BD comment of the day: Suicide is killing more combat vets than Iraq is

Posted By Thomas E. Ricks Friday, September 2, 2011 - 10:08 AM Share

It didn't take Jim Gourley long to get back on the board with this powerful observation about August: "This was the first month that there were no American combat deaths in Iraq. So we can say with certainty that more veterans of that war died as a result of PTSD/depression at home than they did of direct enemy action in country."

Meanwhile, here is another vote for marijuana as a PTSD palliative. I wonder if this is what ultimately may lead to legalization.

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CHARLIE SHERPA

3:20 PM ET

September 2, 2011

What about larger, cumulative picture?

It's a good line and intent, but one specific to August 2011 only. I'd be interested in a comparison of cumulative numbers: KIA/WIA overseas relative to suicides at home. Anyone know of any good data sources?

GOLD STAR FATHER

3:44 PM ET

September 2, 2011

No, Can't be...

@ Charlie: Here's some stuff from the VA. Sorry for the ppt reference, but its got some staggering numbers.

http://www.ptsd.va.gov/professional/pages/ptsd-suicide.asp

www.erie.va.gov/bh/vjoconference2011/assets/FirstRespondersSuicidePrevention.pptx

When I first read Jim's comment from yesterday, I thought it was a typo/word left out. But no, he's right. We have lost more to mental trauma resulting in suicide than all the combat actions since 9/11/01. Not just the months of low count KIA or (thank God) no-count KIA of August 11, but all the months of all of these stinking wars.
What's the answer other than to stop this foolish pace of trtoop cycle into AO's of deadly and dubious value? Alternative/"recreational" drugs? No, regardless of anecdotal evidence of marijuana's worth as a PTSD reliever, DOD surely and VA surely too won't budge. The public may possibly come to terms with pot legalization eventually, but it won't be because of the perceived value of anxiety relief that changes the tide and Federal law.
The VA and DOD, as of October 2010, ((2010) VA/DoD PTSD Clinical Practice Guidelines) have institutionalized "tested" drugs for PTSD therapy. All other direct therapy is coincidental or marginalized as basically witchcraft.

JPWREL

4:49 PM ET

September 2, 2011

GSF has the right answer

What a profoundly sad issue this subject is but as usual I find myself in strong agreement with GSF. His ultimate solution “What's the answer other than to stop this foolish pace of troop cycle into AO's of deadly and dubious value?” is spot on. As far as using marijuana as a PTSD palliative I am not so sure. The numbers indicate a lot of these poor souls are already using and abusing another palliative namely alcohol with little success. Another partial solution would be a more rigorous selection process for recruits and to train them harder, longer and more relentlessly while aggressively weeding out those that don’t or won’t bring their A-game to work 100% of the time.

JAYLEMEUX

7:09 PM ET

September 2, 2011

Pot is also widely used among

Pot is also widely used among vets as a self-medication, often to run from the symptoms of undiagnosed PTSD. I too am skeptical (but open to hearing real scientific evidence) that it has a productive application.

However, what is the connection between PTSD rates and servicemembers who won't or can't bring their A game to work 100% of the time? I don't follow.

JAYLEMEUX

7:10 PM ET

September 2, 2011

My first assertion is based

My first assertion is based on anecdotal evidence, of course.

ERIC_STRATTONIII

6:05 PM ET

September 2, 2011

Mis-diagnosis might also be a problem

PTSD and TBI can end up having very similar Signs and Symptoms and an emerging theory is that due to the damage the pituitary gland suffers from a blast injury the resulting hormonal imbalance can lead to severe depression, mood swings, etc...many people, unless they come in with a direct complaint and patient history of a TBI are not tested for testosterone, HGH, ACTH, etc...levels in their blood and can often be mis-diagnosed with PTSD which is limited in treatment via medications. Not all TBI's get hormonal imbalances from the blast but a large enough proportion have gotten it that is has sparked several studies at the VA and DoD. TBI and the hormonal imbalance that results from concussive force damage to the pituitary gland is a very treatable injury via medications and the studies they are doing at the VA Centers are promising but apparently not going fast enough when suicides reach this level.

WALKING WOUNDED

6:33 AM ET

September 3, 2011

Misdiagnosis is endemic to TBI injury

Eric makes an important point, one that is well known in civilian medicine.

Mild TBI (IE concussion with momentary loss of consciousness) often goes undiagnosed, and even moderate TBI (multiple mild concussions or one bad one) is misdiagnosed. Lack of memory or focus, frustration and impatience are hard to differentiate from bad attitude, or overmedication.

TBI is the most common debilitating injury among military age men, in civilian life. A common symptom is loss of executive function, which again is hard to distinguish from any other beery young man with a motorbike.

The VA and military rehab hospitals are working the TBI/PTSD issues, delaying discharge until active duty rehab has run up to a year. But BD readers should remember that the primary mission of military medicine has always been to keep the ranks full thru prevention, to treat and return injured troops to the firing line. In the words of General Savage, 'paint it with iodine and mark them fit for duty...'

