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The role of the Air Force in Afghanistan is crucial, especially as Taliban forces try to close a supply route through Pakistan's Khyber Pass and Kyrgyzstan seeks to shut a U.S. air base in that country. Nearly 600 airmen have been killed or wounded in Iraq and Afghanistan since the Sept. 11, 2001, terrorist attacks - and 96 percent of them have been on the ground, according to Air Force officials. Their mounting losses - partly due to expanded duties off base - prompted intensive training, begun three years ago, to help the ground airmen survive combat.

Getting military personnel home safely requires much more than an airplane ride and a cursory post-deployment checkup, says Pat Canerdy, administrator of the Army Reserve's Chattanooga-based 591st Transportation Detachment. It's a lesson officials and families alike have had to learn the hard way throughout the global war on terror, which has led to historic highs in suicide and divorce rates.Just more than 5 percent of Army suicide victims had been diagnosed with post-traumatic stress disorder, according to a recent Department of Defense news release, and 17 percent reportedly had problems with substance abuse. Meanwhile, at least 60 percent had relationship problems.

It is notable that the Army only began keeping records on suicides in 1980, a policy likely fueled by the cascade of attempted and successful suicides by Vietnam veterans. In 1983, with the introduction of the diagnosis of Post Traumatic Stress Disorder (PTSD) in the American Psychiatric Association’s Diagnostic & Statistical Manual, the military and VA began, finally, to acknowledge the debilitating effects of this combat-related trauma reaction. Increased risk of suicide is among the many symptoms of the half-million Vietnam veterans diagnosed with chronic PTSD. Using the most conservative estimates, there may be as many as 75,000 active duty military or recently discharged veterans with PTSD or significant symptoms of PTSD, according to psychologist Alan Peterson of the University of Texas. Peterson is a researcher with a multidisciplinary consortium recently awarded a $25 million Department of Defense grant to study behavioral treatments for PTSD.To date, there has been no comprehensive epidemiological study on military suicides resulting from PTSD. In 1988, however, the Centers for Disease Control presented congressional testimony, confirming 9,000 suicides among Vietnam combat veterans.

According to figures obtained by the Associated Press, there has been a steady increase in suicides since 2003, totaling 450 active duty soldiers, with the highest numbers occurring in the past year. Military suicides vary considerably between branches of the service, with the Army and Marine Corps frequently reaching the highest annual rates. Longer and more frequent deployments and the primacy of ground combat operations are factors often blamed for the Army’s higher rates of physical injury, mental illness and suicide. In October 2008, the Army announced a five-year, $50 million collaborative study with the National Institute of Mental Health to address suicide. In a rare public admission of the urgency of the problem, Dr. S. Ward Cassells, assistant secretary of defense for health affairs, stated in the New York Times, “We’ve reached a point where we do need some outside help.” Such efforts are encouraging but will yield little immediate assistance to active duty soldiers, returning veterans and their families.

It was during his first deployment in Iraq that Marine Cpl. David Tracy, 23, of Peekskill earned his Purple Heart."I was up top behind the gun when we stopped at a checkpoint and a roadside bomb exploded on the other side of the barrier," said Tracy, an infantryman who served as a machine gunner in Baghdad and Fallujah.

Legislation introduced recently by Rep. John Hall, D-Dover Plains, would lift the burden of proof from veterans who served in combat zones and have a diagnosis of PTSD, allowing them to receive disability benefits without having to prove that a specific incident caused the disorder.In the Iraq and Afghanistan wars alone, more than 100,000 veterans have been found to have PTSD, but only 42,000 have been granted service-connected disability for their condition, said Hall, chairman of the Veterans Affairs Subcommittee on Disability Assistance and Memorial Affairs.The disability claims backlog at the VA tops 800,000. A large percentage of that number are Vietnam veterans seeking compensation for PTSD, Hall said.

Antonette Zeiss, deputy chief of the VA's Mental Health Services, said members of the current generation of veterans are being encouraged to come in sooner so they can get treatment, even if they are not eligible for benefits. State-of-the-art treatment should now be available without delays, she said.But PTSD is not the whole story, said Zeiss, a clinical psychologist. There are 442,862 veterans enrolled with the VA who have a diagnosis of PTSD out of a total 1,662,375 with some mental-health diagnosis, she said.Continuing conflicts mean those numbers will grow. Up to 17 percent of veterans who have served in Iraq and Afghanistan have PTSD, major depression or other mental-health problems, Dr. Joseph T. English told Congress last year. He is chairman of psychiatry at New York Medical College in Valhalla, which is affiliated with the VA hospitals at Montrose and Castle Point.