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PTSD is a potentially debilitating anxiety disorder triggered by exposure to a traumatic experience such as an interpersonal event like physical or sexual assault, exposure to disaster or accidents, combat or witnessing a traumatic event. There are three main clusters of symptoms: firstly, those related to re‐experiencing the event... | Photo: | Ptsd, War, Post-traumatic Stress Disorder, Military, Pain, Mental Illness,

The epidemic of soldier suicide

Jacob served in the United States Navy for eight years, then transitioned into a civilian position at the shipyard, making a nice living, for the next three. To his friends, he seemed happy, gregarious, even joking. Jacob committed suicide in mid-November of 2013.

Jacob's suicide sent resonating shock and disbelief among his friends and the people that knew him, with the consensus: 'He seemed happy, he had a good job, he was making great money'' it was unexpected. No one ever learned what triggered his suicide, or realized he had these thoughts.

One Active-duty Soldier and 22 Veterans commit suicide per day (which approximates to one life taken every 65 minutes), according to Stop Soldier Suicide (SSS), founded and led by former and active-duty military members. Brian Kinsella, who served as a United States Army officer, founded SSS in 2010 with a few dedicated Veterans, amidst 'the worst suicide crisis our military has ever seen,' in efforts to provide alternative solutions for soldiers, Veterans, and their family members, as well as changing the stigma of receiving treatment. Kinsella knew something had to be done, when one of his soldiers attempted suicide, but the attempt was unsuccessful; then later, learning a fellow soldier took his life days before a deployment.

According to the Dana Foundation, a private philanthropic organization with the commitment to advancing brain research, the rate of soldier suicide has doubled since 2004, creating a devastating epidemic as the suicide rate has steadily increased since the Iraq war, stating, 'All soldiers'and other service members'are at risk.'

The Dana Foundation continues, it is likely military suicides were triggered by 'a psychosocial imminent stressor or stressors,' such as a break-up with a romantic partner, or a humiliating event at work, as that humiliating event triggers self-destructive behavior, including relationship difficulties with other members of the unit. Data evidenced suicides in the Army from 2003 to 2009 were relatively impulsive, triggered by the psychosocial stressor(s).

Stress load may be a formidable indicator of the likelihood, or the contemplation, of suicide. The Dana Foundation continues, stress load, 'defined by the accumulation of stressors, including relationship breakups, job difficulties, and physical problems' many active-duty members experience during their careers. Another stressor includes the contribution of chronic pain and physical disability, as those limitations 'seem to be the precipitants for suicide among a number of older soldiers and those of higher rank.' However, for younger active-duty members who have experienced injury, may be place on limited duty, resulting in depression, believing he/she can no longer be 'the Soldier I used to be.' These thoughts can contribute to a loss of identity, which exacerbates the depression. Although the majority of service members who commit suicide do not have a documented mental illness (which is the antithesis of the general public, where suicide is linked to a major psychiatric disorder), Post Traumatic Stress Disorder (PTSD) or undiagnosed depression is emerging as a contributing factor in suicide contemplation.

PTSD, as defined by the Mayo Clinic, is 'a mental health condition that's triggered by a terrifying event [where] symptoms include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event [where people] have difficulty adjusting and coping'' where often, soldiers and Veterans flash back to the war zone, with the visuals of dead bodies and their comrades who were killed or wounded; soldiers will often feel estranged from friends and family when they return home. The Dana Foundation cites the article, 'Reframing Suicide in the Military,' identifying three pervasive factors contributing to the potential of suicide: failed belongingness, perceived burdensomeness, and habituation of self-injury. Examination of Army suicides yielded the conclusion that these factors may be evident 'in a soldier's not fitting into the unit, not being able to perform as a soldier, facing discharge from the Army, having seen many comrades or civilians die, and experiencing pain or disability from injuries.'

