A mental health patient obsessed by the killings at Sandy Hook Elementary School is in custody after escaping from an Orange County facility the day before, authorities said.

Norris Phuoc Nguyen returned to the Royale Health Care Center at Bristol Street and Warner Avenue in Santa Ana at 4 p.m. Saturday, said Anthony Bertagna, spokesman for the Santa Ana Police Department.

Friday afternoon, Nguyen walked away from the Royale Health Care Center, where he has been detained since December 2012.

Police said the 23-year-old told them he visited a friend while he was away from the facility, and it does not appear Nguyen committed any crimes while he was gone.

---

Authorities became familiar with Nguyen -- who has been diagnosed with schizophrenia and repeatedly detained and institutionalized -- in August 2011. At that time, he walked into the Westminster Police Department dressed in camouflage and holding an assault rifle, saying he wanted to "die by cop," Garden Grove Police Chief Kevin Raney said.

The weapon was not loaded, the chief said, adding that Nguyen did not have a permit for the firearm.

Nguyen was questioned, and police found he was fixated on a teacher at a Garden Grove elementary school that he had attended, Raney said, declining to name the school.

"We have statements and we have the firm belief that he is committed, unfortunately, to harming children at this specific school," Raney said.

Nguyen had been detained periodically since then, Raney said, until it became apparent in interviews with him in December that he was obsessed by the massacre that left 26 dead at a Newtown, Conn., elementary school on Dec. 14, 2012.

Nguyen has spoken repeatedly both about protecting children and endangering them, Raney said.

Nearly two weeks ago, Nguyen's mother, who lives in Huntington Beach, tried to gain custody of her son at a court hearing, but the judge refused to have him released, Raney said.

Related:

• Emotions run high in debate over future of Sandy Hook school
• Guns, paperwork, books flesh out portrait of Newtown killer Adam Lanza
• Investigators: Adam Lanza surrounded by weapons at home; attack took less than 5 minutes

The armed forces mourned a grim toll in 2012 when more troops took their own lives than died in combat, but a precarious question remains: Why is the rate spiking when military life has long been a suicidal deterrent?

Among the services, the Army lost the most active-duty members last year to suicide: 182. Inside that branch, as two wars raged then waned, the annual suicide pace climbed. During 2001, nine out of every 100,000 active-duty soldiers killed themselves, while, during 2011, the suicide rate was nearly 23 per 100,000, according to the American Foundation for Suicide Prevention.

Compare that sobering trend to conflicts and peacetimes past. During the final three years of World War II, the Army’s annual suicide rate didn’t budge above 10 soldiers per 100,000, and during the Korean War in the early 1950s, that annual pace remained at about 11 soldiers per 100,000, according to a study published in 1985 by the Walter Reed Army Institute of Research.

---

Between 1975 and 1986, the Army’s annual suicide rate averaged 13 deaths per 100,000 soldiers, falling to as low as 10 in the early ‘80s, according to series of papers published in the journal Military Medicine. The Army’s suicide rate in 2001 was less than half that for all American males (18.2 per 100,000). Since then, the pace of self harm among active Army troops has more than doubled — and that trend is not ebbing: In January, the Army classified another 33 deaths as "potential suicides" among active-duty, National Guard and Army Reserve soldiers, according to the Department of Defense.

“A once-protective environment has moved to be something very different,” said David Rudd, co-founder and scientific director of the National Center for Veteran Studies based at the University of Utah.

“We need to look at the big picture to really understand what's going on today, but we all too often lose historical perspective,” said Rudd, who testified before Congress on the issue last month. The Army’s suicide pace between 1975 and 1985 should be viewed as the branch’s “baseline” rate, he added.

What has led modern soldiers to become twice as susceptible to suicide?

'The self-esteem generation'
Some answers lie in present military lifestyles and in the multiple deployments of soldiers to Iraq and Afghanistan — but also in stark psychological distinctions between today’s 20-somethings and the mindsets of past generations, according to Rudd and to veterans of recent and past U.S. combat actions.

“The fact is, nobody really understands what it means to be at a wartime, operational tempo for more than a decade,” Rudd said. “What that means for soldiers is: When they come home from those deployments, they’re never really off duty.

