Suicide Prevention Conference Addresses Mental Illness Stigma

BY Michael Tolzmann

SAN ANTONIO, (Army News Service, Jan. 12, 2009) - A staff sergeant who had lost Soldiers in the war zone was called a coward, a wimp and a wuss from a leader when he mentioned he might need psychological help.

It is this type of stigma from toxic leadership that can kill and that is being examined here by scientists, clinicians and specialists in an attempt to eliminate it, said Brig. Gen. (Dr.) Loree K. Sutton, who is the Army's highest ranking psychiatrist.

Sutton described the staff sergeant's real experience during her opening remarks of the 2009 DoD/VA Annual Suicide Prevention Conference being held here through Thursday. More than 750 people - specialists from the active-duty ranks, Department of Veterans Affairs and private enterprise, including social workers, chaplains, researchers, and family members affected by suicide - are gathered here with a common goal of finding ways to reduce suicide, which has been called a needless tragedy.

"The secretary of Defense and chairman of the Joint Chiefs have both emphasized, 'Seeking help is a sign of profound courage and strength. Truly, psychological and spiritual health are just as important for readiness as one's physical health,'" said Sutton, who is the special assistant to the assistant secretary of Defense (Health Affairs) and Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury director.

Sutton said a Soldier's ethos of never leaving a fallen comrade behind applies to those with wounds you can't see. She encourages others to be kinder than necessary, because everyone is battling some kind of problem, and to reach out and intervene early.

During an interview with local San Antonio media, Sutton said she is concerned with an Army and Marine Corps recent rise in suicide.

The four-day event is filled with breakout-session workshops and training focusing on a myriad of suicide-related topics such as crisis negotiation of a suicide in progress, resilience as it relates to suicide prevention, or overall VA suicide prevention strategies and mental health strategic initiatives. The event's keynote speaker drew a large, attentive audience who listened to a Soldier, husband and father who has experienced the effects of suicide through the loss of his own son.

Maj. Gen. Mark Graham has spoken openly about mental health, particularly post-traumatic stress disorder. In 2003, his 21-year old son, Kevin, a top ROTC cadet, hung himself after battling depression. According to Graham, his son feared the repercussion of disclosing his mental health for his career in the Army. His oldest son, Jeff, was killed by an improvised explosive device in Iraq in 2004. Graham said he and his wife have chosen to continue to serve "in memory of our sons."

"Both of my sons died fighting different battles," Graham said, who is the commanding general for the Army's Division West and Fort Carson, Colo.

Early in his speech he asked for a moment of silence for those who have lost their lives and to keep wounded warriors in thoughts and prayers.

Graham asked the questions: Who is that person who has wounds that you can't see? Should they be ashamed? Are they less of a man or woman?

"I can think of few subjects more important that this one," said Graham. He said people need to talk about the challenges and stigma associated with mental health and thoughts of suicide.

"Leaders, be compassionate. Soldiers, it's OK to get help," Graham said. "Untreated depression, PTSD or TBI deserve attention. Encourage those who are afflicted to seek help with no embarrassment," he added.

He said suicide can afflict anyone, regardless of rank, stature or wealth. He emphasized the "ACE" program for Soldiers - Ask your buddy, Care for your buddy, Escort your buddy - and said DoD and VA have a national suicide hotline 1-800-273-TALK (8255)."

Don't be afraid to intervene and save a life," said Graham. "Just being with someone can make a difference."

Graham closed his speech to a standing ovation with a phrase that is commonly used by the general, "We are the land of the free, because of the brave."

(Editor's note: Michael Tolzmann is a writer and editor with the Joint Hometown News Service, Defense Media Activity - San Antonio.)

An information card is distributed by the Army called "ACE" Suicide Intervention.

Ask your buddy:

• Have the courage to ask the question, but stay calm
• Ask the question directly, such as, "Are you thinking of killing yourself?"

Care for your buddy:

• Remove any means that could be used for self-injury
• Calmly control the situation; do not use force
• Actively listen to produce relief
• Never leave your buddy alone
• Escort to the chain of command, a chaplain, a behavioral health professional or a primary care provider

An information card is also distributed by the Army called:
Suicide prevention: Warning signs and risk factors

Warning Signs: When a Soldier presents any combination of the following, the buddy or chain of command should be more vigilant and consider help:

• Talk of suicide or killing someone else
• Giving away property or disregard for what happens to one's property
• Withdrawal from friends and activities
• Problems with girlfriend, boyfriend or spouse
• Acting bizarre or unusual (based on your knowledge of the person)
• In trouble for misconduct
• Soldiers experiencing financial problems
• Soldiers who have lost their job at home (such as Reservists or Guardsmen)
• Soldiers leaving the service

When a Soldier presents any one of these concerns, the Soldier should be seen immediately by a helping provider:

• Talking or hinting about suicide
• Formulating a plan to include acquiring the means to kill oneself
• Having a desire to die
• Obsession with death (music, poetry, artwork)
• Themes of death in letters and notes
• Finalizing personal affairs
• Giving away personal possessions

Risk factors are those things that increase the probability that difficulties could result in serious adverse behavioral or physical health. The risk factors only raise the risk of an individual being suicidal - it does not mean they are suicidal.

Risk factors often associated with suicidal behavior include:

• Relationship problems (loss of girlfriend or boyfriend, or divorce)
• History of previous suicide attempts
• Substance abuse
• History of depression or other mental illness
• Family history of suicide or violence
• Work-related problems
• Transitions (retirement, permanent change of station or discharge)
• A serious medical problem
• Significant loss (death of a loved one, loss due to natural disasters)
• Current/pending disciplinary or legal action
• Setback (academic, career or personal)
• Severe, prolonged and/or perceived unmanageable stress
• A sense of powerlessness, helplessness and/or hoplessness

Suicidal risk is highest when:

• The person sees not way out and fears things may get worse
• The predominant emotions are hopelessness and helplessness
• Thinking is constricted with a tendency to perceive his or her situation as all bad
• Judgment is impaired by use of alcohol or other substances

For more information on Suicide Prevention visit: http://www.armyg1.army.mil/hR/suicide/default.asp

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