Why The Armed Forces Are Looking to Black Women For Answers: Suicide in the Military, Part III: And the Soldiers??

Posted on June 20, 2012 by

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“I Will Survive!”: But Can You Teach That To The Armed Forces?

And, really–can you? That’s the question on everybody’s mind?

For we began discussion with the devastating suicide statistics in the military, which contrasted so starkly with those of black women. And then we analyzed what made these women so resilient, frequently despite markedly adverse circumstances.

So now. . .it’s time to put it together–or imagine how the armed forces will.

One caveat:

Obviously those in the armed forces have numerous other risk factors that religion and social support cannot combat. The very nature of being in active combat precipitates levels of stress found almost nowhere else, and stress is a known precipitating factor for suicide.

But this risk factor seems to be part and parcel of life in the armed forces–the VA can work to alleviate stress, to teach better coping mechanisms, to catch mental illness earlier, but they cannot change the inherent truth that an army fights adn dies. It’s what it’s always done–long before ballooning suicide stats.

 It is this acknowledgement, perhaps, that brought the VA into the realm of black women, where they might learn changes that could be made.

You’ll recall from the last post that two protective factors against suicide for these women were strong social support, and connectedness to religion.

We then asked if the lack of these two factors would in turn be risk factors for suicide.

Seems that’s about the size of it.

And if, indeed, these two indicators, of religion and social support, play a key role in holding people afloat–what are they doing for our men and women in uniform?

Lack of Social Support as a Risk Factor

According to the Suicide Prevention Resource Center (SPRC), lack of social support is one of the risk factors for suicide.Study after study confirms it, including one on college students, who, like servicemen, are separated from friends and family when they choose to study away from home,  Researchers spoke to 1,085 subjects, and determined that

lack of social support — described as feeling unappreciated, unloved and uninvolved with family and friends — emerged as one of the most powerful predictors of persistent suicidal thoughts, even in the absence of other risk factors. [emphasis mine]

The studies on the importance of social support in suicide prevention include direct family as crucial in the support system:

The presence of a spouse or significant other or having feelings of responsibility for children can protect against suicide (Smith, Mercy, & Conn, 1988).

Those are precisely the people our serviceman lose having ‘the presence of,” as they are shipped out for months at a time, often for repeated deployments.

And on the topic: those multiple deployments, which obviously continue to undercut social support from home, are in themselves correlated with higher suicide rates.

According to a New York Times interview with Gen. Peter W. Chiarelli, the former vice chief of staff of the Army, suicide rates have actually dropped for nonmobilized National Guard and Reserve units (to 278 in 2011, from 305 in 2010), while those for deployed units increased.

Those repeated deployments seem to be taking a higher toll on troops than ever before. While in 2010 about 60% of Army suicides occurred during first enlistment, which were considered the most dangerous years, since then there’s been a decrease in soldiers who suicide after one deployment and an increase in those who do so after two or more. In 2011, about 40 percent of suicides occurred after one deployment and another 40 percent were committed after two or more deployments.

Bruce Shahbaz, a civilian serving on the Army’s suicide prevention unit, the Risk Reduction Task Force, re-affirmed that broken relationships were a key factor in soldiers’ suicides.

Suicide is a very complex issue. But I think what you are seeing is the stress that the Army has been under for the past 10 years of persistent conflict. We’re starting to see the effects of the repeated deployment and reintegration cycle and the stress that takes on individuals and families as one of the factors that influences suicides. There is no single cause for suicides, but the heart of it is related to those stresses.

There’s no denying the stress and the toll active combat takes on a person, and that clearly must cause suicide risk to increase. But the more time the soldiers spend away from family and loved ones, the worse the stress, as we’ve seen from the results on social support and suicide.

By 2010, Adm. Mike Mullen, the chairman of the Joint Chiefs of Staff, said the members of the armed forces were spending more time away from their family than ever before. To compound the problem, Mullen believed that the troops heading home were not walking into simple situations. He said,

I think we’re going to see a significant increase in the challenges that we have in terms of our troops and our families because they are going to have some time [together at home] and if things have been pent up or packed in or basically suppressed or sucked up, what ever term you want to use, we’re going to see that as well.

Translation: lack of familial support for months at a time–and a return that just might not feel all that supportive.

In fact, most military suicides occur after the soldier returns home.

