The U.S. Army is administering a mental health and fitness test to soldiers that civil rights groups say unconstitutionally requires active-duty soldiers to believe in "God" or a "higher power" in order to rank as "spiritually fit" enough to serve in the military. The Comprehensive Soldier Fitness (CSF) initiative, first used in 2009, is a "holistic fitness program" used to help reduce the number of suicides and post-traumatic stress disorder (PTSD) cases among military enlistees. Suicides and PTSD cases among troops have reached epidemic proportions in the last year as a result of multiple deployments to Afghanistan and Iraq, and the poor quality of care soldiers get when they come home. The CSF test utilizes a "Soldier Fitness Tracker and Global Assessment Tool" that measures soldiers' emotional, physical, family, social and spiritual "resilience." Soldiers fill out a 100-plus question survey, and if poor results put them in the red zone in any area, they must take remedial courses in the discipline in which they received the low score. Over 800,000 soldiers have taken the test so far, and more than 100,000 of them have gotten remedial training. Non-religious soldiers say the test's spiritual component asks questions written predominantly for soldiers who believe in God, leading atheists and other non-believers to score poorly and be forced to take remedial courses which employ religious imagery to "train" troops up to a satisfactory level of spirituality.