Cost of War: DOD has spent $100 million to address issue of military suicide but is it working?
By: Paul Gattis
Alabama Media Group / Huntsville Times
November 10, 2013 at 9:30 AM
By: Paul Gattis
Alabama Media Group / Huntsville Times
November 10, 2013 at 9:30 AM
Maybe 2013 is the start of a new trend. Maybe, when it comes to troops in the U.S. Army committing suicide, maybe the number is beginning to dwindle.
Maybe.
The cold statistics indicate a slight decrease over the record year of 2012 when 325 troops (both active and non-active) either took their own lives or their deaths are under investigation as a possible suicide.
Through Sept. 30, the suicide rate this year is not keeping pace with 2012. According to the Army, there have been 227 potential suicides among active duty and non-active duty troops. At the same time period last year, there were 247.
A slight downturn, however, does not define a problem solved.
"With the combat deployments, it certainly appeared that suicidal idealizations and suicidal behavior increased," said Dr. David Ferguson, chief of the psychology department at Fox Army Hospital at Redstone Arsenal. "It's really difficult to separate out the statistics and to make comparisons when there is a constantly changing military.
"But it has been alarming, the numbers that have been reported in the recent past."
Each September, the U.S. Department of Defense joins with the rest of the nation to observe Suicide Prevention Month.
"The Department of Defense has no more important responsibility than supporting and protecting those who defend our country and that means we must do everything possible to prevent military suicide," Secretary of Defense Chuck Hagel said in a September press release announcing the observance of Suicide Prevention Month.
Hagel went on to say the DOD has spent more than $100 million on research and prevention of mental health issues - "all of which can be associated with suicide."
For those in uniform, the issue of suicide has achieved a level of prominence. Now that the problem has been identified, the question remains how best to resolve it.
Help is available
In the Army, help is available. You can get it on the phone, on the Internet or in person. But as that $100 million has been spent military-wide to, in part, fund various programs to aid those in uniform, it's unclear whether it's working.
It's too soon to know if for all the effort, the suicide numbers will be in full retreat.
Bill Koch wishes he knew. As director of workforce development for Still Serving Veterans - a Huntsville-based non-profit organization designed to help military personnel transitioning out of the service - he's eager for evidence that the suicide trend is in decline.
He also has two sons who have served in combat.
"When you hear about these guys and gals committing suicide, it's really frustrating," Koch said. "We take it personally. We want to help everybody. The real question is, what's the answer? And I don't know if anybody has an answer for it."
Of course, there is no single answer for stopping suicides, just as there is no single reason for committing suicide.
Ferguson has been working with the Army since 1986 and while acknowledging the help was once inadequate, massive improvements have been made in recent years. Army personnel go through constant training on the issue of suicide - the signs to look for, the places to seek help.
One new technique, Ferguson said, is the embedding of a behavioral health expert in a unit deployed overseas. Those experts have also been placed in standard medical centers, allowing troops to get attention for mental issues in the same place as physical issues.
"That in itself is opening the door for others who never would have set foot in our clinic," he said.
It's an approach attempting to strike at the heart of perhaps the greatest obstacle in the prevention of military suicide - the stigma of asking for help.
Koch provides a poignant perspective on the paradox of carrying a gun and asking for help. He even used himself as an example, saying he waited 15 years after exiting the Marines before he applied for disability pay.
Can soldiers or sailors ask for mental health help?
"To me, it's ironic because the military spends so much time brainwashing the youngsters into thinking they're tougher than nails," he said. "So if you've got that mentality that you're tougher than nails and then somebody tells you it's OK to ask for help, you think 'I'm OK, I'm tougher than nails.' You have this ego thing happening.
"But to send young men and women off to combat, you have to give them that mentality. Otherwise, you've got a bunch of cowards in uniform. We don't want that. How do you balance that? You're Superman, go in and take out the enemy. And oh by the way, if you're feeling bad, come talk to somebody. I can't even reconcile that in my head and I don't have issues."
View full sizeMike Little (submitted photo)
Mike Little would agree. He's a petty officer 2nd class in the Naval Reserves who has served tours of duty in Iraq and Afghanistan. An Illinois native, he's an unwitting expert on the issue of military suicide. He said eight friends who were in the service have killed themselves since 2007 as well as a parent of a friend who was in the service.
"If you really want to look and see how to change the stigma, you need to get rid of the stigma," Little said. "To do that, you can't just tell a guy who has been in the Navy for 30 years, hey, you are no longer going to think it's bad to have mental health problems."
It must start when a man or woman puts on the uniform for the first time, Little said. The stigma must never exist in the first place.
Ferguson, the Redstone Arsenal psychologist, acknowledged that the negative connotation of seeking help is frequently a generational issue and one that the Army is attempting to stamp out.