Soldier suicide is a complex issue;
There is no one solution to prevent soldier or Veteran suicide, observes Laura Black, Stop Soldier Suicide Chief Marketing Officer. However, raising awareness about this dire problem to the general public has made a mammoth impact, as it gains attention to the problem, which will propel people into actively finding solutions, and just as importantly, helps to stop the negative stigma associated with mental health issues. The military is particularly tough in training men and women to be strong; anything perceived to be weakness, such as PTSD, is unacceptable. As an organization based of all-Veterans and active-duty soldiers, it has the advantage of understanding what our service people endure, ''here to help their brothers and sisters in arms in their greatest hour of need.'

The Dana Foundation concurs, there are no simple solutions. However, the Department of Defense (DOD) has recognized this dire problem, where numerous strategies have been in place to combat this epidemic, including training, screening, and improved access to behavioral health care. Primary care physicians are now asking returning soldiers question to ascertain potential risky behavior, drug and alcohol use, and potential home problems, then refer at-risk service members to mental health providers. '' we need to focus more on identifying and putting in place ways to getting help that will be more acceptable to at-risk soldiers,' as they and other service members feel uncomfortable sitting in a public waiting room of a behavioral health, or substance abuse clinic, with the fear of revealing their experiences, which may consequently get them relieved from service, or placed on limited duty.

To Black, communication is critical. No one wants to talk about suicide, perceived to be a taboo issue. However, we must have an open dialogue about this epidemic, talking to soldiers and Veterans, encouraging them to live and to ask for help, as ''suicidal ideations are transient and if you can help someone through a despairing/crisis moment,' get[ting] them appropriate help, you can possibly put them on a healing path.' Black has a stepson whom is in the Army, where they often converse over how he feels, keeping that open dialogue.

SSS has created a national and community-based network of volunteers and partner organizations to provide triage and alternative solutions for at-risk soldiers and Veterans. The triage allows the volunteers to understand what the person needs when they contact SSS. SSS volunteers are not mental health professionals; rather, they are the facilitator in getting the help the soldier or Veteran needs. For example, if the person is exhibiting signs of struggling, but is not in crisis or suicidal, SSS finds the person the appropriate local or national resources, such as Give An Hour for free mental health care, or Boot Campaign for various needs, or free legal help. The key is to pinpoint the factor(s) that is causing stress in their lives, as suicidal thoughts are triggered by an event, such as a breakup, or job loss. Dealing with those trigger events may help deter suicidal thoughts in the future.

A major benefit for SSS is their strong relationship with the Veteran Affairs (VA), who has given SSS a private line for crisis calls. SSS can use the invaluable VA line to stay in contact with the soldier or Veteran who is 'actively seeking suicide as an option and talking about it.' SSS calls the private line and stays on the phone with the person, as he/she is connected with a trained VA counselor to offer counseling, getting him/her through the suicidal period. As a group of former and current military service people, 'who have worn the uniform and understand,' SSS also offers help outside of the military channels, as many soldiers feel they cannot come forward to their command officers, Black continues. Soldiers feel they are unable to come forward for fears, including being perceived as weak, or being taken away from active duty, and being place on restrictive duty.

Just as imperative as communication, awareness and outreach to change the perception of mental health care and the stigma in receiving treatment are critical. As Black recounts, Kinsella rode a motorcycle across country in 2012 in efforts to raise awareness, stopping at military bases and other areas, as people and Veterans rode with Kinsella on various legs of the journey. The ride 'saved one man who was considering suicide the very day Brian was coming through town.' He went on the ride with Kinsella, listening to what Kinsella had to say; the gentleman decided to choose life and to help others, hosting one of the Movie Night For Life events. 'It's a great testament to what we're doing.'

Movie Night for Life is an event where SSS had followers on Facebook volunteer to host a movie event, particularly on Veterans Day, to show the film SSS partnered with, 'Happy New Year,' which accounts a Marine who returned home with both visible and invisible scars, struggling with them inside the VA ward. The film 'put a face on PTSD and suicide' connect[ing] people to the subject in a very real way,' with efforts to emotionally connect the general people, aiming to preventing soldier suicide, with hopes of gaining additional support, joining the valiant fight.

