mental health services available to troops in Iraq, Col. Tribus said.
Five U.S. service members - two doctors and three enlisted men - were killed Monday afternoon at Camp Liberty on the outskirts of Baghdad when a soldier from the 54th Engineer Battalion entered a combat stress center and opened fire.
• See related story:Dad says Army 'broke' Iraq shooting suspect
News reports indicated that the soldier had been disarmed and ejected from the center earlier, but this could not be confirmed.
The incident ranks as the worst act of deliberate soldier-on-soldier violence since the U.S. invaded Iraq. In 2003, an Army sergeant killed at least one soldier and wounded 15 others in a grenade attack at an encampment in Kuwait. Two Army officers were killed in Iraq in 2005 when a mine was placed by the window of an office in Tikrit.
Col. Tribus identified Monday's suspected shooter as Sgt. John M. Russell but did not disclose additional personal details. He said Sgt. Russell has been formally charged with five counts of murder and one count of aggravated assault and is being held at a detention facility near the shooting location.
No reason for the shooting has been determined, officials said, but soldiers in the field cautioned against jumping to a conclusion of "combat stress" until an investigation has been completed.
"The challenges people here have may be unique because they are in the Army, but they're still total persons," said Maj. Roderick Mills, chaplain for the 1st Stryker Brigade Combat Team, 25th Infantry Division. "So there are relationship challenges, life challenges, work challenges. In that respect, they are no different from anyone else, except they are in a high-stress situation."
The clinic where the shooting occurred is part of the 55th Medical Company and deals specifically with mental health issues.
It's under the umbrella of medical Task Force 44, which runs mental health facilities at 25 bases across Iraq and sends mobile teams to smaller, more isolated facilities.
Lt. Col. Steve Lewis, a senior officer with the task force, said troops in Iraq visit the facilities about 5,000 times every month, although some of those are repeat visits.
Most patients go to the clinics of their own volition, but some are sent by their commanding officers.
"It's hard to say which are the top two concerns," he said. "Common concerns are home relationships, marital problems; other times it may be related to work, conflict in the office or what they have observed in battle. It's not uncommon to see a range of [issues]: depression to anxiety as well as anger."
Military commands in Iraq, from platoons to divisions, stress the "battle buddy" system to help spot soldiers having emotional problems and to help steer them to medical help.
Public service announcements dealing with issues such as suicide appear on television in the dining halls and in the morale, welfare and recreation halls.
Troops are also given videos on how to spot soldiers having problems such as depression.
An Army report released earlier this year indicated the suicide rate among U.S. soldiers worldwide had surpassed that in civilian society.
It stood at 20.2 per 100,000 people in 2008 compared with the civilian rate of 19.2 in 2006, the latest year for which civilian figures were available. Officials said a high operational tempo, including 15-month deployments to Iraq at that time, was a factor.
With combat in Iraq now at a low point and U.S. forces taking a secondary, supporting role to Iraqi forces, boredom could become a morale issue for some soldiers when not in the field.
"Obviously you have to concern yourself with boredom, but we keep them very busy here - spiritually, mentally and physically - and not just on operations," said Col. Burt Thompson, commander of the 1st SBCT, 25th Infantry Division, based near Baqouba. "We just have to take care of each other."