The good news is that psych and neuro injuries do respond, but the length of treatment and recovery has to be proportional to the injury. In some cases it will be a lifetime project, not as simple as a hormone supplement.

LESTER_GALULA

6:23 PM ET

September 2, 2011

To be fair

Motorcycle accidents have been more deadly for the Marine Corps than combat losses in some years, and the suicide rate for Marines is lower than the national average, and significantly lower than the average if you only consider the 18-25 demographic.

ERIC_STRATTONIII

6:51 PM ET

September 2, 2011

@Lester

Your right, the numbers are not as bad as the press plays them out but keep in mind the only reasons we have not had perhaps as many as 30 KIA from the wars is due to advances in Field Medicine (TCCC), CASEVAC and Body Armor, if it were not for those three things I would wager our low numbers of KIA would easily be in the 30 thousand area if not more as we slowly approach the total casualty number of WIA/KIA 60k from both conflicts.

SILENTSHWAN

9:33 PM ET

September 2, 2011

It also means

Police Departments have more kills on U.S. Soldiers than Iraqis too.

http://www.saljournal.com/news/story/soldier-killed-9-1-11

Soldier killed in standoff hadn't been confined

JIM GOURLEY

1:08 AM ET

September 3, 2011

Threshold for pretrial confinement...

“Evenson was not considered a flight risk because he had complied with all military rules and orders prior to fleeing.”

Except, you know, the ones about not raping people.

STRYKERCAVSCOUT

3:25 PM ET

September 5, 2011

Student Vets and Suicide

Suicide rates among Student Veterans are staggeringly high too... I can't post the academic article here, but here's a new article that references it. Maybe Tom can post the actual article..

http://campusprogress.org/articles/nearly_half_of_student_veterans_contemplate_suicide_study_reveals_prev/

Anyway, organizations (like Student Veterans of America) are beginning to form to help combat this - we started one at my school. Folks like me who are still on Active Duty have retained the support network - but alot of these kids feel pretty isolated now that they're out and with over 400 student veterans at my university, it seems insane not to be bringing them together. You'd be amazed at the response we've gotten.

SILENTSHWAN

4:58 PM ET

September 5, 2011

More help?

If they can't get to a VA clinic or a VetCenter to help them what makes them think some school club is going to?

HUNTER

8:25 PM ET

September 5, 2011

Silent

Because a student club is probably going to be made up of fellow servicemembers who will actually listen to them and UNDERSTAND. Like any other crisis intervention effort, people like to talk with people who have walked a mile in their moccasins...and actually CARE.

A student club is also going to be local and immediately available whereas a VA clinic of Veteran's organization might not be.

There's good folks at those VA and other veteran's organizations but they are largely overwhelmed. Anything new (might) be better. Let's not dismiss it out of hand. Esp. since Stryker mentioned the welcoming response.

And let's face it the old stuff we got ain't been working so well.

STRYKERCAVSCOUT

9:02 PM ET

September 5, 2011

Most

Most of the folks who come just chat - hang out and the like. We aren't "helping" in the counseling sense, we're recreating some semblence of the peer support network that exists when you're in a unit; we're providing famliar ground and a common language.

For the first year student vets, we're providing 3rd and 4th year student vets who've made the transition, understand the GI Bill, know how to succeed - etc. There are grad students in the program as well, both active and former vets, who can help too for mentorship or even with classes. In addition, former students who've heard about the program have been reaching back to see what they can do about helping our members find jobs.

So maybe it is a club... but so is the military.

STRYKERCAVSCOUT

9:04 PM ET

September 5, 2011

And

And we might be able to push someone towards getting real help if they need it because, having been there ourselves, hearing they need to seek it might be easier from a fellow vet.

Then of course, being around also helps mitigate the sense of isolation which could lead one down that road.

GOLD STAR FATHER

12:45 AM ET

September 6, 2011

Hear, Hear!!

Thanks Stryker. The best therapy for a veteran is the conversation with another veteran.

SILENTSHWAN

12:36 AM ET

September 7, 2011

So VA counselors don't care anymore?

News to me. Anywho,

I'm not dismissing it out of hand, there is proper concern that groups, no matter how well intentioned, will keep veterans isolated and inhibit them from moving on back to civilian world. Veterans have the VFW and many other organizations to get help with various issues, and it's nice StrykerCavScout is facilitating a mentoring program, but the last thing we need is more veterans feeling anymore entitled than they already are through veterans only groups on campus.

Veteran unemployment is still higher than normal unemployment even though companies get tax credits hiring them. Veteran dropout rates are extremely high as well (the VA will be cringing now that they're keeping track starting this semester). Shinseki and others are trying to make schools the bad guy for not "doing more" for the veterans who are so used to the "high structure" of the military life and can't handle the "Chaos" of school life.

Did the military make a generation of soldiers who can't be adults? From the Army standpoint, with them having to attend ACAP to having their hands held at school are these the same soldiers we entrusted multi-million dollar pieces of equipment to? Soldiers have already edged out young men and women in wage and compensation already, and now they're getting free post high-school education and they still need more help?

I'll take the VFW and VA for help, and keep laughing at the guys walking around campus in their suede boots and assault packs who can't let go.