Veteran Suicides: The VA Releases “New” Statistics

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The Department of Veterans Affairs (“the VA”) recently released a report showing state-by-state disparities in suicide rates among Veterans.  Sadly, the data tracks Veteran suicides rates through 2014 leaving a significant time gap in determining whether the trend in 20+ veteran suicides a day is improving.

Veteran Suicides

(U.S. Army photo by Stephen Baker)

The news media has been quick to seize on some of the notable anomalies in the data, some of which is highlighted below from PBS news:

  • Suicide among military veterans is especially high in the western U.S. and rural areas;
  • Suicide rates in Montana, Utah, Nevada and New Mexico averaged 60 per 100,000 individuals compared to the national average of 38.4 (overall in the West was 45.5);
  • Women veterans had a suicide rate 2.5 time higher than for female civilians;
  • A VA study (last year) found that veterans who received the highest doses of opioid painkillers were more than twice as likely to die of suicides than those receiving the lowest doses;  
  • 65% of Veteran suicides were age 50 or older. 

It is difficult to generalize from this somewhat dated report other than to say that Veteran suicide rates are considerably higher than the national average.

Furthermore, it would appear that the VA’s propensity to dispense potent prescription drugs – primarily opioids – may have contributed to high suicide rates among Veterans.

Just who is to blame for the opioid epidemic sweeping the United States?  Finger-pointing suggests that many are to blame for the epidemic, but new candidates emerge daily.

For instance, the New York Times recently reported that insurance companies may need to shoulder part of the blame for opioid abuse.  Why?

“Opioid drugs are generally cheap while safer alternatives are often more expensive.

“Drugmakers, pharmaceutical distributors, pharmacies and doctors have come under intense scrutiny in recent years, but the role that insurers — and the pharmacy benefit managers that run their drug plans — have played in the opioid crisis has received less attention. “

Nevertheless, some institutions took measures far earlier to stem addictive drug treatment.   For instance, Mother Jones reports that: “Partnership HealthPlan, the main public insurance provider for Medi-Cal patients in rural Northern California, discovered an alarming trend: Many counties where Partnership operated had among the highest rates of opioid prescribing and overdose in the state. Hydro­codone was the top-prescribed medication among Partnership patients, who include more than 570,000 Medi-Cal recipients from the vineyards of Sonoma County to the redwoods on the Oregon border. In Lake County, a poor, rural area bordering Sonoma, enough opioid painkillers were prescribed in 2013 to medicate every man, woman, and child with opioids for five months, according to a report by the California Health Care Foundation.”

Unfortunately, the VA is largely unaccountable to anyone and Veterans have few affordable choices other than to rely on treatment options provided by the VA.  With a dismal track record in providing treatment for Veterans with PTSD, it is hard to see how any meaningful progress will be made by the VA in curbing VA suicides.

More disturbing is the thought that Veterans with PTSD incurred from the Gulf Wars and continued deployments in Afghanistan and Iraq will soon be approaching their 50th birthday.   If the VA statistics are credible that “65% of Veteran suicides are over the age of 50,” then we may actually see an uptick in suicide rates among Veterans.

Despite repeated assurances to Congressional Committees, Dr. David Cifu and his cronies at the VA don’t have a clue on how to treat PTSD.   Cocktails of lethal prescription drugs are clearly not the answer, but the VA’s blind insistence that Cognitive Behavioral Therapy and Prolonged Exposure Therapy are the only effective treatment programs is simply ludicrous.

Whatever the reasons, Veterans with PTSD and TBI may not really have a viable financial alternative outside the treatment barriers currently erected by the VA.

Even though the information is dated, the VA has done a good job illustrating the extent of the problem.  While one can draw many inferences from the data, it would be totally wrong to suggest that the VA has a handle on the problem and absurd to think that they have answers!

No wonder Veterans with PTSD and TBI have lost faith in the VA.

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VA Doctor’s Hard Line on HBOT Leads to Veteran Suicide

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As a military veteran with PTSD and TBI, I encounter many brave warriors who have had difficulties getting proper treatment from the Department of Veterans Affairs (“the VA”).

