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April 24, 2014

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J. Patrick Coolican:

Veterans suicide rate: The war at home

J. Patrick Coolican

J. Patrick Coolican

Click to enlarge photo
Click to enlarge photo

Sun editorial

We know that suicide is a terrible problem in Nevada, with a rate 50 percent higher than the national average. Among military veterans and especially young veterans, however, it’s a crisis, according to new data from the Nevada Department of Health and Human Services.

From 2008 to 2010, the Nevada veteran suicide rate was 2.5 times higher than the rate for all Nevadans and nearly quadruple the national nonveteran suicide rate.

In 2010, suicide accounted for more than a quarter of deaths among veterans 24 and younger.

All told, of the 1,545 Nevada suicides between 2008-2010, veterans accounted for a stunning 373 of them, or nearly a quarter.

The explanation: The wars in Iraq and Afghanistan have taken a brutal toll on our young men and women. And they have come home to a bad economy and communities that are often clueless about what veterans have experienced or how to help them.

“Those high numbers are reflective of a decade of war and the impact that has on those who have been asked to serve in that war,” said Luana Ritch, a veteran and public health expert who compiled the data for the Nevada Department of Health and Human Services.

There’s no great repository of data that tracks veterans’ health, other than the Department of Veterans Affairs. But many veterans aren’t in the VA system. And veterans’ death certificates sometimes neglect to mention military service.

Given these data collection issues, it’s possible the problem is even worse than the figures show. Also owing to data collection issues, it’s not clear if the veteran suicide problem is better or worse in other states.

What we do know, however, is that nationally the problem is significant.

The VA estimates that a veteran takes his or her own life every 80 minutes — 6,500 suicides per year. That’s 20 percent of all suicides in the United States.

The Center for a New American Security published a report last year, “Losing the Battle: The Challenge of Military Suicide,” highlighting the dire situation. The report notes that during peacetime military service members historically experience lower suicide rates than the overall population.

Some experts believe there are three bulwarks of suicide prevention: feelings of “belongingness,” feelings of usefulness, and an aversion to pain and death.

The damage to these prevention protections could explain the rising prevalence of military and veteran suicide during wartime. Once home from war, veterans may feel separated from their comrades and alienated, useless on the homefront and tolerant of extreme pain and death because they’ve seen a lot of it and are numb to it.

In 2005, I spent six months studying the neuroscience of post-traumatic stress disorder at Ohio State University and learned about the tragedy of veterans — as well as rape and accident victims — who often suffer silently, tormented without knowing what afflicts them. What I learned is that the public tends to misunderstand post-traumatic stress.

Repeated exposure to extreme stress, like the kind soldiers experience in war, can change your brain chemistry. Symptoms include extreme anxiety and watchfulness to the point of paranoid delusions, nightmares and sleeplessness, rage, depression and an inability to form close relationships. The symptoms can be treated with medication and counseling, but there’s no cure for altered brain chemistry. Veterans suffering from PTSD often self-medicate with drugs and alcohol, which can accelerate the downward spiral.

“Losing the Battle” also blames high suicide rates on systemic failures: a flawed mental health screening process; a cultural stigma attached to seeking help; an insufficient number of care providers; too much prescription medication (an astounding 14 percent of the Army population is prescribed an opiate, according to the report); and finally, multiple agencies across multiple jurisdictions have trouble getting on the same page.

The repercussions for an all-volunteer military could be severe, as family and friends could attempt to dissuade a potential recruit from enlisting if they believe military service will result in psychological harm or even suicide.

I called the VA in Southern Nevada and in Washington but never heard back from them.

Linda Flatt of the Nevada Office of Suicide Prevention shared some information. Warning signs include: thoughts, fantasies, planning and discussion of ways of hurting or killing oneself; recklessness; rage, guilt, anxiety, depression; withdrawal from family and friends; drug and alcohol abuse; and feelings of hopelessness.

Prescription medication and firearms can be especially dangerous for people at risk of suicide; they should be stored safely.

If you or someone you know may be at risk, call the National Suicide Prevention Lifeline at 800-273-8255 or the Veterans Crisis Line at 800-273-8255 and press 1.

