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Joseph Bobrow

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Meds Not Enough to Bring Down Rate of 1 Vet Suicide Per Day

Posted: 06/14/2012 2:00 pm

He was remote and suspicious, and I could feel how depressed he was.

A heavy set Iraq veteran, he came with his wife, who stayed close at all times. But he was not emotionally responsive to her, or to anyone for that matter. On the third evening of the retreat, he chose to watch a film called the Gifts of Grief, one of several programs that were offered.

Two thirds of the way in, I saw him emerge from his deep freeze. First his eyes began to water, then a few tears ran down his cheeks. When the film ended, he got up. The color had returned to his face. His arm was around his wife. A few more tears trickled down. He made no effort to conceal or wipe them away. As I approached him, he began to talk about his losses during the war, how unbearable they had been, how he hadn't told anyone. There were more hugs with his wife, conversation, and, during the large group, he leaned over and gave her a kiss.

He began talking with his fellow vets. He was alive again. In a small group meeting he described how desperate he'd felt and revealed how he'd tried unsuccessfully to kill himself to end it. During the large closing circle he surprised everyone by speaking and expressing his gratitude to all gathered. It was visible that the depression had lifted, at least for the moment. He'd come back from the dead. Then he said something that stopped me: he looked forward to seeing everyone again next year, if he was still here.

This veteran was already in psychological treatment, and on all kinds of medications. After the retreat, a fellow spouse whom his wife had befriended contacted me and let me know that his house was being foreclosed on. It had brought him spiraling back down, and he'd become suicidal again. The support and resources he and his wife received from fellow vets and spouses they'd connected with at the retreat helped him make it through intact.

There are other examples of vets expressing suicidal feelings and even revealing attempts, past and planned, that they've never told anyone, sometimes even their therapist.

A new Department of Defense report brings into sharp focus just how elusive a solution to the continuing alarming rise in suicides among active duty service members is. In 2012, there have been 154 military suicides in 155 days, a rate of one per day, more than the number of combat deaths during the same period. And suicides have also eclipsed car crashes as the top "non-combat" cause of US troop deaths. It is truly alarming that these numbers do not include National Guard and Reservists and Veterans. Paul Rieckhoff, Executive Director of Iraq and Afghanistan Veterans of America, reports that 37 percent of the Iraq and Afghanistan veterans among their approximately 160,000 members know another veteran who has committed suicide.

But when at-risk veterans are in a safe environment with fellow vets they trust, and with whom they can stay connected -- that's what can begin to make a huge difference.

At the Coming Home Project, we call it the power of community. In the military, it goes by the name unit cohesion. In the research world, social support. Although not a panacea, it heals and prevents, strengthens and inoculates, all at the same time. Unit cohesion correlated, in one study, with lower suicide rates.

Feeling safe, understood, and accepted without judgment are pivotal elements of community. Another key is a sense of belonging. Dr. David Kahn, an authority on suicide prevention, wrote in 2008 about studies with students, "Connection and a feeling of social belonging is, I think, the most important initial step in preventing suicide," he said. "Once the person feels that sense of trust in belonging to the community, they may be more receptive to suggestions that they seek help, if they haven't sought it already." This was confirmed at every turn at Coming Home's recent student veterans' retreat near Yosemite.

Jackie Garrick, head of the newly established Defense Suicide Prevention Office at the Pentagon, expressed concern in an interview about the increase in the military suicide rate, "Experts are still struggling to understand suicidal behavior," she said. "What makes one person become suicidal and another not is truly an unknown." I admire her honesty; a good leader is honest. Not knowing is a good place to start. Here is what I've seen and learned:

