Behavioral researchers help Army combat suicides
WASHINGTON (Army News Service, July 19, 2012) -- The desire to "end intense emotional suffering" was among the top factors cited by Soldiers who had at some point attempted suicide, according to researchers from the University of Utah, who interviewed 132 Soldiers at Fort Carson, Colo.
While the preliminary findings are informative, they are not altogether unexpected and it is hard to draw conclusions from a relatively small sampling, said Bruce Shahbaz, the special assistant to the director of Health Promotion, Risk Reduction and Suicide Prevention, Army G-1.
Shahbaz, a former combat medic, is not authorized to comment in detail about the study until it is published in a behavioral health journal later this summer.
So what contributes to "intense emotional suffering?"
"The most reoccurring stressor we've found over the last several years is psychological pain related to a failed relationship," said Shahbaz. He explained that a failed relationship could include anything from marital problems or girlfriend/boyfriend issues, to the loss of a parent or an extremely close friend.
Other contributing factors encompass a range of behavioral health issues, he said, including depression, anxiety disorders, substance abuse and post-traumatic stress disorder.
Frequency and duration of deployments have been widely discussed factors in recent years, but Shahbaz said the issue isn't that simple. He said that while deployments have been trending down in the last few years, suicides have been edging up.
Earlier this month, the Army announced that 147 Soldiers died by suicide in the first six months of the year, an average of one every 30 hours. This includes 89 active duty Soldiers, 36 Army National Guard Soldiers not on active duty and 22 Army Reserve Soldiers not on active duty. This is 12 higher than the Army had at the same point last year.
Shahbaz said researchers theorize that, "if you're constantly deployed, training or preparing for redeployment, you are in a 'zone' and you don't try to reintegrate with family and loved ones. But with longer dwell times, problems surface. The family says he's not acting the same, or perhaps a spouse has taken on responsibilities that the Soldier had previously been doing and conflict arises.
"So we cannot say an increase in suicides are 'caused' by deployment, but we can infer that many are 'deployment related.' It's a subtle but important distinction."
Shahbaz said he thinks that if behavioral interventions had not been in place for the last three years, the rate of suicides would have been significantly higher.
"Unfortunately, we can only measure the number of suicides, not quantify how interventions may have prevented them," Shahbaz said. "We hear, almost daily, about a concerned noncommissioned officer leader who notices a change in a Soldier's behavior and takes action to help that Soldier. Great leaders can make a huge difference each and every day."
About three years ago, now-retired Gen. Peter W. Chiarelli, then the Army's vice chief of staff, led the Army's newly formed Suicide Prevention Task Force.
The task force, which was created to reduce suicides, later had its charter expanded to include health promotion, risk reduction and suicide prevention. The HP/RR/SP office has promoted the expansion of behavioral health screenings at every installation, advocated for improved training in suicide prevention and recommended a large increase in behavioral health counselors and researchers.
Besides behavioral specialists, the HP/RR/SP office has enlisted help from the offices of the Army Surgeon General, the Army Chaplain, the Army Provost Marshal, the Comprehensive Soldier Fitness program, the Installation Management Command, the Army National Guard, the Army Reserve, and even local law enforcement.
"We're taking a comprehensive approach," Shahbaz said. For example, "local law enforcement can point us to certain risk behaviors that could be precursors to suicide, driving at a high rate of speed or DUI for instance, and chaplains have organized retreats for couples having relationship problems and reserve units have financial classes for Soldiers whose homes may be underwater and at risk for foreclosure. Pulling from across the Army is a way for us to get in front of the problem."
Shahbaz said there aren't any simple solutions to the suicide problem.
"Our efforts to promote health, reduce risk, and prevent suicides are continuous and relevant across the entire force," said Walter Morales, chief, Army Suicide Prevention Program, Army G-1. "They include programs that target and focus on prevention, resilience, intervention skills, access to behavioral health and many others that contribute to the overall fitness and discipline of our force."
This coming September, Morales said, the nation will observe "Suicide Prevention Week" and "World Suicide Prevention Day." During that time, he said, the Army will expand its own observance to the entire month of September. That extra effort will allow for maximum exposure of the resources the Army makes available to Soldiers to prevent suicides and to reinforce a cultural change in Army ranks.
"This cultural change would call for all of us to remain personally committed to providing available resources to support the overall fitness of our peers, battle buddies, co-workers, friends, and family members," Morales said.
The suicide study at Fort Carson is just a start.
Shahbaz said the Army Medical Research and Materiel Command has 26 different ongoing studies involving Soldiers and veterans of the active and Reserve Component and their families worldwide.
"Each study is unique, examining different treatments, combinations of therapies and medicines, screenings, interventions, prevention measures and recovery plans," he said.
The largest of the studies underway is STARRS, the Army Study to Assess Risk and Resilience in Service members. That study is conducted by the National Institute of Mental Health in partnership with the Army.
The five-year STARRS study, slated for completion next year, is touted as the largest military study of suicides ever. The study tracks Soldiers from basic training through separation. Soldiers, all volunteers, participating in strict confidentiality, are categorized for resilience, biomarkers, background history and various risk factors with the goal of having a better understanding of the causes of suicides, Shahbaz said.
Col. George Glaze, director of the Health Promotion, Risk Reduction Task Force, said it is important to remove the stigma associated with those struggling with suicidal thoughts.
"A cultural change needs to take place," said Glaze, who has an infantry background. "It's natural for Soldiers to not want to admit they need help."
Glaze said all Soldiers, including officers, noncommissioned officers and below, need to get involved and look out for their fellow Soldiers.
"The sergeant major of the Army, or SMA, is leading the charge," Glaze said. "The SMA himself at one time needed assistance, asked for and got it and worked through the challenges."
Shahbaz emphasized that the most important message to get across to Soldiers, veterans and their families is that help is readily available and that confidentiality is guaranteed when calling the National Suicide Prevention Lifeline toll-free at 1-800-273-8255.
Shahbaz also said that the phone number is for anyone, but that professionals trained in helping servicemembers and their families are on standby to assist. He added that the phone number can even be accessed from Afghanistan.
Another important source of help, he said, is www.suicidepreventionlifeline.org.