Marine Sgt. Thomas R. Bagosy returned from a combat tour in Afghanistan in November 2009 suffering from a severe case of post-traumatic stress disorder. Six months later, when officials at Camp Lejeune, N.C., tried to hospitalize him for treatment, Bagosy shot himself in the head during a standoff with military police.

The White House this week reversed its policy against extending official condolences to the families of military personnel who kill themselves, but the change applies only to those who commit suicide in officially designated combat zones.

In cases such as the one involving Bagosy, 25, who died in the United States but after clear indication of mental disorder related to his war experiences, survivors still will be left without the comfort of a presidential letter.

“I’m angry at this — I really am,” Bagosy’s father, Robert, who also served in the Marine Corps, said Thursday. “Honestly, this is like a slap in the face. A condolence letter means a lot. It’s not going to bring my son back, but it matters.”

The previous White House policy, inherited from past administrations, was to send presidential letters of condolence to families of service members who die in combat zones, with a “specific exemption for suicide,” said Tommy Vietor, a spokesman for the National Security Council. “The key point here is we have put suicide on equal footing with other deaths.”

Presidential condolence letters are not routine when members of the military die away from war zones, no matter the cause. The policy review, officials said, was focused only on how to handle suicides that occurred in war zones.

The military has long struggled with how to handle suicide. Although Adm. Mike Mullen, chairman of the Joint Chiefs of Staff, has supported changing the White House policy to extend condolences in cases of suicide, some in the military have been opposed, in part because of worries that it might lead to more suicides.

In a statement announcing the policy change on Wednesday, President Obama said: “This decision was made after a difficult and exhaustive review of the former policy, and I did not make it lightly. This issue is emotional, painful, and complicated, but these Americans served our nation bravely. They didn’t die because they were weak.”

About two-thirds of military suicides take place outside combat zones, and many of these suicides are related to PTSD or other combat-related stresses. Advocates for military families argue that the treatment of the next of kin should not depend on where the suicide occurred.

“It doesn’t matter how they died, it’s how they lived and how they served,” said Kim Ruocco, national director of suicide education and outreach for Tragedy Assistance Program for Survivors, an organization providing support for military families. “This is a common story; why does it matter where he died?”

Her husband, Maj. John Ruocco, a Marine Cobra helicopter pilot who flew 75 combat missions during a deployment to Iraq, killed himself in 2005, three months after returning home to Camp Pendleton, Calif. “He came back from war and was completely different,” she said.

John Ruocco was depressed and feeling no longer valuable to his Marines or his family, including two young sons, she said.

“He gave until he had nothing left,” Kim Ruocco said. “He never asked for help for fear of the repercussions.”

While applauding the White House policy change as an important step for removing the stigma associated with suicide, the survivors’ advocacy group is pressing for presidential condolence letters to be sent to the next of kin of all service members who die while serving honorably, including in stateside military training accidents or by suicide outside of combat zones.

“With only select families receiving presidential condolence letters, a line is drawn between the value of the life and service of someone who dies on foreign soil and someone who dies in the exact same manner, whether injury, illness or suicide, here at home,” the group said in a statement. “For families, that does not go unnoticed and is often hurtful.”

In a posting Wednesday on the White House blog, Gen. Peter Chiarelli, who commanded the 1st Cavalry Division in Iraq in 2004 and 2005, recalled that he lost 169 soldiers during the division’s year-long deployment. But the monument erected at Fort Hood, Tex., lists 168 names.

“I approved the request of others not to include the name of the one Soldier who committed suicide,” wrote Chiarelli, now the Army’s vice chief of staff. He said that the decision to omit the soldier’s name is “the greatest regret of my military career.”

Chiarelli commended the White House decision to include letters to families of suicide victims. “Any attempt to characterize these individuals as somehow weaker than others is simply misguided,” he said.

Letters also do not go out to service members killed in training accidents in the United States.

“It’s one of those things — you want your child remembered,” said Sara Conkling, whose daughter, Marine Capt. Jessica Conkling, died when the Cobra helicopter she was piloting crashed outside San Diego in 2009. “If not, it hurts a lot.”

“This is your commander-in-chief saying that their death meant something,” said Mary Gallagher, whose husband, Marine Gunnery Sgt. Jim Gallagher, hung himself at Camp Pendleton in 2006, eight months after returning from Iraq. “Those few simple words that their life meant something.”