“They get block leave for a month or so when they get back (from war) and then they’re right back in the field, training. Even at home, you’re away from your family. That level of disconnection is a big deal,” Rudd added.

And at military garrisons on home soil, some service members stay and sleep in private quarters versus the packed barracks of long ago. Rudd said he was surprised to see such a setup earlier this year when he visited the 29 Palms Marine base in Southern California. 

“They had their own TVs, no common areas. Entitlement has grown in younger generations and society has embraced that, giving in to the entitlement,” Rudd said. The military has “made decisions in accommodating these kinds of requests for more privacy and more seclusion by isolating (soldiers) even further.

“This group is the self-esteem generation. My worry is they have not dealt with enough challenges, enough disappointments in life for many of them to build the kind of resilience that is foundational when you go to war,” added Rudd. “This has led to many of us to having thin skin. That doesn’t bode well when you go to war.”

But suicide is not solely a military phenomenon, said Cynthia O. Smith, a spokeswoman for the Department of Defense, who described suicide as “a national public health problem” and the 10th leading cause of death for all Americans.

The Pentagon has, however, rolled out numerous anti-suicide strategies during the past three years, including a 35-percent boost in the number of behavioral, health-care providers who work in primary-care clinics or who are embedded with front-line units, Smith said.

“Suicide prevention is first and foremost a leadership responsibility. Leaders throughout the chain of command must actively promote a constructive command climate that fosters cohesion and encourages individuals to reach out for help when needed,” Smith said. “Seeking help is a sign of strength.”

They went through 'harder times'
But such collective emotional strength may be lacking in today’s warriors when compared to past generations who were perhaps better steeled for battle by the epic financial hardships they faced at home, said Barry Hull, a retired Navy commander and former F/A-18 Hornet pilot who flew missions in the first Gulf War. 

“Stress is all about coping skills. World War II was just as difficult as war today. But think about what the World War II (soldiers) had just come through: The Depression. What creates our coping skills? Trauma, difficulty, adversity,” Hull said. “I’m not stereotyping individuals. I’m stereotyping populations. I’m not saying youngsters today are any less – don’t misunderstand me. But our lives tend to be a little bit less adverse. We typically do not develop the coping skills that some of the older generations did. 

“So you take a young, patriotic guy. He goes over (to Afghanistan or Iraq) and sees things he can’t even comprehend. And so what does it do? He tends to feel the effects of that stress more fully because he has not developed the coping skills that the older generation has developed,” Hull added.

One Iraq veteran who can speak intimately on the suicide epidemic is Andrew O’Brien, who was diagnosed with Post Traumatic Stress Disorder and who knew a 19-year-old soldier — with a wife and child back home — who died in an explosion. That 2009 family tragedy left O’Brien asking: “Why couldn’t it have been me?” In 2010, after returning to his Army base in Hawaii, O’Brien tried to kill himself by swallowing several bottles of pills, including sleep medication and anti-depressants. He awoke in a hospital the next day.

“That older generation, they went through harder times, the Depression, and they had so many worse things going for them. I feel like it made them more prepared,” said O’Brien, who has written an anti-suicide guide and who is scheduled to speak this weekend in New Orleans about his experiences.

But among older and younger veterans, there is one common thread that perhaps leaves both groups vulnerable to post-war struggles, O’Brien said. It is a basic tenet of Army teaching and military character.

“We are trained to be selfless. Being selfless is good when you’re deployed. You’re constantly making sure you’ve got your buddy’s back," O’Brien said. "But when you come back, it’s not good. And you have to live for the rest of your life with survivor guilt, with the fact that we lost that person.”

Related:

• Army withholding findings from Madigan PTSD probe
• Home from war, troops face 'white-knuckled' first month
• Soldier Hard's hip-hop lyrics reveal PTSD's rough edges

Eighty percent of veterans who attempted suicide and survived had received mental health care one month earlier from the Department of Veterans Affairs, underscoring the potential peril of 50-day average wait times they face in trying to access VA treatment, a suicide expert told a Congressional committee Wednesday.

