Monday, March 4, 2013
Why modern soldiers are more susceptible to suicide
By Bill Briggs, NBC News contributor
The armed forces mourned a grim toll in 2012 when more troops took their own lives than died in combat, but a precarious question remains: Why is the rate spiking when military life has long been a suicidal deterrent?
Among the services, the Army lost the most active-duty members last year to suicide: 182. Inside that branch, as two wars raged then waned, the annual suicide pace climbed. During 2001, nine out of every 100,000 active-duty soldiers killed themselves, while, during 2011, the suicide rate was nearly 23 per 100,000, according to the American Foundation for Suicide Prevention.
Compare that sobering trend to conflicts and peacetimes past. During the final three years of World War II, the Army’s annual suicide rate didn’t budge above 10 soldiers per 100,000, and during the Korean War in the early 1950s, that annual pace remained at about 11 soldiers per 100,000, according to a study published in 1985 by the Walter Reed Army Institute of Research.
Between 1975 and 1986, the Army’s annual suicide rate averaged 13 deaths per 100,000 soldiers, falling to as low as 10 in the early ‘80s, according to series of papers published in the journal Military Medicine. The Army’s suicide rate in 2001 was less than half that for all American males (18.2 per 100,000). Since then, the pace of self harm among active Army troops has more than doubled — and that trend is not ebbing: In January, the Army classified another 33 deaths as "potential suicides" among active-duty, National Guard and Army Reserve soldiers, according to the Department of Defense.
“A once-protective environment has moved to be something very different,” said David Rudd, co-founder and scientific director of the National Center for Veteran Studies based at the University of Utah.
“We need to look at the big picture to really understand what's going on today, but we all too often lose historical perspective,” said Rudd, who testified before Congress on the issue last month. The Army’s suicide pace between 1975 and 1985 should be viewed as the branch’s “baseline” rate, he added.
What has led modern soldiers to become twice as susceptible to suicide?
'The self-esteem generation'
Some answers lie in present military lifestyles and in the multiple deployments of soldiers to Iraq and Afghanistan — but also in stark psychological distinctions between today’s 20-somethings and the mindsets of past generations, according to Rudd and to veterans of recent and past U.S. combat actions.
“The fact is, nobody really understands what it means to be at a wartime, operational tempo for more than a decade,” Rudd said. “What that means for soldiers is: When they come home from those deployments, they’re never really off duty.
“They get block leave for a month or so when they get back (from war) and then they’re right back in the field, training. Even at home, you’re away from your family. That level of disconnection is a big deal,” Rudd added.
And at military garrisons on home soil, some service members stay and sleep in private quarters versus the packed barracks of long ago. Rudd said he was surprised to see such a setup earlier this year when he visited the 29 Palms Marine base in Southern California.
“They had their own TVs, no common areas. Entitlement has grown in younger generations and society has embraced that, giving in to the entitlement,” Rudd said. The military has “made decisions in accommodating these kinds of requests for more privacy and more seclusion by isolating (soldiers) even further.
“This group is the self-esteem generation. My worry is they have not dealt with enough challenges, enough disappointments in life for many of them to build the kind of resilience that is foundational when you go to war,” added Rudd. “This has led to many of us to having thin skin. That doesn’t bode well when you go to war.”
But suicide is not solely a military phenomenon, said Cynthia O. Smith, a spokeswoman for the Department of Defense, who described suicide as “a national public health problem” and the 10th leading cause of death for all Americans.
The Pentagon has, however, rolled out numerous anti-suicide strategies during the past three years, including a 35-percent boost in the number of behavioral, health-care providers who work in primary-care clinics or who are embedded with front-line units, Smith said.
“Suicide prevention is first and foremost a leadership responsibility. Leaders throughout the chain of command must actively promote a constructive command climate that fosters cohesion and encourages individuals to reach out for help when needed,” Smith said. “Seeking help is a sign of strength.”
They went through 'harder times'
But such collective emotional strength may be lacking in today’s warriors when compared to past generations who were perhaps better steeled for battle by the epic financial hardships they faced at home, said Barry Hull, a retired Navy commander and former F/A-18 Hornet pilot who flew missions in the first Gulf War.
“Stress is all about coping skills. World War II was just as difficult as war today. But think about what the World War II (soldiers) had just come through: The Depression. What creates our coping skills? Trauma, difficulty, adversity,” Hull said. “I’m not stereotyping individuals. I’m stereotyping populations. I’m not saying youngsters today are any less – don’t misunderstand me. But our lives tend to be a little bit less adverse. We typically do not develop the coping skills that some of the older generations did.
“So you take a young, patriotic guy. He goes over (to Afghanistan or Iraq) and sees things he can’t even comprehend. And so what does it do? He tends to feel the effects of that stress more fully because he has not developed the coping skills that the older generation has developed,” Hull added.
One Iraq veteran who can speak intimately on the suicide epidemic is Andrew O’Brien, who was diagnosed with Post Traumatic Stress Disorder and who knew a 19-year-old soldier — with a wife and child back home — who died in an explosion. That 2009 family tragedy left O’Brien asking: “Why couldn’t it have been me?” In 2010, after returning to his Army base in Hawaii, O’Brien tried to kill himself by swallowing several bottles of pills, including sleep medication and anti-depressants. He awoke in a hospital the next day.
“That older generation, they went through harder times, the Depression, and they had so many worse things going for them. I feel like it made them more prepared,” said O’Brien, who has written an anti-suicide guide and who is scheduled to speak this weekend in New Orleans about his experiences.
But among older and younger veterans, there is one common thread that perhaps leaves both groups vulnerable to post-war struggles, O’Brien said. It is a basic tenet of Army teaching and military character.
“We are trained to be selfless. Being selfless is good when you’re deployed. You’re constantly making sure you’ve got your buddy’s back," O’Brien said. "But when you come back, it’s not good. And you have to live for the rest of your life with survivor guilt, with the fact that we lost that person.”
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