NATO combat operations in Afghanistan are expected to draw to a close by the middle of next year and the U.S. completed its withdrawal of troops from Iraq last December. But while fewer American soldiers are in the line of fire each day, new Pentagon statistics show that an average of one military suicide occurred each day in the first six months of 2012, the fastest pace in the past ten years.

The statistics reported by The Associated Press show that military deaths from suicide outweighed combat deaths by a two-to-one ratio, a dramatic uptick since 2010 and 2011 when military suicides decreased from previous years. See the chart below:

The 154 suicides for active duty troops in the first 155 days of 2012 raises serious questions about why military suicide rates have surged in the first half of 2012. Studies conducted by the Defense Department suggest that soldiers with multiple combat tours are more likely to commit suicide and other studies have found that combat exposure, post-traumatic stress, misuse of prescription medications and personal financial problems can all contribute to military suicides.

A report released last year [PDF] by the Center for a New American Security (CNAS) found that while the military and the Veterans Authority have taken admirable steps to improve suicide prevention and mental health counseling services but serious obstacles remain. They include:

Frequent personnel transfers complicate efforts to provide consistent mental health services.

Personnel transfers occuring quickly after return from deployments hampers efforts to identify mental health conditions in the post-deployment period.

Commanders are not always aware when subordinates are the subject investigation, an event which is sometimes a suicide trigger.

Soldiers are sometimes encouraged to provide untruthful answers in post-deployment mental health screening questionnaires.

A cultural stigma against mental health care persists in the armed forces.

Last month, Secretary of Defense Leon Panetta sent an internal memo to the Pentagon’s top civilian and military leaders addressing the stigma associated with seeking helping for mental distress in the military.

“We must continue to fight to eliminate the stigma from those with post-traumatic stress and other mental health issues,” Panetta wrote, adding that commanders “cannot tolerate any actions that belittle, haze, humiliate or ostracize any individual, especially those who require or are responsibly seeking professional services.”

More than one in five women veterans of the United States armed forces faced some sort of sexual assault during their service. When including calculations of unreported assaults based on Defense Department estimates, some half a million women service members have suffered at the hands of an assailant; nearly 100,000 women were assaulted just since 2006. Yet blaming the victim combines with frequent cover-ups and a self-contained justice system to prevent widespread accountability for alleged offenders.

A new award-winning documentary opening this month sheds light on the issue of rape in the military, and it’s already had an impact on policy — though not enough to satisfy the filmmakers. “There’s not enough deterrent right now in the military,” said Amy Ziering, who produced “The Invisible War,” at a screening at the Netroots Nation 2012 conference. “Once that gets in order, we’re confident things will change.”

The film followed more than a dozen female and male veterans who’d faced sexual assault, vividly airing the toll it has taken — struggles with post-traumatic stress, the ill-effects on their loved ones, and the tremendous impact that the betrayal of their trust had on their own lives, often incurring suicidal feelings and attempts. Some of survivors banded together to file a lawsuit, but that case was dismissed, the documentary reported, on the grounds that the service members cannot sue the military for grievances that are considered “incident” to military service. Rape, it seems, was one such occupational hazard.

Watch a trailer for the movie:

The victims of these rampant sexual assaults have little recourse outside their own chain-of-command, where commanding officers often personally know the assailant. That’s why Ziering stressed in her comments that commanders need to be held accountable, holding up the example of the Catholic church, where action against child abuse only came after bishops’ responsibility became an area of focus. Defense Secretary Leon Panetta viewed “The Invisible War” in April and two days later shifted the discretion for pursuing investigations higher up the chain-of-command in order to distance those determinations from the immediate commanders of accusers and accused alike. (Other steps have since been taken, too.)

Even when complaints are brought up the chain-of-command, there’s little chance alleged assailants face justice. Only a handful of reported cases — already likely a small portion of total assaults — ever reach the prosecution stage in the military justice system, known as a court-martial. Only a fraction of those — less than 200 — have resulted in incarceration for assailants.

At the Netroots screening, Ziering stressed that her film is not anti-military. “I talked to over 70 survivors, and every single one of them said, ‘I don’t want participate in this if it’s anti-military,’” she said. They “want a stronger military,” she added.

Ziering noted that the military was forward-looking in terms of civil rights and integration: “The military is brillitant at changing things.” She hoped this same attitude would take hold with rape and sexual assault, both a “moral” and “national security issue,” because qualified women could be discouraged from serving in the armed forces. The film-makers, responding to reaction to the film, set up a site for activism on the issue at NotInvisilbe.org.

“Everyone needs to see this film,” said a woman in the audience at Netroots who identified herself as a veteran and among the first class of women graduates from West Point. “This can change. If we care about it and make noise about it, this can change.”