  • Even people in therapy and on medications commit suicide.
  • Not every one of the couple thousand service members, veterans and their families and care providers who've attended Coming Home retreats want or need therapy. Those who do should receive the best care - no question.
  • Big top-down programs and public relations campaigns, while useful, only go so far.
  • Massive trickle-down train-the-trainer approaches, likewise, do not necessarily suffice to change a culture.
  • Attention to practical needs of veterans - jobs, housing, education, health care - makes a huge difference, but likewise is not sufficient.
  • Peer-based counseling programs are useful but still require the person to self-identify as having a problem. They are not what I am referring to in this blog as social support or peer support.
  • Online support communities are critically important and useful but need to be complemented with in-person opportunities to stay connected. Some prefer online, others don't. In-person and virtual together are the wave of the future.
  • Military culture is tough to change and we should be realistic about how much stigma reduction to expect. I think the transition home from the war zone and the transition out of the military are critical periods to intervene with community-building approaches.
  • Active Duty Service Members and Guard and Reservists can benefit mightily from genuine community-building peer-support based programs facilitated by trained therapists, chaplains and other veterans and family members, outside of military settings.
  • Stigma vanishes (perhaps temporarily) in these optimal settings, and vets become more open to follow-up services.

Although the need for psychological treatment will continue, and top notch psychological services must be made more accessible, I think the future of suicide prevention and resilience programs (as well as reintegration, transition assistance, and mental health programs) lies in integrative community-based public health approaches that are interdisciplinary, community-building and educational. These will be psychiatry-friendly but not based on compartmentalized, medical models of mental disorder and mental health. They will acknowledge the thirst for spirituality-friendly venues where the moral and spiritual injuries of war that I and others, including Shay, Tick and Dewey, have written about. These wounds are what keep veterans up at night, for decades, and contribute to despair and hopelessness so profound that they often lead to suicide. It takes a community to welcome, weather and help transform such unbearable experiences and feelings. To enable veterans to feel that they belong, they matter, are accepted, and understood.

These optimal settings, based in the community and working in concert with the military and the VA, will cultivate durable, ongoing social support opportunities for veterans and their families. Service members, veterans and their families benefit from such approaches. We should make them part and parcel of reintegration and mental health programming and provide the resources necessary for them to grow.

 

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He was remote and suspicious, and I could feel how depressed he was. A heavy set Iraq veteran, he came with his wife, who stayed close at all times. But he was not emotionally responsive to her, or ...
He was remote and suspicious, and I could feel how depressed he was. A heavy set Iraq veteran, he came with his wife, who stayed close at all times. But he was not emotionally responsive to her, or ...
 
 
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ThinkCreeps
Seriously, it's time.
10:38 AM on 06/19/2012
How to lessen the toll?

Remember to avoid endlessly repeated deployments to pointless needless wars.
Cutting back on redeploying soldiers after multiple severe head injuries might be a good idea too.

Perhaps better mental health risk screening on the way in, if for no other reason than you'd never have a had a better chance to understand the problem, given the orgy of casualties over the last decade, following thirty years where a single one was unacceptable. It has to jolt the career soldier.
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darttabb
Alcohol, Tobacco, & Firearms. Where's the chips?
05:24 PM on 06/16/2012
The headline is wrong. One a day is active duty military. Among veterans, it's more like 18 a day.

Hard to believe we have a Department of Veterans Affairs. Not to mention shameful.
12:18 AM on 06/17/2012
I agree, wholeheartedly, darttabb. Good point!
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Relentless rik
WHOSE MICROBIO IS IT ANYWAY???
03:41 PM on 06/16/2012
The best way to reduce the number of vet suicides is to NOT fight unnecessary wars in the first place.
01:12 PM on 06/16/2012
While military culture is in fact difficult to change -- it can and should be done. The only way to do it is to hold those who engage in any type of harassment and bullying accountable for their actions.Giving a pass to military leaders who view these experiences as signs of weakness and whining will never resolve it. Allowing military leaders to couch 'bullying' as 'intrusive leadership' will never change the culture. It is simple and it is straight forward. Do not allow harassment of anyone.
MajMike
Retired USAF Major, 100% DAV due to combat wounds
03:22 PM on 06/16/2012
That is so much easier said than done as most of the "harassment" is unsaid, simple disdainful looks or even worse, just a lowering of opinion about the veteran. Such things can never be banned or prevented, or even measured, but as one who suffered through it is a powerful depressant. Of course your own mind makes it out to be even worse than it really is, magnifying the problem as we relive the experiences over and over in our heads.
05:51 PM on 06/16/2012
I agree it is easier said than done.

