The link between combat trauma and battlefield stress was known long before post-traumatic stress disorder (PTSD) was clinically diagnosed in the 1970s. Terms like “shell shock” and “combat fatigue” have long been used to explain how the horrors of combat affect the minds and behavior of soldiers. That said, the current conflicts in which the United States finds itself are among the longest in America’s history, dating back to the attacks of 9/11, and that extended exposure has had disturbing consequences for personnel on the front lines.

One of the most disturbing of these has been a rise in the number of suicides, which have spiked over the past few years. Perhaps most worrisome is that the suicide rate is not the only troubling metric facing senior military leaders as they look at continuing overseas wars that may go on for years to come. Substance abuse, divorce, family violence, and other rates of problem behavior are also on the rise, and earlier this year, the Army decided to task one of its most senior leaders to lead the effort to better care for the Army’s soldiers: Vice Chief of Staff of the Army Gen. Peter Chiarelli. We sat down with him recently to see how this effort has been developing.

John D. Gresham: You have a reputation for being really passionate on behalf of the American soldier. What is it in your background, life experience, and career in the Army that makes such a description from your peers and subordinates valid in your mind?

Gen. Peter Chiarelli: That’s a pretty tough question to answer, but I would have to argue that it probably goes back to my upbringing with my father and mom. My father was definitely a huge influence in my life, and he talked often of his experiences in World War II, of some of the great leaders that he had worked for, and how he always thought the highest of those who cared for their soldiers. He entered the Army a private, got a battlefield commission, and left as a lieutenant, but I remember him telling stories to me of Gen. Omar Bradley, who had a reputation for being an individual who really cared for soldiers and their welfare. I have to probably say that, and the fact I spent the majority of my time in operational units and not in headquarters, are the two things that caused me to always ask the question: How will this affect soldiers and their families?

Which takes us to the next question. You have had a number of command assignments over the past couple of decades in combat and crisis zones, so you’ve probably seen as much as anyone. What is it that today American soldiers are doing and dealing with on a personal level? I mean, what are we really asking of these young people to put on hold?

Well, first of all, I think you have to understand that the conflicts in Iraq and Afghanistan are different than any we have ever fought before. I think if you go and talk to historians and people who write on these issues, and you would find that the kind of stress that the soldiers are under is even greater than American soldiers were under in World War II, Vietnam, and even Korea. And why I say that, is it’s a continuous stress. This is not necessarily three or four-day kinetic battles that go on for a period of time, but rather, it’s the understanding that any time you go outside the forward operating base perimeter – and, quite frankly even when you are in the forward operating base with the threat of enemy rockets and mortars – that you are looking the Devil in the eye.

But those soldiers that go outside the forward operating base, be they infantrymen conducting missions or logisticians moving supplies, are under constant threat, with the big killer in these particular conflicts being the Improvised Explosive Device (IED). Now when you look at that, the continuous combat that they find themselves in – and it is a different kind of combat I grant you – the personal level of stress and strain is much greater than it was in the wars I mentioned earlier. I think that point is understood by all.

At the same time, … you [have to] understand that we’ve got individuals that have been on three and four overseas combat deployments since 9/11, with just 12 to 15 months in between those deployments. Many of those deployments were more than 12 months, and we are just now getting off of the 15-month deployments. Frankly, we won’t be completely off 15-month deployments with our enablers until September this year. So you find that the stress factor is not based upon only a single event, or a single 12-month period. We today have soldiers who have spent just seven years in the Army, but have spent upwards of 48 months in combat.