Benefits News

Barbara V. Romberg, Ph.D. is a licensed clinical psychologist and the founder and president of Give an Hour

Recent headlines report an alarming increase in suicide among military personnel over the last several years. The Army reported that 2008 saw the largest number yet in nearly three decades (New York Times, January 30, 2008; MSNBC, January 29, 2009). At least 128 soldiers killed themselves in 2008—compared to 115 in 2007, 102 in 2006, and 87 in 2005. The 2008 suicide rate of 20.2 per 100,000 marked the first time since the Vietnam War era that the rate of suicide within the Army surpassed the overall U.S. rate for people of similar ages and backgrounds.

In addition, the Army is currently investigating 24 suspected suicides in January (NPR, February 6, 2009). If all 24 deaths are confirmed to be suicides, the number of self-inflicted deaths will surpass the 16 combat deaths reported by all branches of the armed forces in Iraq, Afghanistan, and other locations where we are fighting the Global War on Terrorism.

Finally, recent reports indicate that two West Point cadets killed themselves and two others attempted suicide since December (Washington Post, January 30, 2009). Some students suggest there have been five other attempts since the fall.

The military is taking these reports very seriously. There are efforts under way to improve screening and implement programs to help troops identify and cope with stress and depression. In a prevention effort, the Army is conducting a “stand-down” for one month (begun February 15), to identify soldiers at risk for suicide. Extensive education efforts will continue until June. The Army has also hired nearly 300 mental health professionals to provide additional services to those in need of mental health care.

But the military’s efforts will not be enough to prevent further tragedies—too many returning warriors are struggling with the invisible wounds of war. We must all do our part to ensure that our friends and family members are identified and treated if they are in need of services. We must educate ourselves, and we must act if necessary to assist those who are unable to find a reason to live.

Most of us are uncomfortable and frightened by the concept of suicide. We don’t want to think about the possibility that someone we know or love could contemplate ending his or her own life. While most of us have had moments of despair and periods of sadness or depression, relatively few of us know what it is like to feel such overwhelming hopelessness that we would chose to die rather than continue to struggle in the hope of finding a reason to live.

Although we don’t yet know enough about the current wave of suicides within the military to definitively identify the exact causes, we are fairly certain about some of the factors contributing to this alarming trend. We know that our military community is under tremendous strain as a result of multiple deployments AND multiple reintegrations. We must remember that the reintegration period is often more difficult for a returning warrior than his or her time deployed. Our troops spend months and years training for deployment and combat. While the stress of combat is undeniable, so is the difficulty that many have when they try to reenter the world they left behind.

We know that the stress of deployment and reintegration can put significant strain on relationships, which sometimes fail under the pressure. As a result, there are men and women already suffering from depression, anxiety, post-traumatic stress, and traumatic brain injuries who must also deal with the loss of a primary relationship, a sense of loneliness, and a perception of failure.

We also know that many of our returning warriors are affected by the current economic crisis that grips our country. Perhaps a guardsman returns from deployment only to find that he has no job waiting for him, or a spouse is laid off and unable to find work. This type of stress is difficult enough for someone under normal life circumstances. It can be overwhelming and seemingly insurmountable for an individual struggling under the weight of post-traumatic stress, depression, or anxiety.

We know that individuals are more likely to commit suicide if there are barriers to mental health care. While much is being done within the military to address the stigma of seeking appropriate care, much more needs to be done both in the military and in our society to ease the way for those in need to receive the care they deserve. Many of our returning warriors will turn to substance abuse as a way to medicate themselves, in an attempt to ease the pain and numb the feelings. Unfortunately, a history of substance abuse makes one more likely to attempt and commit suicide, given that impaired judgment contributes to fatal decisions.

Finally, we know that individuals are more likely to attempt and commit suicide if they have easy access to lethal weapons. Our service personnel are trained to operate and are quite comfortable with lethal weapons. In addition, they are often exposed to extreme violence, making the choice to solve their pain through violent means a very understandable though brutally tragic choice.

Fortunately, there are things we can all do to help our returning warriors. Armed with knowledge, we can ask the right questions and pay attention to the signs, including the following:

• Talking about Dying -- any mention of dying, disappearing, jumping, shooting oneself, or other types of self harm
• Recent Loss -- through death; divorce; separation; broken relationship; loss of job, money, status, self-confidence, self-esteem; loss of religious faith; loss of interest in friends, sex, hobbies, activities previously enjoyed
• Change in Personality or Mood -- sad, withdrawn, irritable, anxious, tired, indecisive, apathetic
• Change in Behavior -- can’t concentrate on school, work, routine tasks
• Change in Sleep Patterns -- insomnia, often with early waking or oversleeping, nightmare
• Change in Eating Habits -- loss of appetite and weight, or overeating
• Diminished Sexual Interest
• Fear of Losing Control
• Low Self Esteem -- feeling worthlessness, shame, overwhelming guilt, self-hatred, thinking "everyone would be better off without me"
• Hopelessness -- believing things will never get better, nothing will ever change
• Increased Substance Use
• No Sense of Purpose
• Withdrawal from Family and Friends
• Engaging in Reckless or High Risk Behaviors -- seemingly without thinking

If someone you know or love exhibits any of these signs, seek help to determine if they are at risk or in need of care. Don’t be afraid to seek help to determine how best to respond or intervene. Don’t risk your own safety or theirs by approaching someone who is agitated, intoxicated, or violent. Contact the local authorities to make sure everyone is safe; then treatment can proceed and healing can begin.

Many people in crisis can find hope and meaning if we can ensure their safety during the crisis and provide appropriate care. Our warriors are often very well prepared for the battles they face on the ground. We need to ensure that they are well prepared for the internal battles they may face once they return home.

Here is a list of important mental health resources to assist our military community: National Suicide Prevention Hotline for Veterans, 1-800-273-TALK (8255) and press "1" to reach the VA hotline, 24 hours a day, seven days a week, or visit www.suicidepreventionlifeline.org.

National Toll-Free Crisis Management, Information, and Referral Lifeline for Veterans and Families, 1-888-777-4443, seven days a week, 9:00 a.m to 9:00 p.m., Pacific Time.

Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE), around the clock, 365 days a year, by phone at 866-966-1020 and by e-mail at resources@dcoeoutreach.org.

Military One Source, a 24/7 resource for military members, spouses, and families, at militaryonesource.com or 1-800-342-9647.

Give an Hour, providing free mental health services to military personnel and their loved ones, at www.giveanhour.org.

Editors Note: Give an Hour is a strategic partner of Veterans Advantage. For more on our partnership, click here.

Veterans Advantage is also hosting a special online PTSD Transition Center for its members, with customized news and resources to help in this vital area.