VICENZA, Italy -- Two days after Mother's Day in 2008, everything hit rock bottom for a 42-year-old Navy wife.

"I'm thinking, how many pills would it take to kill me? That's how macabre my thought process is. I'm carrying a suicide note around with me for weeks so nobody could read it. I have my bag of pills that nobody knew about, and I wanted to sleep. I had this thought, 'Please God, put me out of my misery,'" she recounts.

For months, she struggled as the pressure in her life built up.

"I put the note in my husband's sock drawer. Everything is neat. It's not a scene. We're all very nice and clean about this thing," she said. "I have my comforter. I'm just grabbing pills … I just talked to God and I cried. It was a terribly emotionally painful period, but I just knew that life could not go on like this.

"I took the pills and then I spit them out because I had a moment of, 'Gosh, what are you doing?' But I put them back in (my mouth). I put the bag away. I put everything away, and I wrapped myself in a comforter and I laid down. And that's all I remember."

When her mother and her son found her face down on the floor of her bedroom, they couldn't find a pulse. Her mother thought she was having some sort of allergic reaction, but her son knew, she said.
The next thing she remembers was waking up in a hospital bed.

"I woke up and thought, 'Oh great. Now what do I do? I didn't plan for this,'" she said. "If you're trying to kill yourself, you don't account for (the possibility that) maybe it won't work and then you have all these after-effects of that."

With the benefit of more than nine years of hindsight, the Navy wife now can see how problems piled on top of problems until she felt hopeless.

"It's not just one thing. It's not just, I got depressed and tried to kill myself. And there's a stigma that you're a weak person. A lot of people who get there are really strong people and they just break," she said.

Asking for help
That's something Chaplain (Lt. Col.) James Foster, former U.S. Army Garrison Italy chaplain, said he has seen.

"It's usually not just one thing. It's usually a multitude of things that pile up in their life and then they feel overwhelmed," he said. "The Army is also recognizing that reaching out for help is a sign of strength. It takes courage and strength to ask for help."

Asking for help wasn't something the Navy wife felt like she could do in the months leading up to her attempt.

"My husband was never around, and when he was around, there were a lot of expectations," she explained. "I was kind of running out of energy because I was fixing everybody's 'stuff.' And everybody thought my life is perfect. And then I was isolating. I wasn't isolating in that I had a lot of friends. I'm very outgoing. But I was isolating in that I didn't really talk to anybody about anything because (I felt) shame."

Breaking down the wall of shame and getting people to 7089talk about their problems can be a major way to prevent suicide, and the resilience program at Army Community Service can help spouses learn the skills to deal with their issues.

"The goal is to give people the skills that, when they face challenges or adversity, they are able to not only grow from those challenges and adversities, but also to thrive," said Michelle McLaughlin, Mobilization, Deployment and Support, Stability and Operations Program manager. "The more you can handle challenges and adversity, the better equipped you are. Then there's less likelihood that you will fall into depression, helplessness, hopelessness, which eventually can lead to suicidal ideation. These skills can help prevent the spiraling that can happen."

Resiliency, resources
The annual resilience program training is mandatory for Soldiers, but there is also an optional program available to spouses. That program is offered every other week, or as part of a quarterly Family Readiness Group Academy designed to train FRG leaders.

"I tell them, 'Your Soldiers are required to take this. Why not get on the same page and speak the same language as what they're learning and speaking?'" McLaughlin said.

Another resource available to Soldiers and spouses is the Military Family Life Counselor, and there is one in the ACS building on Caserma Ederle.

"They are phenomenal, and their confidentiality is great. It's a huge resource, especially for our leaders because there (can be) the stigma of, 'Oh, I can't really talk to anybody because everybody comes to me as the leader,' she said. "I think they're a huge benefit for leaders to have."
Another confidential resource are the chaplains.

"It's privileged communication, which means whatever is said to us in confidence is kept in confidence," Foster said. "We do come from a faith background, but we're ready and willing to see anyone, regardless of their faith tradition -- unless they open the door for religious counsel. (If not), then it just stays as my foundation, not really as a point of counseling or advice based on my beliefs.

Another issue that can prevent people from seeking help for depression or suicidal ideation is the fear that they may be required to enroll in the Exceptional Family Member Program or be sent home early.

"We do compassionate reassignments or early return of dependents when that best serves the family's needs. So, if they need a level of care, whether behavioral health or medical, that we don't have here in Italy, then we'll work to get that family member or the whole family to where they can get that care," said Maj. Rebekah Broady, team lead for Embedded Behavioral Health. "But we treat a lot of families, and a lot of children, a lot of spouses, and a lot of Soldiers here in Italy. We do not send back the vast majority to the States or anywhere else."

Help from Behavioral Health
Major Osceola Evans, chief of Behavioral Health at U.S. Army Health Center--Vicenza, agrees.

"If a child or family member seeks services early on as a preventive measure or as a way to take care of issues before it escalates into something severe, then they may never get to the point where they have to enroll in the EFMP or something like that where it could affect the next duty assignment," he explained. "If you see it in your child or your spouse, encourage them to come in and get help early. If it's something that's treated and they respond to, there's really no repercussion as far as assignments or career effect or anything like that."

In addition, help is readily available at Behavioral Health.

"If someone is feeling suicidal or they're having a panic attack or they just need to get some help immediately, they can always walk into our clinic. On an emergency basis, that person will be seen. We will make changes in our schedule to accommodate the needs of an emergency patient on the spot and get them where they need to go," Evans said.

Family violence increases risk
One factor that can lead to an increased risk of suicide is a history of family violence, according to Susan Swisher, Family Advocacy Program manager at ACS.

"We are briefing about this coexistence between domestic violence and suicide, and (researchers) are finding now that it's not just the adults," she said.

Both victims and perpetrators of family violence, including children, can face an increased risk of suicide. Helping those families end the cycle of violence is a goal of the FAP program.

In addition, there is a Transitional Compensation Program to help victims of domestic violence who are reliant on the service member for their support.

"If the active-duty member has committed a family violence crime, and if they are either separated from the Army because of it or they are incarcerated, then (the family member) is eligible for transitional compensation," said Swisher. "It doesn't jeopardize the family member for reporting. It provides them that support to allow them to get on their feet."

While her husband wasn't physically abusive, the Navy wife said they both came from dysfunctional families.

"I didn't know what I was in for. I was 24. I had dreams of having the white picket fence, the American dream," she said. "We went into a marriage, and we didn't really have coping skills. We were both overachieving, responsible people … I was trying to make my marriage perfect."

Educating families on how to have healthy relationships, whether it's marriage or parenting, is the focus of many classes at ACS.

"The military is really doing a lot to overcome those stigmas, whether it's (post-traumatic stress disorder), having domestic violence in the family, poor parenting approaches, trying to deal with being on your own, school issues, parenting issues, that's what (ACS) is here for," Swisher said.

"We may not have all the resources that we have stateside, but we try to connect people as best as possible … If we know their need, we can really work on getting the resources for them."