General calls for better suicide prevention efforts
October 12, 2010
ALEXANDRIA, Va., Oct. 8, 2010 - The military must address the stress wearing down the force and work to end the stigma surrounding mental health care to combat rising suicide rates, the chair of the Department of Defense Task Force on the Prevention of Suicide said today.
"Suicide prevention is a huge challenge in the military," Army Maj. Gen. (Dr.) Philip Volpe said. "There's stress on our family members and stress on our servicemembers. This is a unique time. Nowhere before in our history did people have to deploy over and over again."
Volpe stressed the need for better military suicide prevention efforts and outlined his task force's recommendations for doing so during the Tragedy Assistance Program for Survivors Suicide Survivor Seminar and Good Grief Camp here, which drew more than 200 family members from across the nation. The issue touched home for many. Nearly all lost a military loved one to suicide, some as recently as a week ago.
Suicide rates have nearly doubled in the military in the past five years, Volpe noted. And the Army's rates have exceeded the civilian population since 2005, with 606 suicides between 2005 and 2009.
The DOD's congressionally mandated suicide prevention task force spent the past year delving into the military's suicide prevention programs in an effort to improve them, Volpe said. The findings and recommendations were submitted to Defense Secretary Robert M. Gates for review in August. Gates will then submit the results to Congress by Nov. 24.
Among its findings, the task force noted a need to address the stressors of nearly a decade of war, Volpe said, particularly related to the high operations tempo. This applies not only to deployed servicemembers, but to servicemembers supporting operations back home as well.
A high operations tempo can prevent servicemembers from creating the bonds they need to pull them through difficult times, he explained. The general cited dwell time, or the time between deployments, as an example.
Military leaders expend a good bit of energy discussing the need for more dwell time, the general noted, but fail to talk about the quality of that time, which ultimately is more important than the length.
"Servicemembers deploy for a year, then come back and their schedule is filled with events," he said. "They never get reconnected again to family, to friends. They never get a chance to live through some of their experiences.
"We're just going and going like an engine without any repair," he added.
The task force also discovered a broken crisis-response system. "There's a whole bunch of hotlines, numbers, but when someone is in crisis, who do you call'" Volpe said. "And what response will you get'"
The task force found a significant variation in response and levels of training within these resources. Some hotlines, he said, refer people to another hotline or resource. As a result, the person in need gets lost in the process.
The task force recommends a 911 equivalent for suicide crisis, Volpe said. People know what to expect when someone has a heart attack, but not when there's a suicide. The military needs one hotline with highly trained people who can take appropriate action.
The task force spent considerable time studying the stigma that prevents servicemembers from seeking help, the general said. The task force found that multiple initiatives are needed to combat it. One solution is to develop anonymous sources where servicemembers can seek help without fear of career repercussion. But leaders must be aware of the drawbacks to that solution, the general said.
When someone remains anonymous, information isn't shared with leaders, Volpe explained. They may see a servicemember's performance declining and try to take action without knowing that the member is seeking behavioral health care.
"While we need to create anonymous sources so people under stress get help, we also need to attack the stigma," Volpe said. "The message needs to be: You can be the best warrior in the world but you're still a human being. And calling in for help is no different than if you call in for help for other reasons.
"It's OK to seek assistance and assistance works," he continued. "Those are the things we have to focus on."
Volpe also called for better training for behavioral health providers and chaplains. "Just because you have a degree on the wall doesn't make you good at understanding suicidal behavior and ways to prevent suicide," he said. "We really need to boost [training] up. There's a lack of understanding of suicidal behavior in our health care system."
A lack of training also exists across the services, Volpe noted. The services are conducting training, but it's not as effective or inclusive as it could be. Mostly, suicide prevention training is conducted with PowerPoint presentations annually so servicemembers can mark the training off a checklist. Volpe called that method inadequate.
The general called for skills-based training, likening it to weapons training. The military would never teach soldiers how to fire a weapon by PowerPoint, he said, and the same applies to suicide prevention. Training needs to include practical lessons in understanding where to go for help and how to raise the issues of concern.
Volpe said there's also a great need for family member training, a comment met by enthusiastic applause from the audience. Family members often say they knew something was wrong with their loved one, but couldn't pinpoint the problem. They didn't know where to go for help or if their actions would help or hinder, he said.
Family members need training on suicide signs and avenues of help, and this training needs to encompass more than just the spouse, but the parents, siblings, other family and friends as well.
"Families are usually the first indicators, first detectors of something not being the same, not being right," he said. "It makes sense for families be included in a comprehensive suicide prevention program."
Volpe concluded by citing a need for better suicide after care, or "postvention," not just for families, but for servicemembers who have lost a battle buddy. Loss puts all loved ones at risk for destructive behaviors, including suicide, he noted.
Suicide prevention isn't about identifying weaknesses but creating strengths, Volpe said.
"We learned early on that we're not only saving the lives of soldiers, sailors, airmen and Marines, but we're making this a better, more ready military by addressing suicide prevention," he said. "We're strengthening the force."
Volpe also thanked the audience for their input into the task force's report at last year's survivor seminar. "What we learned there provided us a guiding light for the remainder of our work," he said.