By Franklin Cook, SPNAC Editor
Ever since the Army announced that suicide in its ranks was at an all-time high last year, news outlets have been brimming with coverage about the causes and solutions for the tragedy unfolding among America’s active military and veterans. Several of the latest installments covered testimony before the Senate Armed Services Committee by some of the military’s top brass (SPNAC readers may refer to the transcripts, or a webcast of the hearing). According to a Stars & Stripes report on the hearing, it “was designed to address plans to deal with the rate of military suicides, which is above the national average.”
Gen. Peter Chiarelli, vice chief of staff for the Army, called the suicide figures for his service “unacceptable” and fixing them “the most difficult and critical mission” of his military career. “The reality is, there is no simple solution. It is going to require a multi-disciplinary approach, and a team effort at every level of command and across all Army components, all services and jurisdictions, as well as partners out of our organization.”
An article on the hearing in Air Force Times summarizes the statistics that are behind the military’s and Veterans Administration’s alarm about suicide:
The Air Force lost 38 airmen to suicide in 2008, a rate of 11.5 suicides per 100,000 airmen. … In 2008, the Army reported 140 confirmed or suspected suicides. That’s 20.2 suicides per 100,000 troops — an all-time high that is nearly twice the national average of 11 suicides per 100,000 … The Navy reported 41 suicides in 2008, a rate of 11.6 per 100,000. The Marine Corps lost 41 Marines last year to confirmed or suspected suicides — up from 25 two years earlier — a rate of 19 per 100,000.
The hearing included testimony from Kathryn Power, director of the Center for Mental Health Services in the Department of Health and Human Services, who shared another potentially troubling indicator with the Senators:
More ominously, 780 callers to a national VA suicide prevention hot line in fiscal 2008 identified themselves as active-duty troops, [she] said. Since Oct. 1, an average of three hotline callers per day have identified themselves as being on active duty, Power said.
Sen. Lindsey Graham, R-S.C., said that indicates many conflicted troops continue to feel a sense of stigma over reporting suicidal thoughts to superiors or military mental health officials.
“When you’ve got this many people feeling they can’t talk to someone within the system, that’s a problem,” Graham said.
Another aspect of the challenge facing those who care for military personnel and veterans was highlighted at the hearing by Brian Altman of the Suicide Prevention Action Network (SPAN USA):
[He] said the services have made improvements on the issue in the last year. But they still need to hire more medical professionals to handle troops suffering from depression — a promise they’ve been making for several years, he said — and to do a better job educating about signs of suicidal thoughts.
“They’ve done a good job with troops … but many times those who commit suicide are not in theater,” he said. “So we would like to see them try and educate spouses and other family members, too, so they can identify the warning signs.”
A recent news release from U.S. Army Forces Command, reprinted in a “Special Report” at the blog Veterans Today, shows how ambitiously Army leadership is responding to suicide (and similar lists of programs are being implemented in the other military branches and in the VA):
On February 15, an Army stand-down began and continues through March 15 … The stand-down teaches peer-to-peer recognition of suicide warning signs and is available to all Army components and Department of the Army civilians … Phase I, an interactive video “Beyond the Front,” allows participants to choose options throughout the film, with the outcome based on their choices … Phase II of the training, also a video, “Shoulder to Shoulder,” reinforces the Army credo of “No Soldier Left Behind” and ties it to helping a Soldier in need …
One of the programs chaplains use is ACE, which stresses the “battle buddy” system. ACE [is] a mnemonic that represents the phrases, “Ask your buddy, Care for your buddy, Escort your buddy” …
[Also,] ASIST (Applied Suicide Intervention Skills Training) program … trains leaders on intervention and working with distressed Soldiers and Families. Army policy requires one ASIST-trained representative in every battalion.
Even with all of the programs coming down the line, Sen. Graham’s observation about stigma is emerging as the key roadblock for troops and small-unit leadership at the operational level. The power of stigma over help-seeking in military culture, in fact, may be the battle upon which winning the war against suicide depends. As Christopher Weaver points out in a post at ProPublica,
It’s a familiar refrain. Since 2003, yearly reports on the Army’s suicide rates have spurred similar news stories and similar reactions by Pentagon officials. Suicide-prevention initiatives — such as the “battle-buddy” program, which relied on ordinary soldiers to keep an eye on each other — have spawned in the wake of the grim statistics, but the numbers have only worsened.
Referring to a Jan. 29 article in the New York Times, Weaver writes,
[It] is absolutely critical to reach out to soldiers and tell them it is not wrong to reach out for help,” [Gen. Peter] Chiarelli told the Times. “We have to change our culture.”
The call for a change in culture also has echoes. A March 2008 report by the Army’s inspector general suggested a new “culture of support for psychological health.” And in April 2005, the Marine Corps Times reported that the Army’s surgeon general, Lt. Gen. Kevin Kiley, told a House Appropriations subcommittee, “That’s still part of our culture: Real men don’t see [mental health counselors]… I would like to see a culture that resets the force mentally.”
If stigma ingrained in military culture is a force that is stopping suicide prevention programs from working effectively, then the vital question to answer is, What is military (and civilian) leadership doing –besides issuing orders, which is a necessary but not sufficient step — to decisively lessen the stigma against help-seeking that is killing so many of those whose sacrifices make our freedom possible?
[The abridged URL for this post is bit.ly/culturestigma .]