Saturday, February 21, 2009

Suicide in the Army: We Need To Do More

I write this post as someone who was almost an Army suicide statistic.

I'm not going to write exactly how close I once was to putting my own weapon under my chin, or when precisely it was, or where I was. Those things really aren't important. But I will say that it was a very, very near thing, and it was no thanks to my fellow soldiers that the event actually didn't happen, but thanks to a civilian. I would, however, like to credit 1SG Grisham, of Soldiers Perspective (much as I strongly disagree with him about Brandon Neely), with giving me the idea that talking out about this stuff can someday help other soldiers not be ashamed of these things.

A lot of people elsewhere are trying to put the blame anywhere else but the war, by pointing out that a lot of the soldiers who are successfully killing themselves are not deployed at the time, and some have never been deployed at all. They blame the low standards of soldiers coming into the Army, without wondering why it's happening that way, and ignoring the fact that many of those suicides have spent anywhere from five to fifteen years in the Army. It's not just junior enlisted who can't adjust to the Army who are killing themselves. It's people who feel they can't solve their problems any other way-or people who are too overwhelmed, or suffering too much from PTSD or depression to think clearly.

What they don't understand is that the Army is strained right now-financially, personnel-wise, and skill-wise. We also have a culture of ignoring problems, especially mental health problems.

When I first sought help for mental health, it was after my now ex-husband had threatened the death of myself and my child. I asked my platoon sergeant and I asked my first sergeant for help. Lest anyone assume the lack of help was due to my views on the war, this was before I was a member of IVAW. I was told by my platoon sergeant that things couldn't be as bad as I was making them sound-that I was tough and would be fine. That I was still taking care of my soldiers, and so it couldn't be affecting me as much as I made out. I just needed to "NCO up". My first sergeant told me that if he had "really meant it", he would have already killed me, so it wasn't a significant threat, despite the fact that he had shot at me before.

The Army gives out their own "signs of suicide". They're so cliched that they're almost a joke. Giving away possessions is the one most people remember, and the one I've never seen with any suicide which has happened in any command I've been in. I know I had no impulse to give things away. If I had the clarity of thought to think to give things away, I don't think I would have been that close in the first place. People joke about it all the time. I know I have. If someone gives something away, there's a lot of "Do I need to call the chaplain?"

Here, in my opinion, from observing the people in my units who have killed themselves, and from examining my own thinking process, are the factors which are 'danger signs', factors which lead to 'more likely', and how you can exercise preventive measures before things get to the point that the soldier already has a plan.

1) Feeling hopeless. If you've told a soldier that there is no way that they can fix their problem, you are increasing the chance that they will do something stupid and drastic. After all, if they can't fix the problem through 'sane' means, they may well take to 'crazy' ones. Never, ever, tell a soldier that nothing can be done. Never underestimate a soldier's problem. Even if it seems unimportant to you, pay attention to how important it is to the soldier. Take 'perception is reality' to a new and different level. If they perceive something as life-ending, it may well become so.

2) Denigrating a soldier's mental health problems-even if they themselves are doing so. It's important to remember that there is still a stigma in the Army on mental health problems. That if you have a serious mental health problem, you're someone to be avoided or isolated. So sometimes soldiers will downplay their own problems. "Oh, hah, the mental health folks say I have PTSD...pretty funny, huh?" The important thing at that point is NOT to agree with them. When they ask those questions, they are feeling you out, and trying to make sure that they will not lose your approval and support simply because they are seeing mental health and now have been diagnosed with a mental health disorder. The answer shouldn't be "Yeah, effing shrinks". That only reinforces their belief that no one will understand what's going on. A better response might be something like, "You know, you might want to take that seriously. They're the doctors, they probably know what they're talking about."

3) Treat mental problems like physical problems. I know that they're harder to see, and sometimes that makes them harder to evaluate when it's important to send soldiers to "mental sick call". But a problem in the head which is ignored, just like a problem on the body that is ignored, just gets worse. People that try to "suck it up" because they don't want a profile wind up hurt worse. People that try to "suck it up" mentally because they're not desperate yet are only going to get to a more desperate point, by which point they may not even think of good solutions like going in to get help. If you see a soldier who seems to be having emotional problems or who is starting to have problems functioning (a good soldier who has suddenly shown signs of turning into a dirtbag, for example), it's important to send your soldier to medical to "get checked out". And it's important to do this with the same quickness that you'd send a soldier with, say, a sprained ankle.

4) Taking away a troubled soldier's responsibilities. This may seem counterintuitive-after all, wouldn't you want to lower the stress on a soldier who's already having problems? A lot of commands do this with the absolute best intentions. What they don't realize is that they are taking away a lot of the ties keeping someone from doing something drastic. I have met soldiers who have told me that they would have killed themselves, but they didn't want to let their squad down, as they had an important position and would have been hard to replace. I'm not saying overload soldiers who are already having stress, but giving them tasks or soldiers commeasurate with their ability at the moment is a /good/ idea, not a bad one.

5) Remember that what a soldier is telling you about their problems may often only be the tip of the iceberg, and that 90 percent of an iceberg is below water, and 'invisible'. Someone telling you they're having problems with their wife may not be telling you, "My wife ran off with her fitness instructor, is taking the kids, and telling me I'll never see them again." That's a real example, by the way. I'm not naming names, but no one wanted to ask questions after he got off the phone with his wife and seemed upset, and so he walked out and tried to take himself over a fifty foot drop. We did manage to stop him (barely), but we also could have stopped him after the phone call, just by asking questions to find out what was wrong. A lot of these I learned the hard way.

