Military Continues to Face Challenges in Mental Health, Suicides

By John M. Grohol, PsyD
Founder & Editor-in-Chief

The U.S. military continues to face many challenges when it comes to mental health care for both their active duty personnel in the field, and when soldiers return home to inadequate care.

The numbers are staggering. In July 2011, 33 active and reserve component service members died as a result of suicide — a record high month. Additionally, the U.S. Department of Veterans Affairs estimates 18 veterans die by suicide each and every day.

While the military has worked hard to focus on the problem in recent years, the new report released by the Center for a New American Security suggests it still has a long way to go.

Part of the problem remains staffing levels, which are still inadequate to meet the needs of most VAs:

Also cited as problematic is a shortage of mental health care providers to treat both active duty troops and veterans. Research by the VA has found that suicide rates decreased by 3.6 deaths per 100,000 in seven regions where staff numbers increased to levels recommended in the 2008 Veterans Health Administration Handbook.

Sixteen regions are still not manned to these levels, the report says. In addition, the Army has filled only 80 percent of its psychiatrist positions and 88 percent of its social work and behavioral health nurse jobs.

Given the current economy and so many people looking for work, it’s odd the military hasn’t been able to staff up to recommended levels across the board.

Nearly half of all suicides in the Army are caused by drug or alcohol overdose. But about 14 percent of active soldiers in the Army are on an opiate medication for pain — the exact same medication that’s ripe for abuse and use as a suicide method.

And while the report commends recent progress on changing the attitude toward mental health issues in the military, it’s clear we still have a long way to go:

[The report] raps the “prevailing wisdom” in the military that suicides are not linked directly to deployments to war.

While an estimated 31 percent of Army suicides are associated with factors that can be traced back prior to enlistment, recent reports have shown that soldiers who have deployed are more likely to die by suicide.

Talk about burying one’s head in the sand… How could the two not be related? Astounding.

Last, because of the ongoing stigma connected to admitting to mental health problems while serving in the military, most personnel are reluctant to volunteer information about their own concerns:

The report also finds flaws in the mental-health screening process following deployment, in which troops are asked to fill out a health-assessment form that asks questions about their physical and psychological status. A 2008 study found that when Army soldiers completed an anonymous survey, their reported rates of depression, PTSD, suicidal thoughts and interest in receiving care were two to four times higher than the responses on the official forms.

The CNAS researchers said that many returning troops lie—and are encouraged to lie—for fear that if they admit to mental health problems, they will not be allowed to go home.

Such assessments also follow military personnel throughout their career, affecting their career advancement and forward movement.

The report isn’t entirely negative. It notes that while the percentage of service members seeking help has improved — from 36 percent in 2009 to 57 percent in 2010 — “the stigmatization of mental health care remains an issue.”

The solutions are fairly simple:

• Fully fund to recommended staffing levels all mental health professions in both active military and veterans’ roles.
• Acknowledge the connection between increased suicidal ideation and other mental health concerns with serving in combat roles.
• Increase health record privacy protections and disconnect a person’s military health record from their formal personnel evaluations, so that admitting and seeking treatment for a mental health concern doesn’t negatively impact a person’s career. If this cannot be done, then:
• Support and fully fund the use of external mental health services for a soldier once stateside, with complete patient privacy rights for such treatment.
• Support greater use of peer-to-peer programs that seek to lessen the stigma associated with mental health concerns.

Read the full article here: New Report: U.S. Losing The Battle Against Military Suicides

Read the full report here: Losing the Battle: The Challenge of Military Suicide

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Dr. John Grohol is the CEO and founder of Psych Central. He has been writing about online behavior, mental health and psychology issues, and the intersection of technology and psychology since 1992. Dr. Grohol also sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member of the Society for Participatory Medicine.

Soldier Saves Friend from Committing Suicide

By Stephenie Tatum

Fort Bragg Public Affairs

FORT BRAGG, N.C., Aug. 31, 2011 – On the outside, Army Spc. Josh Brown looks and acts like an average 22-year-old paratrooper serving in the 82nd Airborne Division here.

Brown’s dark hair is close-cropped against his skull, and he prides himself in the jump wings he’d earned. He also smiles often, revealing the sense of humor he’d often used to mask the growing, gnawing pain in his life.

Yet, no one knew what Brown, whose name is fictitious to protect his privacy, was feeling on the inside. Brown said that a multitude of things led him to want to kill himself. For the past six months, Brown said he was feeling unhappy with himself and the path his life was taking.

He suffered from family and financial issues, relationship problems, constant physical pain from a jump accident, insomnia and poor adjustment after arriving at a new duty station.

If that was not enough, Brown’s 1980 Chevrolet Camaro -- his most-prized possession -- had been vandalized and the process to get it fixed through his insurance company was not going well.

When Brown quit calling and making plans to socialize with his close friend, Army Spc. Christy Sawyer, she’d thought nothing of it and figured he just wanted to spend more time with his other friends.

Sawyer, a medic in 2nd Battalion, 508th Parachute Infantry Regiment, 4th Brigade Combat Team, 82nd Airborne Division, had no idea until the morning of Aug. 7 that Brown, also a medic in the 82nd Division, had been withdrawing and for the past two weeks was planning to commit suicide.

Brown said his issues caused him to become overwhelmed and feel like his world was caving in on him.

The night he decided to end his life had started out like many previous nights, Brown said.

“I went to the club and started drinking,” he recalled. “Part of my plan was to take the $100 I had, and drink as much as I could and then go wreck my car to make it look like an accident.”

