Suicide rates for active-duty service members and veterans are rising

Echo opinion published by Carol Giacomo in The New York Times:

"...more than 20 deaths a day — in other words, more suicides each year than the total American military deaths in Afghanistan and Iraq..." crisis line for veterans is 1-800-273-8255 (press 1

Suicide Has Been Deadlier Than Combat for the Military

The Pentagon has made strides in helping those in need, but the rate of deaths is rising. 
\By Carol Giacomo Ms. Giacomo is a member of The New York Times editorial board.

Struggling with mental demons, Kayla Williams went to her bathroom and held a gun in her hand, contemplating suicide. 

It was 2004, and she’d been home for only a few months after serving as an Army sergeant and Arab linguist in the Iraq war.

But hers is one story that doesn’t end in tragedy: Ms. Williams held those demons at bay long enough to get help and learn to manage the challenges of marriage to a combat-wounded veteran while writing two books about her experiences. “I’m doing well,” she told me. She is now the director of the Military, Veterans and Society program at the Center for a New American Security.

Her journey, like that of so many others, has not been smooth. Recovery sometimes requires working with several therapists, changing providers when one isn’t working and undergoing repeated treatment. The government has begun to acknowledge the danger that suicide poses for an all-volunteer fighting force and has invested $1 billion in seeking solutions.

But that hasn’t proved to be enough. Suicide rates for active-duty service members and veterans are rising, in part, experts say, because a culture of toughness and self-sufficiency may discourage service members in distress from getting the assistance they need.
In some cases, the military services discharge those who seek help, an even worse outcome.

More than 45,000 veterans and active-duty service members have killed themselves in the past six years. That is more than 20 deaths a day — in other words, more suicides each year than the total American military deaths in Afghanistan and Iraq.

The latest Pentagon figures show the suicide rate for active-duty troops across all service branches rose by over a third in five years, to 24.8 per 100,000 active-duty members in 2018. Those most at risk have been enlisted men under 30.

The data for veterans is also alarming. In 2016, veterans were one and a half times more likely to kill themselves than people who hadn’t served in the military, according to the House Committee on Oversight and Reform. Among those ages 18 to 34, the rate went up nearly 80 percent from 2005 to 2016. The risk nearly doubles in the first year after a veteran leaves active duty, experts say.

The Pentagon this year also reported on military families, estimating that in 2017, there were 186 suicide deaths among military spouses and dependents.

Military officials note that the suicide rates for service members and veterans are comparable to the general population after adjusting for the military’s demographics — predominantly young and male. But given the military’s size and influence, it is an institution that is well placed to lead the nation in suicide prevention.

Other than pointing to national trends, officials have offered few explanations for why military suicides are rising. Studies seeking more answers are underway.

Experts say suicides are complex, resulting from many factors, notably impulsive decisions with little warning. Pentagon officials say a majority of service members who die by suicide do not have mental illness. While combat is undoubtedly high stress, there are conflicting views on whether deployments increase risk.

Where there seems to be consensus is that high-quality health care and keeping weapons out of the hands of people in distress can make a positive difference.

Studies show that the Department of Veterans Affairs provides high-quality care, and its Veterans Crisis Line “surpasses most crisis lines” operating today, according to Terri Tanielian, a researcher with the RAND Corporation. (The Veterans Crisis Line is staffed 24/7 at 800-273-8255, press 1. Services also are available online or by texting 838255.)

But Veterans Affairs often can’t accommodate all those needing help, resulting in patients being sent to community-based mental health professionals who lack the training to deal with service members.

Kim Ruocco’s husband, John, a decorated Cobra gunship pilot who flew 75 combat missions as a Marine, also returned home tormented. But he did not seek help to deal with depression and combat trauma. He killed himself in 2005 as he prepared for a second deployment to Iraq. As an executive at the nonprofit Tragedy Assistance Program for Survivors, Ms. Ruocco now helps grieving families and friends and raises awareness about the risk of suicide. She says even when service members in distress know about available resources, they often resist.

“One of the biggest battles is the military culture,” Ms. Ruocco said. “Seeking mental health treatment goes against everything they are taught in boot camp,” where service members are told “to push through pain, to think of everybody else before self, to solve problems with lethal force if necessary.”

Marines wouldn’t think of not working out physically, she said, but “there is no space and time for self-care until it interferes with their ability to do their jobs.” She is confident that if Marines had been drilled on the importance of mental and emotional health, her husband would have found a safe way to cope.

Not only do these deaths devastate families; suicides can also undermine morale and cohesion within units that lose a member this way and can discourage potential recruits, threatening the viability of the all-volunteer force.

The other obvious imperative is doing more to reduce easy access to firearms — the most widely used method of suicide — by distributing gun locks, training individuals in safe storage methods and enabling military commanders to remove a service member’s firearm if warranted. Health care professionals who treat service members and veterans should discuss this issue with their patients, just as they encourage people to wear seat belts and bike helmets.

In the end, everyone has a role in helping those we love who are experiencing tough times to discuss their struggles, reduce alcohol and drug use and seek professional help.