"A lot of progress has been made with that," he said. "The military leadership has modeled seeking help and has encouraged people to get help. That norm, it's still there and when you've got a career field that has people in it that goes back 30 years, you've got some of the old norm that's very much in place.
"But the newer leadership and the mental health leadership in particular is doing away with that stigma and is encouraging people to get help and say there's not going to be any penalty. A lot of progress has been made in it."
In his statement on Suicide Prevention Month in September, Hagel spoke directly to the stigma sometimes attached to those who ask for help.
"Seeking behavioral health care is a choice that embodies moral courage, honor and integrity," Hagel said. "Those values are at the foundation of what we stand for and what we defend."
According to Koch and Little, that's not necessarily reality.
'No one wants to be labeled crazy'
"Nobody wants to talk to a doctor - no one wants to be labeled crazy," said Little, who said he has considered suicide himself, "but people want to talk to their brothers and sisters."
Both Koch and Little said peer groups are more likely avenues for a military person to share their mental struggles than speaking to a health professional.
"To me, the best solution is the battle buddy program," Koch said. "If I've got a very close friend, if I've got a battle buddy, I'm more apt to open up to my battle buddy than anybody else. I'm going to let him know what's going on in my head. I depend on him and he depends on me.
"If they strengthened the battle buddy program, they talk about it, and when they're training for combat, they have battle buddies. But they need to take that program a step farther. That needs to be a buddy for life, or at least a while. If I've got somebody I'm accountable to, I'm a whole lot less likely to think about committing suicide than if I'm not accountable to anybody."
Little pushed Vet to Vet, a peer counseling organization that is administered by veterans who have received mental health treatment from the Veterans Administration. When the Vet to Vet program recently came to the Coast Guard base in Buffalo, N.Y., where Little is now living, he said 35 people immediately signed up.
"I asked them why signed up and they said this is more personal," said Little, a veterans liaison for New York state Sen. Mark Grisanti. "These are people who understand what I've been through."
The pathways to help, in theory, are abundant and that's by design. But as the crisis of military suicide continues, the most effective pathways are still under evaluation.
Ferguson has seen attitudes change about mental health in his 27 years working with the Army and while questions still remain, he's found one certainty.
"What would it have been like if the military had not increased the amount of mental health providers and if there was still a real serious stigma about getting help?" Ferguson said. "What would the numbers have been? My guess is they would have been quite a bit higher.
"I think it's making a difference but it's really hard to measure."
To get help
National suicide-prevention hotline: 1-800-273-8255
Army suicide prevention: www.armyg1.army.mil/hr/suicide
Department of Veterans Affairs suicide-prevention website
For families who have lost a loved one in uniform to suicide
Maybe.
The cold statistics indicate a slight decrease over the record year of 2012 when 325 troops (both active and non-active) either took their own lives or their deaths are under investigation as a possible suicide.
Through Sept. 30, the suicide rate this year is not keeping pace with 2012. According to the Army, there have been 227 potential suicides among active duty and non-active duty troops. At the same time period last year, there were 247.
A slight downturn, however, does not define a problem solved.
"With the combat deployments, it certainly appeared that suicidal idealizations and suicidal behavior increased," said Dr. David Ferguson, chief of the psychology department at Fox Army Hospital at Redstone Arsenal. "It's really difficult to separate out the statistics and to make comparisons when there is a constantly changing military.
"But it has been alarming, the numbers that have been reported in the recent past."
Each September, the U.S. Department of Defense joins with the rest of the nation to observe Suicide Prevention Month.
"The Department of Defense has no more important responsibility than supporting and protecting those who defend our country and that means we must do everything possible to prevent military suicide," Secretary of Defense Chuck Hagel said in a September press release announcing the observance of Suicide Prevention Month.
Hagel went on to say the DOD has spent more than $100 million on research and prevention of mental health issues - "all of which can be associated with suicide."
For those in uniform, the issue of suicide has achieved a level of prominence. Now that the problem has been identified, the question remains how best to resolve it.
Help is available
In the Army, help is available. You can get it on the phone, on the Internet or in person. But as that $100 million has been spent military-wide to, in part, fund various programs to aid those in uniform, it's unclear whether it's working.
It's too soon to know if for all the effort, the suicide numbers will be in full retreat.
Bill Koch wishes he knew. As director of workforce development for Still Serving Veterans - a Huntsville-based non-profit organization designed to help military personnel transitioning out of the service - he's eager for evidence that the suicide trend is in decline.
He also has two sons who have served in combat.
"When you hear about these guys and gals committing suicide, it's really frustrating," Koch said. "We take it personally. We want to help everybody. The real question is, what's the answer? And I don't know if anybody has an answer for it."
Of course, there is no single answer for stopping suicides, just as there is no single reason for committing suicide.