After leaving the club and going to another bar, Brown ran into a friend who knew something was not right with him. After some time, she persuaded him to talk.

“I have things I need to do tonight and you’re not going to stop me,” Brown told the friend.

The friend then contacted Sawyer, a coworker and mutual friend, for help.

The eight missed phone calls and two text messages that night from Brown, and her conversation with their mutual friend told Sawyer that something was very wrong with Brown.

“I had just got back from block leave and had forgotten my phone in the barracks when I went to pick up some friends who were having car trouble,” Sawyer said. “He actually left me a message telling me goodbye. I still have not listened to it. I can’t do it.”

After speaking with her friend, Sawyer drove to the bar to get Brown. When she arrived, Brown was sitting in his car, distraught and unreasonable. Sawyer said she reached in and took the keys out of his ignition. They talked for a long time; Brown continued to tell her he was sticking to his plan to end his life that evening.

Sawyer said she tried to talk Brown out of taking his life.

“I tried to explain to him that I can’t live with that kind of guilt,” she said. “I just kept telling him, ‘It’s not going to happen.’ I was trying to wake him up.”

At one point during the evening, Brown decided to run. He threw himself over the hood of the car, but his friends caught him before he got very far. After the chase and multiple failed attempts to get Brown to calm down and listen to reason, his friends decided to contact the unit chaplain.

The 4th Brigade Combat Team chaplain called Brown’s unit, which then sent staff duty personnel to get him. Sawyer met the staff duty members at an elementary school parking lot in Fayetteville near here, where Brown once again tried to run away.

After being caught a second time, Brown was taken to the barracks and placed on a 24-hour, three-day suicide watch. He was referred to Womack Army Medical Center here for mental health evaluations.

Sawyer credits her concern for Brown for taking action to save him.

“I think mostly, for me, it was the fact that I care about him so much. He is like my baby brother,” she said. “There was no way I was leaving him. I would not have let him go regardless. I was ready to do whatever it took.”

Sawyer said she’d applied her suicide prevention training to save her friend.

“I see [suicide] a lot differently now,” she said. “I think suicide training is something soldiers need to have and it needs to be emphasized.”

Yet, Brown had attended suicide prevention training at his unit just three days before he’d threatened to kill himself.

“I understood the point of it and I saw the briefing, but I guess I just did not want anyone to stop me,” Brown said. “I was not looking for help.”

Brown said his turning point came the next night when the adrenaline wore off and he realized he was still alive.

“Once I got some sleep and woke up the next day, I felt depressed and empty,” Brown said. “Knowing I wasn’t supposed to be here felt weird. For about two days afterwards, everything felt so unnatural. I honestly didn’t expect to be where I was. It was like everything just hit restart.”

Today, Brown is receiving treatment as he continues to serve in the 82nd Division. Brown is thankful, he said, for the help and support he’s received from his fellow soldiers, noncommissioned officers and officers in his unit.

Sawyer said she finds herself getting upset whenever she thinks about the night Brown wanted to take his life and worries about what could have happened if she hadn’t been there.

“I want him and other people who are thinking about doing this to understand what you are doing to the people in your life -- your friends, your family and your spouses and your relationships,” Sawyer said. “This devastates people. I am still so upset.”

Stigma of Suicide

Navy Works to Reduce Stigma of Discussing Suicide


By Electronics Technician 2nd Class Mark A. Moore, Submarine Group Two Public Affairs

April 6, 2010 - GROTON, Conn. (NNS) -- U.S. Fleet Forces (USFF) hosted a Suicide Awareness and Prevention Summit at Naval Submarine Base New London on March 30 and March 31.

The goal of the summit is to provide leadership with available resources and assistance to institutionalize fleet requirements regarding implementation and execution of suicide prevention and awareness policies.

Each year, the Navy loses Sailors to suicide. Many of these Sailors are our own shipmates, and most, if not all, of these tragedies can be prevented. The stigma that some Sailors face with seeking help for their problems can stand in the way of preventing suicide.

Relationship issues, drug abuse, financial problems, legal issues and mental health problems can increase a person's suicide risk, according to experts. Eric Hipple, former Detroit Lions quarterback and author of "Real Men Do Cry", has dedicated his life to suicide prevention after losing his 15 year-old son, Jeff, to suicide in 2000. He's now the Outreach Coordinator for the Depression Center for the University of Michigan. He spoke about his experiences during the summit.

"Ninety percent of all suicides are due to some type of untreated or undiagnosed mental illness, depression being one of those," said Hipple. "If someone suffers from depression and does not get treatment, the chance of them taking their own life is greater than someone who is treated."

So, what is the stigma of seeking help in the military? According to Marie Parker, USFF Suicide Prevention Coordinator, some Sailors fear losing respect from shipmates or vice versa. Also, some Sailors mistakenly believe that getting help will make them lose their security clearance. That, however, is a myth.

According to the Navy's suicide prevention website, "less than 2% of revoked or denied clearances are for psychological problems. In the vast majority of situations, getting counseling or treatment an indicator of the good reliability and judgment required for clearances. Failure to seek help and allowing problems to get worse and start to impact performance, conduct and finances, is more likely lead to clearance loss."

The next USFF Suicide Awareness and Prevention workshops will be held in Gulfport, Miss. on April 20 - 21, Sigonella, Italy on May 10 - 11, Naples, Italy on May 13 - 14 and Rota, Spain on May 17 - 18. The workshops are intended to provide leadership with available resources and assistance to institutionalize fleet requirements regarding implementation and execution of suicide prevention and awareness policies.