FORT HOOD — After four deployments to Iraq and Afghanistan in five years, Army Sgt. Timothy "Ryan" Rinella knew he needed counseling, but he feared a diagnosis of post-traumatic stress disorder would ruin his career.

"I remember him saying, 'It's not as if I don't want to go to counseling, but I want to get promoted, and they look at people with PTSD as weak,' " said his wife, Sarah Rinella, 26.

Her husband, 29, was found dead from a gunshot wound on Sept. 25, one of four soldiers stationed at Fort Hood who apparently took their own lives last weekend.

All four had served combat tours in Iraq or Afghanistan. Their deaths at this sprawling Army base are part of an alarming surge in suicides among young active-duty military personnel, reservists and veterans in Texas.

A Houston Chronicle analysis of the state's vital statistics found that suicides among Texans younger than 35 who had served in the military jumped from 47 in 2006 to 66 in 2009 — an increase of 40 percent.

Last year, suicides made up nearly 25 percent of the deaths of Texans younger than 35 who served in the military. That percentage is more than twice the rate of suicide in the comparable civilian population. Eleven percent of the deaths of civilians younger than 35 in Texas last year were suicides.

National attention has been focused on the record suicide rate in the Army, which lost 163 soldiers to suicide in 2009. But the military only recently began reporting suicides in the Reserve and National Guard, and there are no official statistics on suicides among veterans who are retired or were discharged from the armed forces.

'Silent national epidemic'

The Chronicle's analysis provides a rare look at the military suicide trend in Texas using vital statistics data from the Department of State Health Services, which lists military experience in the state's death records, regardless of whether the deceased served in the armed forces at time of death or at some point in the past. The data does not include suicides of Texans that occurred overseas or in another state.

"The country is mostly unaware of this silent national epidemic in suicides," said Paul Sullivan, executive director of Veterans for Common Sense.

As America approaches a decade of constant warfare, he said, the stress is taking a toll on troops' health, families, and careers, especially in Texas ­- home to an estimated 1.7 million veterans and a multitude of military installations, including Fort Hood, the nation's largest Army base.

"The military needs to wake up and acknowledge that war and multiple deployments are causing suicides," Sullivan said, "and until the military admits that, they won't address the suicide epidemic."

Tom Tarantino, senior legislative associate for Iraq and Afghanistan Veterans of America, sees few parallels between modern military service and that of the past.

"There is a difference between a World War II scenario, where you're gone for the duration and then you come home when the war is over, and the situation right now, where … you can count on being consistently rotated in and out of a combat zone for a year at a time," Tarantino said. "You have a force that has a high potential for breaking and that's why you're seeing these high suicide numbers."

After last weekend's deaths at Fort Hood, Maj. Gen. William Grimsley, the post's senior commander, ordered health and welfare inspections of soldiers' barracks and private cars on post as well as soldiers' homes off-post.

Fort Hood already had stepped up its suicide prevention and risk assessment programs two years ago, said Charlie Green, director of human resources for Fort Hood. All soldiers undergo annual training, as well as additional training by the units' chaplains.

The troops watch films with titles like, I Will Never Quit on Life and Shoulder to Shoulder. Actors perform interactive skits and role-play with the soldiers. Fort Hood even hired a comedian who cracks a few jokes before speaking seriously about his struggle with alcoholism and his own brother's suicide.

But suicides continue an upward trend despite such efforts. So far this year, Fort Hood has confirmed 11 suicides on and around the post, and another five possible suicides that remain under investigation.

"There's not one answer to suicide," Green said. "We can have the best tools in place, and sometimes it just happens."

Suicide sessions no help

Bobbe Alexander's son, Sgt. Kevin Alexander, had attended at least two suicide prevention classes with his Army National Guard unit, most recently in February 2008, only three months before he shot himself to death at the age of 21 at a hotel in El Paso.

Alexander said her son and his friends were so bored during the training that they threw spitballs at each other.

"They weren't paying attention because they didn't consider it was related to them," she said. "Even my son probably didn't think he'd do something like that."

When her son became depressed and his marriage started to fall apart, commanders told his roommates "just be his friend, that he needs a friend," said Alexander, of Elgin.

"When he was in the shape that he was in, they should've sent him home," she said. They should've done something, and they didn't."