“When they had contact a month prior, the question I ask is: How long was it until their next (VA) appointment? Was it scheduled six weeks out? Is that the problem? Or was it scheduled one week out?” David Rudd, head of the National Center for Veteran Studies, testified before the House Committee on Veterans’ Affairs.

“My concern is — from the individuals I talk with that we treat to surviving family members of those who have died — often times, it’s an issue of the (VA) system getting in the way to keep an appointment, to get an appointment, or to get to an appointment,” Rudd said. 

---

According to a VA report released earlier this month, 18 to 22 veterans commit suicide each day. And that rate “has remained steady” since the Iraq and Afghanistan wars began 12 years ago, said Veterans' Committee chairman Rep. Jeff Miller, R-Fla., who noted that during that same span the VA has increased its budget by 39 percent and its staffing by 41 percent.

“When a veteran is in need of care, the difference of a day or a week or a month can be the difference between life and death,” Miller said. “ ... Something somewhere is clearly missing.”

In his State of the Union address Tuesday night, President Barack Obama announced that 34,000 U.S. troops would head home from Afghanistan during the next year.

Given that mammoth flow of young veterans into an already-backlogged VA system, Miller questioned whether the agency’s “one-size-fits all approach” will leave thousands of ex-service members mired in a bureaucracy that “fails to recognize that addressing mental-health needs ... is a task that the VA cannot handle by themselves.”

“We’ve improved our services for veterans but we know there’s a lot more work to be done,” testified Dr. Robert A. Petzel, the VA’s undersecretary for health.

In 2012, for example, the VA’s 24-hour crisis line fielded 193,000 phone calls that resulted in more than 6,400 “rescues” of veterans who were threatening to hurt themselves or their family members, Petzel said.

While the volume of calls to the hotline is increasing, fewer of those calls are “acute” — or people making an imminent threat — “demonstrating that VA’s early intervention appears to be working,” Petzel added.

What’s more, in the past year, VA has hired 1,058 new mental-health providers and the agency expects to meet its hiring goal of 1,600 extra clinicians by June, Petzel testified, adding that last year 1.3 million veterans received mental-health care from the VA, up from 927,000 in 2006. That increase, he contends, shows that “proactive screening” is working to find and treat veterans for Post Traumatic Stress Disorder, depression, substance abuse issues, and the effects of military sexual trauma.

“Your focus is on the process, the number of people hired. Numbers, numbers, numbers,” Miller responded. “The most important number is the number of veterans getting healthy, healthier or helped.”

“It’s time for us not to do the same thing,” Rudd agreed. “More of the same thing isn’t working ... The way we’ve (tried to address these problems) over the years since the start of these wars is we’ve made the VA larger. I think the evidence would suggest the VA does not need to be larger. I was not encouraged when I heard they’re hiring over 1,000 individuals.”

Instead, Rudd testified, VA should partner with the Department of Defense’s health system TRICARE “because their providers are already in those small communities and available."

“That means shifting money to a non-traditional model,” he added. “But that’s how you connect people to people” instead of linking individual veterans into a vast system.

Related: 

• Soldier Hard's hip-hop lyrics reveal PTSD's rough edges
• 22 veterans commit suicide each day: VA report
• Concern grows about military suicides spreading within families

Why do some people reject the existence of PTSD?

The topic is touchy. Even asking the question is slammed as irresponsible.

“Why on Earth would you try to put out something that states combat PTSD isn't a true affliction? Or even try to debunk it? Or to put questions into the minds of society? In the first 155 days of 2012, we lost 154 men,” Amy Cotta, an author and the mother of a Marine wrote in an email to NBC News. Her message arrived minutes after she learned NBC News was seeking to interview a PTSD denier.

Despite exhaustive scientific studies that have explored the symptoms, causes, diagnoses, and prevalence of post-traumatic stress disorder, hardcore skeptics remain.

They exist within the military, where some leaders openly call PTSD a mental weakness, according to mental health advocates. David Weidman, who did two tours in Afghanistan and was diagnosed with PTSD, said all of his senior non-commissioned officers advised him not to seek treatment, instead suggesting he “just put your head down and keep going” in order to maintain any chance at a promotion.

