Three months before her husband shot himself in the family's garage, Nicole Simmons said, she met with a chaplain and her husband's commanders at Fort Bragg.
Help me, and help my husband, Simmons said she told Lt. Col. Marcus Evans and Command Sgt. Maj. Herbert Kirkover.
Her husband, Sgt. Adrian Simmons, had changed, she said she told them.
Simmons, who is pregnant with their second child, thought he was suffering from post-traumatic stress disorder. He couldn't control his temper, and his memory was terrible, she said.
"I said, 'Something is wrong with my husband. He is saying he wants to blow his brains out. He is getting so short-tempered, so short-fused, anything will make him blow,' " Simmons said she told the commanders. "I said, 'I think he needs a psychological evaluation.' "
Soon after that meeting, the 24-year-old Simmons said, a soldier came to the family's Hoke County home to confiscate her husband's personal guns. Hoke County Child Protective Services visited and determined that the couple's 2-year-old son was safe as long as the guns remained out of the house.
But the Army never sent her husband to a counselor, Simmons said.
Now she's fighting for answers. So far, she said, she's not getting any.
Simmons said that after her husband died July 5, soldiers told her the Army was opening an investigation into what happened. But she wasn't contacted for an interview until Wednesday, hours after the Observer sent an email to the 82nd Airborne Division asking why no one had talked with her.
"How can they be doing an investigation if nobody has been to the most important person who went to the command?" Simmons asked. "I want to know why, when I went to command, no one admitted my husband for an evaluation."
The 82nd Airborne Division didn't respond to questions about Simmons' allegations or requests to talk to her husband's chain of command. It has a policy of not discussing ongoing investigations.
Suicide prevention has been a major focus in the Army since 2008, when the number of soldiers who killed themselves doubled from four years earlier. The Army is spending millions of dollars to study suicides and millions more on programs aimed at treating soldiers who may be at risk.
At Fort Bragg, eight active-duty soldiers are thought to have committed suicide this year, which is on pace to match or surpass the 14 who took their lives in 2010.
Col. Chad McRee, who leads Fort Bragg's suicide prevention task force, took over the position from a civilian, he said, in part to change the perception of suicide prevention. It's seen as a mission now instead of a service, McRee said.
Fort Bragg has several programs aimed at helping soldiers who may be thinking of suicide, McRee said.
Soldiers carry a card with instructions for helping their friends. It's called an ACE card, for "ask, care, escort."
Other soldiers are trained in suicide-intervention programs. Fort Bragg also has placed behavioral health clinics in primary care facilities and other nontraditional places to try to reduce the stigma of seeking mental health care.
No one seems to have an explanation as to why Sgt. Adrian Simmons -- whose job was to dole out weapons to other soldiers -- fell through the cracks.
Nicole Simmons is the only person speaking publicly about the case. She has nothing documenting that she met with her husband's commanders and the chaplain to discuss his behavior. She has only her word.
Todd Conormon, a Fayetteville lawyer who specializes in military law, said it doesn't make sense that investigators had not interviewed Simmons.
Her account of the meeting with commanders is troubling, too, Conormon said.
"If that's true that they didn't follow up on that (meeting) with an evaluation to determine whether there is some risk, that would be surprising to me," Conormon said. "If there's indication that they didn't, that probably should be investigated."
Rajeev Ramchand, who studies military suicides for the RAND Corp., said a situation such as the one Simmons describes raises serious questions.
Many people say things about killing themselves after a hard day at work and dismiss it later as a joke, so it can be hard to tell who's being serious, Ramchand said.
"(But) if she's concerned enough to bring it to someone's attention, she knows it's probably more than a thing that you say after a stressful day," he said. "When you hear of cases that don't involve behavioral health care, you kind of have to ask why. Involving the behavioral health system as soon as possible is very important."
Nicole Simmons said the April meeting with commanders wasn't the first time she asked the Army to help her husband.
In 2009, a year after they were married, she said, he told her he wanted to shoot her.
She called Fort Bragg's Family Advocacy Program. They sent him to anger-management classes, which only made him angrier, she said.
Simmons said she asked Family Advocacy for a copy of her file after her husband died but was told she needed a court order to get it.
Simmons said she stayed with her husband because she didn't think the temper was his fault. She thought it was caused by PTSD.
Simmons said she had once seen him reduced to tears when talking about his squad leader being killed in Iraq. He just needed help to get back to normal, she thought.
For a time, she said, her husband seemed to get better. But after two deployments to Iraq and eight years of jumping from airplanes without a major injury, Sgt. Adrian Simmons slipped in a drainage ditch and broke his leg and ankle while walking to his office last winter.
Simmons had always wanted to be a police officer after leaving the military. But the injury ended that dream. Once an infantryman in the 2nd Battalion, 505th Parachute Infantry Regiment, Simmons was spending his days in an arms room around millions of dollars worth of weapons.
Nicole Simmons said her husband's broken ankle and leg started him on a downward spiral. She said he should have been removed from the arms room immediately after she met with his commanders. He told her that working in the arms room made him want to kill himself, she said.
Her husband was supposed to leave the Army on Feb. 9, Nicole Simmons said, but his leave date kept getting extended so he could continue with medical treatment. Aug. 9 would have been his last day in the Army.
