National Guard March 2011 : Page 24
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Nearly twice as many Guardsmen took their lives last year than in 2009. It's a problem with no simple solutions
JEFFREY SEXTON SAYS his son had a big heart.
No doubt about that.
Moved by the poverty of Afghan children, Spc. Jacob Sexton spent time during a 15-day leave from Afghanistan in October 2009 collecting winter coats to take back for them.
"Sometimes," says the elder Sexton, "I wonder if that wasn't part of the reason."
What he means is, did his son's compassion cause the 21-year old Indiana National Guard soldier to shoot himself in the head while watching a movie with friends at a theater in Muncie, Ind., during that same trip home?
The father may have a point. War had pretty much turned the world of Jacob Sexton upside down.
Raised in the small-town embrace of Farmland, Ind., he was sent 6,000 miles away to Iraq where, according to his father, he shot dead a family of four during the tense confusion of a checkpoint stop.
And just before his leave in 2009, an Afghan man rammed with his car the vehicle in which Sexton was riding, forcing Sexton to shoot the man who acted threateningly, but was found to be unarmed.
"When you've got to shoot somebody," says the father, "it's going to affect you."
Especially, perhaps, if the heart of the shooter wants to help, not hurt. If it wants to gather warm winter coats, not take away a life.
But explaining a suicide is not quite that easy. If it were, Gen. Peter Chiarelli, the Army vice chief of staff, wouldn't have almost pleaded in January, "If you think you know one thing that causes people to commit suicide, please let us know."
His remarks came after a release of suicide results for 2010 defying the conventional wisdom that the repeated exposure to combat and all of its horrors was pushing people over the brink.
Instead, the figures from last year showed that most people who committed suicide, in the Army Guard, at least, hadn't left the United States.
Any hope that a drawdown of troops from the twin war zones of Iraq and Afghanistan would eliminate the suicide problem went out the window.
The military is trying hard to get a handle on this scourge that has taken more lives than combat in the last year or so. Has anyone in uniform not heard a discussion or viewed a PowerPoint presentation about the warning signs of suicide?
But preventing an individual from choosing a permanent solution to a temporary problem is as slippery as defeating a determined insurgency.
"We have yet to identify, nor has anybody else, why they might make that choice," says Col. Greg Bliss, the director of the Army National Guard Soldier and Family Support Division in Arlington, Va.
Ken Norton, the director of Connect Suicide Prevention Program that is part of the National Alliance on Mental Illness in New Hampshire, says, "Suicide is a very complex issue. It's very difficult to attribute causal effect to suicide."
"To try to find a magic bullet to stop suicides is impossible," says Jan Kemp, the national mental health program director for suicide prevention for the Department of Veterans Affairs.
That doesn't stop the services from trying, of course. Faced with a growing number of suicides in the ranks of both the active and reserve components in recent years, the Defense Department was forced to put suicide prevention at the top of the to-do list.
One result is a military link to the national Suicide Prevention Hotline. A military member thinking about suicide who calls the hotline at 1-800- 273-TALK (8255) can then press 1 to be connected directly to someone familiar with the military.
"We can follow up and make sure that intervention happened," says Kemp, who is in charge of the military hotline, which gets 400 calls a day.
The Guard has placed in all 54 states, territories and the District of Columbia a director of psychological health assigned to joint force headquarters.
Public Health Service Capt. Joan Hunter, the director of psychological health for the National Guard Bureau, credits those 54 people with intervening in 229 potential suicides from January 2009 to November last year.
"Are we saving lives? Most definitely, we're saving lives," she says.
The Air Guard is putting directors of psychological health at every flying wing, says Maj. Jim Coker of the Air Guard Surgeon General's Office, in an attempt to head off suicides.
Across the Guard, states have been addressing the problem as best they can.
The Texas Guard created a peerto- peer program that educates junior enlisted on the warning signs and encourages them to keep an eye on friends. Col. Orlando Salinas, the joint family support services director, credits the program with preventing seven suicides over the holidays.
"I think we're onto something here and doing something good," he says. "They don't talk to a crusty old man like me. They talk to a friend."
COL. MIKE JOHNSON, who is in charge of veteran and family services for the Guard in Washington state, says the state's count of seven suicides in 2009 made it "the worst across the nation."
"We said, 'Enough is enough,'" he says. "We're not going to accept suicides anymore. We got it in our head that we could alter it, we could change it."
With an array of educational programs promoted across the state and the cooperation of commanders and others, the state goal was to eliminate suicides month by month. When 2010 ended, the state tallied 12 successive months without suicides.
"We might be just lucky," Johnson says, but he believes the prevention programs played a role.
Despite these efforts, the numbers rose dramatically last year across the force. Figures from 2010 show suicides leveled off in the active component, but skyrocketed in the Guard, especially the Army Guard, where numbers jumped from 62 in 2009 to 114 in 2010. The Air Guard numbers went from 11 to 15.
So, despite all the attention and effort, something is being missed.
When the numbers first started climbing a few years ago, the easy explanation was that the twin wars and multiple deployments were to blame. But the figures released in January put paid to that idea.
So why would uniformed personnel with the camaraderie and fraternity that entails feel death is their best option?
To understand, it helps to draw a picture of who makes that choice. In the Army Guard, nearly all of the soldiers who committed suicide were white males. One in five had employment issues, but more than six in 10 had relationship problems.