---

They exist within the veteran community. Kevin R.C. “Hognose” O’Brien, who operates a blog called “WeaponsMan” and identifies himself as “a former Special Forces weapons man,” wrote in July that PTSD was a “quack” diagnosis, “invented” to clump “any odd and many normal behaviors.” He added: “If a vet is wound up tight? PTSD! If he or she is calm? Hypercontrolling due to PTSD! Lose weight, gain weight, maintain weight, those are all PTSD markers. Get in fights? PTSD, natch. And avoid fights? Well, clearly it's .... are you starting to get the idea?” O’Brien declined to be interviewed for this story.

And they exist within medicine. In late September, Washington, D.C. psychiatrist Dr. Joseph Tarantolo authored an op-ed piece titled: “PTSD, The Grand Scapegoat.” In it, Tarantolo described PTSD as a “pseudo-diagnosis” and held that “the PTSDer gets an enormous amount of pseudo-sympathy.” On Friday, Tarantolo’s voicemail message said he was out of the country on vacation.

To Afghanistan veteran Weidman, most people who so stridently dismiss PTSD have simply failed to read the available scientific literature on the subject and are, he said, “uneducated.”

But Weidman acknowledged that different people possess varying degrees of mental “resiliency,” underscoring the slippery nature of diagnosing anxiety disorders. That means, he added, that if an entire platoon collectively endures the same moment of extreme combat violence, not every platoon member will ultimately feel the symptoms of post-traumatic stress. According to the Mayo Clinic, those signs can include “flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.”

“There are people who can experience something who have no side effects. It could be that person (who ends up being a denier),” said Weidman, a student at Penn State-Lehigh Valley. “Or it could be the person who is extremely uneducated and chauvinistic, who says a guy who gets diagnosed with PTSD ‘is not being a man.’ You’re going to have a perfect storm within the individual who’s going to be that outlier, who says: ‘It doesn’t exist.’

“Or, it could be the person who actually has post-traumatic stress, who is not seeking help, who is more living up to society’s ideal male image of being strong and being resilient,” he added. “Those people going to make even more noise.”

Mental health experts say the occasional repudiation of PTSD is merely an extension of the larger societal taint associated with anxiety or mood disorders.

Click here for more military-related coverage from NBC News.

“It comes back down to the stigma of mental illness,” said Jean Teichroew, spokeswoman for the Anxiety and Depression Association of America. “Military members also are afraid to speak out because it’s seen as a weakness. The VA has programs to try to combat that, too. But when you have a sergeant who doesn’t think you should be afraid of a bomb going off near you or seeing a dead body, that’s another issue.”

Still, the rate of diagnosed PTSD cases among Iraq and Afghanistan veterans is higher than the rate of cases associated with men and women who served in past conflicts. That abrupt spike has sparked an ongoing debate within American and British academia as to how common PTSD truly is among military personnel and veterans.

“The suffering of people with PTSD is very real whether we label it an ‘anxiety disorder’ or not. As for the skeptics, some of them may believe that a proportion of veterans without the disorder may report symptoms to secure service-connected disability compensation payments for PTSD,” said Harvard University psychology professor Richard J. McNally. He has penned more then 320 publications on anxiety disorders, including PTSD.

“According to (Department of Veterans Affairs) data reported late last spring, 45 percent of all veterans from Iraq and Afghanistan have applied for service-connected disability compensation, and 31 percent have secured it already. This figure includes all forms of medical problems, however, not just PTSD," McNally said. "The percentage of veterans of World War II and Vietnam who obtained disability compensation is 11 percent and 16 percent, respectively.”

In 2011, the VA listed the three most common service-connected disabilities among veterans receiving federal compensation that year: tinnitus (ringing in the ears) at 10.9 percent, hearing loss at 7.5 percent, and PTSD at 5.3 percent.

Is PTSD being over-diagnosed in post-9/11 veterans?

“Yes. I think it is,” said Simon Wessely, vice dean of academic psychiatry at King’s College in London. “I think that despite the formal criteria, there is a confusion sometimes (about) the normal emotional responses to war — my father still has nightmares about his World War II service in Royal Navy and he is 87, but he doesn't have PTSD.

