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.

Wednesday, February 18, 2009


Yes, I know I've been somewhat off the grid for a while-since getting to my new unit. Allow me to tell you that it's not for any nefarious purposes-I simply have been pretty busy.

My new unit is allowing me a lot more time to actually slow down and take care of myself. Why is this important? Well, as an NCO you get filled with a lot of "take care of your soldiers first" mentality. It's a really good thing-it helps get your joes taken care of and contributes to the effective functioning of the unit. But it only works when the leadership above you also does the same thing. If everyone in the Army did what they were supposed to, and took care of their people, the entire thing would work like a charm. Unfortunately, that's not always the case.

I've been started in something called CPT for my PTSD. Supposedly, it has a high rate of success in reducing the severity of the problem, which would be great. I'm going in with an open mind, and I'll report back to you on how it goes. Unfortunately, it involves something which I believe is known as "exposure therapy", which requires you to reexperience the trauma, a lot, to desensitize you and somehow heal you. I'm not quite sure how it works, but I'm told it will probably make the PTSD worse for a while before it makes it better. This isn't exactly good news for me, because I'm not sure how much worse the woman who's running it is talking about. I've seen some pretty severe PTSD cases, and I hope it doesn't get that bad. The up side, though, is I'm told that once the PTSD gets worked on, a lot of the depression that tends to go along with it will also lift, and it will make me both a more productive and a happier soldier. We'll see.

I'm also trying to do more in the way of education-both my own and of others. For those of you who were unaware, I was a victim of domestic violence while in the military. Which is one of the few trainings the military doesn't do-what it is, and how to recognize it and get help for it. They're starting to, now-I notice a few commercials on AFN about seeking help from Family Advocacy. But at the time I had my problem, domestic violence really wasn't understood very well by leadership, and they blew it off because I didn't fit the profile of the stereotypical battered wife as they understand it.

So I'm going to put out here a few things for leaders and soldiers that may help you recognize some of the signs of domestic abuse that aren't as obvious as bruises on the face:

1) Sudden changes of clothing and/or makeup. Domestic violence is about control-some signs can be that the woman 'gets in trouble' for 'looking too pretty'. If clothing and makeup suddenly become more conservative after a relationship, it could be a warning sign.

2) Sudden changes of friends and associates. Again, domestic violence is a function of control. One of the first major things an abusive partner does is help to cut the victim off from people who could potentially point out a problem or help provide support. This way, when the person is ready to run, they don't have a lot of support to do so. If you see someone systematically cutting off all of their friends, and not seeming too happy about it, it may be something to note.

3) Cutting off from the Army Family. The Army Family, dysfunctional as it may be, offers both a lot of support and a lot of watchful eyes. If you have someone who was formerly very engaged in unit activities who suddenly stops attending after a new relationship or after talking about problems in an existing relationship, it's another potential sign of domestic trouble.

4) Giving up possessions, pets, or things the person formerly used to enjoy, while mentioning that the new partner doesn't like them.

Those obviously aren't complete, and aren't sure signs, but it's my attempt to help show what to be aware of.