As the effects of eight years of war accumulate in Army families, a growing number of military spouses suffering stress, depression and thoughts of suicide can't get the care they need. There is "a severe shortage of mental-health-care facilities for families, both on post and off, especially as post-behavioral health centers are already filled to capacity with soldiers," according to Army psychiatrist Col. Kris Peterson. (Army News Service, October 13, 2009)

    The Army has been closely tracking the uptick in mental health problems of soldiers, and is collaborating with the National Institute of Mental Health on "the largest study ever of suicide and mental health in the military." ("Study to Seek Clues to Soldier Suicides." The Washington Post, August 10, 2009) Military family members aren't included in the study, which was announced in July, the same month that two spouses of multiply-deployed husbands were reported dead of suspected self-inflicted injuries.

    One of the women was a pregnant 40-year-old Army wife in Fayetteville, North Carolina, who called 911 threatening to harm herself. When the police arrived, she was dead of an apparent self-inflicted gunshot wound. A few weeks earlier, Army officials began investigating "the recent suspected suicide of a 172nd spouse in Schweinfurt, according to Lt. Col. Eric Stetson, 172nd Infantry Brigade rear detachment commander." ("Some seek mental health checks for spouses of multiple-deployed soldiers." Stars and Stripes, July 5, 2009) Almost three years ago, another Fort Bragg wife committed suicide by carbon monoxide poisoning, locking herself and her young children in the family car parked in the garage with the engine running. "Her husband, a lieutenant colonel in the Army, had been deployed to Iraq just two months before, just after the birth of the couple's daughter." ("War's Silent Stress: The Family at Home," The Virginian Pilot, August 9, 2009)

    In 2008, Cassy Walton, wife of Houston Army recruiter Nils Aron Andersson, an Iraq War veteran, killed herself a few days after her husband committed suicide.

    During her husband's most recent deployment, Carissa Picard, founder of Military Spouses for Change, wrote:

Here at Fort Hood, Texas ... they cannot give me figures on spouse suicides but they ... see so many attempted suicides in the Emergency Room that the medical staff have become quite adept at handling them. My theory is that these spouses may have reached the point of needing emergency mental health care and this is the only way to receive it.

    Another Army wife said that she was hospitalized upon learning of her husband's second deployment, due to concern that she might harm herself. Military spouse suicides typically aren't made public, so the extent of the problem isn't known. The Army doesn't track suicides by military family members because most occur "off post or involve [family members of] reservists or guardsmen," said Army spokesman Lt. Col. Christopher Garver. (Stars and Stripes, July 5, 2009)

    There is some evidence indicating that spouses of citizen soldiers struggle more during deployments. Guard troops have served the longest tours in Iraq, and a study assessing the effect of deployment on military spouses revealed "Increased spousal distress and poorer coping ... during deployment." The research also found that "Longer deployment was associated with greater adverse outcomes." (Centre for Military & Veterans' Health, 2007) Geographic and social isolation is a major challenge for the Guard spouses who live hundreds of miles from the nearest post, armory or another military family member with a loved one at war.

    Unable to attend the monthly volunteer-driven Family Readiness Groups, the only formal or informal support they receive over the course of a year-long deployment may be a single phone call from the Family Readiness Coordinator. So it's not surprising that "68% of deployed reservists' spouses reported increased stress [as] spouses of Guard or Reserve members may be less prepared than other active duty spouses to cope with [it]." (2008 Health Care Survey of DOD Beneficiaries)

    Among active-duty spouses, a 2008 survey by the American Psychiatric Association found that 40 percent believed their mental health was hurt by their husband's or wife's service overseas. Approximately 25 percent reported regular problems with sleeplessness, anxiety and depression.

    Earlier studies conducted on wives of deployed troops discovered a spectrum of symptoms and diagnoses, such as: depression, anxiety, insomnia, adjustment disorder, nervousness, headaches, dysphoria and changes in eating habits. (Frankel, Snowden, & Nelson, 1992; Milgram & Bar, 1993; Wood & Scarville, 1995; et. al.) "There's a lot of research to show that partners and spouses and kids suffer from secondary PTSD [Post-Traumatic Stress Disorder]," said Tom Berger, a senior analyst for veterans' benefits and mental health issues for the Vietnam Vets of America.

    Investigations into the mental health of wives of retired veterans found that spouses of combat veterans had high levels of distress, poorer physical and psychological health over a lifetime, and greater social isolation than partners of non-combat veterans. A study on caregiver burden among partners of vets with PTSD stated that nearly half of the wives "felt as if they were on the verge of a nervous breakdown." (Beckham, Lytle, and Feldman, 1996) Research published in The Journal of Nervous and Mental Disease stated that:

Partners [of combat veterans] endorsed high levels of psychological distress with elevations on clinical scales at or exceeding the 90th percentile. Severe levels of overall psychological distress, depression and suicidal ideation were prevalent among partners.... These findings are compelling since they demonstrate that partners of veterans with combat-related PTSD experience significant levels of emotional distress that warrant clinical attention. (Manguno-Mire, Ph.D., Sautter, Ph.D. et. al., February, 2007)

    A growing number of today's military spouses are married to active-duty veterans, and it's likely that the psychological distress experienced by wives of combat veterans is compounded by bearing the burden of war at home during multiple deployments, but there are painfully few resources focused on serving this population. Soldiers receive training and courses to prepare them for multiple deployments, but spouses do not. Even when clinical care is available, 66 percent of the military spouses surveyed "worried that looking for assistance for their own issues would harm their loved ones' chances of promotion." (American Psychiatric Association, 2008)

    The stigma that prevents troops from seeking mental health help also affects military spouses, some of whom believe that a wife who asks for help is weak, and "not cut out to be an Army wife." Hypervigilant of the fact that it's their soldier, not themselves, repeatedly putting their boots on the ground and their lives on the line, spouses learn to "suck it up," and suffer in silence.

    In the past year, however, more military wives have begun speaking out, including Sheila Casey, wife of the Army's top soldier, Gen. George Casey, Army chief of staff. Testifying before the Senate Armed Services Committee in June, Mrs. Casey remarked, "Army families are the most brittle part of the force ... [They] are sacrificing too much, and we can no longer ask them to just make the best of it."