“I also think that, for example, depression often gets under diagnosed, and substance misuse also,” Wessely said. “Our evidence also shows, for example, that quite often the triggers for what becomes labeled as PTSD is not combat exposure but actually a reflection of problems back home. It is important that we remember that not every mental health problem in theater is PTSD."

Despite the loose diagnoses or cases of outright PTSD fraud, to those in medicine and the military (post and present) who deny PTSD altogether, Wessely offers three final words: “They are wrong.”

More content from NBCNews.com:

• Older vets to post-9/11 vets: 'We had it harder'
• Double amputee to potential congressional foes: 'Bring it'
• Vet injured in parade crash: I heard someone yelling 'train!'
• Panetta orders review of ethical standards amid misconduct allegations 
• Hearing loss the most prevalent injury among returning veterans
• Your 'thank you' to veterans is welcomed, but not always comfortably received

Follow US news from NBCNews.com on Twitter and Facebook

It began with an Army veteran’s exasperated affirmation and a purposely casual question, just 22 keystrokes.

Then, a gush of feelings, dammed up for years by the attached stigma, cascaded from Rob Ulrey’s mind through his fingers to his computer screen; 770 words, a personal purge, a plea for understanding: “I am tormented in my dreams ... I am functional in society ... I am medicated ... I am always on the lookout for danger ... I have no regrets ... I am just as normal as you."

His opening line: “I have PTSD ... So what?”

---

Last February, that post on Ulrey’s military website — penned partly to set “the media” straight, partly as an online life buoy for men and women like him — resonated with hundreds of current and former service members who posted comments to echo and empathize with the former Army gunner’s frustrations and fears. The reactions haven’t stopped coming: “I am living this with you,” wrote Mike R. on Aug. 27, and “Thanks for these words,” typed Greg H., also on Aug. 27. Talk of the column has spread far and wide among American military ranks. 

"The comments it got, and that it's getting, are really kind of inspiring. It seemed like it touched a lot of people. A lot of it was guys and girls who just seemed real lonely out there, real isolated," Ulrey told NBC News. "And they just seemed real relieved there was somebody out there like them."

Ulrey now looks at his essay as — if not the first embers of a true movement — maybe the early moments of a fundamental shift in the public discourse on Post Traumatic Stress Disorder, a series of anxiety-based symptoms afflicting up to an estimated 500,000 U.S. troops who have served in Iraq and Afghanistan. He wrote the article, he said, at roughly the same time he finally sought treatment, 15 years after an IED in Bosnia shattered his wrist, blew out his eardrums and began chronically haunting his slumber.

“It just came out of me, just kind of flowed from the heart,” Ulrey told NBC News. “I guess my higher calling is to make sure other veterans get this message, get the help they need. But If I can make people understand we’re not the big, evil demons that some people make us out to be, so much the better.”

Indeed, the piece was meant to be aimed largely at "mainstream" media outlets, Ulrey said. Amid a litany of news reports in recent years about young veterans committing violence or suicide, he winced at how often journalists swiftly linked the acts to PTSD. 

Related: New company offers franchises exclusively to ex-military
Related: VA struggling to calculate lost wages for wounded vets, GAO report shows
Related: VA won't cover costs of service dogs assigned for PTSD treatment
Related: President Obama orders VA to expand suicide prevention services

"I, along with my cohorts, have been classified as a potential powder keg just waiting on that spark to set us off into a murderous explosion of ire. This is not the case," Ulrey wrote in his post. 

That sort of breathless PTSD coverage has painted the diagnosis, and perhaps all combat veterans, with a social stain, Ulrey said. PTSD evokes concerned whispers from family members, worried glances from co-workers, and dead-ends at job interviews. 

"The stigma is so negative. I’ve heard time and time again from veterans: 'I’m not getting the looks (from companies) that I should be getting. I’m not getting that second interview.' I know some guys who are leaving stuff off their resumes or downplaying what they did during their time in the service so that it doesn’t trigger those kinds of questions (about mental health). 

"You’re automatically tainted just because of your service, even if you don’t have PTSD at all," Ulrey said. 

But it's not just corporate America that, in Ulrey's view, misunderstands PTSD. Even inside the military, the disorder, and certainlythe act of service members seeking help for it, is often viewed as a personal flaw, or as a lack of mental muscle, he added. 