All of these conversations have been disturbing and caused me to relive the terrible ordeals I faced when dealing with the VA.  Nothing quite compared to the disturbing letter I received from Debbie Lee, the founder of America’s Mighty Warriors (“AMW”).

Eric_Bivins

Veteran Eric Bivins serving his country.

In her open letter (summarized and slightly edited below), Debbie describes the heart-wrenching conversation she had with Kimi Bivins, whose husband Eric (a Marine Veteran), had committed suicide after the callous indifference shown by doctors at the VA to his PTSD and TBI.

Several weeks ago Veteran Eric Bivins reached out to us via email for help with his PTS (Post Traumatic Stress) and getting into Hyperbaric Oxygen Therapy treatments. We replied to his email and told him we would be glad to help. He was scheduled to start Aug 2nd at Rocky My Hyperbaric.

I didn’t hear anything back until Wednesday when his wife called. She informed me that her husband had committed suicide. She was calling to try and get HBOT for her husbands friends he had served with. We are working to connect with them to provide HBOT to provide healing and hope.

Over the last 4 years our foundation, America’s Mighty Warriors (“AMW”) has been an advocate to make this standard of care at the VA and with Tricare. We have paid for over 30 Veterans to receive this 2 month treatment. Every Veteran we sponsored who received treatment has received improvement with their symptoms for PTSD/TBI .

We spoke for about and hour and she shared that her husband was super excited about getting the treatment and had hope for his future. He had numerous problems with the VA in Tennessee.

Long story short, his last visit at the VA was with the Chief of Staff, Dr. John Nadeau to at that facility. When Eric shared his excitement for getting the HBOT treatment Dr Nadeau told him several times that HBOT was a waste and that people were just trying to scam him for his money. 

His wife said he left a defeated man and had his hope crushed by that doctor. We both agree that her husband’s blood is on that doctor’s hands. They had numerous botched surgeries and doctors who disrespected and misdiagnosed or wouldn’t diagnose his medical problems.

Eric had been sober for about 18 months and that next day started drinking and ended up taking his life after several days of abusing alcohol and prescription drugs.

I am working with her to expose this atrocity. She has two daughters who are 12 and 10. I spent about an hour on the phone with her tonight just listening and providing comfort. While we were talking I asked when social security would kick in for her kids and she said hopefully August. I asked about insurance and she said none. I asked how she was doing financially, and she said they are struggling. Then she shared that her roof caved in a few days ago and that they had their roof replaced two years ago and it wasn’t done correctly and they insurance will only cover $2000 in “rot” damage, not the replacement costs.

AMW did a Random Act of Kindness for Kami and her children to help during this difficult time and sent a check for $5000.00. This program was started in response to my sons amazing last letter home. He mentions that Random Acts of Kindness could change our world and I know when I shared with Kami what our board had approved her life was changed, and she was deeply moved.

Please help us to expose another VA that is responsible for killing a Veteran and the help and healing that HBOT is providing for our Veterans struggling with TBI and PTSD.

I have worked with Veterans who have shown me a gallon size baggie of prescription drugs that they were prescribed to take and 2/3rd’s of them say “may cause suicidal tendencies” and we wonder why our suicide rate is so high. Then they find alternative therapies that are helping and have their hope ripped from them by doctors who are not familiar with HBOT and the success our Vets have seen who have received this. How many more lost lives are these Doctors responsible for?

It is hard to fathom the reasons why any qualified VA doctor would rob a patient a moment of hope, particularly when the VA has been demonstrably incompetent in providing an alternative.

Kimi’s story, as reported by Debbie of AMW, serves as a daily reminder that we all need to take action to expose the lies, hypocrisy and arrogance of the VA.  For many Veterans, the VA is a failed institution that treats our brave heroes with disdain.

How can let this young woman’s desperate plea go unheeded?

It is hard for me to watch this video, but Kimi’s experience is not unique. How many more Veterans need to suffer such indignity?