Ferguson has been working with the Army since 1986 and while acknowledging the help was once inadequate, massive improvements have been made in recent years. Army personnel go through constant training on the issue of suicide - the signs to look for, the places to seek help.
One new technique, Ferguson said, is the embedding of a behavioral health expert in a unit deployed overseas. Those experts have also been placed in standard medical centers, allowing troops to get attention for mental issues in the same place as physical issues.
"That in itself is opening the door for others who never would have set foot in our clinic," he said.
It's an approach attempting to strike at the heart of perhaps the greatest obstacle in the prevention of military suicide - the stigma of asking for help.
Koch provides a poignant perspective on the paradox of carrying a gun and asking for help. He even used himself as an example, saying he waited 15 years after exiting the Marines before he applied for disability pay.
Can soldiers or sailors ask for mental health help?
"To me, it's ironic because the military spends so much time brainwashing the youngsters into thinking they're tougher than nails," he said. "So if you've got that mentality that you're tougher than nails and then somebody tells you it's OK to ask for help, you think 'I'm OK, I'm tougher than nails.' You have this ego thing happening.
"But to send young men and women off to combat, you have to give them that mentality. Otherwise, you've got a bunch of cowards in uniform. We don't want that. How do you balance that? You're Superman, go in and take out the enemy. And oh by the way, if you're feeling bad, come talk to somebody. I can't even reconcile that in my head and I don't have issues."
View full sizeMike Little (submitted photo)
Mike Little would agree. He's a petty officer 2nd class in the Naval Reserves who has served tours of duty in Iraq and Afghanistan. An Illinois native, he's an unwitting expert on the issue of military suicide. He said eight friends who were in the service have killed themselves since 2007 as well as a parent of a friend who was in the service.
"If you really want to look and see how to change the stigma, you need to get rid of the stigma," Little said. "To do that, you can't just tell a guy who has been in the Navy for 30 years, hey, you are no longer going to think it's bad to have mental health problems."
It must start when a man or woman puts on the uniform for the first time, Little said. The stigma must never exist in the first place.
Ferguson, the Redstone Arsenal psychologist, acknowledged that the negative connotation of seeking help is frequently a generational issue and one that the Army is attempting to stamp out.
"A lot of progress has been made with that," he said. "The military leadership has modeled seeking help and has encouraged people to get help. That norm, it's still there and when you've got a career field that has people in it that goes back 30 years, you've got some of the old norm that's very much in place.
"But the newer leadership and the mental health leadership in particular is doing away with that stigma and is encouraging people to get help and say there's not going to be any penalty. A lot of progress has been made in it."
In his statement on Suicide Prevention Month in September, Hagel spoke directly to the stigma sometimes attached to those who ask for help.
"Seeking behavioral health care is a choice that embodies moral courage, honor and integrity," Hagel said. "Those values are at the foundation of what we stand for and what we defend."
According to Koch and Little, that's not necessarily reality.
'No one wants to be labeled crazy'
"Nobody wants to talk to a doctor - no one wants to be labeled crazy," said Little, who said he has considered suicide himself, "but people want to talk to their brothers and sisters."
Both Koch and Little said peer groups are more likely avenues for a military person to share their mental struggles than speaking to a health professional.
"To me, the best solution is the battle buddy program," Koch said. "If I've got a very close friend, if I've got a battle buddy, I'm more apt to open up to my battle buddy than anybody else. I'm going to let him know what's going on in my head. I depend on him and he depends on me.
"If they strengthened the battle buddy program, they talk about it, and when they're training for combat, they have battle buddies. But they need to take that program a step farther. That needs to be a buddy for life, or at least a while. If I've got somebody I'm accountable to, I'm a whole lot less likely to think about committing suicide than if I'm not accountable to anybody."
Little pushed Vet to Vet, a peer counseling organization that is administered by veterans who have received mental health treatment from the Veterans Administration. When the Vet to Vet program recently came to the Coast Guard base in Buffalo, N.Y., where Little is now living, he said 35 people immediately signed up.
"I asked them why signed up and they said this is more personal," said Little, a veterans liaison for New York state Sen. Mark Grisanti. "These are people who understand what I've been through."
The pathways to help, in theory, are abundant and that's by design. But as the crisis of military suicide continues, the most effective pathways are still under evaluation.
Ferguson has seen attitudes change about mental health in his 27 years working with the Army and while questions still remain, he's found one certainty.
"What would it have been like if the military had not increased the amount of mental health providers and if there was still a real serious stigma about getting help?" Ferguson said. "What would the numbers have been? My guess is they would have been quite a bit higher.
"I think it's making a difference but it's really hard to measure."
To get help
National suicide-prevention hotline: 1-800-273-8255
Army suicide prevention: www.armyg1.army.mil/hr/suicide
Department of Veterans Affairs suicide-prevention website
For families who have lost a loved one in uniform to suicide
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