Tami Mielke's decision to end her life raises serious questions about South Dakota's care of its emotionally wounded warriors.

A gunshot June 24 at Mielke's rural Sioux Falls acreage silenced the demons that came back from Iraq with the 50-year-old former Air National Guardsman. But it hasn't quieted concerns about the way the Guard helped and supported her after she returned — or any other members who struggle with their war experiences.

And there have been others.

Since the Sept. 11, 2001, attacks on America, 12 South Dakota Army National Guardsmen and one airman have died by suicide, including three who took their lives this year. None of those include Tami Mielke, who was retired by the time she ended her life.

Though just six of those 13 guardsmen had deployed to Iraq or Afghanistan, "Suicides are a problem in the Guard nationally, and we're a cross section of that," said Maj. Gen. Tim Reisch, head of the South Dakota National Guard. "We acknowledge that it's a problem here."

So what are they doing about it, and is it working? In a country where Army Guard and Reserve suicides last year outnumbered active-duty soldier suicides 152 to 151, such questions are not easily answered.

Mielke rose through the ranks of the state's Air National Guard over 28 years. She was considered a potential candidate to become the organization's first female general.

But the horrors of Iraq from her 2010 deployment troubled her the rest of her days. She did become South Dakota's first female Air Guard group commander. But her erratic and, at times, unprofessional behavior — caused by PTSD, friends and family say — cost her that command.

After her suicide, Gov. Dennis Daugaard instructed Reisch to assess the unit climate at the 114th Fighter Wing in Sioux Falls, specifically the treatment of members with deployment-related behavioral health diagnoses, and how those diagnoses are affecting member's careers.

The adjutant general said he heard accusations that the climate and leadership at the base "was poor." He sent a base chaplain and a noncommissioned officer into the ranks to check it out. "None of that was substantiated," Reisch said.

He also noted that the regular Air Force sent 50 to 60 inspectors to Sioux Falls in June to interview about 100 base members at random, asking them in one-on-one conversations about such things as unit climate and morale.

What he heard afterward was positive, Reisch said. But the adjutant general couldn't answer how many of the 100 interviewed had actually been been to Iraq or Afghanistan. "I am confident that many airmen who have been deployed would have been among that number," he said.

He didn't know the specific questions asked of them, either.

Mielke's husband, Steve, said Air Force inspectors did their assessment before his wife's death, and before the suicide of an Air Guard member later this summer. Retired after a long career in the Air Guard himself, he believes he understands how reticent airmen can be to share their true thoughts.

"They're afraid for their jobs," he said. "They're not going to talk to the chaplain or the command chief ... on the record about how things really are."

War was the leading cause of death in the military nearly every year between 2004 and 2011 until suicides became the top means of dying for troops in 2012 and 2013, according to a bar chart published this week in a monthly Pentagon medical statistical analysis journal.

For those last two years, suicide outranked war, cancer, heart disease, homicide, transportation accidents and other causes as the leading killer, accounting for about three in 10 military deaths each of those two years.

Transportation accidents, by a small margin, was the leading cause of military deaths in 2008, slightly more than combat.

The fighting in Iraq and Afghanistan accounted for anywhere from one out of three deaths in the military — in 2005 and 2010 — to more than 46 percent of deaths in 2007, during the height of the Iraq surge, according to the chart.

More than 6,800 troops have died in Iraq and Afghanistan since 9/11 and more than 3,000 additional service members have taken their lives in that same time, according to Pentagon data.

ST. PETERSBURG, Fla. — Sitting and sobbing outside the hotel room where her Marine husband had just hanged himself, Kim Ruocco said she was horrified to find that nearly everyone who responded to the scene somehow managed to make her feel worse.

First she asked the hotel manager where her husband was staying, and he wordlessly backed into another room, shutting the door to avoid her. A trauma specialist told her to lie to her children about what had happened.

And then there was the priest.

Addressing the newly widowed woman, just steps away from her Catholic husband’s body, he said, “You know what Catholics believe about suicide? It’s a sin.”

“I said, ‘Are you telling me that I should tell my kids that their dad is not only dead, but that he’s also in hell?’” she recalled. “And he just looked at me.”