For those wishing to know more about Hyperbaric Oxygen Therapy or HBOT, please CLICK HERE:

And please, take the opportunity to visit our website where we have many resources and articles devoted to helping Veterans find alternative therapy programs for PTSD and TBI.

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Gun Control and Veteran Suicides: Is Research Lacking?

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Like most everyone, the gun control debate is front and center on both sides of the political spectrum.  Sadly, very few – if any – of proposed changes to existing gun control laws would have a major impact on Veteran suicides.

ptsd

I recently came across an interesting article published in the Washington Post entitled “The reasons we don’t study gun violence the same way we study infections.”    The gist of the article is that well over half (actually 62%) of gun-related deaths in the United States reported by CDC are suicides.  Sadly, very little money is allocated to the study of suicides.  Some of these reasons stem from restrictions on gun research, but a chronic lack of funding suggests that other topics receive the lion’s share of research money.

The article, written by Carolyn Johnson,  states the following:

There are a few reasons for the gun violence research disparity. First, there are legislative restrictions on gun research. For two decades, the Centers for Disease Control and Prevention has been prevented from allocating funding that could be used to advocate for or promote gun control. Although that doesn’t explicitly exclude all research on gun violence, it is said to have had a chilling effect on funding.

Aside from political pressure, there is a more philosophical one in which injuries are treated differently than disease. Injuries are a public health issue, but the debate over gun research often becomes mired in a debate over whether a person who intentionally wants to hurt himself or another person will do so, with or without a firearm. Research is also often driven by where researchers see the biggest scientific opportunity to come up with a cure or therapy, and infections or cancer may simply be easier to study than gun violence using traditional tools.

One of the complications of a study like this is that it uses broad categories to look at spending trends. For example, if the majority of gun violence is suicides, it might make more sense to study suicide, regardless of whether it involves a firearm. But suicide, too, has been chronically underfunded compared with its health burden. The number of deaths annually from breast cancer are now about the same as suicide. But breast cancer research received $699 million in NIH research funding in 2016; suicide and suicide prevention received $73 million.

While it is difficulty to draw too many conclusions from Ms. Johnson’s article, it would appear that cure or therapy-related research “may simply be easier to study than gun violence using traditional tools.”   In other words, simple evidence-based studies seem to attract more funding rather than complex studies, such as suicide prevention.

Using Ms. Johnson’s analysis, it is not surprising that the VA feels more comfortable funding marijuana studies which help Veterans cope with the symptoms of PTSD rather than treat brain injury.  In fact, over the last 15 years, the VA has done little – if anything – to treat Veterans with PTSD.

Citing a National Institute of Health 2014 study of the VA, Maj. Ben Richards points out that despite the most sophisticated therapy provided by the VA the average PCL-M score to assess Post Traumatic Stress has fallen only 5 points.  In fact, PCL-M scores for “treated” Veterans is still well above the 50 benchmark considered adequate by the military.

Ben Richard's PTSD VA Study

For more of Maj. Ben Richard’s analysis of the Department of Veteran’s Affairs costly and rather futile effort to help Veterans with PTSD, please CLICK HERE.

While the VA embarks on yet another study to combat the symptoms of PTSD, tens of thousands of needy Veterans are deprived of necessary research to help them reclaim their lives rather than simply cope with their problems.

A well-tested program, Hyperbaric Oxygen therapy (“HBOT”) has allowed Maj. Ben Richards to recover much of his cognitive function.  Yet, Dr. David Cifu and others at the VA still refuse to fund HBOT for Veterans with PTSD.

Veteran suicide rates are currently 22% than the normal population.  Doesn’t it make sense to provide workable therapy programs to Veterans rather than embark yet again on studies that treat symptoms rather than the problem?  Our Veterans deserve much more.

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SFTT News: Week Ending July 1, 2016

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Found below are a few news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage our readers to click on the embedded links to read more on subjects that may be of interest to them.

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

Lawmakers work on legislation to protect Reservist jobs 
The new bill, called the Justice for Servicemembers Act, would make it clear that Congress never intended that the old one, Uniformed Services Employment and Reemployment Rights Act, or USERRA, which dates to 1994, was voluntary — or something an employer coguarduld challenge in the courts, lawmakers and veterans groups said during a press conference on Wednesday.  Read more . . .

