A tragic milestone was reached last year, when 185 active-duty Army soldiers died by suicide, surpassing the 176 soldiers killed in battle in Afghanistan that year. The Army's annual death toll from suicide has more than tripled since 2001, when 52 active-duty soldiers took their own lives.
Just as disturbing: The increase in military suicides came while the military was mounting an aggressive series of suicide prevention campaigns and offering resources to help soldiers and their families.
That demonstrates a difficult truth: Reducing military suicides will not be easy or quick, as Army Gen. Raymond T. Odierno recently told The Huffington Post. The Army's chief of staff, Odierno is charged with recruiting, training and equipping the 1.1 million active-duty, reserve and National Guard soldiers. He's also responsible for the health and well-being of Army troops and their families.
Odierno outlined steps the Army is taking to reduce military suicides, including sleep discipline and better nutrition. But he acknowledged that the suicides won't simply stop when troops are no longer being sent on combat tours to Afghanistan. Meantime, he said, every death is "heartbreaking."
At 59, Odierno is one of the Army's most experienced combat commanders. The son of a World War II Army sergeant, he grew up in Rockaway in northern New Jersey and graduated from West Point in 1976.
Known to troops as "General O" and physically imposing at 6 feet 5 inches tall, he spent almost five years fighting in Iraq, as commander of the 4th Infantry Division, as the operational commander of the "surge" forces in 2007-2008 and as overall U.S. and allied commander until September 2010. Currently, he is overseeing a sweeping Army reorganization, reshaping its 44 combat brigades into 33 more capable units and shedding some 80,000 soldiers over the next four years.
A highly decorated artillery officer, he has led troops at every level from platoon to corps, and has served as primary military adviser to two secretaries of state, Colin Powell and Condoleezza Rice.
Odierno sat down in his spacious Pentagon office with The Huffington Post to talk about the growing number of Army suicides and what the Army can do to strengthen at-risk soldiers.
You've been in a lot of extreme, dangerous situations. What have you learned about what makes soldiers strong?
First, inherently what we do is stressful. Why do I think some people are able to deal with stress differently than others? There are a lot of different factors. Some of it is just personal make-up. Intestinal fortitude. Mental toughness that ensures that people are able to deal with stressful situations.
But it also has to do with where you come from. I came from a loving family, one who gave lots of positive reinforcement, who built up psychologically who I was, who I am, what I might want to do. It built confidence in myself, and I believe that enables you to better deal with stress. It enables you to cope more easily than maybe some other people.
You've always had a mix of soldiers coming into the Army. But it's only been since 2004 or so that the suicide numbers have gone up so dramatically. What's changed?
We've been at war for 12 years, that's what's changed. I think also the social environment has changed. We certainly seem to be having more people coming from split homes, from family backgrounds not as stable as we once had. There is more pressure on young people today than when I was a company commander. So it's a combination of these pressures.
Did you ever have a soldier under your command take his own life?
What was that like?
For me, heartbreaking. I've always said the Army is about soldiers. That's who we are. And every soldier is important to us. And whether we lose him in combat, whether we lose him to suicide or to a motorcycle accident, it's all the same -- we are losing a great young man or woman who we need. There is nothing more heartbreaking to me.
And when we have a suicide, we review what happened. And we always find a place where, if somebody had intervened, almost every time you see signs that we missed. Something we didn't know about his or her background. And we just say, if we knew this, then maybe we could have gotten him the right help. That's the frustrating part about this. We are much better at that today than we were five years ago or 10 years ago.
You must have had soldiers under your command who were at risk like that.
I had a young man who was raised by his grandmother. Had no mother or father -- actually I think the father was in jail. Mother was a drug addict. A great kid, hard-working. He comes into the Army, 18 years old, and he has four kids and a wife who's a little older than he is. He's coming into the Army to get help, to get a job, to get housing, medical care. When you get somebody like that, he's a high-risk person -- not because of who he is but because of the circumstances that he now has. He has some vulnerabilities, you know that upfront. Add that onto a deployment -- he's away for a year in a very stressful situation, separate from his wife, his kids. You now have to recognize that you have a potential for problems.
