ANDREA PLATES WRITES –Military-related suicide is a worldwide contagion.

Since 2017, the number of such deaths in South Korea has gone up. Troop morale has gone down. Angry, conscripted men are calling for women to join their discontented ranks. Gay men and women report harassment, bullying, assault and, according to Amnesty International, criminalization (per Article 92-6 of the military code).  For the past four years, more officers than soldiers have committed suicide.

What preventive steps has the Ministry of National Defense taken, so far? Talks…calling for suicide prevention education and policy meetings.

It’s the same in America. In July, the U.S. Pentagon reported its highest number of veteran suicides in 17 years. The latest grim headlines involve “parking lot suicides” committed on official Veterans Administration grounds in America. Every day, 20-22 men and women who have served in the American military— whether active duty, the Reserves, the National Guard, or veterans— kill themselves. And in other nations around the world, comparable reports suggest the epidemic is endemic to the post-war veteran experience.

What should they be talking about, then, those experts convening end of August  at the Gaylord Opryland Resort and Convention Center, in Nashville, Tennessee, for a Suicide Prevention Conference? What innovations will be unveiled by some 2000 “experts” from the Department of Defense and the Department of Veterans Affairs, for this meeting billed as “One Mission. Many Roles.” #BeThere.

They were not there six years ago, when Daniel Somers, 30, machine gunner of 400 combat missions in Iraq, commented on the daily suicide count, “Is it any wonder? … Where are the big policy initiatives?” Those words, taken from his 2013 suicide note, were memorialized on Gawker, a one-time American celebrity and media blog.

They were not there for John King, 28, the Humvee runner in Iraq who hung himself back home in New York four years after his return.

They most certainly were not there for Justin Bailey, age 27, an Iraq War Marine who died of an overdose of VA- prescribed medications — while in treatment at the West Los Angeles branch of the Department of Veterans Affairs, its largest branch, where I worked for fifteen years.

One of these three men, I knew; two I did not. All three shared a common, and deadly, cocktail of combat-related crises—physical pain, opiate addiction, severe post- traumatic stress disorder (PTSD) and traumatic brain injury (TBI).  Said King’s grieving mother: “Kids are fighting for your country, [but] they’re not getting the help they need.”

Indeed. At the start of the “Forever Wars,” we tried to look away. But we can’t, anymore — not since a VA staffer telephoned Somers’ wife to set up an initial mental health appointment … weeks after his death; not since John King’s VA mental health specialist pronounced him no longer a danger to himself; not since the late Justin Bailey’s case managers somehow failed to make sure that he show up for his initial PTSD evaluation.

Impressive, first-term Senator Kyrsten Sinema (D-Arizona) gave her first speech from the Senate floor on this deadly theme, evoking Somers. John King’s family was honored at a July 4 artillery ceremony in Battery Park, New York. One year after his death back in 2007, Congress passed the Justin Bailey Substance Abuse Disorders Prevention and Treatment Act. Twelve years ago.

Now,  get ready for this: the VA is promoting “gold standard” innovations in the field of suicide prevention: 1) A computer algorithm that scours patient records, tracking medications, treatment, traumatic events and overall health so as to retrieve the names of veterans in the community deemed most likely to die by suicide within a year. So far, some 250 veterans have reportedly been stopped in their suicidal tracks; 2)  A first-ever, nationally standardized template for suicide risk assessment, rolled out at the start of 2019, based upon “high-quality, evidence-based tools;” 3)  Measurement-based care– self-report forms completed by veterans, designed to highlight symptoms of PTSD;  4) The Mission Act, implemented in June of 2019, ensuring private sector care for veterans who live too far from a full-service VA facility, among other factors; 5) A nationwide crisis hotline, manned 24/7; and 6) A nationwide army of Suicide Prevention Coordinators.

These measures are good—but not good enough.  They cannot compensate for compassionate care: those lauded, lengthy suicide risk assessment could detract precious time from direct patient care; those self-report checklists, in the hands of veterans, can’t possibly distinguish true PTSD victims from those chasing compensatory funds. The Mission Act may fast-track appointments for veterans but most private sector clinicians aren’t trained in the intricate  protocols for treating PTSD and TBI. The Veterans Crisis Hotline can be cumbersome. You could die waiting.

I remember the 25-year-old Japanese-American, an Army veteran, who casually ruminated about hanging himself from a tree; he was immediately hospitalized. I remember the double-amputee smuggling heroin in his prosthetic legs, selling it on VA grounds, then screaming, when caught, “I’m gonna kill myself!” Another hospitalization.

You have to be there, to feel it. You have to see it, to know it. You have to look into the patient’s eyes to ferret out fakery from tragic fact.

What’s called for is systemic change, in America and elsewhere. If Congress were to fund those 49,000 nationwide VA jobs that remain empty. If the Department of Veterans Affairs were to hasten its laborious, labyrinthine hiring system. If patient charting requirements were streamlined. If clinicians could concentrate on the patient, rather than the computer chart, before their eyes.

Boots on the ground are needed to win the hearts and minds of civilians in Afghanistan and Iraq (or so they insist).  The same could be said for both patients and staff on the frontlines of federal government.  Measurement matters, but so do the human brain, and heart. Anyone who has been talked out of suicide — or who has directed such talks — can attest to that. More clinical boots on the ground in countries will be the only way to win the war against veteran suicide.

 

Andrea Plate — Masters in Social Work UCLA, Licensed Clinical Social Worker State of California — teaches at Loyola Marymount University and is the Senior Advisor to LMU’s Asia Media International.

 

 

 

 

 

 

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