Abram A1 Tank

US Army turns to Foreign Suppliers to Protect Combat Vehicles
The US Army is turning to foreign systems for an interim solution for advanced protection for its combat vehicles against rocket-propelled grenades, anti-tank guided missiles and other threats.The service’s effort to rapidly integrate already developed solutions is heating up this summer as the Army tests out what will likely be four different solutions on M1 Abrams tanks, Bradley Fighting Vehicles and Stryker combat vehicles.   Read more . . .

Afghan Police Convoy Attacked
A twin suicide attack on a convoy of buses carrying police cadets killed 37 people and wounded 40 others on Thursday, an Afghan official said. The attack took place in Paghman district, some 20 kilometers west of the Afghan capital, Kabul, according to Mousa Rahmati, the district governor of Paghman. The first suicide attacker struck two buses carrying trainee policemen, and a second attacker targeted those who rushed to the scene to help and hit a third bus, Rahmati said. He said that four civilians were among those killed.  Read more . . .

VA Promises to do More to Prevent Veteran Suicides
According to a Veterans Affairs study released last month, nearly 14 percent of veterans reported suicidal thinking at one or both phases of the two-year study. Compared to a 2011 Centers for Disease Control and Prevention study that found 3.7 percent of U.S. adults reported have suicidal thoughts in the year prior, the rates in the VA study are high.   Read more . . .

PTSDcanna

Marijuana Provision Stripped from VA Funding Bill
A provision that would have made it legal for Veterans Affairs doctors to discuss medical marijuana with their patients in some states disappeared mysteriously from the final VA funding bill last week, just before the House approved the legislation by a 239-171 vote. But the measure is not completely dead, as a failure by the Senate on Tuesday to forward the Military Construction and Veterans Affairs funding bill for a vote provides an opportunity for the marijuana provision to be put back in.  Read more . . .

Military Ban on Transgenders Ends
Transgender people will be allowed to serve openly in the U.S. military, the Pentagon announced Thursday, ending one of the last bans on service in the armed forces. Saying it’s the right thing to do, Defense Secretary Ash Carter laid out a yearlong implementation plan declaring that “Americans who want to serve and can meet our standards should be afforded the opportunity to compete to do so.”  Under the new policy, by Oct. 1, transgender troops already serving should be able to receive medical care and begin formally changing their gender identifications in the Pentagon’s personnel system.  Read more . . .

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider becoming a member of Stand For The Troops.

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The VA and Veteran Suicides: Sleeping Beauty Wakes Up

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Only a cynical person could look with amusement on the recent self-serving announcement by the Department of Veterans Affairs (“VA”) that it is taking “additional steps” to address Veteran suicides.   I realize that it is somewhat difficult to get a $180 billion a year bureaucratic behemoth to focus on an issue that has been front-page of every major media outlet, the DoD and even the VA for well over 10 years.

In fact, many legislators and many grieving families are simply scratching their heads and asking the question that most any sane American would ask:   Hasn’t the VA been focused on Veteran suicides all along?   I guess the simple conclusion is this:  Yes, the VA is aware that approximately 22 Veterans commit suicide each day, but our management believes that these “additional steps” will help stem the tide:

Several changes and initiatives are being announced that strengthen VA’s approach to Suicide Prevention. They include:

  • Elevating VA’s Suicide Prevention Program with additional resources to manage and strengthen current programs and initiatives;
  • Meeting urgent mental health needs by providing Veterans with the goal of  same-day evaluations and access by the end of calendar year 2016;
  • Establishing a new standard of care by using measures of Veteran-reported symptoms to tailor mental health treatments to individual needs;
  • Launching a new study, “Coming Home from Afghanistan and Iraq,” to look at the impact of deployment and combat as it relates to suicide, mental health and well-being;
  • Using predictive modeling to guide early interventions for suicide prevention;
  • Using data on suicide attempts and overdoses for surveillance to guide strategies to prevent suicide;
  • Increasing the availability of naloxone rescue kits throughout VA to prevent deaths from opioid overdoses;
  • Enhancing Veteran Mental Health access by establishing three regional tele-mental health hubs; and
  • Continuing to partner with the Department of Defense on suicide prevention and other efforts for a seamless transition from military service to civilian life.

