Abrams might have a point. Rudd, who has been studying veterans’ issues for decades, says about two-thirds of suicide attempts occur in servicemembers who had psychiatric issues before entering military service. However, he says, a preexisting mental health condition alone is not the only risk factor. “What we’re seeing here [are] people with preexisting conditions coming into a high-stress environment,” he says.
The military culture also might contribute to the rising suicide rates. In a recent survey conducted by Blue Star Families, a support organization for military families, 26 percent of respondents indicated their servicemember had demonstrated symptoms of PTSD. Of those respondents, 62 percent said their servicemember did not seek treatment. Most of them were concerned about the lack of confidentiality and, hence, potential effect on their military careers.
“Military members report stigma and worry about their careers,” says Dr. Debbie Bradbard, a licensed clinical psychologist and deputy director of research and policy for Blue Star Families. “It is still an issue. You’re really talking about changing a culture, not doing a training. It’s harder to change a culture.”
That’s why, despite DoD’s efforts to address rising suicide rates, Rudd expects the problem to get worse before it gets better. “Society as a whole still struggles with receptivity to psychiatric issues,” he explains. “It’s a reason why men, in general, don’t seek psychiatric care.” And 95 percent of suicides in the military are committed by men.
“We have excessive barriers to overcome,” Rudd adds. “Psychological injury, for example, is specifically excluded from receiving a Purple Heart.”
Barriers to change
Some argue DoD often uses the preexisting condition idea as a way to avoid committing funds to servicemembers’ treatment. “It’s a workman’s comp issue,” Abrams argues. “PTSD is a mental illness, and if a [servicemember] has it, that puts DoD on the hook financially for the rest of that [servicemember’s] life. DoD sees it as a never-ending black hole.”
That’s why Abrams thinks the military is underreporting the scope of mental illness issues in active duty and retired servicemembers. “Their statistics that only 20 percent of combat veterans suffer from PTSD [tick] me off,” Abrams adds. She says she thinks most servicemembers are going to have symptoms of PTSD in the wake of combat stress but contends DoD’s failure to acknowledge that reflects the agency’s fear of creating a mire of legal and financial issues related to caring for veterans.
The reality is DoD doesn’t have the resources to address the scope of the problem and doesn’t have the funding to increase those resources either. Dr. Barbara Van Dahlen, psychologist and founder of Give an Hour, says organizations that demand DoD do better at tracking suicides, including suicides of family members, should understand the available funding must go directly to resources to help servicemembers recover from combat stress.
The shortage of mental health services and service providers in the military is a problem that can’t easily be addressed because there’s also a shortage in the civilian population, meaning it’s not even easy to fill the gaps by partnering with mental health providers outside of the military.
Ironically, the shortages are less apparent because only a minority of servicemembers suffering from PTSD, traumatic brain injury, anxiety, depression, and other mental health disorders seek care. Garrick agrees. She believes DoD’s biggest challenge is getting the message out that it’s OK to seek help and resources are available.
But Bradbard says more servicemembers suffering from psychological trauma will go to a chaplain before they’ll go to a doctor or mental health provider because there is greater confidentiality. She notes Military Suicide Research Consortium data has shown training gatekeepers is key. “Department heads, commanding officers, master chiefs — those who have access to someone who is in trouble — need training,” she says. “Training gatekeepers is effective in reducing suicide rates in the civilian population.”
Resources
September is Suicide Prevention Awareness Month. If you or a loved one are suffering from PTSD, traumatic brain injury, anxiety, depression, or other issues that increase the risk of suicide, seek help. Below are resources for support, counseling, and networking with others facing similar concerns.
Blue Star Families (202) 630-2583
www.bluestarfam.org
Defense Suicide Prevention Office Military Crisis Line: (800) 273-8255, press 1, or text 838255
www.suicideoutreach.org
Give an Hour
www.giveanhour.org
Operation I.V. (855) 8-USHERO (874376)
www.operationiv.org
Fountain House (212) 582-0340
www.fountainhouse.org
[CONTINUES ON PAGE 120]
SEPTEMBER 2013 MILITARY OFFICER 103
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