Why Are So Many Vets Killing Themselves?
Tuesday, August 31, 2010
We'll talk about the latest Department of Defense report on suicides in the military. We'll speak with a woman who's launched an initiative to build more resilience among marines, soldiers and sailors dealing with the stress of war.
ALISON ST JOHN (Host): You’re listening to These Days on KPBS. I’m Alison St John, in for Maureen Cavanaugh. The Department of Defense has just come out with its most comprehensive report yet on suicide in the Armed Forces. It notes that almost 2 million members of the military have deployed to Iraq and Afghanistan, and that these wars are amongst the longest conflicts in the history of this nation. The stress building up for those fighting the wars is enormous, and it's come to the point where the military is seeing an average of one suicide every 36 hours. Jamie Reno is KPBS' new military blogger, and he’s written about this phenomenon and about the new report’s call to action to stop this rising tide of suicides. Jamie, thanks so much for being with us.
JAMIE RENO (Curator, Home Post Blog, KPBS): Oh, thanks for having me. It’s great to be here.
ST JOHN: And also on the line, we have Dr. Barbara Van Dahlen, a licensed clinical psychologist who’s working to build a network of mental health professionals outside the military who can help stem that tide. So, Barbara, thank you also for joining us from Washington, D.C.
DR. BARBARA VAN DAHLEN (Clinical Psychologist): It’s my pleasure to join you. Thank you for covering this important topic.
ST JOHN: Yes, so, Jamie, let’s start off with the major findings in this report. You wrote…
ST JOHN: …in your blog that this was an uncommonly candid report. Why is that?
RENO: Well, uncommonly candid because really the military hasn’t – has never really developed a task force to look at the situation before. And, by the way, the task force was congressionally mandated. So you’ve got to give some credit to our politicians for pushing the military along a little bit here because this is – this has become a crisis. I mean, the numbers are, as you said, they’re staggering and they’re disturbing. And the military has actually done, you know, they have implemented some effective methods but these programs are not centrally organized. There’s kind of a lack of, you know, strategic planning. And we’re just not seeing the results of these programs obviously, needless to say.
ST JOHN: So what is the rate for returning veterans?
RENO: Well, the report noted that, like you said, one suicide every 36 hours. It’s – The report noted that between 2005 and 2009 more than 1100 service members committed suicide. Since 2001, 252 service members have killed themselves.
ST JOHN: And which branch of the military is seeing the highest number of suicides?
RENO: Yeah, the ones that are increasing at the most rapid rate are the Army and the Marines. And…
ST JOHN: Do they know why?
RENO: Well, you know, there are a number of reasons, Alison. I think the – my theory – Everyone has their theories. A couple of things, specifically, the nature of the war. It’s – I mean, all wars are highly stressful but the nature of the 24-hour fear of an IED exploding beneath you no matter where you are, the multiple tours that our troops are forced to make, which is kind of unprecedented in our – in military history, you know, there are – there’s another thing that hasn’t been talked about a whole lot and I didn’t mention this is my – in the piece that was already up on my blog but I’m going to be writing about it, is the – they’re giving out drugs, all kinds of anti-anxiety and anti-depressant drugs, you know, instead of really facing – You can’t really do much therapy when you’re out in the field but they’re giving out these medicines which, as we all know when we watch those commercials can increase suicidal tendencies for some people. So that’s another issue that I…
ST JOHN: To try – Drugs which are to try to treat the symptoms of post traumatic stress but are actually…
ST JOHN: …having a side effect. Yeah.
ST JOHN: Yeah.
RENO: Well, potentially, yeah, I mean, that’s just a theory of mine and there – a few other people have been talking about this but…
ST JOHN: You’re presumably going to be looking into this a lot more. This is a brand new blog.
ST JOHN: And, by the way, I’ll just give out the address for anyone who’s interested in looking at it. It’s http://homepost.kpbs.org so the name of the blog is Home Post, and you’ll be writing about all these issues and more.
RENO: Thank you.
ST JOHN: I wanted to ask Dr. Van Dahlen, why is it so different now from what’s happened after previous wars like Vietnam and Desert Storm even?
DR. VAN DAHLEN: Well, you know, many of these issues that we’re seeing today we have seen – we’ve always seen them. They’re – These issues of men and now women coming home, bringing the war home with them, struggling with post traumatic stress, we have some new features, as Jamie said, you know, the constant 24/7 distress, anxiety about IED explosions. We have traumatic brain injuries that are different this war. So some features are very similar and we had a lot of folks who came home from Vietnam who were severely psychologically injured and some recovered over many years, some never did. The men and women who are bearing the brunt of this war are doing multiple tours. I mean, five…
DR. VAN DAHLEN: …years ago when I began Give An Hour it wasn’t uncommon to hear of two and three tours. Now, it’s not uncommon to hear of four and five tours. So that’s very different, so it’s a very complex issue in terms of why we’re seeing the suicide rate as we are. And one of the things that is also distressing and concerning, some of these suicides are folks who have never been deployed, who have never gone to combat. And so what’s happening in the military environment itself that’s creating stress and distress and what does that say about the folks who are coming in and the training. It’s extremely complicated but from where we sit in the mental health community, the issue is, okay, let’s study and look at that but, more importantly, let’s do whatever needs to be done to respond to the crisis and get services to folks who need it.