Dr. Paula Clayton, medical director for the American Foundation for Suicide Prevention, says, "The key to kind of understanding suicide is something that the services don't totally accept. Ninety percent of the people who kill themselves have a mental disorder."
Depression, she says, shows itself in many ways. A lack of joy. Too much drinking or drug use.
"Depression can be lethal," she says, but treated if it is diagnosed.
But the Guard suffers the inherent problems of a part-time force which sees many of its members only two days a month. Many members have no health care in their civilian world and lose access to military-provided health care six months after leaving active duty.
Also, Bliss points out the active component's ready access to such things as police and traffic reports, which can help draw that picture of a person losing control.
"We don't have that," says Bliss, who says some units have discovered a member had committed suicide only when the family called to ask about possible insurance benefits.
The figures from 2010 raise the question, too, of what is a Guard suicide.
Maj. Gen. Ray Carpenter, the acting director of the Army Guard who has made the issue a priority, told an audience recently of a recruit who committed suicide in December before he had even attended his first drill. But he is listed among the Guard suicides.
"Whether it's a day or a year or a decade," Bliss says, a man or woman becomes a Guardsman immediately upon taking the oath. "We realize there may be things they brought into the Guard that are driving them in that direction."
Some wonder if the answer may be found at the recruiting point. Are people being screened well enough and asked their reasons for joining the armed forces?
Hunter says the waiver program that overlooks potential deal breakers in recruiting should be looked at. Have the right people been given waivers? Were the waivers correct?
"That's sort of an untouchable," she says of the topic, "but it exists."
Clayton doubts that the military effort to teach resiliency will have an impact on the suicide rate. It might help those with more minor stresses.
"But when you're really depressed, it doesn't work," she says. "I don't think there are data ... that show resiliency protects you against getting depressed."
Other experts outside the military say the problem has not yet received enough attention. For one thing, it has not been given enough money.
When the Pentagon budget received $600 million in 2008 for mental health counseling of troops, only a fraction was given to the Guard to provide help during dwell time.
Norton from New Hampshire says, "I hate to say it in this economic climate, but I think it does need more funding."
He helped put suicide prevention in the 2009 National Defense Authorization Act, but it wasn't funded.
He would like to see a full-court press put on so communities are involved. Community resources should be aware of the military members in their midst, and military members should be aware of resources in their communities.
In Missoula, Mont., Dr. Dana Headapohl does medical examinations for the Reserves, so she's aware of the Guard and of its battle with suicide in its ranks. Her specialty is occupational and environmental medicine.
She believes there is a lot of undiagnosed post-traumatic stress disorder.
"As part of the monthly meeting, there should be a formalized presentation of mental health issues," she says. "We have an obligation to help protect these folks. It has to be part of the culture, part of the training."
NGAUS SUPPORTS A bill introduced last month by Sen. Patty Murray, D-Wash., and Sen. Claire McCaskill, D-Mo. It would require the military to provide access to mental health assessments with licensed professionals during unit meetings.
Hunter is encouraged by the sincere efforts she sees in the Defense Department and the National Guard Bureau to develop some plan to go after this menace. But sincerity is not enough.
"We don't have the money. We don't have the personnel," she says.
She envisions a full assault on the problem that enlists surgeons general, chaplains, local resources and federal agencies like the Department of Health and Human Services so that no Guardsman or Reservist or service member of any kind is left out.
The Guard needs a program for all 54 states, territories and the district, but, she cautions, "A cookie cutter approach is not going to work."
Any program must be malleable enough for states to adapt it to their unique population, she says, but it must include those things proven to work.
Kemp, too, foresees a broad network of counselors, both inside and outside the military.
"That's my goal, that everyone knows there's someone who can help," she says. "We need people in the community to help us. We need family and friends."
Back in Indiana, Jeffrey Sexton says he knew his son had been affected by the wars because of things he said. But he didn't think it was serious enough for him to seek professional help.
"I knew he was having trouble sleeping at night," he says. "He was more of a party person [than before]. We didn't put two and two together."
But after Jacob killed himself on that October night, his father had conversations with several of his son's friends. They shared with him things they'd been told by Jacob.
"Everybody was getting bits and pieces of the story," the father says. Had he known what Jacob was telling others, combined with what he was hearing from his son, he would have sought help, he says.
Jeffrey Sexton would like to tell his story to soldiers and airmen of the Indiana Guard.
He knows what he'll tell them about keeping an eye on someone that is having a hard time.
"If he says something to you and it doesn't sound quite right," he says, "tell somebody."
Ron Jensen can be contacted at (202) 408-5885 or email@example.com.
A Societal Problem
• Suicide was the 11th leading cause of death for Americans of all ages in 2007, the last year for which nationwide data is available.
• More than 34,000 suicides occurred in the United States in 2007, which is one every 15 minutes. About one in seven is a veteran.
• More than 376,000 people with self-inflicted injuries are treated in emergency rooms each year.
• Men take their own lives at nearly four times the rate of women, but women attempt suicide two to three times more often than men.
• It is a myth that suicides go up during the holiday season; in fact, December is a low month for suicides, which are more likely to take place in the spring and fall.
• Firearms are the most commonly used method of suicide for men (55.7 percent); poison is the most common method for women (40.2 percent).
Source: Centers for Disease Control and Prevention
Read the full article at http://www.nationalguardmagazine.com/article/Suicide/659762/63188/article.html.