Every week this year, on average, a sailor has taken their own life.
Mid-way through suicide prevention month, the Navy is staring down one of the worst tolls for self-inflicted deaths in years -- and officials are attacking the problem from multiple angles, through training and resources while trying to foster a culture that doesn't stigmatize mental health.
As of Sept. 6, 42 of the 436,793 sailors in the active-duty and reserve had taken their own lives in 2016. These statistics do not count veterans, with a recent study finding that roughly 20 veterans commit suicide every day.
The Navy's numbers are on track to be as bad or worse than in the past few years, including a ten-year high of 69 in 2014.
The service is launching a wide-ranging study of sailor suicides and urging everyone across the service to monitor their colleagues and use resources like the Military Crisis Line -- 1-800-273-8255 -- when they're in trouble.
Sailors can also reach out to their designated command suicide prevention coordinator, medical personnel, a chaplain or anyone they feel comfortable speaking to, whether they need to vent or they want to enroll in treatment.
The most at risk people are young, single white men.
The Navy and Marine Corps expect their people to be warriors, to defend their country and each other, and a Navy leader wants them to know that fighting for themselves is just as important.
"I think it’s a tremendous display of strength to fight for yourself," Assistant Navy Secretary for Manpower and Reserve Affairs Franklin Parker said in a Sept. 2 interview in his Pentagon office. "When your emotional health is on the line, don’t make that sacrifice. Stand up and fight for yourself."
Parker, who was personally touched by the suicide of a high school classmate and went on to be a college crisis counselor, told his team that this issue was at the top of his priorities when he started the job earlier this year.
"If I had a message for anybody out there, a simple message would be: You’re not alone," he said. "There are other people who feel that way too."
And, he added, there are people willing to help if you're willing to reach out.
The challenge for the military, an expert told Navy Times, is taking all of the research available and channeling the right resources toward prevention programs.
"You want a seamless transition to be able to get people to care and manage that, and so then that gets to resources and capacity," Dr. Timothy Lineberry, chief medical officer at Aurora Health Care in Wisconsin and a former Air Force staff psychiatrist who did research as part of the Defense Department's Military Suicide Prevention Research Program.
"That’s one of the inherent challenges," he said. "It doesn’t take long on Google to find out there’s a shortage of mental health clinicians, period."
Even once the culture supports coming forward and there are resources to handle every case, the remaining challenge is ditching the stigma of coming forward.
"Leadership and [the] services recognize it’s a problem and it’s important. That’s a positive," he said. "I think the degree of wanting somebody to get help and doing that, the shift has happened."
But to get a sailor to report him or herself is much more difficult.
"I think the best example of that is the person who says, 'if somebody came to me and needed help or was thinking about suicide, I would get them to help, whereas I wouldn’t necessarily reach out for the help,' " Lineberry said.
Some of that is due to mental illness itself, he added, which can cause sufferers to heap shame onto themselves.
"So the big, key things we can ask people to do is be aware, be supportive of others getting help, recognize it takes courage to get help, and do that," he said.
'Sense of urgency'
As with other behavioral issues like drinking, hazing and sexual harassment, the Navy is trying to effect a cultural shift that will open sailors up to asking for help and recognizing the warning signs.
"I think it's something that requires a constant sense of urgency," he said. "We have to constantly weigh what some of the things are we’re doing, because you really want to make sure that whatever message you’re sending is a message that’s getting through, and it’s not a message that’s lost in something else."
Sailors and Marines receive annual suicide prevention training, but the services still struggle to get through to everyone.
The Navy reports that 98 percent of its suicide victims are male. Additionally, 70 percent are white, 58 percent are under 30 and 81 percent are enlisted.
More than half have never been married, though Parker acknowledged that divorce and break-ups can be a big factor behind suicides.
"Some common drivers are things like relationship stress, financial stress. I know one of the things we’ve been taking a look at is operational stress," Parker said in the interview with Navy Times. "It's usually not just one. It’s a number of things in combination where it suddenly creates this enormous weight and it’s too much to handle."
The suicide numbers are slightly different for the Marine Corps, where 94 percent are men, 83 percent are white, 77 percent are under 30 and 54 percent are married.
Generally, the statistics are about on par with the make-up of the services.
"It is important to note that these common demographics do not necessarily represent those who are the most at risk," Parker said.
The numbers are gathered in yearly case reviews with the help of the Uniformed Services University of the Health Sciences. The so-called "deep dives" look into the prior two years of cases, including all pending investigations, for trends.
"The purpose of the study is to better understand help-seeking behaviors prior to the suicide attempt, communication about suicidal intent, perceived barriers to mental health care and reasons for attempting suicide," Ensign Marc Rockwellpate, a Navy spokesman, told Navy Times.
The department is also working with the Navy and Marine Corps Public Health Center to collect data that includes suicides and suicide attempts from 2011 to 2014, looking at the timeline to assess common concerns and stressors.
A range of services are available to anyone who reaches out. And reaching out can be as small as telling a friend or family member what's going on, all the way up to requesting time off for treatment.
The fear of being "that guy" in a command is ever-present, but leadership hopes training efforts will remove that stigma, and the fear of negative consequences that could come with seeking help.
"If we’re able to develop that culture where people can feel as they though they will not be penalized – either career-wise or socially – where people realize that it’s okay to go through a struggle, then I think that really helps get there," Parker said.
That requires guidance to commanding officers and other leaders on how to guide a sailor in that situation, he added, but the department is working hard to get rid of the misperception that mental health treatment could affect advancement chances or even a sailor's job altogether.
"The fact that someone is dealing with a personal challenge should not be a career detriment," he said. "Those are the types of concerns that would really keep someone from reaching out."