Silent Casualties: discussion on soldier suicide and prevention training

Overshadowed by endless reports of suicide bombers, insurgent uprisings, terrorist threats and roadside IED detonations, there is a frighteningly telling drift in soldier fatalities on the rise. The Army's most recent Suicide Event Report documents a soldier suicide rate higher than has been recorded in nearly 26 years. Perhaps even more suggestive, the numbers appear to have grown increasingly since the start of major combat operations in 2002.

Both the media and Army Public Relations outlets are careful to denote that the current suicide rate is still slightly lower than that of the contemporary civilian population. This they do without questioning data collection methods. In one of the many human-interest stories available, a family member of the casualty in question reported that although her husband's death was listed as 'non-hostile' the chaplain assigned to the case told her that it had in fact been a suicide.

It is impossible to determine whether or not this particular case was inaccurately reported, but this story raises an interesting suspicion. The actual suicide rates could be much higher if commanders and chaplains are practicing 'diplomatic' death reporting in order to preserve their soldier's honor and/or the death benefits that would be lost to his or her family members were the fatality reported as a suicide.

Concerns about the Army's suicide rate appear in media outlets as early as 2003 and in the familial stories that speckle search inquiries. The media reports casually mention the suicide issue in small bylines that list the facts and end without explanation or argument. These stories appear with the express purpose of perpetuating a general mood within the media about current operations thereby generating greater readership for the aforementioned outlet. These bylines make no studious attempt in examining current prevention practices, availability of resources, or delve beyond the surface of the mechanisms already at work in addressing the problem.

One of the major overhauls currently underway is being lead by Colonel (Dr.) Loree Sutton who is pictured on the left. Col. Sutton has been tasked with establishing a new Defense Department office that will focus on psychology, psychiatry, and brain trauma. Fred Baker, a reporter for the American Forces Press Service comments, "The hopes are that the center becomes the leading international resource for all psychological health and brain injury education, training, research, treatment and prevention."

Key senior leaders are aware of and actively addressing suicide. Though high tech, private, and imaginative programs like militaryonesource have been created in recent years there still appears to be a broken link in communication and training between the desks of major power positions held by visionaries like Col. Sutton and her contemporary Col. Elspeth Ritchie who is the psychiatric consultant to the Army and the ranks of average soldiers.

When asked in a random sample poll, 3rd and 4th year ROTC cadets (who will soon become Platoon Leaders in charge of the training and welfare of up to 50 troops) were surprised to learn that the Army even had suicide prevention programs. One cadet even exposed the current stigmatic 'culture-of-war' climate that prevents a great deal of suicide preventative care by remarking that people who suffer from PTSD should "learn to suck it up."

Another cadet who served in the National Guard as an enlisted soldier and completed a tour of duty in Bosnia recalled that during training, soldiers who attempted suicide or claimed they felt suicidal were publicly punished. These soldiers were forced to either wear their shirts inside out or walk around with a bright orange vest on so that they could be identified. Their bootlaces and belts were taken from them and they were returned to their units under the proviso that the soldier's immediate colleagues pull 24-hour guard duty over them.

Soldiers who have received suicide prevention training overwhelmingly reported a gratuitous use of PowerPoint Presentations. Though they are capable of transmitting large amounts of information to large audiences in a short period of time, these presentations are impersonal and dehumanizing. Soldiers complain that the constant exposure to this method desensitizes them from the importance of the information being disseminated.

Presentations are customarily conducted at the platoon or company level by unit NCO's and Junior Officers assigned with an 'additional duty.' This method groups soldiers together with colleagues who know and depend upon each other and is mediated by someone that may or may not have the prerequisite skills and training to conduct such a session. The failure in providing some means of anonymity reduces the likelihood that a soldier in need of treatment will speak up.

One aspect of suicide prevention practices that most soldiers seem to feel they are well informed about and prepared to use without fear of stigma or reprisal is internet services and '1-800' number resources. These services could link soldiers to local crisis centers where they could get immediate personal assistance. In addition to crisis management, these facilities offer programs such as marriage, financial, and job counseling. The preventative effort here targets the issues that may trigger suicidal thoughts and depression rather than merely practice reactive training.

That many people are concerned and working toward providing soldiers with adequate opportunities, treatment, and care should go without saying. The military and the Department of Defense with the blessing and backing of the federal government are addressing the problem in new and innovative ways. That being said, it is imperative to mission success that the bridges between the changes taking place at defense department and command levels trickle down.

If Army commanders want to see a reduction in suicide rates (and therefore benefit from the collectively improved cohesion and morale) they must face the reality that prevention training needs to start earlier in soldiers' careers and work from the bottom 'buddy' levels up. Platoon Leaders, Platoon Sergeants, and Squad Leaders should be given more training and required to assess and report not only on their subordinates' performance but on their morale as well.

It is time for a wake up call. Our Army has prided itself on its adaptability and flexibility. No matter how much we train, we cannot always escape those roadside explosions or predict every deadly ambush. We can, however, recognize and prevent suicide. These silenced casualties are not only victims of war- they are victims of neglect and their deaths are the direct result of failed training practices and access to available resources.