Six representatives from across the Fort Bragg installation held a media roundtable discussing suicide prevention Sept. 20 at Stryker Golf Course. (Spc. Paul A. Holston / Army)
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More than half of the 301 service members who died by suicide in 2011 sought treatment from a mental health specialist or received in-patient care before they died, with nearly a third getting services within 90 days of their deaths, according to a Pentagon report.
The findings of the 2011 Defense Department Suicide Event Report call into question the effectiveness of behavioral health services in preventing suicide and, compared with previous yearly summaries, whether the effort to encourage troops to get help for mental health conditions is working.
According to http://t2health.org/sites/default/files/dodser/DoDSER-2011-AR-12122012.pdf">the report, more than half of the service members who committed suicide in 2011 had no known diagnosis of mental illness. Three-quarters were sober and drug-free at the time of their deaths.
But 157 sought in-patient or outpatient care with a mental health specialist, 25 had seen a chaplain, and 68 used family advocacy services or were enrolled in substance abuse programs before they died.
The Pentagon has launched an all-out effort to improve troops' overall mental health with programs that teach resiliency and encourage them to get mental health treatment.
Military leaders have even come forward to discuss their own mental health struggles to encourage troops to seek help.
But despite the initiatives and campaigns, all four services this year have exceeded the numbers in the 2011 report, with 177 soldiers, 56 airmen, 56 sailors and 46 Marines dying by suicide as of Dec. 1.
In 2011, 167 soldiers, 50 airmen, 52 sailors and 32 Marines died by suicide.
DoD established the Defense Suicide Prevention Office in 2011 to oversee development and implementation of suicide prevention programs within the department and military services.
Jackie Garrick, interim director of the DSPO, recently told the Defense Health Board her office plans to promote outreach instead of focusing primarily on reducing stigma of seeking psychiatric care.
"Is it good enough to put a poster on a wall and wait by the phone? I don't think so. We have to turn this paradigm around and get in front of this problem," Garrick said.
One of the tools the Pentagon is developing is WARN, a "Wellness Assessment Risk Nexus," which uses an algorithm based on life, health and economic factors to determine whether a person is at risk.
Studies — including the new Pentagon report — show people who contemplate or commit suicide often have experienced a broken relationship, had problems at work or were publicly embarrassed in their jobs, or were in debt before they died.
According to the 2011 report, 47 percent of troops who committed suicide suffered a failed intimate relationship before their deaths and 37 percent had a work-related administrative or legal issue.
"If we can get to these guys earlier, if we can develop these types of dashboards that can inform us and inform our health-offering behavior … instead of help-seeking behavior … it could help," Garrick said.
She said the Pentagon also plans to roll out programs that emphasize peer-to-peer counseling and adopt strategies to teach family members and friends to recognize warning signs and intervene if necessary.
Part of that outreach will include encouraging those close to at-risk service members to consider locking up weapons or removing excess medications from their homes.
In 2011, 172 suicides were completed using a gun — 141 with privately owned firearms, 31 with military-issued weapons.
Only 11 suicides last year resulted from drug overdoses, although of the 935 attempts in 2011, 559, or 60 percent, involved drug overdoses.
According to the report, the number of suicides is not directly related to combat stress or participation: 85 percent had no "direct combat history" and 53 percent never deployed to Iraq or Afghanistan.
Regarding attempts, 60 percent had no history of deploying to Iraq or Afghanistan and 83 percent had no direct combat history.
The statistics appear to support Defense Secretary Leon Panetta's assertion that military suicides are a reflection of a broader societal problem.
"From substance abuse to financial distress and relationship problems, the risk factors for suicide also reflect problems in general society," he said at a suicide prevention conference earlier this year.
The Pentagon report, released annually since 2008, analyzes the demographics, method, history, context and health factors of active-duty and mobilized reserve component members who commit or attempt suicide.
According to the report, in 2011:
• 95 percent of those who committed suicide were men.
• 67 percent were age 29 and younger, and 50 percent were grades E-1 to E-4.
• 60 percent were either at home or in their barracks at the time of their deaths.
Regarding the 935 attempts documented in the 2011 report:
• 73 percent were male, 27 percent were female.
• 81 percent were ages 29 and below.
• 60 percent of attempts were drug overdoses while 12 percent — the second most common method — used a sharp or blunt object.
• 42 percent were prescribed medication for a mental health condition.
• 60 percent had not deployed to Iraq or Afghanistan; 83 percent had no direct participation in combat.
For those who need help, the Veterans Crisis Line is available around the clock at 800-273-8255.