But, that does not relieve the Military and it's Civilian Leadership of the responsibility of holding harassers responsible.

Nor does it absolve those in positions of leadership of the responsibility of making it crystal clear that no level of harassment will be tolerated.

Nor does it absolve those who sit idly by and watch the harassment of the responsibility to do something to stop it.

And most of all it does not absolve the organization of the responsibility of making the wrongs they do right.

Anything less than full accountability for this behavior is a decision to be complicit in it.

Anyone who engages in it or is unwilling to stand up and stop it is a coward.
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marinemomof3
"They lied mom", I know son, I know.
12:47 PM on 06/16/2012
Remember Michele Bachmanns’s attempted $4 billion cut from disabled veterans compensation? Well, “they’re ba-ack…” Except this time they are looking to cut away at our VA healthcare.

http://www.disabledveterans.org/2011/04/16/republicans-seek-to-cut-1-3-million-veterans/

CUTS SO THE RICH CAN GET ANOTHER TAX CUT IN THE AMOUNT OF $5 TRILLION OVER THE NEXT 10 YEARS.......((NOT INCLUDING THE EXISTING BUSH '01 AND '03 TAX CUTS))

Support the troops and Veterans, vote these hypocrites OUT !
04:53 AM on 06/16/2012
And in my earlier post I forgot to mention that many of us feel that the mental health professionals are just kind of flaky, even the ones in uniform. No offense.
04:51 AM on 06/16/2012
Just to ask, has anyone checked the relative rate of suicides across the rest of the population? The military was actually below teh civilian rate not that long ago.
Now, that being said, Vets have a distinct set of problems that can be addressed, and suicide can be examined in that small population and the causes addressed (and to some extent that is being tried). One of the big components missing is the spiritual aspect of out personality. Most people do in fact crave some contact with the supernatural. Of course, in this day and age it has become fashionable to ignore to deny any higher power. Yet, when it comes down to the fundamentals, and combat tends to screen the distractions quite brutally, the only point of reference in the universe is yourself it's a pretty lonely place. Your health has many components: physical, emotional, social, AND spiritual. It is part of our makeup. Denying that fact often causes much damage.
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marinemomof3
"They lied mom", I know son, I know.
12:43 PM on 06/16/2012
More accurate figures then what the government feeds nasty civilians.

http://blogdredd.blogspot.com/2012/05/surge-of-snap-sergeants-2.html

PART OF THIS POST:

Dredd
Our government is a wartocracy.
273 Fans Become a fan
22 hours ago ( 2:29 PM)
I guess that means it won't help with the actual figure (18 per day, 6,570 per year) either.