Instead, Simmons woke up on the morning of July 5 and noticed that her husband's bag, shoes and computer were still at home. She looked outside. The truck was still there. She called his mother, then went to get their son some juice and noticed a note on the refrigerator. It directed her to look at his computer. On the desktop was a suicide note:
"I am not sorry. I mentally was not here anymore. My temper is going and my memory was too. I didn't need help. I just wanted it to stop."
Experts say it's difficult to evaluate whether the Army's suicide-prevention efforts are working.
Armywide, suicides rose from 139 in 2008 to 162 in 2009 and remained nearly steady with 155 in 2010. This year, through six months, 77 soldiers have committed suicide.
Although the rate has not dropped, researchers and military officials say it's impossible to know whether it would have kept climbing if not for the prevention programs.
In October 2008, the Army began a partnership with the National Institute of Mental Health for a $50 million study to analyze risk factors for suicide and factors that help prevent it. Known as the Army Study to Assess Risk and Resilience in Service members, it is three studies under one umbrella. Researchers at the National Institute of Mental Health and four universities are looking at historical data to see if there are common links to determine if specific risks link soldiers who attempt or commit suicide.
They also are surveying and following new soldiers in a longitudinal study that begins the second day of basic training. In addition, they will study soldiers who have been in the Army to research how different experiences affect soldiers psychologically.
Michael Schoenbaum, a senior adviser at the National Institute of Mental Health, said the idea is to be able to target at-risk soldiers and get them help or to figure out if some risks can be reduced without compromising the military's mission.
Researchers have found that married soldiers are less likely to commit suicide than single or divorced soldiers. Relationship problems, on the other hand, are common in cases of suicide. But they're also common in cases that don't end in suicide, so it's impossible to narrow the field of at-risk soldiers by simply pinpointing ones with relationship troubles, Schoenbaum said.
If researchers find factors with recruiting or training, those risks could be addressed, said Schoenbaum, who is among the researchers working on the Army STARRS study.
Pinpointing risks that lead to suicide isn't easy.
"Suicide isn't like food poisoning where you just figure out what is the spoiled ingredient in the salad bar and you go and you remove the tuna salad and then you've solved the problem," Schoenbaum said. "There are many complex factors underlying suicide. Most people who experience any of those factors never attempt to kill themselves, let alone actually kill themselves."
David Rudd, dean of the University of Utah department of psychology, is a former Army psychologist and former president of the American Association of Suicidology. He also is part of a current study treating soldiers who attempt suicide at Fort Carson, Colo.
Rudd said the most important thing he has learned so far is that help can be more effective the sooner someone responds to a problem.
In many ways, he said, the uptick in suicides is related to the past decade spent fighting two wars.
Experts know deployment increases the risk for mental health problems, and mental health problems increase the risk for suicide, he said.
Another way to look at it: There have always been suicides in the military, at a rate of about 10 per 100,000. But the spike in suicides has been seen among all troops, including those who have never deployed. It's not just soldiers who have seen the horrors of war.
So the question becomes, to what extent is the increase in suicides attributable to the current conflicts, Rudd said.
Even though about a third of people who commit suicide in the Army have never deployed, the wars still may play a part in their stress, he said.
"The stress is felt by the system as a whole. It's not just isolated to those that are doing the fighting," Rudd said.
The research commissioned by the Army and the Department of Defense has the potential to change the way the nation treats suicide prevention, a subject that Rudd believes hasn't had enough rigorous scientific study in the civilian world.
But programs geared toward issues such as reducing the stigma against seeking help take a long time to work their way through the force.
Another part of the problem is people don't know what to do when someone is suicidal, Rudd said.
"People are more likely to respond to someone having a heart attack than they are to respond to someone having warning signs of suicide," he said.
A major aspect of Fort Bragg's suicide prevention programs, McRee said, is making sure people do know how to respond to those warning signs.
After meeting with the commanders in April, Nicole Simmons said, her husband became calmer than he had been in months. At the time, Simmons thought he was working through his personal issues. Now, she thinks he was resigned to end his own life.
Without telling anyone, he had changed his life insurance policy to put his mother in charge of the funeral. Simmons wonders why nobody noticed the change at such an odd time, weeks before he was set to leave the military.
After her husband's death, Simmons began wearing his dog tags around her neck. She hasn't removed them since he died. The last note he wrote remains on the refrigerator. She can quote his suicide letter nearly by heart.
She often wonders what she could have done differently.
"I'm his wife. I feel like I should've been able to do something. I should've been able to stop him," Simmons said. "What could I have done differently that would've made my husband want help before he took his life?"
Just as often, the 24-year-old pregnant widow wonders why leaders in the 82nd Airborne Division didn't refer her husband to a counselor.
She's living minute by minute, because the future is so hard to think about.
She has a baby due in February and a 2-year-old son to raise.
To make matters worse, she said, she was told last week that she won't be eligible for military benefits if investigators conclude that her husband's death was unrelated to the Army.
So she is fighting back and looking for answers to what she believes is the one central question: Why didn't the Army help her husband?
"I refuse to not let my husband be heard anymore," Simmons said. "This is people's lives and mental issues that need to be dealt with and need to be helped."
Copyright (c) 2011, The Fayetteville Observer, N.C.
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