As the Army's senior leader on suicide prevention, I would like to add a few comments regarding Robert Haddick's Small Wars Journal post Army's 'suicide watch' report is spineless (SWJ 16 June 2009).
I am glad that we agree on certain points. Congress and the Army should aggressively implement and fund suicide prevention programs. Commanders at all levels must give sincere attention to the issue. We need to prioritize improvements to the welfare of Soldiers and their Families. Attention to suicide, its causes and prevention, are part of force preservation. All of these points appear in the Army Campaign Plan for Health Promotion, Risk Reduction, and Suicide Prevention (ACPHP), which the Army published on April 16, 2009.
The Army's collection and dissemination of suicide data is intended to be helpful in not only understanding the issue, but also in keeping awareness of the issue at the forefront of our leaders' minds. It is in no way disrespectful or depersonalizing to Soldiers. It is meant to save lives. You may not realize that senior Army leadership receives a briefing, in painful detail, about every Army suicide so that we can learn lessons on what might be done to prevent future suicides. Those briefings occur on a monthly basis, and I attend every one of them. Let me assure you, each suicide represents an anguishing, heartbreaking tragedy. The details of those briefings include personal information about the deceased Soldier that is subject to privacy laws and considerations for next of kin, and so are not released to the public. But they absolutely reinforce the necessity of being transparent in our discussions about suicide and learning from the cases in order to prevent further suicides.
Also, gauging the scope and nature of the suicide problem absolutely requires data collection, including counting the number of suicides. In October, the Army entered into a memorandum of understanding with the National Institute of Mental Health to conduct a longitudinal study to ascertain the factors involved in suicide and to identify effective suicide intervention techniques. Any statistical or epidemiological analysis to assess causation and remedies involves data collection.
I should also mention that the number of suicides is public information that the Army provides to Congress on a monthly basis. Simultaneous press briefings on the subject foster transparency in the Army's approach to the suicide problem and relay lessons learned that may actually help society as it wrestles with the same problem.
The statistical summary never purported to be more than just that -- a summary. We have frequently cited the Army's suicide rate as you suggested and compared it to the like civilian population. The Army's rate for 2008 was 20 per 100,000; however, the latest suicide rate for the demographically adjusted civilian population from the Center for Disease Control (CDC) - 19 per 100,000 - dates from 2006, as their statistics lag by two years. It marked the first time the Army's rate was above the CDC rate. After 2006, no comparison data is yet available from the CDC. It may be that the civilian suicide rate also spiked from 2007 to date. In any case, however one measures the rate, it is unacceptable, and we are committed to bringing it down.
I appreciate your interest about the suicides within the Army, and hope that these comments help address your concerns.
General Peter W. Chiarelli is the Vice Chief of Staff of the U.S. Army.
Comments
I am professionally a psychologist. About an ice age ago some of my colleagues at the Univeristy of Washington built a scale using a survey of recent experience--life events that when used could predict the "development of a major illness in the next two years". This can been done NOW with the current knowledge gained from the events that seem to be common to a suicidal to rank a serve persons probability to commit a "rare event." Get to the science figure out the policy later
The entire ACPHP is a burocratic waste. The fact is, the army is looking at this problem all wrong. Entering into "a longitudinal study to ascertain the factors involved in suicide and to identify effective suicide intervention techniques" is the wrong answer. We shouldn't be looking for ways to prevent suicidal soldiers from killing themselves. We should be looking for ways to prevent soldiers from becoming suicidal.
I am an NCO in the US Army. I just finished writing a lengthy email to GEN Chiarelli before I found this article. I just want to mention something that I think people should consider when we talk suicide. Using the Army's terms of "Suicide Prevention" or "Suicide Awareness" is great but you lose to many to this narrow topic. The real focus should be on "Self Destructive Behaviors". Most soldiers hear the word suicide and turn a deaf ear because they do not think it applies to them. Some feel suicide is wrong spiritually and just in general or they think of things like my insurance won't pay my family. So they do things to increase their risk.
