Keys to preventing suicide: End the stigma, get better data

Stigma and a lack of good data are making it harder for the United States to combat the scourge of suicides among military members and veterans, according to a report released this week by the Center for a New American Security.

“I have no idea how many [veterans] die by suicide each day,” Jan Kemp, national mental health program director for the U.S. Department of Veterans Affairs, said at a forum introducing the report. “You’ve seen [the statistic], 18 a day. Honestly I don’t know how correct we are. It’s our best guess right now.”

Trying to reduce the number of suicides in the Army has been “the most difficult challenge in my 40 years in the military,” said Gen. Peter Chiarelli, the vice chief of staff of the Army, who also spoke at the forum. “The circumstances surrounding each suicide are as unique as the individuals themselves. That’s what makes this so incredibly tough.”

Chiarelli said the active-duty Army lost 156 soldiers to suicide in 2010, down from 162 in 2009. But he said the hardest part is identifying which 250 or so soldiers might be at serious risk of suicide ahead of time, in part because brain science is still immature.

“The number one systemic recommendation I would make is the study of the brain,” Chiarelli said, noting that fully half of active-duty soldiers who commit suicide are undergoing some kind of mental health treatment.

The CNAS report, titled “Losing the Battle: the Challenge of Military Suicide,” was authored by the center’s Dr. Margaret Harrell and Nancy Berglass. It lists more than a dozen such obstacles and offers suggestions toward overcoming them.

Much of the problem, it indicates, stems from the military’s inability to establish an open flow of information about a servicemember’s experiences and potential problems.

From the moment a servicemember returns home, it notes, they are often encouraged to fake their way through the post-deployment health screening. An honest answer to a question about traumatic experiences, one that might prompt further evaluation, could keep them from promptly reuniting with their families. But answering dishonestly makes it more difficult to link future mental health treatment to their military service.

Leaders must stress honesty, the report says.

And commanders might not be aware of the medical problems — or legal problems — faced by troops under their command, a problem that can be exacerbated when the servicemember transfers assignments soon after a deployment. The result is a combat veteran who finds himself in a new unit, surrounded by peers and superiors who don’t know what that person has been through and aren’t able to diagnose lingering demons.

The report recommends establishing a unit cohesion period that would delay personnel transfers in the immediate aftermath of a deployment.

“The services need to ensure that information about a service member’s mental health well-being is being transferred when that individual moves,” the report says.

Other recommendations include ridding the services of abusive leaders who haze and abuse subordinates, empowering health care workers to inform commanders when a servicemember may be a threat to himself, and loosening legal restrictions preventing leaders from asking troops about their personally owned weapons.


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