The last figures I had heard was one service member every 80 minutes, which is very close to your figures :(
02:19 PM on 06/16/2012
18 per day must include all vets, which is a much larger population. I suspect that suicide is also a national problem, not just a military problem.
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Zapato Roto
04:26 AM on 06/16/2012
We should be embarassed as a nation of the way we take care of our vets. When they return from several missions they don't have a job, they end up homeless, and it has taken the nation a long time to recognize PTSD. They were put in harms way, whether we agree or not with the mission, without questioning it. Some have lost limbs, they have sacrificed their families and their well being in the process. It is right to treat them as heros when they come back. And for those who have paid the ultimate price we should take care of their families including their kids education, without making of it a party propaganda, or for some other motive.
03:57 AM on 06/16/2012
As an Iraq war vet, I am glad this issue is being discussed. The impact of multiple deployments to combat zones has yet to be fully elucidated. Proper mental health screening and treatment for all veterans needs to be a high priority.
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realitytrumpsbull
Two 'alves of coconut!
01:06 AM on 06/16/2012
I think the military should do more in the lending dept., to ensure that those battling the various forces of evil 'round the world aren't being financially attacked on the home front in their absence, and that they're on sound fiscal footing whether they're in a tank cupola halfway around the world, or kicking rocks on some forgotten Army base, standing by to stand by etc., or even after they leave the service, that information and counseling/advisory/resources be placed at their disposal to ensure that 'home', that which is supposedly being fought for and defended, is not being stolen away by some financier with computerized, systematic machinations or other similar circumstances in the background, there. Mental: War is hell, people are thrust into uniforms, training programs, finally airplanes, bid goodbye and sent over the horizon to return victorious, but, what's the head-trip really like for these folks, and in the example of people like Bales, what's really left after the 3rd-4th time sticking their head in the lion's mouth, there? Time to enlist more alphabet soup to study and fully understand this phenomenon to the maximum extent humanly possible. Maybe if they do that, they'll have a fighting chance to stop things like suicide, and berzerkerism.
04:43 AM on 06/16/2012
Actually there is a lot of help in that category. USAA will drop your APR to a rock bottom level while deployed, as well as put out a credit alert to help prevent identity theft. There is abundant financial counseling available as well, for those who choose to taek advantage of it.
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imdesign
Expression is Everything.
12:18 AM on 06/16/2012
The machine is big enough to effect global change, if it chooses to. The machine, made up of defense spending and driven by media propaganda to influence a global attitude to accept conflict and death as part of life, is in need of a huge paradigm shift.

If...the same budgets were spent on reducing hunger, homelessness, poverty, starvation, sickness world wide we would have a different village to live in. It's not because we don't have enough, it's only because trade and economics are the bargaining tools used to create demand. We now have food on the futures trading floor so profit is the motivation, not equal distribution.

It suits corporations to have conflict. And men and women will answer the call to defend, only to be discarded once their finished with, or of no use. Here I am not reducing their service, but I am fully questioning the intention of those who still see war as a solution. It is not.

If, the budget for war was used as a builder of bridges, irrespective of religion, race, colour, culture, nationality, so that the strategy was not to defend and attack, but to seek a path where we meet in equality, tolerance and acceptance, maybe we would leave a better home for our kids. Imagine politics, corporations and media committed to this.

Imagine. You may say I'm a dreamer.....
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david mielke
Nebraska liberal
04:21 AM on 06/16/2012
Dream on, my friend. F+F.
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imdesign
Expression is Everything.
07:16 PM on 06/17/2012
....but I'm not the only one....

Thank you!!
04:44 AM on 06/16/2012
Yes. You are a dreamer. Keep dreaming. The rest of us will deal with the real world for you.....
12:47 PM on 06/16/2012
The real world is what dreamers make it
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imdesign
Expression is Everything.
07:18 PM on 06/17/2012
I didn't say I had left the real world (as it is now) or not dealing with it at all. But with what energy I choose to deal with it, every minute of every day.
09:32 PM on 06/15/2012
Big surprise, a pill cant cure everything, and people should realize that on many levels. Regular citizens, myself included, owe a great debt to our veterans that we can never repay. We should at least be able to offer every man and woman who comes home the full support of our country in every-way, economically, socially and medically.
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JoeLosFeliz
Paid posters: unethical, no credibility
06:21 PM on 06/15/2012
The whole "I support the troops" thing coming from the right is nothing but a bunch of hot air. As a friend of an Iraq vet who committed suicide before being redeployed (mid 2000s), I can attest to the fact of how little support these men received. He left behind a small child, a girlfriend, and two parents - all of whom will never fully recover from the loss.
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marinemomof3
"They lied mom", I know son, I know.
12:49 PM on 06/16/2012
Do you support this ??