Veteran Suicides

While I guess we should all take some solace from the fact that these “additional steps” may help reduce suicides among Veterans, many of us wonder why it has taken so long for the VA to recognize that its current treatment process has proved to be inadequate.  Indeed, the VA seems more intent on throwing cold water on alternative therapy programs than doing much at all to help get Veterans in help they need for PTSD and TBI.   More prescription drugs is not the answer according to the F.D.A., but I suppose it will be difficult for the VA to radically change its modus operandi.

Having been in business for many years, I am suspect when people tell me they are “taking steps.”   To paraphrase the late British columnist Bernard Levin, I have no idea whether these are “fast steps,” “double-time steps,” or as is often the case for bloated government bureaucracies: “marching in place and hoping for a better outcome.”

Judging from the VA’s record, I am not at all convinced that these “additional steps” – even if implemented – will improved the outcome so fervently desired by Veterans and their loved ones.  For the most part, these “additional steps” seem more like a public relations initiative rather than something will bring about a major change in the way PTSD and TBI are diagnosed and treated by the VA.  I hope I am wrong.

Accountability and responsibility is a theme well understood by the brave men and women who serve in our armed forces.  Sadly, accountability and responsibility seem to be in short supply at the VA.  We should all be outraged!

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Veteran Suicide Hotline Gets Scrapped

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In yet another example of “sending the wrong message,” the Pentagon is curtailing funding for Vets4Warriors which operates a highly regarded Veteran suicide hotline. According to a New York Times article published yesterday, Keita Franklin, director of the Defense Suicide Prevention Office, announced that suicide counseling previously offered by Vets4Warriors will now be taken over by another help line, Military OneSource, “which has more services available.” Ms. Franklin goes on to say that:

“It will still be peer to peer, 24 hours a day, but with more services we can connect callers with,” Ms. Franklin said of Military OneSource (1-800-342-9647), which will take over calls from active-duty troops next month. “Imagine a call center where if you need family support or financial support services, we have that all right there.”

Now, I am not an expert in suicide prevention, but I suspect that dismantling a reasonably successful suicide hotline for Veterans in exchange for what appears to be a supermarket of Veteran services is not going to reduce suicide rates.  Mind you, the VA has not proven to be particularly effective at providing meaningful treatment for Veterans suffering PTSD and other ailments.

While I am hopeful that Ms. Franklin will be proven right in the long-run, past history suggests that “Big Brother’s” approach to providing meaningful treatment alternatives to Veterans suffering from PTSD has not proven to be very successful.  More importantly, big bureaucracies operating under such grandiose names as Military OneSource are generally not very nimble at adjusting their programs to the needs of individual veterans or endorsing new treatment alternatives.   In fact, Military OneSource sounds more like a supermarket than a place where a high-risk Veteran would seek out companionship of a fellow Veteran to work through a particular problem.

Veteran Suicide Rate Still Stands at 22 a Day

In is hard to image that Veteran suicide rates still remain at 22 a day, which is exactly the same number when the US Army released its Suicide Prevention Report some 5 years ago.

Will the consolidation of suicide prevention hot line services under Military OneSource stem the tide? I think not. In fact, most Veterans are vitally concerned about the privacy of their conversations and to convince them to share their problems and concerns with “Big Brother” is probably the last thing they would want to do.  I am stunned that this “privacy” consideration did not deter the bureaucracy from taken a second-look at what appears to be a rush decision to bring third-party services under Big Brother’s umbrella.

While budgetary concerns are most certainly important, SFTT is not convinced that this consolidation effort seems thought out well, particularly where it concerns getting Veterans at “high risk” the treatment they both deserve and need.