What do you learn from managing a case like this that you can use more broadly in your suicide prevention efforts?
First, that you have to have systems in place that help the family. We have that at the installation [base] level, so we have family readiness groups. And we have places they can go, like Army Family Strong, to try to reduce potential problems when a soldier is deployed. As a commander, you work with a soldier to make sure he is willing to communicate if there is a problem at home. And you have his or her immediate supervisor watch the soldier carefully to make sure he's not having another problem adding on to a domestic problem. Because one thing we have found is he might be able to handle two or three problems, but then the fourth one is overwhelming.
So with a soldier like that, who may be at risk of suicide, how do you build resilience, give him the confidence you got when you were growing up?
Most of the time, these are good kids. The reason they came in is because they wanted to make a better life for themselves. For me, that's number one. They are doing this for a positive reason. They want to improve themselves, improve their families' ability to live.
Studies show that if they have more confidence in themselves mentally -- for example, if they increase their education, they increase their abilities to do their job in the right way, become more physically fit and are able to do well in physical training -- this starts to build their confidence. Then we try to give them coping skills and, depending on the individual, get them linked spiritually into whatever they happen to believe in.
The other piece, which the [Army] Surgeon General is working now, is the triad of sleep, nutrition and physical fitness. We are finding that, especially in high-stress environments, lack of sleep and bad nutrition potentially decreases your resilience and ability to cope. So it's all of these things we are focusing on in order to help these individuals.
What about that first line of help for at-risk soldiers, his peers -- the battle buddies who know him or her best?
Peer intervention, and what I call the bystander mentality. We have to eliminate that [bystander mentality] because what happens is you have friends and peers who observe [a problem], they know it, they choose not to do anything.
Or they don't know what to do.
Right. They may try to intervene themselves, and if they don't make any progress, they don't know what else to do. So what we are trying to tell people is intervene, let people know if you see a change in attitude or behavior. And we've had a little bit of success there. We are seeing peers come forward.
And do they know what to do, where to go, what the resources are? Do you have good peer training?
They get trained, they get the information on where they need to go. Now, I'm not willing to say yet that it's ... enough.
I hear from many in the military that they're afraid to get help or to turn someone else in for fear that it will jeopardize their career. How do you deal with that?
The Army works against itself sometimes. We want strong, independent, mentally and physically tough people because we need that to accomplish the mission. And it gets into a bit of the stigma of coming forward and saying, well, you know, I have a little problem. Maybe you have a vulnerability and a weakness. So you have to create an environment within your command where this becomes acceptable.
I can dictate it from my level for the whole Army, but that's not gonna work. It has to be developed in companies and platoons and battalions, where you have an environment in which people realize it's OK. And that if you have a problem, a mental health issue or anxiety or depression, it's curable! For me, that's the key. Not only can you recover, you can build on it. In my mind, people who get help can be stronger and better afterwards. So we have to change the culture at the lowest level.
That's a big change.
How far along are you in getting that change done?
We are in the beginning. If I use a football analogy, we are on about the 35-yard line and we still got quite a ways to go. But we're not on the goal line anymore. We've come off the goal line and we're starting to move forward. That said, from 2003 to now, we've come a long way with this suicide prevention. But this is a problem that's not going to end when Afghanistan is finished. This is something that's going to go on for many years afterwards. We have to be prepared to understand that.
This interview has been edited and condensed for clarity.
This article is part of a special Huffington Post series, "Invisible Casualties," in which we shine a spotlight on suicide-prevention efforts within the military. To see all the articles, blog posts, audio and video, click here.
For a review of warning signs someone may be at risk of suicide, click here. For a list of resources to get free and confidential help, click here. If you or someone you know needs help, call the national crisis line for the military and veterans at 1-800-273-8255, or send a text to 838255.
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