Remember Michele Bachmanns’s attempted $4 billion cut from disabled veterans compensation? Well, “they’re ba-ack…” Except this time they are looking to cut away at our VA healthcare.

http://www.disabledveterans.org/2011/04/16/republicans-seek-to-cut-1-3-million-veterans/
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JoeLosFeliz
Paid posters: unethical, no credibility
02:00 PM on 06/16/2012
Disgusting.
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VileOverlord
Vile Overlord is pleased by the carnage
05:22 PM on 06/15/2012
All kidding aside, I am a Vet who wrestled with the idea of suicide and some days still do. I was part of the first Gulf War, the one no one remembers. I was there very briefly and while my claims to fame are the stuff of redacted pages in my file I fought daily with the idea of ending it. I sought counseling and was in it for years. I have recently been able to stop taking the meds and am on a fairly even keel. I read about what is going on and have repeatedly said that meds are not the answer. Maybe meds AND counseling but never meds alone. I was lucky and was already in when the wave of W's idiocy started flooding the clinics. The VA needs money to hire more counselors. Congress continue to drag their feet and obstruct. This is the real reason for these deaths. This is the reason to stop the GOP.
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Stanley Bonk
"mad, bad, and dangerous to know"
02:58 AM on 06/16/2012
A lot of us remember that war, my friend. It was honorable, and you fought with the good wishes of the entire world behind you. A despot attemped to invade another sovereign nation, and you helped to drive that invader back. You need feel no shame for that.

The Government, on the other hand, didn't care what happened to the men who returned from that conflict or what it did to them. The people who run the miliitary rarely do. I'm glad you could find the kind of help you needed, and I hope you can put the trauma behind you. If we spent as much money caring for the people who came back as we do to send them over, we might be on the way to a better and stonger military, and healthier veterans.
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marinemomof3
"They lied mom", I know son, I know.
12:31 PM on 06/16/2012
Oh my I remember ! I was living in Brussels at the time. Got a phone call 4 am from the American embassy. Not a night I will soon forget.

Saddam had the Europeans experiencing de ja vu. As an American living in Belgium, those people treated us (headquarters for multi-national corps, NATO, etc) like kings and queens.

Those were the days when Bush Sr. and even Cheney had bits of brain matter.

Do you walk? I can't take meds. When I had two in Iraq in '08 I HAD TO WALK......some days it was up to 12 + miles......lost weight that summer :)

My thoughts and prayers will be with you friend.
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mansterEZ
searching for secular humanist fact-based truth
04:35 PM on 06/15/2012
I've fought in a war zone many many years ago and can say that I've contemplated suicide many times. Have only had a handful of good nights sleep in 40 years. I also joke to my wife she should just put me out of my misery. Medication wrecks ones liver and kidneys. I've seen and ushered people out suffering from renal failure. It's a very UGLY way to die.
Kali03
I am an Obama supporter
08:14 PM on 06/15/2012
Have you tried acupuncture? Or Yoga Warriors?

http://www.yogawarriors.com/

Complementary alternative medicine is your friend, sir.

Namaste
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mansterEZ
searching for secular humanist fact-based truth
03:53 PM on 08/02/2012
Yes I've tried everything, but have a plethora of other physical ailments to try and manage.

Thanx for your valued input. :)
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Beavis Human
11:12 PM on 08/01/2012
If you haven't already tried, I would recommend that you try vaporizing some medical marijuana in the evening before bedtime. An indica strain will work best for this purpose. It is a great aid to getting a good night's sleep and will not harm your organs or leave you with negative after-effects the next morning. It is also believed to help with PTSD and reduce suicides.
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mansterEZ
searching for secular humanist fact-based truth
03:59 PM on 08/02/2012
I do this periodically, however, the place where I work tests for drugs without notice so I must be aware at all times. I am hoping for a time when cannabis use is legalized so that being able to manage continued suffering is my choice alone.