DoD Health Officials Concerned Over Military SuicidesBy Sgt. 1st Class Doug Sample, USA
American Forces Press Service WASHINGTON, April 15, 2004 -- The number of suicides in Iraq has the full attention of Defense Department health officials, who are asking soldiers suffering from combat related stress to seek medical assistance.
In an interview with American Forces Radio and Television Service, Dr. David N. Tornberg, deputy assistant secretary of defense for clinical and program policy, said suicide deaths are a "primary concern" for his office.
"It's very important for anyone who is feeling stressed to come forward, to speak to their chaplain, to speak to a mental health practitioner or physician, to speak to someone in your line of authority," he said.
Especially troubling to Tornberg is an Army report by mental health experts that revealed soldiers committed suicide at elevated rates during 2003, with those deployed to Iraq and Kuwait experiencing the greatest increase.
DoD officials have reported a drop in the number of suicides this year, with no suicides reported in January or February, and just one in March.
Tornberg said males ages 18-25 with financial, legal and relationship problems compose the largest risk group for suicide.
According to DoD statistics, there were 24 suicide deaths in 2003 in Kuwait and Iraq - a rate of 17.3 per 100,000. The overall Army suicide rate during the same time period was 12.8 per 100,000 soldiers.
Still, officials say the Army suicide rates of 12.2 for 2003 and 11.9 from 1995 to 2002 remain lower than the national average of 21.5 per 100,000 for males ages 20 to 34 - the age span for most U.S. soldiers in Iraq.
Though the military has several comprehensive programs in place to address the mental health needs of service members, Tornberg said more emphasis will be placed on suicide prevention training for leaders and troops, beginning before and after the deployment cycle.
Prior to deployment, service members receive mental health screenings, and during the course of deployment, mental health support teams are available to provide assistance as needed, Tornberg said.
Upon redeployment, service members go through a "re-integration" process designed to help their transition back into family life. Service members are also re-screened for mental health problems. "Follow-on services are available if they should encounter any difficulties," he said.
Tornberg said last year the military conducted a first-of-its-kind study of service members in a battle zone. Mental health experts surveyed 756 soldiers in Iraq between late August and early October.
The study consisted of hundreds interviews of soldiers, their leaders, and support forces such as behavioral health and medical-care providers and unit ministry staffs.
"They learned a lot from that trip," he said. "First and foremost, it reaffirmed the fact that the battlefield today, despite all training, is a very stressful environment."
Surprisingly, Tornberg said the majority, some 77 percent of the troops interviewed, did not feel an "excessive" degree of stress, and felt they were managing their stresses well. He said he believes they considered the stress levels they anticipated as the benchmark in determining whether they experienced "excessive" stress.
Still, he said recommendations in the report have called for making behavioral health care more accessible to soldiers in combat and other high-stress environments "so that mental health professionals are actively available and ready down at the battle lines."
He said the study further revealed a need to optimize the well-being of soldiers by enhancing environmental and living conditions in theater.
One of the significant developments in the Iraq study, he said, was the success of combat stress control teams. He said the teams have been used in the past, but that DoD has substantially increased the program and its focus.
Plans are to have combat stress teams "fully integrated" into the battlefield and readily available to provide intervention as close to the front as possible, he said.
"There is just no substitute for having those services readily available," he said. "It's worked marvelously well in uplifting the mental health of the troops."
He noted that 96 percent of soldiers who have ready access to mental health resources are able to return to their units.
Tornberg said each service has its own stress management program to acquaint service members to the various reactions to stress and the appropriate management of those conditions.
The Army's Applied Suicide Intervention Skills Training, or "ASIST" program, is a computer-based program that, along with classroom training, offers soldiers and leaders training involving suicidal behavior.
The Army introduced the program about three years ago to give anyone who might come in contact with a person at risk of committing suicide the tools to intervene.
A "Soldiers, Leaders and Communities Saving Lives" suicide prevention campaign launched earlier was aimed at teaching soldiers how to recognize early signs of suicidal behavior and how to respond.
In February, the Army set up a toll-free crisis hotline to help curb suicides among soldiers during high-stress periods.
Tornberg urged service members who are having problems dealing with stress to come forward and address their issues. He also wants service members to look out for comrades who may be displaying signs of stress. "It would be important to talk to that individual," he said, "but also seek help for him or her as well."
He said many service members don't seek help from a mental health professional because they see that as a "sign of weakness" or believe a stigma is attached to seeking help.
"It is absolutely not" he said. "Reaction to stress is a condition experienced throughout society, not just in the military -- particularly in the young, particularly in the aged," he explained. "It's something that we as a society have to address. And the stigma is something that we want to be removed."
He said service members should seek help for stress disorders just as they would for an ankle sprain.
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