After their son's death, leaders from his unit mentioned that they'd like Alexander and her husband to talk to troops about the impact of suicide on loved ones. "We'd like to do that," she said. But the leaders didn't follow up.

Diane Langham's son, Iraq war veteran Joshua Witte­nauer, 28, killed himself in March 2009 in Bedford after leaving the Marine Corps.

Wittenauer had enlisted at 17. "He just liked the discipline of it, and he thought he could make a difference," said his mother, who lives in Texarkana. "He loved it until he went to Iraq."

Langham said her son rarely talked about his experience during the 2003 invasion. He told her his unit had fought hard in Fallujah to recover the bodies of other service members and once hinted to his brother "that he had killed his daughter a dozen times over there, meaning I guess (kids) the age of his (brother's) daughter," Langham said.

"He hid a lot of stuff really well," she said. "And there was times that he was like the old Josh, but then there was times that he was quieter, withdrawn. And you'd ask him what's wrong: 'Oh nothing. Thinking.' "

Langham encouraged her son to talk to a therapist or minister, but Wittenauer wanted to become a police officer and he thought mental health treatment would "go on his permanent record" and dog him for the rest of his life.

Counselors were civilians

His mother thinks counseling should be mandatory for all combat veterans.

"It's sad that they bring these kids over there and they go through what they go through, and they come home, and they give them two or three days worth of, 'Blah blah, blah it wasn't your fault, you did what you had to do, blah, blah, blah,' and then they turn them loose and they expect them to live with this," Langham said.

Sgt. Timothy Rinella, who went by his middle name, Ryan, did seek counseling before his death, but his wife says he assumed nothing he said was confidential, and suspected the content of his private sessions were relayed up the chain of command. He also had trouble taking some of the counselors seriously, she said.

Although her husband had been deployed four times, Sarah Rinella said, some of his counselors were civilians who'd never gone through a deployment themselves. "They're trying to counsel him and tell him what to do," she said, "but how can they really know what to do if they've never experienced it?"

She said her husband left on his first deployment just 13 days after their wedding. In the couple's nearly eight-year marriage, she estimates they spent about four-and-a -half years apart.

The sergeant missed the birth of his first son. He got emergency leave to return home from Iraq for the birth of his second, but missed it by just 20 minutes when his flight got delayed.

"It obviously hurt him that he missed all these things, but he never complained about it," Sarah Rinella said.

"I was a proud Army wife," she said. "My husband was a proud soldier. I never wanted him to leave the Army. I just wanted them to take care of him. He was working for them, so they needed to help him, and not just him. I know many a soldier who had the same problems."

The 2010 National Defense Authorization Act requires a mandatory face-to-face screening by a mental health professional for every service member returning from Iraq or Afghanistan, but the military has yet to implement the law, said IAVA's Tarantino.

Mandatory screenings are key to reducing stigma, Tarantino said.

"Now you're not the guy that everyone sees as having to go to the counselor, you're not the guy who looks weak," he said. "Now you're the guy whose pain-in-the-butt first sergeant makes you go and sit in a room with a guy for 15 minutes, but what happens in that room is between you and that guy."

Changes in policy

A Defense Department spokeswoman who asked not to be identified told the Chronicle that the Pentagon issued new policy guidance on July 19 to each of the armed services and the Joint Staff, requiring person-to-person mental health assessments for all service members who deploy to combat zones.

"Mental health assessments will be conducted person-to-person - this can be face-to-face, by telephone, or by secure videoconference in a private setting," the spokeswoman said.

She said the assessments will be conducted at four different points: within two months prior to deployment, three to six months after returning from deployment, seven to 12 months after returning from deployment, and 16 to 24 months after returning from deployment.

For now, stunned friends and relatives grapple with the latest quartet of tragedies at Fort Hood.

When members of Rinella's unit converged on his house after his death, they seemed almost desperate to comprehend how all their suicide prevention training had failed to save the outgoing sergeant nicknamed "Pookie."

"He must've kept it inside good because his first sergeant came over, they all came over, and they were shocked, just shook up pretty bad," said his roommate, Josh Roum, 29. "They just kept on asking the question why: 'None of the signs were there. Why? Why would he do something like this?' "

lindsay.wise@chron.com

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