"They’ve been suffering with it and they’ve been afraid to say anything about it, because they were afraid of the ramifications," Ulrey said. "In the military, if you need to go to mental health, then you’re weak. And we don’t have weak in the military. We’re warriors, we’re not supposed to feel this way. But it will take out the baddest dude or the littlest, wimpiest dude. It doesn’t discriminate."

At the top of the U.S. military pyramid, however, leaders say they are toiling to change that old thinking. 

"Seeking help is a sign of strength not weakness," said Cynthia O. Smith, a spokeswoman for the Defense Department. "No, military careers aren't at risk for seeking help." 

As proof, Smith e-mailed NBC News a memo, signed May 10 by Secretary of Defense Leon Panetta, that read: "Leaders throughout the chain of command must actively promote a constructive command climate that ... encourages individuals to reach out for help when needed."

And on the topic of Ulrey's matter-of-fact pitch for America to stop demonizing PTSD and those diagnosed with it, Smith said: "Mental health disorders, like most medical conditions, are treatable. Many service members with symptoms of PTSD recover with appropriate medication and/or psychotherapy within a few months."

Ulrey's medication includes prescribed blood-pressure drugs that prevent the flashback nightmares he once suffered. Those dreams used to wake him with a jolt four to five times a night and caused him to sweat so profusely that his sheets often were drenched by dawn. 

"I have never physically assaulted anyone out of anger or rage," he typed last February. "I have never committed violence in the workplace, just like the vast majority of those who suffer with me. My co-workers know I spent time in the military but they do not know of my daily struggles, and they won’t."

But like any good writer, Ulrey has picked up on the irony in his larger quest to convince the world to simply see soldiers and veterans as regular folks who are dealing with battlefield stress on their own terms. In his current job as a law enforcement officer — he asked to keep his city of residence out of this article to protect his family — Ulrey earlier this month faced a pointed question from his boss. 

"He saw the article and asked me: 'Do I need to know anything about this? Do I need to be worried?’ I said, ‘No not at all.' 

"It had been bugging him and, I guess, bugging the other supervisors I work with for a couple of months. That was the whole purpose of the article. So that people don’t get that question from co-workers or supervisors," Ulrey said. "Even if we have PTSD, we’re OK. I am not going to freak out on you."

More content from NBCNews.com:

• With 50 days to go, challenges for Romney and Obama
• Chicago mayor sues to end teachers strike
• Richer communities get more funds to clean up toxic brownfields
• Occupy protesters blast 'criminality' of Wall Street
• Video: New evidence could clear Army doc of 1970 slayings
• 19-year-old charged with shaking baby to death

Follow US News from NBCNews.com on Twitter and Facebook

 

The military has released a new mobile app designed for post-traumatic stress disorder patients in a therapy known as prolonged exposure.

PE Coach was developed by the Departments of Defense and Veterans Affairs and offers users a mobile way of assessing symptoms, recording therapy sessions, receiving reminders for homework and appointments and learning more about PTSD.

The app is available on Apple and Android devices, but is advised for use only when a patient is receiving professional prolonged exposure therapy.

---

That type of treatment focuses on "exposure practice," or approaching situations the patient has been avoiding because they seem unsafe or are related to the trauma that brought on PTSD. For veterans, this might include avoiding crowded public places or congested traffic. The treatment also involves revisiting the traumatic memory with a clinician in order to learn how to better handle the stressful feelings that it raises.

Part of the therapy, Dr. Greg Reger, a clinical psychologist at DOD's National Center for Telehealth and Technology, told NBC News, is recording each therapy session and listening to it daily in order to overcome fear around those situations. Traditionally, Reger said, patients would leave an appointment with CD recordings and several sheets of paper to help complete daily homework assignments that include confronting an anxiety-inducing scenario.

"Our patients don’t avoid (homework assignments) because they don’t want to get better," Reger said, "but any inconvenience provides an excuse not to do something even if it helps you get better."

