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Veteran Suicide

Suicide is a rare, but emotionally devastating, event. I am sometimes criticized for minimizing its impact. That is not my purpose. Completed suicides number slightly less than 43,000 in 2015. For every suicide, there are a reported 25 attempts. Ideation strikes many more. If we examine the rate of suicide in our country, I believe it can guide us to a greater state of understating about the emotional health of our population. I know determining the results are more difficult, but if our rate of suicide is increasing, then we know that the underlying causes are not being addressed successfully.

But getting the right data can be difficult. Reuters has run a series of articles on suicide based on Veterans Administration research. This first article [LINK HERE] indicates that Military Sexual Trauma (MST) increased suicide among male veterans experiencing MST by 70%, and among female veterans by 100%. The population affected were 1.1% of men and 21.2% of women in the sample studied. Data was taken from a study in the American Journal of Preventative Medicine. [LINK HERE]

Reuters followed with more articles on veteran suicide based on additional research. The most recent article pointed to a 32% increase between 2001 and 2014. [LINK HERE] Civilian suicides are reported to have increased by 23% in the same time period.

I caution readers that some interpretation of the statistics have been challenged in the past. This article noted that the 2012 statistics reported in 2013 were based on research conducted in less than half the states, and that the report containing the data should not be extrapolated to the whole population. [LINK HERE] The current data apparently correct that limitation.

What I see in the reporting is that the Veterans Administration is learning how to identify, if they can get access to the data, individuals who are higher at risk. Earlier, I wrote about a VA algorithm developed to identify Veterans who are at a higher risk of suicide. Although the algorithm is stated to be ineffective for the general population, it did seem to have application among those highest at risk for suicide. 

My research on the general population reaches similar conclusions, but I am  still looking for more complete data. According to the original ACE Study, the highest rates of suicide attempts were differentiated by number of ACE's reported: 7+ ACE's attempted at a rate of 35.2%; 6 ACE's at a rate of 21.8%; and 5 ACE's at rate of 13.8%. Using this data, plus information about behavior acquisition patterns, I believe we can identify the group highest at risk, just as the Veterans Administration has. Putting an identification process in place is an important step in suicide prevention.

I think about it this way. In Alaska, we have had 14 years of suicide prevention efforts. As with the U.S. as a whole, rates seem to be increasing. Is our current strategy working, from a data perspective. I know people get excited when programs are implemented, but they need to be objectively evaluated. Perhaps our programs are somewhat effective because they have stopped or slowed the increase in suicide. According to the national data I cite of a 23% civilian increase during the same time period Veteran suicide increased by 32%, existing programs have not been successful at reducing the rate.

Here is my point. Because suicide is such a rare event, and is preceded by occurrences and behaviors earlier in life, such as MST, that it could be our entry point for learning how to identify trauma victims and intervene early. While the Veteran's algorithm may not be successful for identifying at risk Veterans there, it might benefit from additional research that looks at other variables such as ACE related behaviors adopted earlier. Smoking, alcohol and drug abuse, domestic violence, promiscuity, health issues and many more negative behaviors and health outcomes should be examined for relevance in predicting suicide ideation, attempts and completions. If we can build upon identifying high risk individuals an algorithm based on high risk behaviors, perhaps we can identify other patterns that indicate future risk for suicide.

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Patrick Anderson posted:

I grieve with both of you, Barbara and Robert, for your losses.

Barbara, you might be interested in an article written by Dr. Felitti  [LINK HERE] titled "The Origins of Addiction: Evidence from the Adverse Childhood Experiences Study." On page 8 he cites research that discussed Viet Nam veterans and their recovery from addiction. 5% of those considered addicted were still using 10 months after their return to the U.S. This bolsters support for your proposal to screen for ACE's when soldiers are recruited. 

Also, you might find work being done by the Magis Group to be of benefit. They developed a model that trained soldiers being deployed to the Middle East to protect their mental health. [LINK HERE

 

Thank you, Patrick.  I will pursue both of those recommendations.  Would working through my Congressman be the best way of contacting leadership in the military to make this proposal?  Thanks for everything that you are doing.

I grieve with both of you, Barbara and Robert, for your losses.

Barbara, you might be interested in an article written by Dr. Felitti  [LINK HERE] titled "The Origins of Addiction: Evidence from the Adverse Childhood Experiences Study." On page 8 he cites research that discussed Viet Nam veterans and their recovery from addiction. 5% of those considered addicted were still using 10 months after their return to the U.S. This bolsters support for your proposal to screen for ACE's when soldiers are recruited. 

Also, you might find work being done by the Magis Group to be of benefit. They developed a model that trained soldiers being deployed to the Middle East to protect their mental health. [LINK HERE

 

I appreciate seeing research to better understand the suicide rates among veterans especially.  My younger brother, Allan, served with the 101st Airborne in Vietnam and was awarded two bronze stars during two tours.  He struggled when he returned as many veterans did at that time. Allan was hospitalized and followed by the VA as an outpatient but eventually committed suicide.This devastated  our family and what I discovered later was that he had been sexually molested by a male teacher and physically traumatized to the point of hospitalization but my father's complaint to the principal and school brought no justice or healing.  (This was in the 1960's  in the Midwest before we even talked about boys being sexually molested.) (In addition, the only ACE in our family was "emotional neglect" in the sense of never speaking about emotions and being self-sufficient and tough it out.) I do not believe that he suffered MST but given the findings of the study sited, that the suicide rate is 70% to 100% of those who did, I would suggest that perhaps they were made vulnerable to this by earlier, undisclosed events.  And when they were traumatized by an organization (the military) that provided food, shelter, clothing, skill-building, , a purpose in life, a sense of belonging, and life-long respect from this great country, then it makes sense to those of us who understand the power of internalizing a trusted attachment (we don't survive without it) then this betrayal by a "parent" or "sibling" in this "family" would lead to suicide.  So, to me, it would be useful to screen for ACES when young people are recruited (also for all personnel in charge of them.) And I am not suggesting therapy for everyone but education about trauma and resilience. It can be very effective.  Ideally we can all become trauma-informed ("It's not who we are but what happened to us early in our lives in our bodies, hearts and minds.")  It is not about being "bad" or "sick" --not pathology but social learning, attachment and emotional regulation that can be healed.  And I'm sure that the military understands toughness and  one kind of resilience.  I am suggesting that resilience, that includes Daniel Goleman's emotional intelligence--(self-awareness, self-management, social awareness  and relationship management) would go a long way in healing individuals and organizations. My main focus in my work right now is to spread the word about ACES-Resilience, and begin to help to build a more resilient and just society starting in  the offices of obstetricians, pediatricians and nurses because of the immense importance of the Prenatal to Three stage of development, and in schools where teachers can do incredible work in building resilience in their students at all ages. And, increasingly, the public and social services, faith-based organizations and business communities are becoming aware of the possibilities. My hope is that the military/Veterans organizations will begin to contribute more to that understanding.  As Jane Stevens has written, ACEs Science is a "unified science" of "human development that recasts our understanding of how to solve our most intractable problems, such as poverty and homelessness, was well as childhood trauma."  And we are beginning to understand and practice what helps us create resilience. 

 

My mother had been a WASP pilot, during WW II, but took her own life 12 years before President Carter signed the legislation changing the status of the women pilots from civilian to military Veterans status. I don't know if "military sexual trauma" may have been an issue she contended with, but some other challenges noted in this article were also items she may have contended with. Tomorrow is the 51st anniversary of her [handgun] suicide-which I witnessed.

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