Article archive / November 1, 2012
Originally published: . Volume 4, No. 3. Source pages: 6, 7.
Amid celebrations and honoring of veterans this year, there remains a concern for military men and women due to continued high suicide rates.
An August 16, 2012 press release form the Department of Defense confirmed the rising suicide rates in the military. This last July saw high numbers, and in a press release General Lloyd J. Austin, III, vice chief of staff of the Army, said in the release, “Suicide is the toughest enemy I have faced in my 37 years in the Army.”
In August this year, President Obama issued an Executive order to improve the mental health for Veterans, service members and their families. Because of this, the VA has been hiring 1,600 mental health professionals and increasing the support for the Veterans Crisis line.
But experts also say that families, communities, and private sector professionals must be fully engaged in helping also.
Using 2010 information from the CDC and Defense Department, Time Magazine noted that military suicides are high, but the causes are unclear. Time reported that suicides are 95 percent male, 95 percent enlisted, 80 percent white, and 47 percent under the age of 25. Eighty-three percent were in the US at the time of suicide. Eleven percent had combat history. Seven percent had major depression, 5 percent PTSD, and 3 percent Traumatic Brain Injury. Twenty-six percent had substance abuse.
The military site “Real Warriors” (http://www.realwarriors.net/), an initiative by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, and the recently launched Online Toolkit for Providers, notes that military training, survival skills, and the military culture may cause challenges in reintegration for returning service members.
The Times spoke with two Louisiana psychologists, Dr. Dana Boose and Dr. Andrew Thrasher, about what their perspectives and what they view as important in the Louisiana community and in efforts to assist the returning servicemen and women to transition back to home.
Dr. Dana Boose is a Clinical Psychologist in the Post Deployment Healthcare Clinic at the Alexandria VA Healthcare System. She is also commissioned as a Captain in the Louisiana Army National Guard.
PT: Can you comment on what you see as the most important things that local Louisiana psychologists and mental health professionals could do, in your opinion, to help in this area?
Dr. Boose: “ I concur … family and community connectedness and easy access to effective care are essential,” she said.
“Additionally, we as mental health professionals need to be keenly aware of the risk factors associated with suicide and need to be proactive in our care!
One of the most salient risk factors that encompasses a number of different areas includes loss-loss which can manifest itself in many different ways: death of a fellow soldier/close friend in combat, loss of a relationship upon return (marriage/friendship), loss of employment, loss of physical functioning (may have been injured during deployment), or loss of cognitive functioning (especially debilitating among young, otherwise healthy veterans who have endured a traumatic brain injury that contributes to cognitive impairment). Other relevant risk factors to include in your assessment are presence of substance abuse, access to weapons, separation or pending separation from military, and problems adjusting to their civilian roles post deployment, among others.
“Another area of impact is assisting veterans in easing their transition back to civilian life. They go through an intense train-up to deploy, but comparatively not the same amount of attention is given to assisting these veterans in understanding and learning how to adjust to assuming their roles as fathers, mothers, sons, daughters, employees, students, etc. upon their return home…many veterans experience extreme difficulty with this transition and I believe it largely contributes to exacerbation of mental health problems among our veterans.”
PT: What factors do you see as promoting the returning veterans feeling more connected and less isolated?
Dr. Boose: “Two things immediately come to mind: Veterans need support from their community–one of the biggest needs for returning veterans continues to be employment. In my work I see a positive correlation between employment and feeling connected and empowered among veterans. They need jobs when they come home. Perhaps one of the greatest ways a community could demonstrate support for their veterans is to recognize the vast training, skills and experience that our veterans gain during their military training, and assist them in job placement upon their return from duty.” “They need patience and understanding from friends and family members and their community. Unfortunately it's easy for people to make blanket statements, and sometimes family members are the worst culprits, with comments such as "he's crazy", "she's changed", or placing any number of negative labels upon a veteran without truly taking the time to understand or appreciate what he or she has been through—largely contributing to feelings of isolation and avoidance for the veteran. Take time to understand a veteran's experiences and what he or she is going through– volunteer to help veterans, spend time with them. Whenever possible, offer services to veterans in appreciation of their sacrifices–they appreciate it.