Related: Combat to corporate: PTSD stigma blocks some veterans
Related: First opera about Iraq War reaches out to veterans suffering from PTSD

Patients, for example, might find it difficult to listen to the recording if the only CD player available to them is in a car. They might also feel self-conscious about taking notes in public after going into a crowded mall or driving through rush hour traffic, but PE Coach allows a patient to type descriptions directly into the phone. The app, Reger said, is a "dramatic shift" in how convenient it is to stick to daily therapy.

Since a quiet pre-release in March, the app has been downloaded more than 2,000 times. A separate DOD and VA app called PTSD Coach, which was designed for wide use, has been downloaded more than 66,000 times since last year.

Reger said the app would be used by many VA and DOD mental health clinicians who are trained in prolonged exposure therapy.

The ability of the app to capture the homework data, even time-stamping when a patient listened to the therapy recordings, helps clinicians monitor the success of the treatment in ways he or she couldn't do before, Reger said.

"We want to celebrate the response they’ve had because of their hard work." 

Rebecca Ruiz is a reporter at NBC News and a 2011-2012 Rosalynn Carter Mental Health Journalism Fellow. Follow her on Twitter here.

More content from NBCNews.com:

• Eagle Scouts return badges to protest ban on gays
• Woman charged with murder in husband's slaying outside Dunwoody day care
• Study: Dispersants in Gulf could damage marine food web
• Man in Batman theater scare blames misunderstanding
• Video: RV driver backs into neighbor's pool

Follow US News from NBCNews.com on Twitter and Facebook

 

Mental health disorders in active-duty troops increased 65 percent since 2000, according to a report released this week by the Armed Forces Health Surveillance Center.

The report looked at a 12-year period between 2000 and 2011 and found that more than 936,000 service members had been diagnosed with at least one mental disorder. Of those diagnoses, about 85 percent were cases of adjustment disorders, depression, alcohol abuse and anxiety, among other conditions.

---

Between 2003 and 2008, the rate of post-traumatic stress disorder (PTSD) increased nearly sixfold; by 2011, there were more than 100,000 diagnoses. The report, however, did not evaluate mental disorders in relationship to deployments.

 

Stay informed with the latest headlines; sign up for our newsletter

Previous studies have found a link between deployment and increased rates of PTSD. In a 2008 report, researchers found that Marines who had no pre-deployment mental disorder and served in Iraq and Afghanistan were likely to have lower rates of all types of mental disorders except PTSD when compared to Marines who had not deployed for combat. Other studies have shown greater rates of PTSD and anxiety disorders in service members who had deployed a second or third time.

Related: Mental health group says combat PTSD deserves Purple Heart

This week's analysis, published in the June 2012 Medical Surveillance Monthly Report, showed that nearly 70 percent of all mental health problems were related to "life circumstances," a category that includes deployment, bereavement and relationships. Over the 12-year period, rates of mental illness related to life circumstances remained stable until 2003 and peaked in 2005. The rates declined and then increased again in 2009.

Women, service members 20 and younger and healthcare workers were the most vulnerable groups, according to the report. Rates of some mental disorders among women were more than twice as high than for men; rates of mental illness for many diagnoses were highest among those 20 and younger; and healthcare workers had relatively high rates of mental illness, particularly for PTSD.

Related: Women in the infantry? Bad idea, female Marine officer says

The report, which was based on medical records of active-duty service members, said the rates of mental disorders and problems were likely "underestimates" if individuals didn't seek or receive care or were improperly diagnosed.

"These findings reinforce previous reports that have documented a rise in demand for mental health services in the active component force and suggest that continued focus on detection and treatment for mental health issues is warranted," the report said.

Rebecca Ruiz is a reporter at msnbc.com and a 2011-2012 Rosalynn Carter Mental Health Journalism Fellow. Follow her on Twitter here.

More content from msnbc.com and NBC News:

• Guantanamo detainee who served bin Laden returns to Sudan
• Citizen sues US after being wrongly flagged as deportable immigrant
• No charges for mother who abandoned severely disabled daughter at bar
• Drop the 'i' word? Debating the term 'illegal immigrant'
• Video: Teacher goes airborne on police pursuit

Federal prosecutors have charged 107 people, including doctors and nurses, in seven U.S. cities, accusing them of taking part in schemes to cheat the Medicare system out of $452 million through phony billing. Authorities are calling this the largest one-day takedown ever by the government’s Medicare fraud task force.