Between time away and stress of combat, there has been a rupture between soldier and those the soldier could formerly count on–and he is left feeling along, adrift, afraid, hopeless–and, we worry, ready to  die.

The social  support piece may be precisely what’s wreaking havoc. The Military Wire claims that

Army Vice Chief of Staff, General Chiarelli, Brig. Gen. McGuire, Col. Languirand of the Army Suicide Prevention Task Force and Dr. Col. Ritchie, an Army Psychiatrist, determined that approximately 60 percent of Army suicides [were due] to failed relationships – especially intimate relationship problems.

Cannon Targets   526

Away from family–with relationships failing; well, the armed forces are behind the eight ball when it comes to the protective value of social support.

Friar Peter Sousa, a recently retired U.S. Army Reserves chaplain who has served military men and women part-time for 26 years, shared that the breakdown of relationships back home plays a crucial role in the suicides.

“Young people today deal with a lot of broken relationships. That’s a key factor for many suicides. A number of soldiers have come to me saying that their wife and their girlfriend have moved in with somebody else and they have cleaned their bank accounts. And the soldiers feel totally helpless, being so far away.”Acknowledging that many factors have driven soldiers to take their lives, Sousa insisted that “it has often been a failed relationship that broke the camel’s back.”

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Lack of Religion as a Risk Factor

And what of religion?

Irreligiosity itself, it turns out, can be a risk factor for suicide, as well.

For example, in a 2004 article in the American Journal of Psychiatry, authors Kanita Dervic et al studied depressed inpatients who either reported themselves as belonging to a specific religion, or as having no religious affiliation. After statistical analyses were run, it turned out that

Religiously unaffiliated subjects had significantly more lifetime suicide attempts and more first-degree relatives who committed suicide than subjects who endorsed a religious affiliation.  . . . [It] was found that greater moral objections to suicide and lower aggression level in religiously affiliated subjects may function as protective  factors against suicide attempts.

And what of religion’s protective abilities in the military?

Well, doesn’t look that good. Religious practice in the armed forces is declining.  In a country where overall affiliated religious practice is on a downturn, active troops are less religious still than the population as a whole.

They affiliate with formal religions less–and the numbers who have ‘no preference’ or ‘don’t know’ their religion is well more than twice that of the general public.

According to the Strategy Page, Americans overall are 78 percent Christian, 1.3 percent Jewish, .5 percent Moslem, .4 percent Hindu, 13 percent unknown or none and the rest various other sects and faiths. But the troops are 55 percent Christian, .3 percent Moslem, .27 percent Jewish, .04 percent Hindu, .24 percent Buddhist and 34 percent unknown or no preference.

That 34% unaffiliated may be the most relevant in this discussion.

There is certainly no condemnation of religious decisions–but it is possible that becoming unmoored from religious underpinnings plays a role in large increase in suicides (see the above table by Taliaferro).

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If the VA is serious about applying the lessons about suicide they learn from black women, some things are gong to have to change in the way the military structures life for its troops.

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WHERE TO GO FROM HERE:

Religion

But. . .having determined that religion is a protective factor in suicide, the army might find itself stymied about how to make that fact work for them. In fact, they deserve many points for trying–but haven’t really gotten the appreciation they might have hoped.

To return to Friar Peter Sousa, military chaplain for over 26 years. He said of the growing suicide rate:

It is very much a spiritual issue, and the Army is aware of this. They have contacted chaplaincies to help our soldiers. They can’t promote a specific religion, but they can promote what they call ‘spiritual fitness’ or ‘spiritual well being.’

Given what the VA learns from black women’s protective factors, the idea of promoting spiritual well-being seems a good one. How well such an approach has been received by troops is another matter altogether.

As far back as 2009 some higher-ranking officers were given ‘talking points’ for how to run programs dealing with suicide in their units. Called “Suicide Awareness For Soldiers,” it pulled no punches in encouraging religion. It began by clarifying that

Behavioral health providers need to openly advocate spirituality and religiosity as resiliency factors.

Under the “Spiritual’ bullet of the talking points, officers are encouraged to say:

“Spirituality looks outside of oneself for meaning and provides resiliency for failures in life experiences. Religiosity adds the dimension of a supportive community to help one deal with crises. Connectivity to the Divine is fundamental to developing resiliency that allows one to deal with disappointments.”

