Suicides Climb Despite Prevention Efforts
Written by Kelly Kennedy
Thursday, 01 July 2010 09:44
Vice Chiefs Say Solutions Have Been Elusive.

The difference between [the Afghanistan War] and a nightmare is that when you wake up from a nightmare it's over. This is all too tragically real.

July 5, 2010 (Army Times) - As Congress continues to take military leaders to task over his­torically high suicide rates and mental health issues among the troops, the service vice chiefs said the problems are too complicated for quick solutions:

■ The Army has seen its suicide numbers start to drop among active-duty soldiers this year, but the number of reservists killing themselves has increased.

■ The Marine Corps has seen the number of young noncommissioned officer suicides go down this year, while younger enlisted and older NCO suicide rates rose.

■ There is not enough "good science" available to differentiate between traumatic brain injuries and post-traumatic stress, which leads to delays in treatment.

■ There are not enough mental health counselors available either in the military or the civilian world to address the problems.

Despite the challenges, all of the vice chiefs said they would refocus their efforts.

"The increase in suicides by military personnel in the last few years is alarming," said Sen. Carl Levin, D-Mich., chairman of the Senate Armed Services Committee, addressing the vice chiefs at a June 22 hearing. "These increases indicate that despite the services’ efforts, there is still much work to be done." Gen. Peter Chiarelli, Army vice chief of staff, said his service has had 62 active-duty suicides so far this year, compared with 89 at the same point last year. But there have been 53 Reserve and National Guard suicides this year, compared with 42 for the same period in 2009.

"The decrease in active-duty suicides would seem to indicate the refocused efforts by our Army are beginning to work," he said. "Conversely, the increase in suicides among reserve-component soldiers not on active duty may reflect the Army’s more limited ability to influence these soldiers once they return home." Chiarelli said he hoped telemedicine - screening and counseling by telephone or online - would help, as well as improvements in treatment of PTSD and TBI.

He also emphasized the military’s resiliency programs, which teach people better coping skills for life issues, such as financial or marital problems.

He also said the Army uses the Automated Neuropsychological Assessments Metrics cognitive function test on troops before they deploy as a baseline to test for TBI.

However, the Army stopped testing soldiers when they return home because the test provides "too many false positives," he said, adding that he would rather have his already short-staffed mental health providers assist soldiers who have been diagnosed with an issue than have them try to work through all those false positives.

Gen. Jim Amos, assistant commandant of the Marine Corps, said his service functions in the same way. But Gen. Carrol Chandler, Air Force vice chief of staff, said his service does use the cognitive test before and after airmen deploy. He said he has enough people to han­dle the false positives.

Chiarelli said several times that the issue is not funding, but rather finding mental health professionals willing to live and work near bases.

Stigma still an issue

All the vice chiefs said the stig­ma within the military that clings to mental health treatment is still a problem, and Chiarelli praised a pilot program that allows people to seek treatment for substance abuse without having it reported to their chains of command -

which can be a career killer.

Substance abuse often plays a role in suicide because it can cause people to make quick decisions rather than think things out. And people often self-medicate with alcohol or drugs when trying to escape painful memories, so troops with PTSD also often deal with substance abuse issues, experts say. But Amos and Chiarelli also said they are surprised that most suicides are not among combat veterans who have deployed multiple times. In the Army, 71 percent of those who killed themselves had deployed once or not at all. Chiarelli did not say what those combat tours entailed.

Adm. Jonathan Greenert, vice chief of naval operations, said the rate of sailor suicides has gone down, but a survey showed that the attempted suicide rate was about one in every 35 sailors - or 2.8 percent - in 2008, the highest among the services.

The attempted suicide rate in the Army was 2 percent, with the Marine Corps at 2.3 percent and the Air Force at 1.6 percent, according to the 2008 survey.

Amos said the Corps began a non­commissioned officer training pro­gram last year for young leaders, and suicides in that group appear to be going down. He said the pro­gram would be extended through­out the Corps because suicide rates of those not included in the pro­gram have gone up this year.

Chandler said "the number of airmen taking their own lives has been rising, despite our commit­ment." So far this year, 45 airmen have killed themselves, compared with 33 at the same point last year. The vice chiefs asked for stan­dardized licensing of mental health care professionals across state lines, an end to mandatory retirement for health care providers at age 42, and help find­ing mental health nurses.
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