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Predictive Modeling to Prevent Veteran Suicides

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A study entitled “Predictive Modeling and Concentration of the Risk of Suicide: Implications for Preventive Interventions in the US Department of Veterans Affairs,” has recently been published online by the American Journal of Public Health.  In the extract cited below, the VA claims that predictive modeling can help identify Veterans with a high risk to commit suicide and, therefore, provide enhanced intervention to prevent Veteran Suicides:

 Objectives. The Veterans Health Administration (VHA) evaluated the use of predictive modeling to identify patients at risk for suicide and to supplement ongoing care with risk-stratified interventions.

Methods. Suicide data came from the National Death Index. Predictors were measures from VHA clinical records incorporating patient-months from October 1, 2008, to September 30, 2011, for all suicide decedents and 1% of living patients, divided randomly into development and validation samples. We used data on all patients alive on September 30, 2010, to evaluate predictions of suicide risk over 1 year.

Results. Modeling demonstrated that suicide rates were 82 and 60 times greater than the rate in the overall sample in the highest 0.01% stratum for calculated risk for the development and validation samples, respectively; 39 and 30 times greater in the highest 0.10%; 14 and 12 times greater in the highest 1.00%; and 6.3 and 5.7 times greater in the highest 5.00%.

Conclusions. Predictive modeling can identify high-risk patients who were not identified on clinical grounds. VHA is developing modeling to enhance clinical care and to guide the delivery of preventive interventions. (Am J Public Health. Published online ahead of print June 11, 2015: e1–e8. doi:10.2105/AJPH.2015.302737)
Read More: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2015.302737

Assuming the findings our correct, this is a great tool in helping to provide targeted preventative treatment to those Veterans.

Veteran Suicides Still at Crisis Levels

While many public and private studies have provided hope that Veterans can reclaim control of their lives, veteran suicides continue to remain at near crisis levels.  Since the historic 2010 US Army study on veteran suicides and suicide prevention, most evidence continues to suggest that 22 veterans commit suicide each day.

Senator Richard Blumenthal (Democrat of Connecticut) is quoted as saying “When you have 8,000 veterans a year committing suicide, then you have a serious problem.”

Many other government leaders on both sides of the aisle echo similar views, but there has been little meaningful improvement in veteran suicide rates over the past five years.

While we are hopeful that the diagnostic modeling with bring targeted relief to long-suffering Veterans, past experience would suggest that VA is slow to implement change and many Veterans will not receive the help they require.

It has become very fashionable to blame the VA for all problems – real or imagined – but clearly more must be done to address this alarming problem.

 

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Veterans with PTSD – Insights by Dr. Henry Grayson

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Dr. Henry Grayson, one of SFTT’s distinguished members of its medical task force always points that there are no two identical cases of Post Traumatic Stress.   In effect, each individual brings a set of prior conscious and unconscious experiences – dare I call it “baggage” – that is often triggered in totally unpredictable ways during periods of great stress.  Many veterans have suffered traumatic events in combat and this battlefield stress is almost impossible to overcome when these brave warriors return home.

Dr. Grayson touches on many aspects of this in this lengthy but informative video which discusses his book “Use Your Body to Heal Your Mind.” Dr. Henry Grayson is a scientific and spiritual psychologist who founded and directed the National Institute for the Psychotherapies in New York City. He is the author of Mindful Loving, The New Physics of Love, as well as co-author of three professional books. Dr. Grayson integrates diverse psychotherapies with neuroscience, quantum physics, subtle energies with Eastern and Western spiritual mindfulness. He practices in New York City and Connecticut. SFTT is indeed fortunate to count on Dr. Grayson in our efforts to support our brave Veterans.

Retired Veterans Seek Help

While many focus on Post-traumatic stress disorder for Veterans returning from our wars in Afghanistan and Iraq.  Sadly, many traumatized Veterans from Vietnam were largely ignored and many still suffer from the invisible wounds of that war.  Found below is an excerpt from an article which describes how these Veterans cope with these recurring “nightmares.”

