The Mental Health Advisory Team (MHAT) IV was established by the Office of the U.S. Army Surgeon General at the request of the Commanding General, Multi-National Force-Iraq (MNF-I). The mission of MHAT IV was to (a) assess Soldier and Marine mental health and wellbeing, (b) examine the delivery of behavioral health care in Operation Iraqi Freedom (OIF), and (c) provide recommendations for sustainment and improvement to command. Part of the MHAT IV mission was to review the status of the theater's suicide prevention and surveillance programs, including an analysis of completed suicides. The MHAT IV assessed the mental health of the deployed force from August 28, 2006 to October 3, 2006. Recommendations are based on findings from anonymous Soldier (N = 1,320) and Marine (N = 447) surveys, and on behavioral health, primary care, and unit ministry team surveys; focus group interviews with Soldiers and Marines, as well as interviews and focus groups with Army and Navy behavioral health personnel; various secondary sources; and personal observations by team members.