For example, a person who has had a major event in their life may, instead of "suicide", drink heavily jump on their motorcycle or in their car and take chances not realizing in the back of their mind they hope to die. A now retired LTC did some research in the late 80's on accidents with fatalities and found that a great number had a major life event that would be commonly found in someone who commits suicide or has suicide gestures. The answer is not adressing this with commanders. Commanders should be responsible for ensuring that leadres at the lowest level have the tools and knowledge to identify people who fit in these areas. I have given COUNTLESS suicide awarenes or prevention classes and I rarely see leaders above the lower levels. When in fact, a lot of these leaders fit the group of those with "Self Destructive Behaviors". Stresses of war, seperation, money, and the list goes on. I think GEN Chiarelli is on to something but I must agree that with everything the Army does it seems to end up in flashy style that really doesn't work once all the studies have been refined and a product to teach is pushed out. They just do not seem to connect. Well, my 2 cents for what it's worth.
Via e-mail from Major Daniel Wilt, Jr.:
I am currently assigned to Fort Riley, Kansas and am training for my third deployment to the desert. I am writing in response to the multiple recent posts and articles regarding the increased rate of suicides by our Soldiers. The tragedy of what is has been making headlines as news this year, is a story that I have been sharing with people for over two years now. It is exactly why I have written my book, Finding Myself (A Soldier's Recovery From Betrayal, Embattlement, & Divorce), and why I have set up my website at <a href="http://www.findingmyself.org/">http://www.findingmyself.org</a>.
In my book, Finding Myself (A Soldier's Recovery From Betrayal, Embattlement, & Divorce), I wrote about why many Soldiers are willing to kill themselves. When I returned from my second tour in the desert, I too could have been a victim of suicide as my past command treated me with contempt when I tried to get the help I needed.
This year alone we have on record the deaths of over 100 Army Soldiers. That doesnt account for all of the different branches of service, DoD civilians, or family members. I work hard to help others who find themselves in similar situations by sharing with them the need to help themselves. Furthermore, I am working with the Armys senior leadership and offering them views from a different perspective. The Army is listening. How do I know this? I have personally been contacted by GEN Chiarelli and members of the Suicide Prevention Task Force, with which I have a meeting scheduled on 14 Jul. I'm hoping that more of my ideas are incorporated with what the VCSA and his staff are already doing.
The point Im making is that many people are not asking for help because we are ostracized when we do. I know that from personal experience and from what I have seen in my past units. The lack of support and feeling like there is no other way out is why people are ending their lives. This lack of support is from a few isolated failed leaders, not by Army leadership. I am grateful for what GEN Chiarelli and the Suicide Prevention Task Force are doing.
To those who support the men and women in service and to our leaders effecting change - Hooah!
Daniel O. Wilt, Jr.
Major, U.S. Army
The assertions that the trend in Army suicides is a demonstration of the stress the Army is under and that suicide rates will diminish as dwell times increase are speculative at best.
Increasing the size of the Army is not a good answer to much of anything at this time other than being able to say the Army is larger. We should fix the one we have before we try to enlarge it.
The Army is large enough to meet requirements -- it would be better if there were less tail and more tooth -- but the overall size is adequate. Anyone suggesting an increase in size hopefully has the funds to defray the added costs. We're likely to have trouble meeting the payroll for current strength in the near future...
People have breaking points and a few will always exercise an option to quit, upper level fixes will have minimal effect. Suicide reduction efforts at Battalion and above will do little; even less will accrue from E Ring, though they could reduce personnel turbulence in units; that would help. Regardless, sensible and active leadership at Company and below can lower the incidence.
As the poster above said, what's required is simply:<blockquote>"just hands on leadership by small unit leaders."</blockquote>That will garner a reduction -- but everyone must realize there is no panacea, no way to eliminate suicide. None.
