Like soldiers, civilian contractors often suffer the effects of post-traumatic stress disorder, or PTSD, leaving them prone to depression, thoughts of suicide and erratic behavior. Unlike soldiers, however, who can access resources through the military and the Department of Veterans Affairs, companies typically provide contractors little in the way of counseling on the ground or treatment once they return home.
"There are thousands of guys coming home untreated," said Paul Brand, a psychologist who consults for DynCorp, one of the few companies that offer post-traumatic stress screening and in-country counseling to its employees. "These are private businesses out to make a profit. Most companies make money by not putting systems in place to take care of their employees' mental health… Frankly, it is a travesty that not enough has been done to give contractors the support they need."
Psychologists who treat contractors say the lack of immediate resources for employees in Iraq augment the effects of post-traumatic stress disorder and can lead to erratic and dangerous behavior.
"PTSD if treated right away can be staved off," said Robert Brizendine, a psychologist who has treated many contractors returning to California from Iraq.
"The problem is two-fold in many cases. There is the manifestation of a brain injury and secondary emotional problems. Frontal lobe injuries, caused by small head injuries just from getting bounced around the way these guys do regularly can lead to real impulse problems – the sort where people go out and kill people."
Brizendine said he had treated patients who described wanting to kill themselves or other people.
The VA estimates that 34 percent of soldiers suffer from post-traumatic stress. A DynCorp study found that 24 percent of contractors reported having symptoms, a number the company's psychologist, Paul Brand, said was probably low due to people too embarrassed to report conditions honestly.
Some 125,000 American and international contractors are working in Iraq.
In its report, Congress said Blackwater charges the government $1,222 each day for a single security contractor, which according to the Associated Press, works out to $445,000 on an annual basis -- more than six times the cost of a U.S. soldier. A Blackwater contractor can make more than $100,000 a year.
Former contractors told ABCNEWS.com that they were sent to Iraq with little more than two weeks training. They said pleas for help in Iraq often went ignored and since returning home they have had a difficult time getting employers and insurance companies to pay for the attention they need.
"There was no one around. There were no psychological services," said Monty Finch, who early in 2006 drove trucks for KBR Halliburton in Anbar province.
Finch said he became increasingly anxious after routinely running into a bomb shelter at night when insurgents would shell his camp, and after the truck in front of him on a convoy was struck by an improvised explosive device.
"Every second of every minute I had the feeling that my number was up. I went to a supervisor and said, 'Things are getting pretty crazy. I can't sleep.' He told me everyone felt the same way and I should get over it."
Finch said he could see the stress taking its toll on other contractors. Some, he said, stopped wearing their body armor.