6) Our overall reluctance to spend money. Soldiers that come in with immediate crises often have to wait weeks for mental health appointments. Referring them out to the civilian economy (at least while not deployed) could get them an appointment that week, and sometimes even that day. But it's hard to get a civilian referral out, even when mental health facilities are intensely overworked.

7) Stop assuming soldiers are faking. I think we need to start looking at this from a different perspective. If you think someone is faking a mental health problem, wouldn't that mean that they probably have some mental health issues in the first place? Sane people having no emotional problems don't decide to randomly fake mental illnesses. So maybe the best place for them /is/ mental health, whether you think they necessarily have a disorder or not. Soldiers that have struggled for whether or not to speak out for a long time, who get shut down the first time they try to share with accusations of faking, are unlikely to reemerge. I also learned this one the hard way. A first sergeant thought one of my soldiers didn't actually have mental illness, but was just a dirtbag. He stopped talking about his problems. At the time, I trusted the superior judgement of my higher up NCOs. I fucked up there as his squad leader-and now he's dead. Sometimes you don't catch them all-but I hope my negative example can help teach others what not to do at least.

If anyone else has any that they've observed, or thought, I'd be happy to include them here.


Davy said...

Good post, I had a really dark time a few years back, and took some painkillers and almost achieved my goal, I was at a TRADOC unit at Ft. Gordon and they didnt even know I was knocked out for several days because they were that shitty at leading, anyway the biggest sign that I was going out of control for me was that I lost all inhibition and fear, I would do crazy, risky stuff all the time and say anything to anyone, I just didnt care, and your right, the only time I felt somewhat better was when I actually had a task with a set goal, that sense of daily accomplishment really helps, its the hurry up and wait shit that gives someone too much time to dwell and it also makes servicemembers feel pretty worthless because there not achieving anything

Wendy said...

I have a son-in-law who is on terminal leave from the Army. He was on medication for PTSD, he was attending counseling for PTSD - but the minute he went on terminal leave - the Army's interest in him terminated. We lost our oldest son to suicide in 2004 - I think it gives me some experience in this area - and I will tell you this young man is suicidal. He threatens my daughter that if she leaves him or tries to take the children that he will keill himself or her and the children. WHERE IS THE ARMY THAT CARES SO MUCH FOR THEIR SOLDIERS??? Fort Rucker doesn't give a damn about this young man, they just want to get him "gone".... Prior to his diagnosis of PTSD, he was an exceptional soldier - now he is just excess junk to the Army.
My daughter struggles with a man who is has severe mood swings, has panic attacks, is hurassing and terrorizing his two small children, now refuses to take medication and attend counseling becuase now they can't "make" him - I forced my daughter to remove all the guns from their house as a precaution... The Army's management of his case has ruined this young man's life and now they are just shifting him out without any oversight. This situation is a train wreck that is waiting to happen - and no one in the Army cares.

Anonymous said...

I am glad that i am not the only one who has had a cloudy day. Because of things that happened in my marriage, coupled with the stress of deployment, I was ready to "end it all." The thing that stopped me was the fact that I didn't have any bullets with me at the time, and I wanted it to happen quickly. I didn't want to use a knife because that would take to long. I didn't want to go wait for the train to come--which was behind the barracks where I was living at the time--since that wasn't predictable enough. I didn't want to take anything that would poison me because there would too much pain involved. Maybe that was a wimpy thought, but I'm still alive. That was one of the darkest moments I've experienced where I was really ready to complete the task. Thoughts had passed through my mind before, but nothing ever that serious. Once I got back from deployment, I still had some issues with my mind and my marriage, which made me think about actually using some of the mental health service assistance. After some sessions, which are ongoing, I started to feel better about myself. Eventually, my marriage fell back into place too, so for the time being, I am doing well. I tell all of this because no one would have been able to see what I was feeling without me letting them know. Some of the guys in my unit noticed that I was different than normal, and they even tried talking to me, but I kept them out of my 'personal space.' That might have been another reason why I didn't go through with things too: I didn't want to disappoint them. Whatever the case, the assistance that I received has helped. So, I guess that's a success story.

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Anonymous said...

I'm going to send this post to some of my friends -- it's so very relevant. Earlier this year, I tried to get help with an eating disorder that was making me ill while on active duty, and instead of the medical treatment that I was hoping for, I was put through the ringer of substance abuse counseling (for laxative abuse? really?), mental health "professionals" who were just looking for a reason to discharge me, and insults from NCOs who seemed to think it was all just a big plot to get attention. So much for going quietly to the BAS and trying to have a confidental talk with the doc... I understand that strength is a key element to a successful military, but isn't that all the more reason to encourage good mental and physical health instead of denigrating the soldiers who are brave enough to actually seek help for the issues that are holding them back?

rainsong1121 said...

My boyfriend is a part of the 101st Airborne. Currently with an injured back and they changed his MOS to 14 Juliet. He found out yesterday his orders are to Japan. He's been very depressed for a long time but never told the Army because of the stereotype it held. He said that the 101st Airborne has the highest rate of suicide of any Army base..and these are men who haven't deployed! He said when someone kills themselves the Army makes everyone fill out this suicide survey. He told me that they were all told how to answer on the paper!!! How insensitive and messed up is that?

Last night we went to his company and told them he was about to snap and blow his head off. He was on suicide watch all night and is now going to a mental health facility to be locked down anywhere from 2-4 weeks. He gets no contact by email, phone, computer, nothing. I just don't understand how the Army can allow our soldiers to feel so ashamed to admit they have a problem that it even gets to this.

Does anyone know how the Army handles suicide threats/mental health lock up? Do they discharge you from the Army?