American troops in Afghanistan are suffering with the highest rates of mental health problems since 2005 and morale has plummeted, according to a new report.
It gave the first detailed glimpse of the psychological cost of a campaign commanders and officials say has reversed the Taliban's momentum.
It says the dramatic increase in fighting there is one of the key factors affecting mental health.
For instance, some 70-80% of troops surveyed for the report said they had seen a friend killed or wounded.
The report also said that the psychological problems may actually be fewer than expected, given the high level of combat troops are seeing. And the military said it has doubled the mental health staff in the country to help troops cope with their problems.
The data comes from a mental health team that polled more than 900 soldiers, 335 marines and 85 mental health workers on the Afghan battlefield during last July and August, as troops surged into the country under the Obama administration's new strategy for fighting the insurgency.
President Barack Obama sent an additional 30,000 troops there last year to build the force to the current 100,000. Commanders and administration officials say the push has weakened the Taliban, and a limited troop withdrawal is planned by this July.
The new study also reaffirms the long-held view on the price paid for repeated tours of duty: mental health problems were greater for troops on their third or fourth deployment.
The military says it boosted the mental health staff in the country to one for every 646 soldiers last year compared, compared to one for every 1,123 in 2009.
* Only 46.5% of soldiers said their morale was medium, high or very high last year, compared to 65.7% in 2005. For marines, it was only 58.6 % last year compared to 70.4% when they were surveyed in 2006 in Iraq. (The report compares numbers of the marines to their time in Iraq because they were not in Afghanistan in significant numbers before the surge)
* Nearly 80% of marines and soldiers said they had seen a member of their unit killed or wounded, compared to rough half who said that in the earlier years.
* Nearly one in five soldiers and marines reported psychological problems such as acute stress, depression or anxiety last year. The number for soldiers was one in 10 in 2005 and for marines about one in eight in 2006.