RENO: I would say…
ST JOHN: And – Jamie.
RENO: I would add to that that Barbara—and I’m sure, Barbara, you can comment on with your expertise, but the subtext of all of this is, to me, I think PTSD to a large degree, post traumatic stress, which is, you know, there have been – there have been suggestions that as many as 35 to 40% of the troops who come home are suffering from PTSD and are not necessarily getting the treatment that they need because the V.A. is so overloaded with – and backlogged with, you know, they have so many people on the waiting lists and they’re just – they just don’t have the numbers, the manpower.
ST JOHN: So, Jamie, you had mentioned earlier that there – what the military is doing to try to get a handle on this has been uncoor – not coordinated enough.
RENO: That’s right. And that’s one of the recommendations that they’re giving. They’re going to be handing over to, you know, to the top brass now about what to do. I mean, basically, the final report, which is being sent today in fact, this is a well-timed interview because it’s going to be sent to Defense Secretary Robert Gates today. There are some 76 recommendations.
DR. VAN DAHLEN: Umm-hmm.
ST JOHN: Can you give us an example of a few?
RENO: Sure, sure. Among them, well, obviously, reduce stress on the force. They have acknowledged, thankfully, that the multiple tours are taking their toll. I mean, can you imagine one tour, you know, I mean, when you talk to Vietnam veterans, typically, they did one – they did one tour, you know, for 8 months or 12 months or what have you, but can you imagine going back three, four – as Barbara said, three, four or five times into the same hell hole, if you will. It’s just – it’s very – it’s inhumane.
ST JOHN: And I believe that that’s one of the things is they’re trying to do with is increased well time for the people being deployed to Afghanistan.
RENO: That’s right.
ST JOHN: The amount of time they spend at home between deployments.
RENO: That’s right.
ST JOHN: So…
RENO: But, you know, even that, a multiple tour, this PTSD doesn’t go away quickly and it’s – that’s not going to – that certainly is going to help but…
ST JOHN: What are some of the other recommendations they’re making, Jamie?
RENO: Well, they’re talking about folks in that overall service member wellbeing mind, body and spirit, they’re talking about developing a comprehensive stigma reduction campaign which, as we all know, there’s a real stigma among especially Marines, you know, that these are – this is a macho, tough group of guys and women and even – even admitting you have a problem, there’s a stigma that, unfortunately, some of our leadership, they don’t do enough to dispel the notion that having PTSD means you’re weak. Obviously, some of the toughest men I’ve ever met, men and women, some of the toughest people I’ve ever met in my life have suffered from PTSD and they’re – One of the recommendations is to have a comprehensive stigma reduction campaign which will really spread the word that, first of all, you’re not going to suffer from any sort of, you know, blacklisting or reduction in pay or what, you know…
ST JOHN: Your career might be affected.
ST JOHN: Umm-hmm.
RENO: And there’s a real great fear of that.
ST JOHN: So speaking of stigma, I mean, I think what you’re saying is – has led to a lot of people not wanting to go for help inside the military and…
RENO: That’s right.
ST JOHN: …Dr. Van Dahlen, you’ve started an organization to address that called Give An Hour. Can you describe what it does?
DR. VAN DAHLEN: Sure, I’d be glad to, and before I do I want to just echo a point that Jamie was making because I think it’s critical for listeners to understand that really what needs to happen is a huge cultural shift within the military which is very difficult to accomplish, meaning you can – And I’ve seen this repeatedly. Commanding officers, they get it that we need to tell our men and women that it’s okay to seek help…
RENO: Some of them get it. Some of them get it.
DR. VAN DAHLEN: Yes, some of them get it but even those who do don’t understand that what that requires is a cultural shift all the way down that needs to begin from the day the person signs on the line that they’re joining the military. That is going to take a very long time…
DR. VAN DAHLEN: …for that to occur so that it’s part of the culture. Just as you clean your weapon, just as you take care of your pack, here’s how you take care of your mind, your body, and that we expect those who serve to suffer psychological consequences of serving. So that’s a really critical piece. This is not just that the brass at the top or even the brass in the middle or the folks at the bottom say, okay, if you need counseling, go get it. It’s a much more pronounced and intense shift that, by the way, our society doesn’t do a very good job of tolerating or understanding mental health issues. And in this case, these are ones we expect that are normal reactions to this kind of stress. So that is one of the reasons why I founded Give An Hour with the recognition that we need to offer options. So some folks will go within the military and some folks will get into the V.A. A lot of people either won’t go because they’re afraid of the career-damaging possible consequences, some won’t be able to go even if they want to because they don’t live near the V.A. or they don’t have enough mental health professionals within DOD, so Give An Hour is really harnessing the civilian mental health community so that we, our civilian mental health population steps up, gives an hour a week to provide free care to service members, veterans, their families, their communities and other organizations that are helping this population.
