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Why Military Suicide Prevention Fails

An active duty service member dies by suicide nearly every day, and 22 veterans kill themselves each day. On base, we’re swapping inspirational quotes and looking at slideshows to “solve” the problem.

Posted on November 11, 2015, at 3:31 p.m. ET

Lance Cpl. Emmanuel Ramos / Via Flickr

When friends and family ask what goes on at Army National Guard drill, I tell them: PowerPoint presentations, mostly.

“Suicide Prevention” was the third slideshow of the day, a hot afternoon at the armory in Troy, New York. Heads were nodding throughout the metal folding chairs, and the presenter, some sergeant pulled into the role, had called on soldiers to read the slides aloud.

Slide after clip-art-filled slide, soldiers read with all the enthusiasm of boys reciting verses from Habakkuk.

Then lyrics to a song from my teenage years flashed across the screen. Lyrics to the kind of song one finds incredibly emotional at age 12, and then noxiously lame at age 13. Lyrics that an officer on the verge of retirement was asked to read out loud.

In a class about the incredibly important and difficult topic of military suicide, we soldiers were treated to a rendition of Good Charlotte's "Hold On," as performed by a gray-haired lieutenant colonel.

I guess slideshows on suicide are better than nothing, but they strike me as emblematic of the military’s carpet-bombing approach to a mental health crisis it doesn’t quite know how to respond to, but is told by a disconnected public that it must. Suicide rates among people in the military increased 80% from 2002 to 2009, compared to a 15% increase among similar civilians, and have stayed high for the past five years. An active duty service member dies by suicide nearly every day, and 22 veterans kill themselves each day.

It seems like every soldier who's been in for a while knows somebody who killed themselves, and everybody wonders what demons possessed the happy, jolly people we’ve known, and everybody wonders if there was something they could have done — including me.

I joined the Army when I was 17 and deployed to Iraq when I was 19. I was a photographer there, and I'll never forget the day I was brought to the room of a man who had shot himself in the head. It was someone I recognized. I had seen him the night before, when he left the cafeteria.

Nobody knows what causes military suicide. In one study, more than half of soldiers who died by suicide never deployed to Iraq and Afghanistan. In a 2013 Defense Department report on suicide, only 15% had experienced direct combat. Regardless, a July study from New York University Langone Medical Center found that more than 270,000 Vietnam vets still struggle with post-traumatic stress disorder 40 years after the end of the war, which bodes poorly for Iraq and Afghanistan vets.

In 2009, the Department of Defense and the Department of Veterans Affairs responded to the spike in suicides with awareness efforts that, in retrospect, were seen as “one-size-fits-all.” If the wars in Iraq and Afghanistan taught us anything, it is that the military is great at chopping down trees, but not as good at seeing the forest (although at Fort Bliss, in Texas, more trees were planted as part of suicide prevention efforts).

Here’s how the military satire site Duffel Blog described it: “The mandatory suicide prevention program instituted Army-wide includes suicide prevention video vignettes paired with a 2700-slide PowerPoint presentation. The class is usually taught by a therapist, the unit Chaplain, or some poor bastard NCO that was forced into being a certified suicide prevention instructor.”

Over time, a balkanized system of more than 900 suicide prevention programs, many of them redundant, was developed. Nobody knew what worked and what didn't; suicide rates stayed high. Despite their noble intentions and hardworking employees, these programs often have the whiff of check the box, cover your ass.

One of these programs was a six-year, $287 million optimism and resiliency campaign. When the campaign ended, more than half of the 770,000 soldiers were revealed to be pessimistic, with low job satisfaction. Confronted with the results of the campaign, the military did what it thought was best: it lowered its standard for optimism until it got higher scores.

The problem becomes abstract, soldiers tune out, and the result is that, in a community where virtually everyone has a personal connection to suicide, soldiers can’t even say the word “suicide.” During an advanced course on suicide intervention a few years ago (this one, called ASIST, might actually be working), we were told to close our eyes and imagine a drive home from work on a cloudless Friday afternoon. When we opened our eyes, one of our instructors stood on top of a chair and told us she was going to jump off.

The room was silent. Everyone participating in that particular session was a higher-ranking individual with deployments and decades of life experience under their belts. But when faced with a threat of self-harm, even a simulated one, all of us found it harder than we expected to respond.

Despite all the hours we’d spent in suicide awareness training, nobody in the class felt comfortable even saying the word suicide. One of the exercises required us to ask someone, straight out, if they were thinking of committing suicide. My gut dropped. I could feel a pressure on the side of my face, and I could see the others' faces, gripped tightly as they stumbled toward saying the word.

When the word became an action, a possibility, it was as if the word “suicide” became daunting, something dark and taboo and eerie, something to stay away from.

It was the best training I had for years, if only because it opened my eyes to the paralysis surrounding suicide among service members. And when I resumed the normal routine of slideshows and inspirational quotes, I knew how much more we needed.

But during what I thought would be yet another awful suicide brief last month, something remarkable happened: The presenter threw out the script. Two members of our battalion had just killed themselves. Instead of a slideshow, the presenter let people talk.

And people had so much to say about friends they'd lost, about their dark and lonely hours. Instead of one-way instruction, there was dialogue. People talked about suicide in a way that brought it out into the open.

Lower-ranking people saw their bosses talk about their vulnerabilities, their insecurities. They also learned their bosses had vulnerabilities and insecurities. Maybe they also learned it was OK to have such things. Friends of one of the soldiers who died talked about how shocked they had been, how they had just seen him and sensed nothing wrong.

According to veterans’ advocates, this is the kind of dialogue the military should have more of. "The military has not been doing a great job responding to military suicide at all," Paul Rieckhoff, head of Iraq and Afghanistan Veterans of America, told me. Among other efforts, Rieckhoff holds community events such as movie screenings to connect veterans into the community.

“They’ve got to be connected to people. That's how you save lives, that's how you get them into programs, get them off drugs,” Rieckhoff said. “The DOD is not thinking about it as a community solution.”

For all our camaraderie and brotherhood, the military doesn’t excel at community solutions. The military is held together by shared hardship and its isolation from the civilian community. Many of those who kill themselves are those who have left the military and re-entered civilian life. In a nation increasingly separated from the reality of its wars, the dialogue needs to be expanded.

Once we start thinking of the military suicide problem as an American suicide problem, it’ll be clear we need more than slideshows.

If you are thinking about suicide, talk to someone. You can reach the National Suicide Prevention Lifeline at (800-273-TALK [8255]) or National Suicide Hopeline (800-SUICIDE [784-2433]).