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October 30, 2014

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Deployment to war doesn’t figure in majority of military suicides

Nate Evans had three children depending on him and held down a good job running a hyperbaric chamber at a hospital.

But what he really wanted was to go to war.

In 2008, as the U.S. death toll in Iraq and Afghanistan approached 5,000, Evans became a medic in the Navy Reserve and was assigned to a Marine company.

“He wanted in the trenches,” said his wife, Catherine Evans. To her relief, he never deployed to either war.

But that did not save him. Evans, 28, committed suicide last November near his home outside Salt Lake City — one of at least 524 U.S. service members who took their own lives in 2012.

His case was hardly unusual. The most recent Pentagon data show that a slight majority — 52 percent — of troops who have committed suicide while on active duty were never assigned to Afghanistan or Iraq.

The numbers, from 2008-11, upend the popular belief that a large increase in suicides over the last decade stems from the psychological toll of combat and repeated deployments to war.

To researchers trying to unravel the causes of the rise, the statistics suggest that the mental health and life circumstances of new recruits are at least as important — and possibly more so — than the pressures of being in the military. It is clear that some enter with a predisposition to suicide and that stressors other than war are pushing them over the edge, experts said.

“A lot of the risk for suicide in the military is the stuff they bring with them,” said Dr. Murray Stein, a psychiatrist at the University of California, San Diego, who is studying suicide in the Army.

Among the unanswered questions: Did the type of people volunteering for service change after 9/11, when going to war — and dying — went from being an abstract possibility to a significant risk? One theory is that more recruits have backgrounds and psychological histories that make them prone to suicide.

“Wartime is almost certainly going to be different than peacetime,” said Ronald Kessler, a Harvard sociologist and suicide authority.

•••

The Los Angeles Times interviewed relatives and friends of five service members who committed suicide without having gone to Afghanistan or Iraq. All were men who married young. In four cases, their relationships were over or crumbling.

They struggled with the direction of their lives and joined the military in search of purpose or meaning, their relatives and friends said.

And they concealed their psychological problems. Four of the men longed to go to war, and the disappointment of not being sent only heightened a sense of desperation.

For Michael Griffin, enlisting in the Army at age 25 was a last-ditch effort to right his life. A former skinhead, he was struggling to find work, and he and his wife had separated.

“He thought the military would provide structure and allow him to support his son,” said his mother, Cherei Griffin, who now lives in Utah.

He joined at a time when the military had temporarily relaxed its entry standards due to a shortage of volunteers — a two-year period whose importance in the suicide rate remains a subject of debate.

On his application, Griffin was less than truthful. He denied having ever taken drugs. His widow, Megan Griffin, said he was a heavy drinker and had used methamphetamine around the end of high school.

He also failed to reveal that he had been diagnosed with bipolar disorder, which became known to the military only in the wake of his suicide in May 2009.

Griffin had been in the Army just eight months — all of it spent in the U.S. — before he went absent without leave and shot and killed himself in Westminster, Calif., not far from where he grew up.

“He was in a hole and couldn’t get out,” said his widow, who shares a house in Lakewood with their son and her parents.

Less than 20 percent of the suicide victims in 2011 had been diagnosed with a mood disorder such as depression, according to Pentagon data. Experts say that is certainly lower than the actual rate, suggesting that mental illness often goes undetected during recruitment and then remains hidden.

Though help is available, many service members still see psychological problems as a shameful obstacle to career advancement. A 2008 study showed that they were up to four times as likely to reveal emotional troubles when their responses were anonymous.

Robert Koyle was training to be an Air Force intelligence analyst when his wife discovered a six-page document called “The End.” on his home computer.

It described his frustration with what he saw as a culture of bullying in the military, his difficult childhood in Lancaster, Calif., and how his marriage had saved him. His wife, Roni Koyle, said that she urged him to seek help but that he said there was nothing to fear. Besides, he told her, seeing a psychologist would prevent him from getting the security clearance he needed.

“He felt he was finally doing something with his life and didn’t want to get kicked out,” she said.

Eventually he got the clearance, and the couple moved to Anchorage, Alaska, where Koyle worked 12-hour shifts in a windowless room eavesdropping on foreign radio signals.

He killed himself at home Dec. 3, 2011, using his own gun. He was 26.

•••

Traditionally, the military has been healthier than the general population, physically and mentally.

Screening of recruits, fitness standards and ready access to medical care gave the armed forces an advantage. The suicide rate among active-duty military personnel was about half that of civilians with similar demographic characteristics.

But after the war in Afghanistan began in 2001, the rate began to climb.

By 2009, it had risen nearly 80 percent to 18.3 out of every 100,000 service members. In the Army, it reached 22.4 suicides per 100,000 soldiers.

The rates leveled off over the next two years as the military encouraged troops to seek psychological help and expanded its treatment options. The Pentagon has not released the 2012 rate, but the total of 352 suicides — compared with 299 in 2011 — suggests that it may be on the rise again.

In addition to those suicides, 172 reservists and National Guard members who were not on active duty took their own lives last year, according to statistics provided by the service branches. The Pentagon does not include those cases in its data.

Suicide was once viewed as the breaking point in a long buildup of stress, but researchers now tend to believe that some people have an underlying vulnerability that makes them more likely to kill themselves when faced with certain stressful situations, said Dr. J. John Mann, a Columbia University psychiatrist.

Nearly half the victims who were on active duty in 2011 had a failed intimate relationship, often within a few months of their deaths, according to the Pentagon. More than a third were facing administrative or disciplinary problems or some kind of legal trouble.

Jacqueline Garrick, who heads the Defense Department’s suicide prevention office, said service members have more contact with the civilian world than they did in the past — more live off base, for example — and therefore may be less insulated from its stresses.

Not only have the majority of suicide victims never been to war, but even among those who did go, fewer than a third witnessed combat.

The greatest risk is in a service member’s first year or two, officials said. In all, only 8 percent of suicide victims in 2011 had been deployed more than once.

Still, the wars in Iraq and Afghanistan may play an indirect role.

Craig Bryan, research director at the University of Utah’s National Center for Veterans studies, said the military has become a more stressful and demanding place, even for those not sent to war.

“If these service members are coming in with pre-existing vulnerabilities, it’s more likely these vulnerabilities will be activated,” Bryan said.

The camaraderie that buffers against suicide has faded, said Dr. Elspeth Ritchie, a psychiatrist and retired Army colonel, leaving some newcomers feeling lost in the shuffle of troops to and from the Middle East. With so much attention focused on the war effort, their psychological problems may escape notice more easily.

Evans, the medic from Utah, finished basic training just as his Marine unit was coming back from Afghanistan.

He told his wife that he felt like a stranger among the returning warriors. “They had already built up those bonds without my husband,” she said.

As he kept getting passed over for deployment, frustration turned to anger, Catherine Evans said. He ruled out counseling for fear it would prevent him from deploying.

She said he hit her, so she got a protective order and forced him to move out. The couple divorced last June.

Five months later, he left a note instructing his family to sell his motorcycle and other possessions to pay for his funeral and called his ex-wife to say he couldn’t live without her.

Alerted by his family, police pulled over his pickup truck on the highway. After a two-hour standoff, he shot himself in the head.

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