[They got an earful for a response: The Military Religious Freedom Foundation (MRFF), which claims to have "battled the rampant proselytizing” in the military for years. said "it is not only an unconstitutional promotion of Christianity for the soldiers who are mandated to attend it, but for the behavioral health providers and non-Christian chaplains who must present it.”

Worse still--the suicide rates continued to go up.]

In 2011, the Army developed a survey to assess, really, what learning about black women teaches is important–the soldier’s family relationships, and his emotional and social well-being–and his spiritual health.

According to the New York Times, there was protest from atheists, who threatened to take it all the way to court. But some legal minds doubt they would win.

Robert Tuttle at George  Washington University  Law School said if the test pushed people to “engage in religious experience,” it would be out on its ear. But it doesn’t.

The situation seems to be at a standstill.

In sum, on the religious front, the army certainly seems to be trying to do their part to increase suicide protection by bolstering religion amongst the troops–but seems they truly have a losing battle in front of them.

Perhaps it might go better in another arena?

Social Support

Despite the military’s best efforts, the issue of social support plagues its efforts to improve the suicide rate. As addressed, the repeated deployments tear at the structure of the social support system a serviceman might have had–and there seems little alternative to this, save fighting all battles in our backyards.

I might make a few suggestions, but I understand I make them out of ignorance of the vast scope of how global warfare is fought:

1. Fewer repeat deployments, and, if required, more time–real time–in between, for the soldier to get to know his family, children and friends again.
2. Automatic referrals for couples counseling when the serviceman returns home after an extended stay.
3. Requisite check-ups with the VA mental health service while the troop is at home, making sure his transition his smooth.
4. More emotional and practical support provided, via the VA’s resources, to the spouse, children, mother–the relatives who remain at home while a unit is deployed, so tension and resentment don’t build up. 
5. Better and more consistent psychiatric care–perhaps a nurse-practitioner assigned to every 15-20 soldiers, who checks in with them on a semi-regular basis, scanning for signs of trouble, and becoming one more piece of the support system.

Looks like there’s room for improvement there, I’d say.

At Fort Hood, for just example, the mental health care system is under so much strain that USA Today writes,

Counselors are booked. The 12-bed inpatient psychiatric ward is full more often than not. Overflow patient-soldiers are sent to private local clinics that stay open for 10 hours a day, six days a week to meet the demand.

Clearly some better ‘in-house’ support is needed, particularly for those already more at risk.

6. Continued development of sites and encouraging soldiers to use those that exist similar to the one set up by joint effort by the Tennessee National Guard, The Jason Foundation, Inc., and E4 Health. Guard Your Buddy connects all members of the Guard to each other, to the community, and to other resources, via facebook pages, phone numbers and e-mail, and encourages members to “Be a Battle Buddy,” to learn to discern the signs of suicide risk and make the pledge to be there for your buddy. [And, but of course, there's a "Guard Your Buddy" app, too, to "provide the men, women, and families in the Tennessee National Guard anytime, anywhere access to critical life resources, on-demand counseling, and on-call suicide prevention."]

7. Better work encouraging the establishment of the support network within a combat unit–perhaps including social workers or psychologists to help build connectedness.

For in the end, once the social support of family and friends has been pulled away from one in combat, s/he is left to rely on the support of those with him in his unit.

And there is concern the army may be failing on this front. In the article “Reframing Suicide in the Military, ” the authors argue that the army has failed in creating social integration in the garrisons. They describe a horrifying scenario, first where a man suicided due to the loss of social support from his unit [something that should be considered a risk factor and screened for repeatedly].

But the story’s ending is most upsetting, both in the grisly details, and in what it says about the very lack of support provided after yet another system has been yanked away from the troops:

 A Sergeant First Class, depressed in part by the loss of friends from his unit after return from deployment, committed suicide while transitioning to Drill Sergeant School. Incredibly, his absence went unnoticed and his demise was not discovered by his unit for nearly five weeks until his landlord called the Army post to inquire why he had not paid his rent.

They can analyze black women’s resiliency all they want, but in the end the armed forces will need to work to support the social resources the troop has left at home, so they’ll be more prepared, in turn, to support the troop, and bolster the connections to those he has come to embrace, far away from those he loves.

There really is no choice.