JOINT BASE LEWIS-MCCHORD, Wash. - With thousands of service members returning from war each year, the Army continuously seeks ways to ease their transitions.

For a nation at war for almost a decade, suicide prevention has become increasingly important. Officials are concerned about the rising number of troops attempting to take their own lives.

"Unfortunately, last year was the highest number of suicides we've had in the Army, and so this has the Army vice chief of staff's visibility," said Col. Jeff Coe, I Corps deputy surgeon. "There is a lot of effort being poured into suicide prevention and awareness."

While experts aren't able to give a definitive reason why suicide rates are up, many point to the stress associated with combat.

"This is our ninth year as a nation at war, and the percentage of Soldiers who have not deployed to Iraq or Afghanistan is very small," Coe said.

One of the first things Soldiers do when they redeploy is go through a reverse Soldier readiness process, part of which takes them through a series of behavioral health questions. Those questions, asked by behavioral health professionals, are key to identifying an "at risk" Soldier.

"It's not just about suicide prevention, but it's that entire gammet of behavioral health - suicide being one of the components within it," Coe said.

The Army is actively seeking ways help Soldiers at risk before it's too late, starting on the battlefield. Combat stress teams provide services downrange similar to those offered in garrison, and commanders are responsible for identifying Soldiers who might be considered at risk.

"That's kind of the first line of defense," Coe said.

By the time a unit returns home, the behavioral health team at Madigan Army Medical Center has already received information about its Soldiers and focuses on getting them the help they need.

Margaret Mackenzie, suicide prevention program manager, said the military is taking suicide prevention very seriously by devoting a lot of time and resources to it.

"The research is just absolutely astounding," Mackenzie said. "The collaboration with researchers and the top names in suicide prevention is wonderful and shows the military is really looking at the causes of suicidal behavior," she said.

Having been a military health professional for more than 30 years, Mackenzie has seen plenty of changes in the way suicide prevention has been handled. One of those changes is removing the stigma attached to getting help.

"People are finally realizing it's not a character flaw to seek help," she said.

Mackenzie estimated more than a dozen Soldiers came to her office in a week's time looking for posters and resources to help promote suicide awareness within their units. Although most said they were from units that recently redeployed, Mackenzie and Coe agreed suicide can affect anyone - including family members and service members who have not deployed.

"Anybody who has a life stressor is at risk," Coe said. "What tends to happen is a number of these stressors accumulate, and that's what puts people at risk."

Programs such as Applied Suicide Intervention Skills Training teach Soldiers and civilians in key positions how to identify and respond to warning signs.

"It's the idea of being active and finding people in crisis before they go to the point where they hurt themselves," Mackenzie said.

Military Family Life Consultants is another program that focuses on family members.

"These folks have been joined with the rear detachments, and they've been providing resources, assistance and counseling to the family members while the Soldiers are deployed," Coe said.

MAMC is planning a symposium to educate family members on how to recognize symptoms of post-traumatic-stress disorder so they know when to get help, while FMWR has Warrior Adventure Quest to help combat veterans get a safe adrenaline rush without taking extreme measures.

"We really want to help our Soldiers," Coe said. "Every life is valuable," emphasizing there are no repercussions for getting help.

"The Army's charter is more about holistically improving the physical, mental, and spiritual health of our Soldiers and their families than solely focusing on suicide prevention," said Army vice chief of staff, Gen. Peter Chiarelli. "If we do the first, we are convinced that the second will happen."

Despite the tremendous amount of resources available, Mackenzie said one of the biggest challenges is getting Soldiers to take advantage of them. There are three ways to get help: in person, online and by telephone. She highly recommends local community resource guides,

"Whether you want to go over to the recreation center and rent a kayak or you're in a crisis and desperate for help of some kind ... almost every program offered to you on this base is on that guide," Mackenzie said. "I've been around the military a long time, and the wealth of resources is mind boggling. Use your resources because the Army really is working hard to be helpful to you and your families."

Laura M. Levering is a reporter with Joint Base Lewis-McChord's weekly newspaper, the Northwest Guardian.


Suicide prevention resources

Common reactions

Many of the reactions listed below are normal for people who experience high stress situations. It is not uncommon for Soldiers to experience some or all of the following reactions:

Aca,!Ac Physical: trouble falling asleep, oversleeping, waking up in the middle of the night, fatigue, feeling jumpy, being easily startled, difficulty with intimacy

Aca,!Ac Emotional: feeling overwhelmed, depression, irritability, feeling numb, difficulty adjusting to routines, discomfort being around other people or in crowds, frustration, guilt, crying spells

Aca,!Ac Cognitive: difficulty with memory, loss of interest/motivation, concentration problems, loss of trust

These reactions may be uncomfortable, but in most cases are not causes for concern. Typically, the common reactions stop after six to eight weeks.

When normal reactions become problematic

Aca,!Ac Problems that interfere with a Soldier's ability to do the things that he or she needs to do in any important area of life (work, home, family, social, spiritual) are the clearest signs that a normal reaction after deployment may be turning into a more serious problem.

Aca,!Ac If a Soldier's distress persists longer than six to eight weeks, it may be a sign that your loved one needs professional help.

What are the signs of suicide

Watch for signs of suicide and take them seriously! Here are a few to look for:

(1) Talking about death and suicide:

Aca,!Ac You might say things like, "There's no point in living" or "I'd be better off dead"

Aca,!Ac threaten to kill or hurt yourself

Aca,!Ac talk or write about death a lot

(2) Planning or preparing:

Aca,!Ac gathering guns or other items to use to kill yourself

Aca,!Ac getting in touch with military buddies or other friends to say "goodbye"

Aca,!Ac giving away things you own

Aca,!Ac suddenly getting finances in order or planning a funeral

(3) Mood changes:

Aca,!Ac sad or hopeless

Aca,!Ac irritable, anxious or overwhelmed

Aca,!Ac excessively or suddenly angry or have unpredictable mood swings

Aca,!Ac calm or happy after being depressed

(4) Behavior changes:

Aca,!Ac reckless actions

Aca,!Ac a drop-off in work performance

Aca,!Ac loss of interest in hobbies or enjoyable activities

Aca,!Ac staying away from family and friends

Aca,!Ac changes in eating or sleeping habits

Aca,!Ac abuse of alcohol or other drugs