Working with the military as a proactive mental health care provider gives me the opportunity to better understand our active duty service members and veterans. I have witnessed their dedication to duty, their strong moral standards and rich culture. Unfortunately, over the years that our country has moved to an all-volunteer force, our civilian population has had less opportunity to understand and interact with the military, and the divide between service members and civilians is increasing.
This morning, I received a distressed text from a colleague, a fellow therapist, "I'm about to board a plane, but I just got a referral from a vet. He's depressed because his girlfriend broke up with him. I asked if he was suicidal. He said no but admits to owning a gun. I can't see him until I get back in town next week. Do you think I should worry?"
As a psychotherapist, it is commonplace to get referrals from people who are in the dumps over a break up, and often times they own firearms. My reply to her text was, "If he wasn't a vet, would you worry?"
I knew her answer would be "no."
With all the publicity surrounding military suicides, increased reports of PTSD (Post Traumatic Stress Disorder) and TBI (Traumatic Brain Injury), are we tarnishing the way we view our service members? Although the awareness is meant to help them, it may be double-edged sword, possibly harming their image and potentially making it harder to understand, help and support them.
A few hours after the text, I received a call from a friend who owns a large telemarketing company. He wanted my advice on a new hire. They are in the process of searching for a VP of Customer Relations, and their top pick just got out of the Navy after 12 years of service.
"I like the guy a lot," my friend said. "He's very smart and well-qualified, but I'm wondering if there is any way to tell if he was going to go crazy down the road... any warning signs I should look for... any specific questions I should ask to assess for mental damage."
I responded by asking him if he would have the same reservations if the candidate weren't coming straight out of the military. Of course, he replied "no."
Since only 1 percent of our country currently serves in our armed forces, I can't blame the majority of us for not knowing and understanding the military culture. If they did, or if the draft was still in place, requiring everyone to serve, would the general public perception be different?
Many people who understand the dedicated culture and rigorous job training the troops go through would argue that vets are more qualified than the average civilian. For starters, every military candidate must take the ASVAB (the Armed Services Vocational Aptitude Battery), the most widely used multiple-aptitude test battery in the world. You need to have a certain AFQT (Armed Forces Qualifying Test) score to enlist in the military. These scores help determine how qualified one is for certain occupational specialties. The ASVAB also provides useful career information. These results help determine what career path is a good fit for you. It's quite brilliant if you think about it; the young adult right out of high school gets to learn what line of work he or she would naturally be good at. How many civilians do you know who could have benefited from information like that at a young age?
Veterans have some other advantages. America's Heroes at Work has compiled a list of the "Top 10 Reasons to Hire a Veteran or Wounded Warrior." Some of the key points are the robust ability this population has to learn new skills and concepts. Service members exhibit profound leadership qualities and have tremendous flexibility to work effectively independently or in teams. They are diverse, have strong interpersonal skills, and work efficiently in fast-paced environments. Additionally, they are incredibly respectful and have a deep sense of personal integrity.
When I speak to groups and organizations about being careful not to stigmatize our vets, inevitably an audience member will ask me about the increased number of PTSD diagnosis and suicide rates. It's true that suicide rates in the military are steadily climbing and outnumbering civilian suicides, but are we comparing apples to apples? Nearly one half (49.3 percent) of active duty enlisted personnel are 25 years old or younger. If comparing military suicide rates to the general population, shouldn't we also compare it to that specific age group? Rand Corporation, a non-profit research organization, has extensively studied military suicides. In their attempts to compile the most accurate facts, they've created an adjustment comparison, taking into consideration key demographics including age, sex and racial make-up. Turns out, when taking the new data into account, the outcome is different. "These results show that the suicide rate in the synthetic civilian population is both fairly constant and substantially higher than that in DoD," RAND states in its findings.
Has PTSD also developed a bad rep? Richard J. McNally, a Harvard researcher, thinks so. In his May 2012 article titled "Are We Winning the War Against Post-Traumatic Stress Disorder?" his answer is, "Yes, we might be." McNally reports that while early estimates suggested as many as 30 percent of all troops develop PTSD, he feels those numbers aren't accurate, finding that current surveys actually show the rates ranging from 2.1 percent to 13.8 percent. He adds in the article that the U.S. Millennium survey of U.S. troops found that 4.3 percent of all American military personnel deployed to Iraq and Afghanistan have developed PTSD.
Part of the current problem is that for a variety of reasons, there isn't a truly effective way to collect data and truly measure those affected by PTSD. Another key factor often ignored is that the vast majority of those identified of having PTSD symptoms will recover and go back to living a normal and healthy life.
I'm not arguing that PTSD doesn't exist -- it is a real and serious problem -- or that suicide rates aren't climbing -- they are and require serious attention. These are top priority issues the military is dealing with and trying to improve by working harder on prevention and resilience building. I'm confident these efforts will pay off. Alternatively, we civilians need to do a better job understanding and supporting our service members who have given all to protect our country. We can start by trying to learn more about our military training and culture. We can shift our thinking from problematic to positive when we think about hiring, counseling or dealing with our service members.
Do active duty and vets have a branding problem? I think so, and I think we all have a duty to lend a hand and polish that brand.
Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.
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