That experience in 2005 started Ruocco on what has become a full-time mission to help fellow survivors cope, heal and thrive. That often starts with an annual seminar for and by those who have lost troops and veterans to suicide.

Her journey culminated in the creation of the National Military Suicide Survivor Seminar, which recently convened in St. Petersburg, Fla. The program is organized by the Tragedy Assistance Program for Survivors (TAPS), a non-profit group that provides assistance to loved ones of fallen troops. This year’s event drew roughly 650 survivors from around the country, all of whom lost a servicemember to suicide.

Amid the devastating personal stories at the seminar – Ruocco’s is sadly representative -- perhaps the most striking element of the gathering was the laughter, which filled the palm-lined veranda of the beachside resort where it was held. Old friends met and caught up, and seminar veterans welcomed newbies with smiles and warm embraces. Many wore buttons that read “I’m a hugger.”

There are, of course, plenty of tears at the three-day get-together, and especially in private grief sessions where participants share their sadness and deepest fears. Emotions are raw, and often bubble to the surface, with survivors sometimes breaking down even as they check in. Organizers spend several days training hotel staff on what to expect and how to be sensitive to survivors struggling with their emotions in public. But equally, there are waterslides and s’mores and music and art. Child survivors splash in the gulf while their parents learn to write songs or create collages. At heart, the seminar is meant to be a celebration – of the lives of loved ones lost and survivors – and that is a good thing, said Frank Campbell, a social worker and nationally recognized suicide expert, who spoke at the conference.

“If all you do is come together to grieve, that’s a funeral service,” he said.

Last week, the Pentagon announced the death of the first American serviceman in the war against ISIS. Marine Lance Cpl. Sean Neal was killed in what was described as a “non-combat incident” in Iraq, making him the first American to die in “Operation Inherent Resolve” – America’s latest military excursion into that country.

Cpl. Neal was only 19 years old. He would have only been eight at the outset of the U.S. invasion of Iraq, and merely six on 9/11 – a child at the time of both these events. The fact that he ended up losing his life in Iraq is on one hand tragic, and on the other completely absurd.

The tragedy here is that a young man with a long future ahead of him ended up dying in a distant country before even reaching the age of twenty. The absurdity is that men such as him are still losing their lives as a result of still-inexplicable decisions made over a decade ago. The Iraq War never ended, but now it’s being fought by men who were just children when it started. Walter Lippman once said, “I don’t think old men ought to promote wars for young men to fight.” In our time, old men have been promoting wars that kids would ultimately end up fighting.

This is not just the case on the American side. Most of the Iraqis who have joined up with the utopian nihilists of Islamic State are themselves young men whose upbringing occurred against the backdrop of the American occupation of their country. They grew up watching their fathers and brothers being rounded up and detained by foreign soldiers, and bore witness as their once-stable country violently went to pieces around them. As shocking as the actions of IS have been, it’s not hard to imagine why so many people who grew up in such brutal circumstances might find a movement such as this attractive.

And again, behind their inglorious martyrdoms, are the machinations of former-Baath Party officials who once organized young Iraqis to die for the cause Arab Nationalism and who now do the same for religious extremism. The cause may be different, but in many ways the results are the same.

In this context it is stunning to remember the statements of those who assured us over a decade ago that the war in Iraq would take “weeks rather than months” to bring to its completion. The more cautious and conservative among them gave us an absolute maximum estimate of “five months” before we could go back to normalcy, and start watching America-friendly democracies begin to bloom across the Middle East. If this prediction had been in any way honest or correct, Cpl. Sean Neal may have been sitting in a college classroom today rather than lying in a flag-draped coffin on a military flight back home. Alas, it wasn’t.

One thing is certain however: Neal won’t be the last. Current and former American military officials are already preparing the public for a new conflict in Iraq – with scarcely suppressed and genuinely creepy elation – that they say will be “generational” and will take decades to bring to its completion. If recent history is any guide, their prediction of decades-long conflict means we should actually be preparing ourselves for a war which is going to last perhaps for a century. That’s not derisive rhetoric; history actually seems to be pointing in just that direction.