The Americans putting their lives on the line in combat are dying by their own hands at an alarming rate. The Army recently reported 133 confirmed suicides last year; 18 soldiers killed themselves in February alone. The public knows little else about who they were and where they came from. Though military officials have acknowledged unmet mental health needs in the armed forces, the suicide rate exposes persistent barriers to treatment. The consequences could be especially acute for soldiers of color, a major but often overlooked subgroup. A study by the RAND Corporation last year estimated that 31 percent of returning troops from the Iraq and Afghanistan wars suffered from a mental health condition, including Post Traumatic Stress Disorder and depression, or traumatic brain injury. Researchers also found that “women, and Hispanics are more likely than their counterparts to meet screening criteria for PTSD and major depression”–both risk factors in military suicide. Research on veterans from the Vietnam Era (when the military was less racially diverse) have linked ethnicity to PTSD prevalence: Blacks, Latinos and American Indians suffered from especially high risk, and experiences of racial discrimination could amplify the trauma of combat. An untold number of troops suffer in silence. Only about half of those surveyed by RAND sought professional mental health care in the past year. Many troops fear stigma and career repercussions, on top of a paucity of quality treatment services. For people of color, the scope of the problem remains largely undefined. As with the mental health system generally, a lack of culturally competent services could deter many veterans of color from seeking help through military health facilities. And little is known about how race may influence the effectiveness of mainstream therapies. In a 2007 report on PTSD treatment, the Institutes of Medicine of the National Academies noted that medical research has been “mostly silent on the acceptability, efficacy, or generalizability of treatment in ethnic and cultural minorities… The committee expects that the psychotherapies in particular might pose special challenges in different cultural groups but was unable to comment because none of the studies addressed it.” Outside the combat theater, military suicide folds into a host of other stressors, including family and economic problems in soldiers’ communities. Today, the country, and its troops, face the perfect storm of social and military trauma. If the Pentagon is serious about focusing on the psychological fallout of war, it will need to look deeper into the military communities historically rendered invisible. Image: Iraq Solidarity Campaign