At a news conference Wednesday, Attorney General Eric Holder said they “underscore the Justice Department’s determination to move aggressively in bringing to justice those who would violate our laws and defraud the Medicare program for their personal gain.”

Read the original story at CNBC.com

The 107 health care professionals, also including social workers and owners of health care companies, charged Wednesday worked in Miami, Tampa, Chicago, Detroit, Houston, Los Angeles and Baton Rouge.

---

The arrests are the latest in a three-year crackdown on health care fraud, which is estimated to cost taxpayers between $80 and $160 billion per year. Authorities recovered a record $4.1 billion last year.

Government Announces Massive Crackdown on Medicare Fraud

The government has also suspended payments to the 52 provider organizations where the individuals worked. Health and Human Services Secretary Kathleen Sebelius said the operation, including the arrests and the cutoffs of payments, are part of an effort to preempt fraud instead of relying on what she called the old “pay and chase” model.

“Now, we’re analyzing patterns and trends and claims data, instead of just going claim by claim,” Sebelius said.

Still, court filings allege the defendants were able to carry out their schemes for years.

NY Judge Denies DSK Motion to Dismiss Maid's Civil Suit

In Baton Rouge, seven people who ran two community mental health centers are accused of submitting more than $225 million in false claims for mental health services in a scheme that began in 2005 and continued through October. This case alone is one of the biggest ever Medicare fraud cases.

Government officials say the defendants from Baton Rouge rounded up drug addicts, homeless people and the elderly and used them to submit false claims for treatment.

Foreign Corruption Crackdown

In Houston, owners of four private ambulance companies were accused of billing the system for non-existent or unnecessary runs.

In Miami, more than 50 professionals were charged with carrying out a $137 million scam involving mental health services and home health care.

5 Things You Should Know Before and After Investing

Other cases involved fraudulent billing for ambulance services, durable medical equipment, psychotherapy and prescription drugs.

Pete Williams, NBC News’ justice correspondent, contributed to this report.  Follow Scott Cohn on Twitter.

More content from msnbc.com and NBC News:

• George Zimmerman's old Myspace page includes slurs against Mexicans
• Chicago pays $45 million in 3 years to settle complaints against cops
• Maryland court finds pit bulls are 'inherently dangerous'
• Video: Obama describes raid that killed bin Laden
• NJ mom arrested after allegedly taking daughter, 5, tanning

Follow US News on msnbc.com on Twitter and Facebook

Chicago’s Cook County Jail, a harsh holding cell stuffed with up to 11,000 prisoners at any given time, is about to become even more crowded, according to The Chicago News Cooperative.

Tom Dart, The Cook County Sheriff, told The Chicago News Cooperative on Monday that of those 11,000 prisoners, about 2,000 have some form of serious mental illness. But he fears the situation could get much worse: Chicago has plans to shutter half of its 12 city-run mental health centers by the end of April in a bid to save $2 million, and that could leave many mentally ill patients without the treatment they need.

---

“It will definitely have a negative impact on jail populations,” Dart told The Chicago News Cooperative. “It will have direct consequences for us in my general jail population and some of the problems I have here, because a lot of the people with these issues act out more, as you would expect, so that’s a direct consequence.”

Without resources to treat them, those with mental health issues are more likely to have run-ins with the police, reported The Chicago News Cooperative.

Related: For mentally ill inmates, care behind bars can be lacking

“It’s going to increase the number of calls they get,” Amy Watson, associate professor at the Jane Addams College of Social Work at the University of Illinois, Chicago, said of the Chicago Police Department, “because it is the only place left to call.”

It costs about $143 per day to house a typical detainee at Cook County Jail, the media organization reported. To house a detainee with mental health issues costs two to three times as much, the sheriff said.

More content from msnbc.com and NBC News

• Making a Difference: Kids fishing for (and catching) success
• Rev. Graham: Obama seen as 'son of Islam'
• Lawmaker: 'Radical' Girl Scouts out to destroy American values
• Where do problem teachers go? LA's 'rubber room'