To quote the Marine commandant, Gen. David Berger, “We must create a community where seeking help and assistance are simply normal, important decisions Marines and sailors make.”

As mentioned above, the crisis line for veterans is 1-800-273-8255 (press 1). Another resource for those having thoughts of suicide is the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can find a list of additional resources at SpeakingOfSuicide.com/resources.

Michelle Obama Speaks to Military Families: I'd Like to Join Her

As a military wife for 13 of my husband's 23 years as a US Navy veteran, I can unequivocally say Mrs. Michelle Obama is doing something no one like her has ever done before.

Mrs. Obama is a beautifully high profile, potential fist lady to a President, who is visiting with military families and listening to them - really listening - to their stories. This is amazing, because life as a military wife means obeying. Knowing someone is actually listening, indeed, is rare.

Mrs. Obama's military families listening tour is hardly noticed by the big money media markets. Although support for veterans, especially during a time of undeclared war in Iraq and Afghanistan, are all the buzz, it's not very challenging to listen to their families speak about recurring hardships. Low pay and constant change are the least of the hardships. Oh yes, there are the Navy Relief societies and chaplains. While those resources look great in the chain of command, they are actually desperation charities. Really impoverished families use them for the purposes of support. Ordained and commissioned chaplains are primarily focused on the active duty military person, providing token attention to the daily plight of families outside of Sunday services. Having someone listen to pleas for support from families is almost non-existent in the military.

I discovered Mrs. Obama's round table discussions by accidentally catching a C-Span forum held in Norfolk, VA. Her attractive attentiveness to everyone who spoke was noteworthy.

Ironically, my husband and our family lived in Norfolk VA for 6 of our Navy years. My husband was stationed aboard the USS Intrepid (CVS 11) - yes, it's the aircraft carrier now museum that will hopefully return to its place in New York Harbor some day soon. Additionally, my husband was also stationed with HC-6, a helicopter squadron; and he was a US Navy corrections counselor at the infamous brig when the low morale of active duty Vietnam War Veterans were filling the bleak cells of the old military prison.

So, I know what it's like to be a military wife in Norfolk VA. It's lonely. In spite of a warmly cordial civilian population in Norfolk, the multitude of various military commands are confusing and perennial lifestyle changes are considered normal. A spouse is on shore duty; or on sea duty; or is promoted; or is not promoted so, therefore, must move; or on temporary duty someplace else while the family stays behind; or, on weekend watch, or living on base or must move off base. Changes never end. Everybody accepts change as being ho-hum. Except, it isn't, especially for children.

Wives never know who their pediatrician or obstetrician will be when they see a physician. Medical records get lost. Civilian housing is expensive. Waiting lists for base housing contain so many rules, one never knows how long of a civilian lease to sign. Consequently, families pray for any housing opening to save money, regardless of the neighborhood. Moreover, during a time of war, the lives of families are burdened with the additionally anxiety of safety. Thank goodness for e-mail, because, when I was a military wife, the snail mail only arrived whenever the ship happened to get it to a port where there was a post office. Families of submarine sailors and officers hardly ever received mail.

As a result of the stress caused by separation hardships, I was not at all surprised by the focused reception Mrs. Obama received from her forum audience - who were both officers and enlisted families, Marines and Navy.

This was was absolutely not a campaign rally. Walls were barren of campaign posters; flashy buttons did not appear. There were no prepared speeches. People who attended, nearly all women, sat quietly until they were motivated to speak. Mrs. Obama responded with intelligent sensitivity to every speaker.

"Few sacrifice more to serve their country than you, and I know that too often it seems like you're doing it on your own,” Mrs. Obama told participants in a round table discussion of military families at Norfolk Virginia's Old Dominion University. (Reported by The Washington Times
http://washingtontimes.com/news/2008/aug/07/michelle-obama-courts-vital-military-families/).

My life as a military wife ended in 1981, but the plight of the families has not changed much over time. In fact, the stress is worsened by an additional factor I never experienced. Many of the families spoke about caring for the parents of the active duty members while they are deployed. In other words, a wife must care for a mother-in-law while the son is absent. So, this is an additional stress. A spouse cares for a home, keeps a budget, raises children; plus, often, cares for aging parents. This is likely because the parents of military personnel are living longer and therefore requiring long term care. A sandwich generation of military families is an entirely new and stressful (not to mention expensive) generational development.

To say, "Thank You Mrs. Obama" for your support for military families is an understatement.

In fact, if it were possible for me to join her, believe me, I'd be there in a heartbeat. Indeed, Mrs. Obama, if you or somebody who knows you reads this blog, please contact me so I can participate in your listening tour. I'd just like to be a reporter on the beat or the person who passes around the microphone.

More important, I'd like to journal all the heartfelt stories we'd hear on this tour.

So, if anybody is listening to me, a military wife 25 years removed, please do me the honor of asking for my help. And, of course, thank you Mrs. Obama for finally giving our nations military families the listening respect they rightfully deserve.