ST JOHN: And it’s not just giving one hour, is it, to them?
DR. VAN DAHLEN: No, it’s giving an hour a week. And we ask our people to – our mental health professionals to commit to staying in our network a year. Most of them who have joined, who joined in the beginning, they’re still in. They want to do this, they want to do their part. We have over 5000 mental health professionals, several hundred in California, who have stepped up, who are there, available. They see family members, they see children, they see parents, they see service members. And, again, as I said, we also now are getting many requests from other organizations. Let’s say an organization is helping veterans find jobs. Well, what they’re finding is the main reason these folks are having trouble coming home and finding jobs, one, the economy, and two, their mental health issues that are coming home with them. So they need expertise in how do we assist folks so that their post traumatic stress reactions don’t interfere with their interview or that the employer is – understand these are fantastic resources, these men and women who serve our country, but here’s what you need to know about what they went through. So there’s a huge need for, again, sort of the mental health features of this war to be understood and addressed. That’s how we’re going to reduce the suicide rate, that’s how we’ll help people reintegrate into our communities.
ST JOHN: So if you’re listening and you have a question, 888-895-5727 is the number to call to reach Dr. Barbara Van Dahlen, and Jamie Reno, KPBS’s new military blogger, to talk about some of the barriers really to getting the help that Dr. Van Dahlen and Jamie are both talking about. I mean, there’s a bit of a barrier also for mental health professionals to share the details of their work but, Dr. Van Dahlen, perhaps you can talk a bit about some of the feedback you’ve had from people who’ve been helped by the Give An Hour project.
DR. VAN DAHLEN: Well, you know, it’s – there’s some common threads that we hear over and over. One being that service members will tell us, you know, they thought that it wouldn’t happen to them. It’s sort of what Jamie was saying. You know, that these tough, well-trained, impressive men and women who serve our country expect that they can withstand anything. They’re sort of trained to do that. They have experience handling amazing responsibility and things that us in the civilian world, many of us would never volunteer to do. And so when this happens to them, when they start feeling intense anxiety, when they become depressed, when they start to feel like the world is, you know, kind of becoming dark and foreboding and scary and – it’s very disorienting. They don’t understand what it is. They think they should be able to push through it. They think that, you know, flashbacks won’t happen to them. And so when they finally seek help or somebody says, hey, you know what, that happened to me, here’s what I did, and they start dealing with it. As Jamie said, beyond just medication, they start understanding there’s – there are effective treatments that assist people with post traumatic stress, with depression that results from combat. They then have this sort of epiphany which is, oh, my God, now I understand. This is – this makes sense to me. I can handle this. I can manage this. I don’t need to be ashamed. I can lead a productive life. I can continue to serve my country. That’s the kind of story we hear over and over. The other is from family members who are terrified. They see their loved one, their husband, their wife, their son or daughter, starting to spiral and they reach out to us and ask how do I help them get help? We often suggest that they connect with a mental health professional who helps them help their son or daughter or loved one and then we continue to hear from them over months, saying, you know, they’re doing better, they’re moving on. So it’s…
ST JOHN: Yeah.
DR. VAN DAHLEN: …this sense of awareness that there are things we can do. These are normal consequences and – but, literally, we’re saving people’s lives because as we see from the suicide data, people are suffering to the point where they take their own lives because they don’t see a way out.
ST JOHN: And they think that, you know, I should be strong enough to deal with this alone.
DR. VAN DAHLEN: Exactly.
ST JOHN: And yet what you’re saying is that perhaps even an hour a week on the phone with somebody could make a difference.
DR. VAN DAHLEN: Could save somebody’s life.
ST JOHN: And what you’re mentioning about the family members, I think, is also very much the untold story, the amount of families that are just struggling with the symptoms of the stress that is being generated by these wars.
RENO: Every family obviously that has a, you know, soldier or Marine or sailor that has, you know, any kind of PTSD or traumatic brain injury, every family suffers. It’s, you know, it hits home, literally.