PT: I see that the VA is adding help for these veterans, and also recommending coordination between the VA and other agencies and people in the community. Do you have a comment about how that is going?
Dr. Boose: “I am excited about what the VA is doing for our veterans and their families, as well as how the VA partners with community agencies to ensure our veterans needs are met. The VA recognizes the increased need and benefit of incorporating the family into the veteran's care; to this end we are offering treatment groups specifically for spouses of veterans as well as couples counseling. Educational interventions for family members to better understand the veteran's experiences are available. The Vet Center also provides readjustment counseling and couples/family counseling. As I previously mentioned employment is an ongoing need; the VA's vocational rehabilitation program works closely with the Louisiana Workforce Commission in an attempt to locate jobs for veterans. The VA has a homeless veteran's program that works closely with local shelters and the local housing authority in Alexandria assisting veterans in securing housing. We also have a veteran's justice outreach program that works closely with our local district attorney's office and judges to identify veterans in the justice system with mental health needs and seeks to provide them with needed mental health care. As the needs of our veterans evolve I'm certain that the VA and the community will continue to think of novel ways to come together in the interest of assisting our veterans.” The Times also interviewed Dr. Andrew Thrasher. Dr. Thrasher is a licensed psychologist at the Psychotherapy Clinic, LLC, in Sulphur, Louisiana. He is a also veteran and he is member of the Give An Hour program.
PT: It looks like there are some complex things going on with the suicide rate and wonder if you can comment on that? Dr. Thrasher: “The 38th Annual National Suicide Prevention Week took place this year September the 9th through the 15th. Unfortunately, suicide is still a major concern for the nation and especially in our military. I Googled suicide in the military and, after wading through the political finger pointing (which president is at fault), found some interesting information. It seems people suffering from PTSD may have a significantly higher risk of suicide than other trauma survivors diagnosed with other psychiatric illnesses (Ferrada-Noli et al., 1998). An excellent graphic from Time http://www.time.com/time/interacti ve/0,31813,2119360,00.html breaks down military suicide data very well and also presents a few surprises. For example, only 11 percent experienced combat and as few as five percent were diagnosed with PTSD. The top two behavioral issues involved with suicide in the military were substance abuse with 26 percent and major depressive disorder with seven percent. PTSD was third with five percent.”
PT: Can you give a little perspective on yourself as a veteran?
Dr. Thrasher: “My personal experience with the military occurred when I joined the draft. For those of you unfamiliar with the term draft, it is a rather antiquated ritual that used to occur in the United States. At the age of 18, men in this country were required to sign up for the military draft and could be called into the military service at any time. To avoid any future surprises of being called to service, I volunteered for the draft to fulfill my two year obligation. I was stationed at Colorado Springs, Colorado and was rather enjoying my stint in the Army. I wanted to believe that I was protecting my country from the enemy infiltrating the ski resorts in Colorado.
“My illusion ended one morning when I was ordered to report for battle to an unknown destination in the Middle East. I was a member of the missile command which was part of the Strategic Army Corps (STRAC). Apparently, I could be deployed to battle in order to strike quickly in the case of a military emergency. The emergency was called off and I was not deployed; however, I vividly remember standing in line, with my rifle, at the airport preparing to board a military plane. Even though I was a soldier, I was completely unprepared to go into battle. I am sure that the stress of just thinking about going into battle caused me some degree of PTSD. I can only imagine the horror of being involved in combat and will always have a warm spot for those that served our country in this manner.”
PT: How are you currently involved with assisting the military?
Dr. Thrasher: “My current involvement with the military involves volunteer work with Give an Hour http://www.giveanhour.org/.
“This is a worthwhile organization that gives psychologists an opportunity to give back to the troops that were deployed and are now integrating back into civilian life.”
Dr. Dana Boose is a Clinical Psychologist in the Post Deployment Healthcare Clinic at the Alexandria VA Healthcare System. She is also a Captain in the Louisiana Army National Guard. She talked with Times about the ways to help veterans readjust to civilian life. Photo taken earlier this year at events of the 2225th Bridge Company in Marrero, LA. (Courtesy photo)
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