Black accounts, social media and Facebook have been vital in the awareness campaign. A Veteran with PTSD had reached out to SSS; he had lost his job with an imminent threat in losing his home, unable to pay for food or his bills, and began to contemplate suicide, fearing he would be unable to care for his family. SSS immediately intervened, by asking followers to raise funds in order to help him pay the bills, relieving his stress over the holidays, all within 36 hours; SSS is continuing their work with the family in finding resources, such as getting his VA rating. SSS specifically requests people to send checks directly to the billing companies in the name of the families.

Grek and Staff Sgt. Reese
Grek and Staff Sgt. Reese

U.S. Army Staff Sgt. Kevin Reese and his military working dog Grek wait at a safe house before conducting an assault against insurgents. | Photo: |
Facebook is a useful tool in raising awareness and support. For example, Judy Fridono, guardian of, and messenger for, Ricochet, the only known dog who uses surfing as therapy for children with special needs, people with disabilities, and Wounded Warriors, has raised increased awareness through Ricochet's philanthropic Facebook page about soldier suicide, particularly in sharing the story of Ricochet's partnership with retired Staff Sergeant Randall Dexter, during their six-week Canine Inspired Community Re-integration (CICR) program, which helps service members to reduce their PTSD symptoms with the assistance of canine therapy, offered by Paws'itive Teams, who customize their service dogs to the needs of people with disabilities, in the San Diego area. According to the Dana Foundation, animal-assisted therapy (AAT) serves as a helpful tool in decreasing the PTSD symptoms in wounded soldiers, and service dogs can help Veterans regain structure and regain independence.

On April 5, 2005 Staff Sergeant Dexter's life changed when he was a combat medic during Operation Iraqi Freedom; he and his squad were hit with a large improvised explosive device (IED), as he suffered a concussion, three Iraqis were severely injured, one with an open head wound, who unfortunately, didn't survive; these injuries were the first major injuries Staff Sergeant Dexter saw and treated. As Staff Sergeant Dexter recalls, these traumatic visuals and experiences would ultimately cause his PTSD.

Staff Sergeant Dexter felt hopeless...
...until he met Ricochet in February of 2013. He was partnered with her during the CICR program, which he initially dreaded, as it forced him to leave his house, but he knew he had to make a change. After their time in the CICR program had ended, Staff Sergeant Dexter and Ricochet knew they could help more people, creating the PTSD Battle Buddy Initiative, with aspirations to raise awareness of PTSD symptoms, removing the stigma associated with it, and providing support to Veterans and their families, and therefore, greatly reducing the suicide rate. As Fridono reflects, 'The more Ricochet helped Randy, the more I realized she could do more.' Staff Sergeant Dexter knew he could use his experiences in helping others, letting them know they weren't alone.

Fridono hopes for people to come together to raise awareness, reaching out to this population, '' what we really need to do is get the media to help us [as] Individuals with PTSD tend to isolate themselves. They don't go outside. So, we need to reach them where they are, in their homes.' Staff Sergeant Dexter continues, 'If you're suffering, or know anyone who is suffering, get as much education as you can.' PTSD does not signal the end.

Soldier suicide is prevalent; we must acknowledge there is a problem, where it will only grow as the number of Veterans grows. As Black states, the highest number of suicides originates from the Veteran population aged 50 and over. The implication is that with the recent war which has 'lasted longer than any war our nation has faced, there will be a tidal wave of suicides'' if we do not actively seek solutions for the prevention of soldier suicide. We must stop the stigma behind mental health issues, encouraging people to seek help, by creating a dialogue; our soldiers and Veterans 'are suffering and need our help' The people who have fought for our country deserve more from us than to be shamed, shunned and forgotten. It takes courage to volunteer to go to war and die.' We, as a nation, have the responsibility to reach out to offer help. Black continues, '' we must be brave and reach out to help when our warriors come home, veil lifted, and suffering.'

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Updated Aug 12, 2017 12:04 PM EDT | More details


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