Sunday, September 30, 2012

Suicide is a fight we can't win, but we can minimize losses

The Army Times (a Gannet publication, similar in nature in my opinion to the Weekly World News when it comes to fact checking) has a headline on its most recent issue procliming that "The Army is losing the war on suicide."

If one looks at this as a war, where winning can only be defined as the opposing side stops doing whatever it is you don't want them to do--e.g. The Nazis had to stop being Nazis, the American Secessionists had to return to the union and recognize federal authority, the Carthaginians had to stop breathing; then this is a "war" that we cannot win.  Suicide is a part of human nature.  There simply is no way to completely eradicate any human behavior.  Whether a societal norm (think Japanese seppuku) or a taboo, (think Catholicism) suicide still happens, and will always happen.  What we can do is seek ways to limit it in frequency.
That doesn't mean the Army (or society in general) needs to throw up its collective hands and surrender.  What needs to happen (and for that matter is happening) is that the military needs to remove the stigma of seeking treatment, remove the barriers to reaching out for help.  Additionally, when someone is abusing the mental health system, they need to be punished in the severest terms, because they are stealing a resource from those who need it.
First, remove the stigma.  I think we really only pay lip-service to that because seeking treatment is encouraged by the chain of command, but then when you are found to actually have issues, some commands often seek to "help" you by getting you out of the service.  Not many "careerists" are willing to risk losing their livelihood.  I have witnessed people being ostracized for seeking treatment, people who are "cut from the fold" because they have PTSD.  Soldiers are supposed to rely on their battle buddies to help them, now find themselves suddenly left out in the cold because their buddies received orders not to talk to them because they sought help.  
Until we severely punish those who do attach a stigma to seeking help, punish these "leaders" who do this to our soldiers, we will not see a change for the better.  If you were a Soldier with the beginnings of suicidal ideations, and saw a valued and respected member of the team get treated like damaged goods, an infection to be excised, a weak member to be culled from the herd, would you then turn to those same people for help?  I know I wouldn't.
So we need to make the system work better--absolute confidentiality, and when a soldier does need to be removed from the general population, needs to be hospitalized, needs treatment, that soldier is given the care they need, with ZERO impact on their career--in terms of losing their assignment, promotion, job, or rating.  If the docs determine that the Soldier needs to leave the service--in the best interests of the Soldier, then the Soldier does not return to the unit for months of out processing.  They are transferred from the treatment center to a medical out processing station, replete with counselors who will not only help them through their problems, but also help them with the transition back to civilian life.  They will help them with job placement, benefits, and further treatment.  They will ensure they don't fall victim to the VA, which is famous for scheduling the "soonest" appointments for 6 months from now.  We have to apply overwhelming force to the problem.  Our best and brightest need to be charged with fixing this.  They need to team up with medical professionals, not work at cross-purposes.  Maybe this has already happened.  If it has, based on current trends of suicides per capita in relation to historical data, then they have failed.  If it hasn't, and this is a priority, then why haven't we fixed it?
Next, frequency.  We need to do a better job of screening soldiers, both on initial entry and throughout their careers.  We need to do a far better job of getting them in front of mental health professionals as a matter of routine.  They check my teeth and prostate annually, why not my mind?  Why does my health assessment end with a physical, but not a mental evaluation?  Why is it left up to the individual to determine if what they are feeling is normal, or within limit, or off the deep end?  We basically have a system that lets all of our mental health problems deteriorate until they reach a crisis or the Soldier has a mental break. We do very little to preemptive treatment.  With earlier identification and treatment, I believe we'd see a decline in frequency.
Early detection isn't necessarily the only thing we need to improve on, though.  We need to be recruiting the right kinds of people, and yes, we need to revamp our indoctrination process.  We need to instill a bit more iron into our troops in basic training.  We need these kids to be made into men and women, not recognized as delicate individual flowers.  They are a part of something larger, people will depend on them and they on others, and they must not fail.  It is far harder to consider suicide when you know others depend on you.  The knowledge that others depend on me has brought me back from an edge or two.
We need to detect early, destigmatize treatment, and demonstrate to our Soldiers how vital they are to the organization.

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