Combat stress afflicts civilian contractors returning from Iraq

Mental health issues often slip under the radar

Contractors who have worked in Iraq are returning home with the same kinds of combat-related mental health problems that afflict US military personnel, according to contractors, industry officials, and mental health specialists.

But, they say, the private workers are largely left to find care on their own , and their problems are often ignored or are inadequately treated.

A vast second army of contractors, up to 126,000 Americans, Iraqis, and other foreigners, are working for the US government in Iraq.

Many work side by side with soldiers and are exposed to the same dangers, but they must mostly fend for themselves in navigating the civilian healthcare system when they come back to the United States.

With no widespread screening, many workers are not identified as suffering from post-traumatic stress disorder or other problems, mental health experts and contractors say. And, they add, the quality of treatment for others can vary widely because of limited civilian expertise in combat-related disorders.

Only a few mental health professionals have focused on the issue, but they warn that the number of contractors leaving Iraq with mental health problems is large and growing.

"I think the numbers are in the thousands, maybe tens of thousands," said Paul Brand, a psychologist and chief executive of Mission Critical Psychological Services, a Chicago firm hired by Dyncorp International, a major contractor in Iraq, to assess and treat its workers.

"Many are going undiagnosed. These guys are fighting demons, and they don't know how to cope."

Jana Crowder, who runs a website for contractors seeking help, says she gets new evidence of that every day in phone calls from desperate workers.

"In the first few years of the war, we were seeing a few trickle in," said Crowder, of Knoxville, Tenn. "Now, as contractors start coming home, you are starting to see a lot more."

Workers tell haunting tales of their psychological torment. Tate Mallory, a police officer from South Dakota who worked as a Dyncorp police trainer, was grievously wounded by a rocket- powered grenade last fall. After returning home, he was so mentally scarred, he said, that he begged his brother to kill him.

Kenneth Allen, a 70-year-old truck driver from Georgia whose convoy was ambushed in Iraq, says he endures mood swings and jittery nerves and is often awake all night.

And Nathaniel Anderson, a Texan whose truck was hit by rockets while hauling jet fuel, lost a contractor friend to suicide. Though suffering from stress- related symptoms himself, he has yet to see a doctor.

The war's toll on contractors has largely been hidden from public view. About 1,000 have died since the conflict began, and nearly 13,000 have been injured.