I applaud General Chiarelli for his leadership behind efforts to reduce the incidence of suicides in the Army and for caring enough to correspond on this subject with the Small Wars Journal community. I am confident that he welcomes any ideas on refinements or wholesale changes in the Army's Suicide Prevention Program.
I am concerned that the disturbing trend in Army suicides is beyond his or the Army's control, and is a demonstration of the increasing stress that the Army is under as a result of repeated deployments in an era of persistent conflict. The Army is not big enough to meet all of the requirements imposed on it without putting its soldiers under more strain than they should be asked to bear.
The solution is a bigger Army. The House and Senate are considering Senator Lieberman's recommendation that the Army be increased by 30,000; this proposal would increase dwell time between deployments and build not just a larger but also a stronger and healthier Army. Suicide rates will diminish as dwell times increase.
I just browsed the Army Campaign Plan for Health Promotion, Risk Reduction and Suicide Prevention <a href="http://www.armyg1.army.mil/hr/suicide/docs/Complete%20Signed%20Campaign…;. It appears that our response to combating suicide is to expand the bureaucracy. Look at all of the central planning, organization, and coordination in that document.
I could replace the title of the plan, make a few other minor edits and the "campaign plan" would look just like a plan for the implementation of a bureaucracy dealing with anything from improving the Army Oil Analysis Program to oversight of the Combined Federal Campaign. It amazes me that anyone would hold up this document as evidence that we are doing something worthwhile and, in my opinion, reinforces the original point made by Haddick in the <a href="http://smallwarsjournal.com/blog/2009/06/armys-suicide-watch-report-is/… post</a> that the Army is completely on the defensive and unable to respond.
The emphasis is placed upon some surprising things, in my opinion. For example, there is a lot of emphasis on making sure that Soldiers are aware of, and have no stigma attached to, behavioral health resources. There are checklists for installation commanders. There are plans to fund more behavioral and primary health resources. Those are not horrible things, but does the first item require central planning, and are any of those the areas where our problems really lie? That's like reducing fatalities from car accidents by increasing the size of the emergency room staff and setting up more speed traps. Here is what worked for my Soldiers: you get a speeding ticket, you spend the next two Saturdays on staff duty. No central planning necessary - just hands on leadership by small unit leaders.
Here are some things that are (inexplicably, in my opinion) missing from the "campaign plan."
1. No mention of stabilization in terms of time at a particular duty station, predictability of deployments (duration or location), or time in a duty position. On page 25 - the only page that made a bit of sense, in my opinion - there was at least some attention given to stabilization in the 90 to 120 days following a deployment. There's a start.
2. No mention of the underlying causes that we suspect (my guesses would include factors in #1, above, along with insufficient leader involvement and declining morals overall). There is mention of certain behaviors that help to identify potential, such as drug and alcohol abuse, and involuntary separations. No mention of factors that are difficult to track with data, which reinforces my suspicion that this is little more than a centralized eyewash by people who are out of touch.
3. No mention of how we gauge the effectiveness of the new bureaucracy. Are we to assume that if suicides decline that it was due to the "campaign plan?" I suppose it will be characterized as such on some OER support forms, but the rest of us will probably be a little more skeptical, for good reason.
I share Mr. Haddick's appreciation for General Chiarelli responding, but I highly disagree with Haddick's comment that this "response shows how seriously you and the Army are taking this worrisome and tragic problem." I think it shows just how poorly we respond to issues that are only successful if implemented by small unit leaders. The scope of this plan is absurd on its face and even more absurd as one reads the details. If there is any central planning that should be taking place, it is by addressing item #1, above; making some additions to the curricula in PLDC, BNCOC, OBC; and finding a way to ensure that the Army Values on leader evaluations are more than just an automatic "yes" check.
Dear General Chiarelli:
Thank you for responding to my post on the Army's monthly suicide report.
Your response shows how seriously you and the Army are taking this worrisome and tragic problem. Readers of <i>Small Wars Journal</i>, many of whom are officers and NCOs responsible for soldiers, will benefit from your remarks.
Best wishes,
Robert Haddick