DR. VAN DAHLEN: And we know from the literature before these wars started, so this is not literature that came out of the war, that secondary trauma, meaning exactly what Jamie’s talking about, families where someone is experiencing post traumatic stress, if that person isn’t treated, isn’t getting help, isn’t healing, it causes secondary trauma for the children, the spouses…
DR. VAN DAHLEN: …and so you have these generational issues. We’ve received many e-mails from Vietnam veterans’ children thanking us for starting Give An Hour saying, I wish this had existed for my family, for my father, because we suffered because he suffered.
ST JOHN: So, Jamie, I wanted to ask you whether this is one of the things that you’re hoping to get a dialogue going on with your blog? What is the goal that you have for this new military blog on the KPBS site?
RENO: Well, I have a lot of goals, Alison. I want to talk about – certainly, I want to talk – you know, I’m very – As you may recall, in my 17 years at Newsweek, I did a lot of coverage. I was the – I’m – I was the lead reporter on the “Failing Our Wounded” cover story that got so much national attention which talked about how the V.A. was not doing its job in terms of integrating, you know, getting active duty into the veteran world and integrating them back into society and that they were, you know, they were just – You know, I have a real strong, great respect and passion for men and women in uniform. And I want to – I want to cover the whole spectrum. I want to cover the problems they’re having, I want to cover the political sides of this. Obviously, I want to focus on San Diego and all the bases here, you know, the naval and marine bases here locally. I want to talk about – I want to have some fun, too. I don’t want it to all be heavy. I want to talk about movies and books about war and military. I really want to kind of – sort of an all purpose military blog that can be enjoyed by active duty veterans and the general public. I want it to be broad – you know, as broadly based as possible but still really address the specific issues that I’ve been covering, you know, as a journalist for nearly 25 years.
ST JOHN: I was going to ask you that, that this is not just a blog for people who are in the military…
RENO: No, no, not at all. I really want the general public to get something out of it so I’m not going to be speaking too much military speak, the jargon, you know, to be – I’ll do some of that but I really want to be accessible, which is kind of, you know, how I’ve always been as a journalist. I want to get to as many people as possible and, you know, effect some change. I really want people to think about – because for a lot of reasons, but I think that perhaps the number one reason why the wars in Iraq and Afghanistan, I mean, they’re certainly getting a lot of attention in the media now because, you know, of what’s – the drawdown in Iraq and the surge and everything else but, generally speaking, they’re not in the general public conversation as much as Vietnam or Korea or World War II, not that I was alive during World War II, but, you know, they’re not quite on the, you know…
ST JOHN: Part of everyday discussion here in San Diego.
RENO: Yeah, and I think it’s because we have an all-voluntary military. We don’t have a draft.
ST JOHN: And yet here in San Diego, just in the paper today, talking about how San Diego County is now getting more resources than any other county in the nation…
RENO: That’s right.
ST JOHN: …from the federal government for the military so it’s such an integral part of who we are in San Diego.
RENO: Oh, it absolutely is. You know, and it always has been, it always will be, and it looks like that’s only going to, as you say, it’s only going to get, you know – I was aware of that several days ago on that. And it’s, you know, it’s largely because of the changing focus from cold war to Middle East to China, you know, to Iran…
ST JOHN: Pacific Rim, yeah. Let…
RENO: That’s the new focus.
ST JOHN: We have a caller on the line here who’s listening and wants to join the conversation, specifically about the report that you wrote about in your blog, the suicide report. So, Phil from Encinitas, thanks for your call. What’s your question?
PHIL (Caller, Encinitas): Hey, I served a couple of tours and, number one, I found that there’s a tremendous amount of resources and attention that are being given. In both my post deployments, I almost felt like I should have some sort of a symptomatic problem because they, you know, they said, well, do you have marital problems or road rage or any of these things and it made me, you know, reflect back and think how does the military, compared to civilian population, as far as suicide rates, marital problems, all these things that, you know, I’m not trying to take away that the conflict over there can create…
ST JOHN: Right, so…
RENO: No, that’s a very fair question and good question…
ST JOHN: And we just have sixty seconds to answer it. Reno, Jamie…
RENO: Well, I do – I do know that the rates in the mili – the suicide rates of late have been higher than society at large. I don’t have the exact numbers but I do know that they’ve increased to the point where they’re higher than society at large.
ST JOHN: So I think we’re going to have to – This is a good point to stop in a way because, you know, this is a subject that ain’t about to go away but it’s one that’s being addressed more and more. And, Jamie, your blog is going to be addressing that among all the other issues that you’re going to be talking about. So…
ST JOHN: …we’ll no doubt have other programs where we can continue this conversation. And I’d like to thank Dr. Barbara Van Dahlen very much for joining us from Washington, D.C. Thank you, Doctor…
DR. VAN DAHLEN: It’s my pleasure.
ST JOHN: …Van Dahlen and good luck with your work. And Jamie Reno, once again you can see his blog at http://homepost.kpbs.org. I’d like to thank you both very much for joining and for those of you who are listening. I’m Alison St John.
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