Chiarelli: suicides down, but not enough
June 24, 2010
WASHINGTON (Army News Service, June 24, 2010) -- While the number of suicides among active-duty Soldiers has fallen, the Army's vice chief told lawmakers that the progress is not enough.
Despite a 30-percent decrease this year, Vice Chief of Staff of the Army Gen. Peter Chiarelli told members of the Senate Armed Services Committee Tuesday that the Army still has "much more to do."
Army suicide rates had been on the rise since 2004. In 2007, for instance, 115 Soldiers committed suicide; in 2008 that number jumped to 140, and then rose again to 163 in 2009. But in 2010, the Army has seen a significant reduction in suicides among active-duty Soldiers. As of June 10, there have been 62 suicides -- at the same time in 2009 there were 89.
"There is no greater priority for me and the other senior leaders of the United States Army than the safety and well-being of our Soldiers," Chiarelli said. "The men and women who wear the uniform of our nation are the best in the world and we owe them and their families a tremendous debt of gratitude for their service and many sacrifices."
While active-duty Soldier deaths have come down, suicides among reserve-component Soldiers have not. As of June 10, there have been 53 suicides among the Army Reserve and National Guard. Last year at this time it was 42.
Chiarelli told lawmakers that suicides in the Army are "a holistic problem with holistic solutions and that is how we're approaching it."
Such solutions include "telehealth" options that allows Soldiers to interface with mental health professionals through technology, without actually sitting face-to-face with the provider.
"We give every Soldier a 30-to-40-minute session with a behavioral health specialist using the internet, using virtual -- putting together a virtual net of providers who can take an entire brigade and put everybody, from brigade commander to the youngest private in that unit through a 30-40 minute screen. I mean this is the kind of thing I would like to be able to provide to reserve-component Soldiers when they get back (from deployment)."
Chiarelli said younger Soldiers indicate an "overwhelming" preference for on-line counseling, verses face-to-face counseling.
The Army has other programs as well that help Soldiers get mental health assistance, Chiarelli said. The TRICARE Assistance Program, for instance, allows Soldiers to use a telephone, a computer, or even a computer with video-conferencing capabilities, to communicate directly with licensed counselors about stress management issues, family difficulties and pressures, family separations and deployments, relationships and marital issues, parent/child communication, or any personal problems that might adversely impact work performance, health, or well-being.
But one problem with telemedicine, Chiarelli told lawmakers, is the issue of getting mental health providers licensed to practice across state lines.
"I can go ahead and provide a TRICARE referral for a Soldier at Fort Campbell, Ky., to drive 100 miles to Nashville to see a psychiatrist, but I cannot hook him up over the internet," the general said, unless the provider is accredited through the military and on a military installation.
The general also told lawmakers that the Army is experiencing a shortage of mental health professionals, but said that the shortage is not funding related. "It's a matter of finding folks," he said, and getting them to move to where Soldiers are. "We are short behavioral health experts."
Sen. Carl Levin, chairman of the committee, said that studies indicate Army suicides occur largely because of traumatic brain injuries and post traumatic stress disorder.
Chiarelli said he hopes the Army's adoption telehealth could help lower the number of misdiagnoses of TBI and PTSD, but said that such diagnosis remain difficult due to their similar symptoms.
"Science on the brain is just not as good as it is in other parts of the body," he said. "Researchers are struggling today to find the linkages and learn everything they can about the brain, and because of this we're going to see some misdiagnoses."
Chiarelli also discussed another program, the Confidential Alcohol Treatment and Education Pilot, that is currently in place at three Army facilities. The program allows Soldiers' to seek help for alcohol abuse problems -- without being referred to their chain of command afterward. The program is designed to eliminate the career-damaging stigma Soldiers often face from claiming mental injury.
"In addition to three facilities, we're starting the program at Fort Carson (Colo.) in August and expanding it to two others. The only problem that we're having is trying to recruit the number of drug and alcohol counselors that we need in order to ensure that when 'so-and-so' refers himself for this problem that, in fact, they can be seen immediately and not be told to 'come back six weeks from now and we'll take care of you.' We're seeing great results from the three installations we started the pilot at."
Chiarelli also told the committee that he "took great exception" to a recent National Public Radio report which criticized current Army mental health policies, insisting that human knowledge of the brain still is not advanced enough to diagnose TBI and PTSD efficiently.
"It criticizes leadership for not caring and not doing anything about it. I think that's far from the truth," Chiarelli said. "There's no doubt you could go to any one of our posts and find Soldiers who are struggling because of our inability to nail down and diagnose exactly what treatment they need for these behavioral health issues, but I promise you it is not for a lack of trying or real care on the part of our doctors, and our leadership is totally committed to working these issues."