Suicide Among The Ranks: What The Army Is Doing

January 22, 2009

Suicide is a tough topic to discuss. In it’s wake, it leaves so many victims, who often blame themselves for what happened. With the death of the person who committed suicide, come many questions, often the survivors blame and beat themselves up, because they didn’t recognize the signs or discounted them. Over the past several years, suicides in the military services, especially in the Marine Corps and the Army have seen a dramatic increase. In the Army it’s become a huge concern, from the highest ranking officer, to the lowest enlisted servicemember. Just this past year alone, there have numerous suicides reported among the recruiting cadre in the Houston area. It’s a trend that’s become extremely alarming. The question has been asked over and over again … ‘What are we doing to prevent suicides amongst the ranks of the Army?’ In the past, the stigma attached to a Soldier seeking psychological help has been something that has kept many of them from seeking help. They didn’t want to be labeled as a coward, a wimp or a wuss. Leadership often told these Soldiers to ’suck it up and soldier on.’ Psychological problems were seen as a weakness in the military culture. Because of this stigma, many would not seek help for their problems, and might feel that suicide was the only answer for them to be able to escape the emotional pain that they were dealing with.

The Army is working hard to change the mindset and eradicate the social stigma that comes with seeking psychological help. This past week, the Army held the 2009 DoD/VA Annual Suicide Prevention Conference in San Antonio, Texas. More than 750 people attended the 4 day conference, from specialists in the field, active duty Soldiers, to VA and private groups such as Social Workers, Chaplains, Researchers and family members who have been affected by military suicide. The goal of the conference was to find ways to reduce suicide amongst the ranks and to prevent the needless tragedy that suicide is.

“The secretary of Defense and chairman of the Joint Chiefs of staff have both emphasized, ’seeking help is a sign of profound courage and strength. Truly, psychological and spiritual health are just as important for readiness as one’s physical health,” said Brig. General (Dr) Loree K. Sutton, special assistant to the assistant secretary of Defense Health Affairs and Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury director.1

According to Sutton, the Soldier’s ethos of never leaving a comrade behind should apply to psychological wounds as well as physical wounds. Just because you can’t see a wound, doesn’t mean that it doesn’t exist. Sutton stressed things that fellow Soldiers can do to assist with suicide prevention. As she stated, everyone deals with problems in their lives and it’s important to be able to recognize the warning signs when a friend or comrade isn’t coping well with their problems, to reach out and offer assistance and intervene early … before it’s too late.

Each day of the conference was filled with breakout session workshops and training that was focused on different suicide related topics. Topics covered were things such as crisis intervention, crisis negation of a suicide in progress, prevention strategies and mental health initiatives. The keynote speaker at the event was Major General Mark Graham. Graham had an especially poignant message, as a Soldier, a husband and a father who experienced the effects that the suicide of a loved one has on a person. Graham himself lost one of his sons to suicide. Since then he has been active in speaking openly about mental health issues, especially PTSD. In 2003, Graham’s then 23 year old son Kevin was ranked as a top cadet in his ROTC class. Kevin hung himself after struggling with depression for some time. His son was afraid to disclose to anyone about his mental health issues out of fear for his own military career. A year after losing Kevin, Graham’s oldest son Jeff, who was also serving in the Army, was killed by an IED in Iraq. Graham and his wife made the decision to continue to serve, in memory of their sons.

“Both of my sons died fighting different battles,” Graham said. Graham is the commanding general for the Army’s Division West and Fort Carson, Colorado.2

As he began his speech, he asked the members of the audience to think about three questions that he posed to them. Those questions were: ‘Who is that person who had wounds that you can’t see? Should they be ashamed? Are they less of a man or woman?’

“I can think of few subjects more important than this one,” Graham told the audience. He shared that people need to be able to talk about the challenges and stigma that is associated with mental health and thoughts of suicide. “Leaders, be compassionate. Soldiers, it’s OK to get help,” Graham said. “Untreated depression, PTSD and TBI deserve attention. Encourage those who are afflicted to seek help with no embaressment,” he added.3

As General Graham told the audience, suicide is something that knows no boundaries. It can affect anyone, regardless of race, their rank, their social status, people from all walks of life and regardless of their socio-economic position. He emphasized the ACE program, which is the Army’s suicide prevention program. ACE stands for: A=Ask your buddy. C=Care for your buddy. E=Escort your buddy. He also emphasized that the DoD/VA operated a 24/7 national suicide prevention hotline. That number is 1-800-273-TALK(8255)

Below is information that the Army provides to all Soldiers about the importance of suicide prevention and what they can do. The information instructs them on what they should do if their buddy appears depressed, what to look for. It also provides information on what they should do if they find themselves feeling depressed as well.

• Have the courage to ask the question, but stay calm
• Ask the question directly, such as, “Are you thinking of killing yourself?”

Care for your buddy:
• Remove any means that could be used for self-injury
• Calmly control the situation; do not use force
• Actively listen to produce relief
• Never leave your buddy alone
• Escort to the chain of command, a chaplain, a behavioral health professional or a primary care provider

An information card is also distributed by the Army called:
Suicide prevention: Warning signs and risk factors

Warning Signs: When a Soldier presents any combination of the following, the buddy or chain of command should be more vigilant and consider help:

• Talk of suicide or killing someone else
• Giving away property or disregard for what happens to one’s property
• Withdrawal from friends and activities
• Problems with girlfriend, boyfriend or spouse
• Acting bizarre or unusual (based on your knowledge of the person)
• In trouble for misconduct
• Soldiers experiencing financial problems
• Soldiers who have lost their job at home (such as Reservists or Guardsmen)
• Soldiers leaving the service

When a Soldier presents any one of these concerns, the Soldier should be seen immediately by a helping provider:

• Talking or hinting about suicide
• Formulating a plan to include acquiring the means to kill oneself
• Having a desire to die
• Obsession with death (music, poetry, artwork)
• Themes of death in letters and notes
• Finalizing personal affairs
• Giving away personal possessions

Risk factors are those things that increase the probability that difficulties could result in serious adverse behavioral or physical health. The risk factors only raise the risk of an individual being suicidal - it does not mean they are suicidal.
Risk factors often associated with suicidal behavior include:

• Relationship problems (loss of girlfriend or boyfriend, or divorce)
• History of previous suicide attempts
• Substance abuse
• History of depression or other mental illness
• Family history of suicide or violence
• Work-related problems
• Transitions (retirement, permanent change of station or discharge)
• A serious medical problem
• Significant loss (death of a loved one, loss due to natural disasters)
• Current/pending disciplinary or legal action
• Setback (academic, career or personal)
• Severe, prolonged and/or perceived unmanageable stress
• A sense of powerlessness, helplessness and/or hoplessness

Suicidal risk is highest when:

• The person sees not way out and fears things may get worse
• The predominant emotions are hopelessness and helplessness
• Thinking is constricted with a tendency to perceive his or her situation as all bad
• Judgment is impaired by use of alcohol or other substances

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