By Gerald Korson

Veterans up to four times more prone to suicide

Chaplains say 'first responders' are needed to reverse increasing rates among soldiers

Private Smith, 22, was three months into his first deployment to Iraq when he learned that his girlfriend was involved with someone else. After that news, he began to abuse alcohol regularly. One night, he refused to go work out with his buddies in the gym, which was unusual for him. He shot and killed himself later that evening.

That story is one of five vignettes featured in a new interactive film being developed by the U.S. Army to train its troops in how to spot the warning signs that a soldier is considering suicide, which ranks just behind accidents as the second leading cause of noncombat deaths in the U.S. military, according to the National Alliance on Mental Illness.

Suicide is increasing among soldiers and veterans, a trend that has the U.S. Department of Veterans Affairs (VA), the various branches of the U.S. military and their corps of chaplains strategizing about how to better recognize the warning signs and intervene more effectively.

Last month, the U.S. Army reported 89 confirmed suicides and 32 suspected suicides among its soldiers in 2007. Of these, 34 soldiers ended their lives while serving in Iraq.

While those 121 cases represent a 20 percent increase over the 102 Army suicides reported in 2006, just as alarming is the fact that 2,100 soldiers attempted suicide in 2007 -- a rate of nearly six per day. By way of comparison, there were 1,500 Army suicide attempts in 2006 and just 500 in 2002, the year before coalition forces invaded Iraq.

Most shocking of all is recent data showing that veterans were found to be twice as likely to commit suicide as civilians, and vets aged 20 to 24 were up to four times as likely. The information was collected by CBS News, whose investigation last November of the death records of 45 states revealed at least 6,256 suicides among veterans in the year 2005 alone.

While these figures involve vets of all wars, and not all deaths are directly attributable to war-related psychological problems such as post-traumatic stress disorder (PTSD), the numbers provide evidence for what CBS characterized as a military suicide "epidemic" -- a term to which the VA takes exception.

"One suicide is too many," VA spokesman Phil Budahn told Our Sunday Visitor. "There is an unfortunate historical record of an incidence of suicide among returning combat vets for about the first five years after they return. We've seen that in other conflicts going back at least as far as World War II."

Stress from relationships

Although PTSD is a contributing cause in many instances, problems in relationships have been the most common stress factor among active-duty and returning vets alike.

Active-duty service personnel "are under stress in harm's way, and hearing about troubles back home cause more stress," said Father (Cmdr.) John Hannigan, a Chicago priest and Marine chaplain who spent 19 months ministering to soldiers in Iraq and now serves at the Marine Corps Air Ground Combat Center in Twentynine Palms, Calif. "They come back home and notice things have changed, and that the people in their lives have changed. ... They have not fully recovered from the stress of warfare, and now they're faced with a different type of stress."

Multiple other factors exist. A Department of Defense task force concluded last June that extended tours of duty and multiple deployments increase soldiers' mental health risk. A January report by the Iraq and Afghanistan Veterans of America (IAVA) cites studies that a shortage of trained mental-health professionals in combat zones and insufficient psychological evaluations of returning combat veterans mean that many with PTSD or suicidal tendencies go undiagnosed.

Those are concerns that both the military and the VA are getting better at addressing, Budahn said. The VA has been "ramping up since the fighting began" and has added 3,000 mental health professionals to its system in the past two years. VA health workers now routinely ask questions and look for signs that might indicate PTSD regardless of what medical concern brought the veteran to its facility.

One of the keys to success in preventing suicide is early intervention.

"We have good hard clinical studies that show that the incidence and severity of PTSD could be lessened if care is provided closer to the front lines," he said. "The military is doing a better job than it ever has in the past in terms of providing that care to the soldiers, so that sometimes they're talking about it within hours of a traumatizing event. All that helps ultimately to defuse the development of more serious problems later."

Father Hannigan believes support for the military and veterans is sufficient but that more can always be done.

"We need everyone to be first responders," he said. "Everyone must be aware of and prevent suicidal ideations. Joking about killing oneself must always be taken seriously, just as jokes about hijacking are not tolerated anymore at airports."

Fear of being 'weak'

One big obstacle to mental-health care screening has been that the active-duty soldier or veteran often has had to seek help on his own initiative. That goes against the image of a soldier as a tough individual who can handle extreme pain and stress. IAVA stated in its recent report that 50 percent of soldiers and Marines in Iraq who test positive for mental-health problems worry that fellow service members will see them as weak or that the diagnosis will hurt their military career. "Because of these fears, those most in need of counseling will rarely seek it out," the report said.

That's where tools like the Army's new interactive suicide-prevention training video come in: It's part of an effort to de-stigmatize mental-health issues and to encourage military men and women to recognize when someone is at risk for suicide and to offer appropriate help. Father Hannigan himself was in San Diego in February to participate in a mandatory seminar on "Understanding and Addressing Combat Stress."

For veterans and their families who experience readjustment issues, the VA has extended hours at many of its 153 hospitals, 881 outpatient clinics and 209 vet centers. It has also set up a suicide hotline at 1-800-273-TALK (8255).

Gerald Korson, a former OSV editor, writes from Indiana.