Military suicide – The war within our ranks

While there is no single answer to preventing suicide in the armed services or among our veterans, several observations, ideas and suggestions come to mind following the appearance of Gens. Peter Chiarelli, Carrol Chandler, James Amos and Adm. Jonathan Greenert, along with Dr. Robert L. Jesse from the VA last Tuesday before the Senate Armed Services Committee.

First, we must commend the committee and the witnesses on how they professionally and civilly interacted on a subject that makes many uncomfortable. Suicide is rarely talked about with family or even a close friend, let alone your platoon leader or a general. Starting to discuss the issue is a step toward prevention.

So, where do we stand, and what are the issues surrounding suicide in the armed services, among our veterans?

Navy Adm. Greenert put it succinctly: “Suicide destroys families, devastates communities and unravels the cohesive social fabric and morale inside our commands.” Air Force Gen. Chandler: “The number of airmen taking their lives has been rising, despite our commitment to prevention.” Marine Gen. Amos: “With every suicide case, there is a unique life to understand.” Army Gen. Chiarelli: “Many more suffer from behavioral health issues such as depression, anxiety, traumatic brain injury and post-traumatic stress — often referred to as the invisible wounds of war.”

This is the bottom line — suicide among our service members and veterans today is a public health crisis. Consider the facts:

Based on the most recent data, more than 34,500 people died by suicide in the United States in 2007. Approximately 20 percent of those individuals — or one in five — are veterans.

Suicide is the fourth-leading cause of death in the United States for adults 18 to 65 years old and the third-leading cause of death in teens and young adults from ages 15 to 24. Currently, 67 percent of all Marines are between the ages of 17 and 25.

Male veterans are twice as likely to die by suicide as male non-veterans. 

The number of suicide attempts by Army personnel has increased six-fold since the wars in Afghanistan and Iraq began.

Depression, Post Traumatic Stress Disorder and Traumatic Brain Injury are medical conditions that can be life threatening.

Witnesses all agreed suicide prevention starts with leadership, and we concur. We need to let our military service members and our veterans know that seeking help for mental disorders, including alcohol and substance abuse, is a sign of strength, not weakness. The keys to improving these statistics lay in reducing the stigma associated with mental illness, encouraging help-seeking behavior and being aware of warning signs and treatment options.

Suicide is most often the result of unrecognized and untreated mental disorders. In more than 120 studies of a series of completed suicides, at least 90 percent of the individuals involved were suffering from a mental illness at the time of their death. The most important interventions are recognizing and treating these underlying illnesses, such as depression, alcohol and substance abuse, post-traumatic stress and traumatic brain injury. Many veterans and active duty military resist seeking help. These barriers must be identified and overcome. And it appears that our military leaders are working diligently to accomplishing these important changes in mindset and operating procedures.

In the armed services and among veterans, we should strengthen interventions that work, such as regular consultation with a primary care physician, effective clinical care for mental illness and substance abuse, and we should encourage stronger connections to family, which would include extending leave between multiple deployments. Furthermore, we suggest more education about risk for suicide among family, peers, chaplains and anyone with strong ties to servicemen and woman. 

Congress needs to heed the words of Army Major Gen. Mark Graham, on the suicide death of his son, Kevin, an ROTC cadet at the University of Kentucky, “I knew my son was sad … but I didn’t know you could die from being sad.” The message is clear: Untreated depression can be fatal. 

By treating mental disorders the same way we treat combat-related injuries and wounds, we can take major steps in addressing the alarming suicide rates among our service members and veterans. This would include improving pay and incentives for military medical professionals working in the behavioral health and substance abuse fields, support of innovative technology such as Web-based behavioral health screening and continued support to the Departments of Defense and Veterans Affairs in their efforts to erase stigma and to report and prevent suicide. Congress must ensure our service members and their families are given access to the mental health resources necessary to stem the short- and long-term impacts of the invisible wounds of war.

  Robert Gebbia is national executive director of the American Foundation for Suicide Prevention, the nation’s leading not-for-profit organization dedicated to understanding and preventing suicide.