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  1. Comment removed by moderator. Inappropriate

  2. Thank you, Patrick, and thank you BChap.

    It deeply pains my heart to know the facts about PTSD and its impact on our wonderful generation after generation of young men and women who give so much for so little in return. I wish millions of dollars would be raised as easily for them, as for election campaigns.

    I also think another column could be devoted to those Americans suffering from PTSD over job losses, the economic suffering, and the state of America today. It's a helpless feeling to be at the mercy of the political machinery driving the corporate greed to what I call Anti-Americanism.

    God bless our troops, and BChap, it's wonderful for you to share how you overcame PTSD and reached out to others instead of becoming a statistic.

  3. If you want to save the lives of young people stop going to war.

  4. I have often wondered how being exposed for a long time to life threatening situations could affect your body chemistry. My solution to dealing with it was NEVER discuss it. It has only been within the last 5 years that my children knew I was in the service. It was just something I never talked about. Now that I am old, it no longer matters like it used to.

  5. PTSD is a type of silent killer. Our society has not done an adequate job in addressing it, and if anything, has put PTSD on a low priority list.

    As the USA divests itself from the Middle Eastern wars, money should be spent to assist our Vets, both at home and abroad, to insure they are okay. The very government that sends men and women to war or to police the world, should be responsible for their care, welfare, and safety, both while they are in service, and when they returm home. Sadly, we have found, the system has failed many in this regard.

    It costs us nothing to be compassionate and kind to one another, and that is a start.

    Blessings and Peace,
    Star

  6. Thanks for writing this important piece Patrick, as it affects more than just the 1% of Americans going into combat, and those immediate family members and veterans - it is having an impact on all Americans (whether they're aware of it or not)!

    I've often wondered, especially everytime some horrific story is published about another veteran tragedy, just how many of us are struggling with surviving between suicide and homicide? Of course, I am NOT advocating either extreme!

    THE Question: How many - and how many more - for how much longer?

    Here's my view of the truth: General Washington was right about judging a nation and society by how they treat (or better yet, mistreat and fail to treat) their veterans - and I'd add their neighbors that are disabled, seriously ill, and elderly!

    The truth is most Americans say they care and have mastered the politically correct positon of "supporting our troops" and "caring for our veterans" right up until the question of costs and taxes comes up!

    That's the bottom-line, Americans putting their money where their mouth is - and the reality that so many today are just full of bull and don't really care! There, I've come out and publicly said it clearly after 40 years of knowing this truth - too many Americans don't really, sincerely, genuinely care!

    But, hey, when there's a chance to spend Trillions, shuffle Billions and make more Millionaires going to war - then, both sides of the political aisle take turns feeding the military industrial complex! Why not? It's not like their sons and daughters are going to be going into harms way (the few that are serving from political elite families seem to be safely in the rear with the gear doing relatively safe jobs)!

    Yeah, it's tough being in the JAG (Judge Advocate General) Corp working as a military attorney, and hey, having to go overseas for a whopping three months to serve as a physician in a well secured "Green Zone" is really tough too - you know compared to actually being in the Combat Arms and deployed for years on end! These politically posing patriots make many of Combat Disabled Veterans just want to puke in revulsion!

    The truth is we should not even have to ask, let alone plead and beg, for the V.A. Healthcare we were promised to be fully funded - when we have over a MILLION Disabled Veterans fighting to get through the dreaded bureacracy of the Veterans Benefit Administration just to get a V.A. I.D. Card and be able to walk in to a V.A. Healthcare Facility - it is a NATIONAL SHAME!

    The truth is we have one major political party that doesn't even believe in Mental Health, and the other major political party in America has mastered making every excuse imaginable for failing to live up to "keeping the promise" to America's Veterans!

    But, hey, when it comes to Corporate Contract Law there is no greater sacrament more fundamental than making sure those business men get paid in full and on time with bigger bonuses!

  7. I have used my GI benefits and have appreciated what they have afforded me. I was able to buy my first home without a down payment. I put myself through college with a monthly stipend from the VA (while I worked full time). I thought at the time that those programs were very well administered. The VA health care system is another story. The clinics are very poorly run, rudeness on the phone, lack of follow-up, etc. It truly is a shame. As I have stated on previous posts, however, the hospital is very well run and full of wonderful people.