This is a common story among older combat veterans, who have contended with both the stigma of appearing weak and the lack of knowledge about the mental effects of combat. Post-traumatic stress disorder (PTSD) — characterized by hyper-vigilance, intrusive thoughts, nightmares and avoidance — wasn’t a formal diagnosis until 1980, and effective treatments weren’t widely available until the 1990s.

“They came home, stayed quiet and tried to muddle on as best they could,” says Steven Thorp, a San Diego psychologist with the U.S. Department of Veterans Affairs. “They worked really hard as a distraction, 70, 80 hours a week, so PTSD didn’t really hit them full force until they retired, or the kids left the house, or they’re reminded of loss through the deaths of their friends.”

Dillard didn’t know how to right himself, but he knew exactly what had changed him: one long, terrible night in the jungles north of Saigon during his first tour, when Delta Company, his unit from the 101st Airborne Division, was nearly overrun by hundreds of North Vietnamese soldiers. That night he witnessed heroics by his captain, Paul Bucha, and waited with Delta Company buddies like Calvin Heath and Bill Heaney for a dawn they feared would never come.

“That night marked all of us,” says Dillard, 66, who now lives on a ranch in Livingston, Texas, and assists other veterans with their disability claims. “It’s been the source of lots of nightmares.” via: PTSD, Post-Traumatic Stress Disorder – Retired Veterans Seek Help – AARP

Military Suicides and PTSD

Our military leadership is rightly concerned about the rate of suicide among military veterans.  SFTT has been reported on this growing problem for some time, but little substantive change has occurred over the last several years.  Sure, the government has announced many measures to deal with the problem such as the “Clay Hunt Suicide Prevention Act for American Veterans,” but suicide rates continue to be high.  Found below are some of the recent government initiatives, but the even more compelling arguments why these token actions are not enough to stem this epidemic problem.

Suicides by active-duty troops and veterans are at levels that would have been unthinkable a generation ago. Each day, on average, a current service member dies by suicide, and each hour a veteran does the same.

In response, President Obama signed the Clay Hunt Suicide Prevention for American Veterans Act in February. The act aims to make information on suicide prevention more easily available to veterans; it offers financial incentives to mental health professionals who work with vets; and it requires an annual evaluation of the military’s mental health programs by an independent source.

The law is commendable, but it won’t come close to ending military suicides. That would require radical changes in the policies, procedures, attitudes and culture in two of our biggest bureaucracies: the departments of Defense and Veterans Affairs.

Fifteen years ago, the suicide rate among patients in a large HMO in Detroit was seven times the national average. Its leaders decided to try to end suicides — not just reduce them but end them. In four years, the incidence of suicide at the HMO was reduced 75%; with more tinkering, the rate went down to zero, and has stayed there, at last count, for 2 1/2 years. The difference was an all-out commitment to the cause.

The HMO also implemented measures to provide timely care by enabling patients to get immediate help through email with physicians, to make same-day medical appointments and to get prescriptions filled the same day too.

A similar commitment by the military could achieve dramatic results, at least among active-duty troops. These troops are in the system now, their activities are being monitored regularly, so there are plenty of opportunities for assessment and treatment.

Then there is the matter of stigma. It’s not the military’s responsibility alone to destigmatize psychological problems, but there are steps the military can take.  Service members with PTSD who are able to manage it should be strongly considered for promotions just as though they had recovered from physical wounds. Their ability to overcome mental injury should be recognized, so it inspires others.

To keep its troops mentally healthy, the Defense Department must reduce the number and duration of combat deployments and do more to prepare troops for assymetrical warfare. It must help them adjust to life when they come home — with jobs, housing, loans and legal assistance. It must enforce, not just approve, a policy of zero tolerance related to sexual harassment and assault.

Each element has a price, and collectively the cost will be astronomical. We must be prepared to pay it if we are sincere in our commitment to support our troops.

John Bateson was executive director of a nationally certified suicide prevention center in the San Francisco Bay Area for 16 years. His latest book is “The Last and Greatest Battle: Finding the Will, Commitment, and Strategy to End Military Suicides.”  via: Support our troops? Dealing with PTSD requires commitment

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